Community Health Nursing key points

           

·      Community-group of people living in the same place or having a particular characteristic  is common.

·      Epidemiology_ a branch of science which deal with incidence, distribution and possible Control of disease and  other factor related to health

·      Epidemiological triad-Agent, host ,environment

·      Host-A person or other animal that provide the place to an infectious  agent under natural condition

·      Obligate   host-only men is host .E g. Measles, typhoid

·      source-person ,animal ,object, substance that passes the infectious agent

·      Reservoir-Any person,    object ,animal, In which infectious agent lives or multiplies  for its Survival called reservoir

·      Source and reservoir not  same  e g.   .Hook warm-source-dust and soil , reservoir

·      case are types(i)clinical(ii)subclinical(iii)latent

·      Clinical case  appearent  active, mild, moderate ,typical, ,severe and fatal important  Source of infection   than severe case because  they are abudent & spread the  infection Wherever  they go

·      Subclinical case in  appearent  , dormant , covered, missed   ,or ,abortive case. In which disease agent lives ,multiplying or grow but  doesn’t show sign and symptoms it  self. These type of case Only detect by lab. Investigation.

·      Latent case-it Is a inactive, dormant , due to Immunity, infection hide which demonstrable  presence in blood,   tissue   ,or body secretion of the host. (sign& symptom  show after  decrease Immunity, but subclinical never show s & s)

·      First case of communicable   disease introduced into the population unit being studied is called Primary case.(first case in the investigation of the outbreak of a potential epidemic disease)

·      Secondary case-that develop contact   with primary case

·      Index case first case to come to the attention of investigator .It is not always a primary case (first case that indicates existence of outbreak)

·      Infection transmitted by direct contact from skin to skin , mucosa to mucosa, mucosa  to skin, Is called direct contact transmission of disease.

·      Droplet  transmission – droplet of saliva &  naso-pharyngel  secretion during coughing ,sneezing ,speaking & spitting in to surrounding atmosphere . ( partical  more than 10 mm. Filtered by the nasal mucosa less than 5 mm. can penetrate deeply in alveoli and other tissue)

·      Transmission of infection though placenta to new born is called vertical transmission Or trans-placental.

·      Indirect transmission of disease occur by 5f's (flies , finger , fomites  ,food, & fluid)  transmission.

·      Termination of complete transmission of infection   by extermination of the infectious agent Through surveillance & containment called Eradication.

·      Surveillance continues scrutiny of the factor that determine the occurance & distribution  of Disease or other conditions of illness .It essential for prevention & control of disease.

·      A methods for identifying the missing case & there by requirement for supplementing the notified case is called sentinel surveillance.

·      The period between exposure to an infection & the appearance of first sign and symptoms of disease is called incubation period.

·      Maximum and pic level of sing and symptoms of disease Is called prodermal period.

·      Symptoms indicative of an approaching disease Very  dangerous stage because patients Remain very contagious. Highest point of disease condition with specific sign and symptoms called  fastigium stage.

·      Defervecence stage-to become calm,subsidence of fever to a normal temperature.

·      Convalescence stage prior of recovery after a disease.

·      Defection stage is just like a converscence stage.

·      Latent period-the period from disease initiation to disease detection

·      .

·      Generation time,infectivity period is a interval of  time between recipient of infectious host And maximum infectivity of the host.

·      Communicable period-the time during which an infectious agent may be transfer directly Or indirectly from an infected person to an animal including arthropods.

·      Lodgement and development and multiplication of parasite on the surface of the body or in The clothing called  infestation.Ex.-Lice,mite.

·      Contamination A disease that is transmitted through direct contact to body and body fluid called contagious  disease.

·      Epidemic- epi -.Means- upon ,demos means = people

Wide spread occurance of infectious disease in a community at periticular time, rapid onset ,in Large number of popul action with in a short period of time is called Epidemic

·      .

·      Constant presence of disease with in given geographical area called endemic .E x. Cholera

·      Pandemic large proportion of population affected such as nation ,world .ex.Influenzain1918.

·      Sporadic means scattered case of infectious disease ,no connection each others ,for a long interval .

·      Exotics a disease which are important only in own country .ex.-Rabies in u. k.

·      An  infection or infectious  agent transfer from vertebral animal to man called  zoonoses .

·      Infection transmitted from animal vertebrate to men is called antropozoonses.

·      Infection transmitted from man to vertebrate animal called zoonatroponesex.

·      Infection found in both men and lower vertebrate in both direction Is called amphixenoses.

·      Epidemic in animal population called epizoonetic

·      Endemic in animal population is called enzoonetic.

·      Outbreak of disease in bird population is called epornithic.

·      Infection occurance after 24  hours after of admission in a hospital is called hospital  acquired  Or nosocomial infection.

·      Infection occur during  the low body immune system that organism normally present in the Body but does not cause disease but when body immunity is low is called opportunistic infection.

·      Adverse consequence of a preventive diagnosis or therepeutic regiment that cause disease Called iatrogenic disease (physician induce)

·      Quarentine-the period during which free entry to a country by human ,animal plant or Agriculture product with significance health risk is prohibited in order to limit the spread of  Potential infectious disease

·      Incidence-is a health or indicator useful for taking action to control disease for research into etiology(all new case 0f disease is called incidence)

·      Prevelance-the term prevelance refers to all new case and all old case existing at a given point in time ,over a period of time in a given population

·      Incidence and prevelance are measurement of morbidity.

·      Submerged portion of iceberg phenomena represent the hidden mass of disease.

·      Floting tip of iceberg phenomenon represent all visible case which are seen by physician

·      Screening-it is a search for a disease among appearently healthy individual for prevention of disease or the search for unrecognized disease or defect by means of rapidly applied test, examination or other procedure in appearent healthy  individuals (screening done in large population) 3type of screening 1 mass 2 high risk 3 multiphasic screening

·      Acceptability-test should be acceptable to those person who are involve eg. Pain full procedure ,vaginal examination.

·      Repeatability any test which are repeat ,should be given same result on same material or same individual that it called reliability repeatability

·      .

·      Validity it refers to what extant the  occurately measure which is purpose to measure .it has two component 1.sensitivity 2 specificity

·      Sensitivity-it has the ability to identify currectlly all those who have the disease that is true positive and false negative(90% have true positive which have currectly disease,10%have false negative who does not have disease)

·      Specificity ability of test to identify currectly who do not have disease is true negative means 90%non disease case will true negative result,10%false positive means patient who do not have disease are told they have disease

·      IMMUNITY-specific defence of body is observe or come into observation when micro-organism enter into the defence against these antigen inform of specific defence is called immunity

·      Immunity which is develops when body come in contact with infection and body give response to against infection by developing antibody or when antigen(vaccine) are introduced into the human body and develop antibody against vaccine is called active immunity.

·      (when immunity develop after infection is called active natural immunity and when antibody develop against vaccine antigen or toxoid is called active acquired immunity)

·      When antibody develop by human being and animal and transferred to another to protection against disease is called passive immunity (antibody transfer from mother to newborn through placenta or breast milk-igA is called passive natural immunity  and if antibody or immunoglobulin inject in human body it develop passive artificial immunity)

·      Herd immunity –it is a level of resistance of a community or group of people to aperticular disease.

·      Active immunity take time to develop but it superior to passive immunity.

·      Live vaccine made up from live attenuated bacteria it also called toxoid

·      Humoral immunity develop by the passive immunization or injection of immunoglobulin .it present in plasma ,it develop by activation of B-cell.

·      Cellular immunity develop by the active infection or vaccination .it present in cellular level develop by activation of t-cell.

·      Immunobiological substance that protect the body against infectious disease by producing antibody and immune mechanism is called vaccine .it two type live and killed.

·      Immunization normaly  achived  by single dose of live vaccine except polio

·      When two live vaccine required to administered should take gap at least 3 week and different site

·      Pertusis vaccine contraindicated in neurological disorder like seizure   , epilepsy.

·      Cold chain is a system of storage and transport of vaccine at law temperature from manufacturing to the actual site.

·      Vaccine which must be stored in freezer is like polio,measles and BCG.but never be allowed to freezed.

·      BCG vaccine should be use with in 3 hours after open and during this time place in 2to8 degree temperature and measles vaccine use with in one hour after dilution.

·      Normal saline used as a dilution for the BCG vaccine and sterile water use in measles(in measles stabilizer sorbitol is used)

·      In DPT vaccine aluminium hydroxide or aluminium phosphate is used as a adjuvant to improve sensitivity of vaccine .

·      Triage system use START means simple triage and rapid treatment.

·      Temporary harding of water is due to the calcium ,megnisium ,bicarbonate  ,it can be removedby the adding lime (caHco3) and sodium bicarbonate.

·      Permanat harding or water due to the calcium,megnisium ,nitrate, chloride it remove by boiling of water.

·      Water purification chlorine act as a germicidal and it use 0.5gm for 20 litter of water.

·      Constitutionof ORS new by WHO-Nacl-2.6gm,Kcl-1.5gm,trisodiumcitrate-2.9gm,glucose13.5gm,portalwater-1 lt.

·      Mid arm circumference yield a relative reliable estimation of the body muscle mass.the useof ‘shakir tap’further simplified assessment of mid arm circumference,the  tapis shading of three colorwhic indicate diffren level of nutrition.RED-<12.5 indicates sever malnutrition,YELLOW-12.5-13.5 indicates mild to moderate malnutrition.,GREEN->13.5 indicates satisfavtory malnutrition.

·      Birth rate is a simplest indicator of fertility ,but is unsatisfactory measure of fertility because the total population is not expose to child bearing.

·      GFR(general fertility rate ) is the number of live births per 1000 women in the reproductive age group(15-45year) in a given year.

·      NRR(net reproduction rate )is define as the average number of children a women would have if she were pass through reproductive year bearing children at the same rate as well as the women now each agegroup.

·      Epidemic drops –is due to the contamination of mustard oil with argenine oil which contain the toxicant sanguinarine .it inhibit the pyruvic acid which accumulate in muscle leading to bilateral non inflammatory swelling of lower limb,dyspnea,glaucoma,cardiac failure and death.

·      One aganwadi worker cover 1000 population,ASHA also on a 1000  population one.

·      Subcenter cover 5000 population in general population,and 3000 in hilly population ,primary health center cover 30000 population in general population and 20000 in hilly population,communityhealth center cover 80000-120000 populaton.

·      Three tiers system(self local government) include –1. Panchayat at village level, 2.panchayat samity  at block level 3,zila parisad at distric level.

·      Community  development block cover 100 village and 80000-120000 population,and its incharge is BDO-OFFICER(block development officer)

·      IUD –Most  cu-T 380 for10year,cu-T 200 for 4 year, NOVA –T for 5 year.

·      Lng -20 is t shape IUD,release 20mg oflevonogastrel and it has less failure rate 02% less chanceof ectopic pregnance.

·      Most common complication with IUD is hemorrhage

·      Most common problem with IUD is expulsion ,and most common cause of removal of IUD is pain.

·      Best  copper-t insertion time is second and third day of menses and with in day of the beginning of mc. Period, immediate post partum insertion – during 1^st week of after delivery, or if post purperial  than 6-8 week after delivery.

·      IUD not a first choise of nulliparus women,ideal candicate for IUD is has born at least one child and history of pelvic dialation ,has normal menstrural period .

·      IUD does not protect from STD, so need to use condom.

·      Oral pill also known as combine pill,progestron only pill,post coital pill,once a month pill,

·      OCP  increase the chance of breast cancer and decrease the chance of ovarian cancer.

·      Beginning of OCP  5th day of menstrual cycle followed by a break 7 day ,and it take at same time before going to bed. It contain 28 tab.(21 tab. Hormonal pill and 7 pill iron) iron is give for decrease cancer of anemia ,intact the pituitary function and regulate menstruation.

·      Hormonal –levonorgestrol 0.75 mg for emergency contraception most common used one tab. 75mg with 72hours and 2^nd tab. after 12 hour of first tablet.

·      Combine pill prevent release of ovum from ovary by blocking GnRH .

·      Progestron only pill -cervical mucus thick and scanty ,inhibit sperm penetration ,progestron also inhibit tubal motility delay transport of sperm to the uterine cavity.

·      Oral pill is contraindicated in such condition as-ca breast ,liver disease, history of hyperlipidemia ,cardiac abnormality.

·      Depot medroxy progesterone acetate(DMPA) and norethistrone acetate NET-EN) are the example of injectable hormone device.

·      Perkail sign  mucus plug formation after ovulation

·      Spinnbarkeit means evaluation of the elasticity of cervicalmucus used to determine time of ovulation.(esic-2016)

·      Sub-dermal implant (implanone) decrease the risk of osteoporosis women

·      Health survey and development committee give by bhore committee  in1946 by sir jocef bhore.

·      Health survey and planning committee give by mudaliar committee in1962.

·      Malaria eredication program given by chadda committee in 1963.

·      Multipurpose health worker scheme given by kartar singh committee in 1973.

·      Noise is measure in decibel ,recommended maximum noise level is 85 decibels

·       Central Registration of death and birth act 1969 become effective in april 1970,accornding to act birth should be registered with in 14 day and death should be register with in 7 day

·      Census is every 10 year first regular census taken in india 1881.latest in 2011.

·      In 2005 program launched –RCH ii launched,janani suraksha yojana, national rural heath mission started.

·      Main objective of janani surakhsha yojana(12 april 2005) is to reduce infant mortality rate and maternal mortality rate and to increase the number  of institutional delivery.

·      Vital monitoring step for infant is RPT(RESPIRATION,PULSE TEMPRATURE)

·      SOME OCCUPATIONAL DISEASE

·      Coal dust cause anthrecosis

·      Silica dust silicosis

·      Iron dust siderosis

·      Asbestos  cause fibrus lung called pneumoconiosis ,asbestosis.

·      Tobacco dust cause tobacosis

·      Cotton dust cause byssinosis

·      Sugar cane dust cause baggassosis

·      Grain dust  cause farmer lung

·      Welder flash due to u,v radiation

·      Heat stoke, heat cramp  burn due to excessive heat

·      Cold cause trench foot ,frost bite ,chilblains

·      Incineration is a best method of choice  for most biological waste

·      Chemical disinfectant use for mainly for liquid waste like blood ,urine ,stool etc.

·      Dry thermal treatment use mainly for anatomical waste and non infectious sharp

·      Label and symbol for biological and cytotoxic hazard

·      In 2006 following program launched-

-RNCTP cover whole country since march 2006

-national family health survey 3^rd conducted

-ban on child labour

-IMNCI was launched in 16  state

• ·      Indian public health standered for PHC and SUB CENTER  formulated in 2007.
• ·      In 2008 non-communicable disease programme as pilot project launched on 4^th jan.
• ·      DALY disability adjustment life year ,it measure of burden of disease and effectiveness                   of intervention .it expresses year of life lost to premature death and year lived with disability Adjusted for severity of disability.
• ·      HALE is health adjusted life expectancy
• ·      Success of DOTS(direct observe treatment shorter )
• -political commitment
• -good duality sputum microscopy
• -direct observe treatment
• -uninterrupted supply of good quality drug
• -accountability

·      Pulse polio immunization programme run for 3 day first day booth coverage is done  and second and third day door to door visit is done is called mouping up stretege.

·      For the prevention of vitamin A deficiency  1 lakh IU of vitamin  A  is given at 9 month and then 2 lakh IU after every six month of interval.

·      Measles patient have vitamin-A deficiency so vitamin a supplement is given

·      BCG vaccine given at birth 0.05 ml and at 6week give 0.1ml ID , standered size  –left upper arm middle of deltoid( wheel 5mm induration read after 48 to 72 hours ,papule at 2 to 3 week ,4 to 5 week after papule grow and break and covered with crust .,scar at 8 to 12 week.

·      Bcg  ,opv ,yellow fever, typhoid, cholera ,rubella ,measles, encephalitis is a live vaccine.(BOY Love The CRIME)

·      expanded  immunization  program launched by WHO IN 1974(EPI) ,in 1978 in india epi for six killer disease ,in 1985-universal  immunization programme launched  ,in 1995 pulse polio immunization programme launched.

·      EPI include –DPT,BCG,OPV,MEASLES. - IN 1995-PPI,HEP.B added in jan.2002

·      Polio free declared by WHO on 27 march 2014.

·      World polio day 24^th oct.

·      World t.b. day 24^th march

·      World  health day  7^th april

·      Dpt ,hib and hep.B and opv give at 6,10,14 week,measles and vitamin A given at 9 month and mmr at 15-18 month,5to 6year DT ,10year –TT,16 year-TT

·      Know a day injectable polio vaccine also start to give in fractional dose two time  first at 6 week and second on 14 week.Route is intradermal and 0.1ml,before it was given 0.5ml by SC/IM ROUTE.

·      VACCINE damaged by freezing- DPT,DT,TT,HEP.B

·      Vaccine that can be frozen with out harm-opv,measles MMR ,BCG before constitution.

·      Unicef introduce a primary healthcare  concept in 1982 is known as GOBI-3FS

-G-Growth monitoring to assess child development

-O- ORAL dehydration solution

-B- BREAST FEEDING

-I- IMMUNIZATION

-F-FOOD SUPPLIMENT FOR PREGNAT WOMEN

-F-FAMILY PLANNIG

-F-FEMALE LITRACY

• ·      HOLDER method -65 degree c for30 minute and immediate cooling to 5degree
• ·      HTST(HIGH TEMPRATURE SHORT TIME)-72 degree C FOR 15 second and cooled at 4 degree C
• ·      Rice water stool  is an important clinical manifestation of cholera caused by vibriocholera. Hanging drop stool test done ant its drug of choice is doxicyclin for adult and cotrimoxazole for the children and flurazolidone for pregnant women.
• ·      Rabies also known as hydrophobia, it transfer from dog bite.causative agent lyssa virus.
• ·      Tetanus is charecterised by muscle rigidity, facial muscle rigidity called risus sardoricus,back muscle rigidity called oppisthotonic posture,it cause by clostridium tetani.it secreate exotoxin known as tetanospasmin  affect nervous system.
• ·      Tetanus is one disease in which herd immunity does not protect the individual.
• ·      Leprosy is caused by mycobacterium lepry ,it also known as hensen’s disease ,touch is first sensation which loss ,drug of choice  is DAPSON.
• ·      TRACHOMA –chronic infectious disease of conjectivitis and cornea causative agent Chlamydia trachomaties,for trachoma control programme 1963 use SAFE strategy(S-SURGERY,A-ANTIBIOTIC,F-FACIAL CLEANING,E-ENVIONMENTAL MODIFICATION)
• ·      Malaria  is a protozoal disease  transmitted by female anephelus mosquito, fever have three stage cold,hot and sweating
• ·      Typhoid –step ladder fever and rose like spot in abdomen ,it is cause by salmonella typhi . typhi dot test and widal  test is done for 0:H antigen titer
• ·      Measles is a more contagious  air born disease ,cause by paramyxo virus  , koplic spot seen in mouth near lower molar teath, also show 3C SIGN( cough , coryza  and conjectivitis)
• ·      In measles first symptom is fever it occure at 10^th  day and 0n 14 day rash appear first on ear, isolation for the maximum 7 day need
• ·      Dengue is caused by  aerbo virus and transmitted by mosquito aedes agypti(aedes agypti also transmit the chikungunia and yellow fever) it show herman sign ,raddle back fever.(3 day fever and 3day normal) incubatin  period 3 to  10 day
• ·      For the detection and investigation of malaria take blood slides (thin and thick) and geimsa stain is done.
• ·      Polio is cause by picorna virus incubation period 7 to 14 day,it affect nervous system and lower limb,decending flaccid paralysis, transmitted through feco-oral route.only 1% patient affected with paralytic polio.
• ·      Culex tritaniorrhynchus is moisquito transmit the  japanies encephalitis
• ·      Lymphatic filariasis is cause by wucheria borcropti, transmite through culex mosquito it is only single disease sample taken in night time.because its agent in day in lymph and in night in blood plasma(biological clock), in this person look like elephant like leg and chyluria  milky color urine is indicator of filariasis.
• ·      ChiCken pox caused by vericela zoster virus and also known as human alpha virus -3,IP-14 TO 16 DAY ,first rash in trunk, centripetal and pleomorphism.
• ·      Rubella(german measles) also known as 3^rd day disease cause by togavirus.in this lymph adenopathy  is occure affect post auricular and post cervical lymph node.
• ·      In rubella first rash appear at face
• ·      In mums period of maximum infectivity is just before &at onset of parotid gland swealing,once the swealing of gland subside case may reguard as no large infection.
• ·      For the swine flue H1N1  need isolation and n95 mask wear by patient and staff.isolate the patient for 7 day after onset of symptom or 24hours after resolution of fever and respiratory symptom.
• ·      Diphtheria is cause by cornibacterium diptheriae ,IP is 2 to 6 day, submendibular gland swealling give bullneck  appearance, croup like cough is also seen.
• ·      Whooping cough(pertusis) 100 day cough disease , hight pich inspiration like whoop ,hacking night cough.
• ·      Subcenter level use drug kit A and B
• ·      At PHC level use  PHC equipment kit
• ·      At CHC level use equipment kit –E TO kit-B
•  

·      HEATH  PROGRAM IN INDIA

·      National malaria contrOl programme  1953,during first five year plan

·      National malaria erredication programme 1958

·      National filarial control programme1955

·      National leprosy control programme 1955 only dapson therepy

·      National leprosy erredication programme 1983

·      National world leprosy day 30 january (nearest Sunday)

·      National tuberculosis programme 1962

·      Revise national tuberculosis control program 1992 (sputum microscopy and DOTS)

·      DOTS PLUS   MDR 1997

·      National aids control program 1987

·      First case of HIV dected on 1986(tamilnadu)in india

·      National aids control policy

·      NACO branded the STI/RTI service as surksha clinic.

·      Red ribbon express project (2007-2009),world health day on 1st December.

·      National program for control of blindness (1976-100%centrally sponsored  reject with trachoma  control programs  started in 1968)

·      World sighy day 13 oct 2016

·      Iodine deficiency disorder program 1962.

·      Idd(iodin deficiency day) day 21 oct

·      Universal  immunizations program 1985.

·      Pulse polio immunizations program launched in 1995.

·      WHO,launched  EPI in 1974,in india EPI 1978

·      National rural health mission started on 5th april 2005 for 7year (2005-2012) to improve health care  delivery system. 1ASHA(accredited social health activist)

·      Reproductive & child health program (RcH) 1997include

Ø family planning

Ø Child servival and safe motherhood 1992

Ø Client approach to health care

Ø Prevention and management of std

Ø Diarrhoeal control-zink to be use as adjuct to ORS.

Ø Pneumonia – cotri -moxazole

Ø Vitamin-A first dose  1  lakh unit,2^nd dose 2 lakh unit

Ø Prevation and  control of anemia  - 6 month to 5 year.iron in liquid form 20 mg elimentory iron ,100 meq. folic acid/day for 100 day,6 year to 10 year-30mg elimentory iron,250meq.folic acid for100day   

·      RCH 2^ND phase 1 april 2005

·      Janani surksha yojana launched  12 april2005

·      National mental health programme 1982

·      Special nutrition program 1970  for year child below 5year  pregnant mother , nursing morther, supply food  300kcl,and10-12 gm protein/day,beneficieries women 500 kcl,25gm protein.

·      Icds  programme 1975

·      Mid day meal programme 1961

·      Balwadi programme 1970

·      Prevention of food adultration 1954

·      Consumer protection act 1954

·      arthotolidin test to check accuracy and speed of water develop in 1918,0.1 ml reagent and 1 ml water (yellow color produce)

·    Some disease and their incubation period

Ø 1.Chicken pox (14-16 days)

Ø 2.Measles 10- 14 day

Ø 3.Rubella 14-21 day

Ø 4.Mumps 14- 21 day

Ø 5.Influnza 18 -72 hours

Ø 6.Syphillis 9- 90day

Ø 7.Cholera hours to 5 day

Ø 8.Typhoid 10 -14 day

Ø 9.Rabies 3- 8 weeks

Ø 10.JE-- 5-15day

Ø 11.Diptheria 2- 6day

Ø 12.Whoping Cough- 7- 14 day

Ø 13.TB 3- 6 weeks

Ø 14.Polio- 7-14day

Ø 15.SARS- 3- 5day

Ø 16.Meningococal meningitis 3- 4day

Ø 17.Trachoma 5-12day

Ø 18.Tetanus 6- 10 day

Ø 19.HIV months to 10 years

Ø 20. Staphylococcal food poisoning-- 1- 6 hrs

Ø 21.Ascriasis--- about two months

Ø 22.Hook worm 5weeks to 9 months

Ø 21.Filariasis 8- 16 months

Ø 22.Leprosy----- 3- 5yearsñ

Ø 23.Hydated diseases-- months to years variable

Ø 24.Malaria  Vivex  8-17 day

Ø 25. Falciparum - 9-14 day

Ø 26.Scabies ---3- 6 weeks

Ø 27.Kalazar--- 1- 4months

                                                               THANKS FOR READING

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Social Awareness and Action to Neutralise Pneumonia Successfully' (SAANS) campaign

NOSG PIC

The Union Ministry for Health and Family Welfare (MoHFW) launched the launch of SAANS campaign i.e. “Social Awareness and Action to Neutralise Pneumonia Successfully” to control Pneumonia. 

This campaign will mobilize people's for protecting and preventing children from pneumonia; and health personnel, governments & other stakeholders to prioritize treatment towards the control of Pneumonia — one of the most fatal childhood illnesses. 

Child deaths caused by pneumonia

As per data from the Health Management Information System (HMIS), a digital initiative by National Health Mission, out of 1000 live births in India, 37 children under five die. Of these, 5.3 deaths are caused due to pneumonia.

As per HMIS data, Madhya Pradesh has the highest number of pneumonia-caused child deaths, followed by Gujarat.

Under the SAANS campaign, (OBJECTIVE)

New interventions have been included like

1. Under SAANS, the government is targeting a reduction in pneumonia-caused deaths by 2025 to less than 3 deaths out of 1000 live births. 
2. A child suffering from Pneumonia will be treated with pre-referral dose of Amoxicillin by ASHA; 
3. Pulse Oximeter will be used at the Health and Wellness Centre for identification of low oxygen levels in the blood and if required treated by use of Oxygen. 
4. The initiative also aims to create mass awareness about the most effective solutions for pneumonia prevention like breast feeding, age appropriate complementary feeding, immunization, good quality air etc.
5. The web portal for home based care of children including newborn visited by ASHA, was also launched at the Summit. 
6. This portal has all the resource materials (training materials, IEC videos, audios, banners, posters etc.) for the home visits of ASHAs. 

AIIMS Jodhpur Nursing Officer Exam. Date declered

SCHEME OF RECRUITMENT EXAMINATION INCLUDING IMPORTANT DATES FOR THE POST OF 
NURSING OFFICER (STAFF NURSE-GRADE-II) FOR AIIMS BHOPAL, JODHPUR, PATNA AND RAIPUR 
SCHEDULED ON 07.02.2020 IN ONLINE (CBT) MODE ACROSS THE COUNTRY

Status for application & rejected :-

Wednesday 08
th January, 2020

application with reason for rejection.:-

Wednesday 15
th January, 2020 (upto 5:00 p.m.)

Last date for uploading of images / 
submission of required documents

Date of uploading of Admit Card :- Thursday 30th January, 2020

Date of Recruitment Examination :- Friday 07th February, 2020

Tentative date of declaration of result :- Thursday 20
th February, 2020

Timing & Duration of Examination 09:00 AM to 12:00 Noon
Duration of Examination The duration of the examination shall be 3 hrs. (180 minutes)

http://nursingofficeroth.aiimsexams.org/pdf/Updated%20scheme%20of%20Examination_nursingofficerotheraiims.pdf

SEXUAL DISORDER

SEXUAL DISORDER

Sexual disorder is related to sexual function and gender identify.

v Alteration in sexual behavior or paraphilia’s: -Abnormal behavior for minimum six month, it is also classified in following.

Ø  Exhibitionism: -Sexual urges and fantasies that result in exposure of genitals to strangers to bring sexual gratification or arousal.

Ø  Transexualism: - Feeling that one’s gender is inappropriate and desiring to acquire sexual characteristics of the opposite gender.

Ø  Fetishism:- Using non-living object for sexual gratification.

Ø  Pedophilia: -Desiring sexual activity with a child younger than 13 years.

Ø  Frotteurism: -Non consenting person,intense sexual arousal or desire when rubbing against a non- consenting person.

Ø  Sexual masochism: -Sexual gratification that involves receiving pain.

Ø  Sexual sadism: -Sexual gratification that involves inflicting pain.

Ø  Sexual voyeurism: -Sexual gratification through observing other is disrobing or engaging in sexual activity.

Ø  Zoophilias: -Intense sexual arousal or desire for sexual contact with animals.

Ø  Transvestism: -Sexual arousal or desire though wearing clothes of opposite sex.

v Sexual expression disorder:-

Ø  Bisexuality: -Sexual attraction to and activity with both gender.

Ø  Hetero sexuality: -Sexual attraction to opposite.

Ø  Homosexuality: -Same sex sexual attraction.

v Sexual dysfunction: - It occur when disturbance in any phase of sexual response cycle.

Ø  Phase of sexual attraction:-

§  Phase 1 (desire)

§  Phase 2 (excitement)

§  Phase 3 (orgasm-peak level of sex)

§  Phase 4 (resolution-feeling of general relaxation and wellbeing after ejaculation)

SEXUAL DYSFUNCTION ARE CLASSIFIED IN FOLLOWING:-

v Sexual aversion disorder: -Extreme aversion to genital sexual contact with sexual partner.

v Erectile dysfunction or impotence: -Unable to maintain or attain adequate erection till satisfactory completion of sexual activity or inter course. It is also classified in two type

 

                                                                       

                                                              

v Dyspareunia: -Pain during sexual intercourse.

v Veganism: -In vagina occur involuntary contraction in 2/3 outer part. By which impossibility of intercourse or penile insertion

Quick review point for Nervous System

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•        1.Hypothalamus regulate (SAH-FEAST)
• Ø  S – Stress response
• Ø  A – autonomic response  include sympathetic & parasympathetic
• Ø  H – Hormone production
• Ø  F – Fluid balance
• Ø  E – Emotion
• Ø  A – Appetite
• Ø  S – SLEEP
• Ø  T – Temperature regulation
• ·       is a relay station of sensory impulse, provide pain gate , and is part of reticular activation  system(provide sense  about familiar things)
• ·       Pons contain respiratory center and regulate breathing (AD-PR – means   apneustic for depth, inspiration and pneumocystis for the rate )
• ·       Medulla oblongata contain all afferent and efferent tract of cardiac , respiratory , vomiting and vasomotor reflex center (sneezing coughing)
• ·       Cerebellum coordinate muscle movement   posture  , equilibrium , muscle tone.
• ·       Spinal cord contain horns (inner column of gray matter contain two anterior and two posterior horns. Posterior horns connect with afferent (sensory) nerve fibers, and anterior horns connect with efferent( motor) nerve fiber. (anterior part for MTP-means m- motor, T- temperature, P – pain & posterior part for PVT means – P- pressure, V – vibration, T – Touch sense)
• ·        Frontal lobe contain broca’s area for speech, and other is moral ,emotional reasoning, judgement,concentration.
• ·       Parietal lobe responsible for interpretation of test, pain, touch, temperature and pressure.
• ·       Temporal lobe for auditory, wernic’s area for sensory and speech.
• ·       Occipital for the vision area.
• ·       Limbic systiem for emotional patterns and visceral patterns of survival.
• ·       Cerebrospinal fluid normal volume is 120- 150 ml and pressure about 50 to 175mmh2o
• ·       Neurotransmitter (PASAND)
• Ø  P- POLYPEPTIDE
• Ø  A – ACETYLCHOLIN
• Ø  S – SEROTONIN
• Ø  A – AMINO ACID
• Ø  N – NPREPINEPHRIN
• Ø  D- DOPAMINE
• ·       Sypathetic( adrenergic ) fiber dilate the pupil,increase the heart rate and rhythm, contractblood vessels ,  and relax smooth muscle of bronchi.
• ·       Parasympathetic (cholinergic ) fiber produce opposite effect of sympathetic system.
• ·       Always check with the client about the possibility of pregnancy before any radiological procedure are done.
• ·       Asses the need to withhold metformin if iodinated contrast dye is used for a diagnostic procedure because of the risk for metformin induce lactic acidosis.
• ·       An MRI contraindicated in a pregnant women because the increase in amniotic fluid temperature that occurs during the procedure maybe harmful to the fetus .
• ·       Insertion of a spinal needle through the L3-L4 interspace  into lumber subarachnoid space to obtain CSF  ,puncture is contraindicate in increase intracranial pressure , sample taken in fetal attitude position   , c-shape lateral recumbent position, after  procedure flat position should be given.
• ·       Caloric testing ( oculovestibular reflex) it provide the information about the function of vestibular portion of 8^th cranial nerve and it aid the diagnosis of cerebellar and brain stem lesion, in which provide supine position to  patient and head elevated and inject hot or cold water in ear and heck for nystagmus( involuntary eye movement) remember TRIC  is  COWS ( Means  C- COLD WATER –OPPOSITE EYE NYSTAGMUS AND WARM WATER SAME EYE NYSTAGMUS),If test is positive nystagmus means no lesion.
• ·       Level of consciousness is the   most sensitive indicator of neurological status, it check by GLASSGO COMA SCALE.
• ·       Rhythmic, with period of apnea is called  Cheyne –stokes it indicate metabolic dysfunction in the cerebral hemisphere or basal ganglia
• ·       Regular rapid and deep sustained respiration is called neurogenic hyperventilatation . indicate a dysfunction in the low midbrain and middle pons.
• ·       Irregular respiration, with pauses at the end of inspiration and expiration is called apneustic ,indicate dysfunction in the meddle and caudal pons.
• ·       Cluster of breath with irregular spaced pauses called cluster respiration , indicate dysfunction in the medulla and pons
• ·       One dilated pupil indicate compressed cranial nerve 3^rd .
• ·       Bilateral dilated ,fixed pupils called ominus sign,indicate midbrain injury.
• ·       Pinpoint pupil indicate pons damage(pontine damage) and organophosphate poisoning.
• ·       Flexor( decorticate posturing) in which client flexes one or both arms on the chest and may extend the legs stiffly. It indicate nonfunctioning cortex.
• ·       Extensor ( decerebrate posturing ) client stiffly extended one or both arm and possible the legs. It indicate brainstem lesion.
• ·       Flaccid posturing – client display no motor response in any extremity.
• ·       Babinski reflex means dorsi flexion of the big toe and fanning of the other toe ,elicited by firmly stroking the lateral aspect of the sole of the foot.(is a pathological or abnormal reflex in anyone older than 2 year and represent the presence of central nervous system disease.
• ·       Blink reflex –involuntary closure of the eyelids in response to stimulation of the cornea ,it indicate dysfunction of cranial nerve –V
• ·       Gag reflex (contraction of pharyngeal muscle , elicited by touching the back of the throat ) loss of gag reflex indicate dysfunction of cranial nerve ix and x.
• ·       Involuntary flexion of the hip and knee when the neck is passively flexed indicate meningeal irritation  is called brudzinski sign.
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•  Kernig’s sing Loss of the ability of a supine client to straighten the knee and hip; indicate meningeal irritation.
• ·        In GCS score is based on a scale of 1-15 point a score lower than 8 indicate that coma is present
• ·       A score lower than 8 indicate that coma is present.
• ·       In GCS lowest possible score is 3 point means deep coma or death and highest possible score is 15 point means fully conscious and in GCS scale EVM is checked E – MEANS eye opening point  response maximum is 4,V – Verbal response  max. point is 5, M – MEANS  Motar  response max. point  is  6.
• ·       Altered level of consciousness, which is the most sensitive and earliest indication of increase ICP. Other widened pulse pressure , slow pulse , vomiting(fist sign in new born).
• ·       Late sings  of increase ICP include increase systolic blood pressure ,widening pulse pressure and slow heart.
• ·       Maintaining respiratory status( increase rate )  and prevent hypoxia ,maintain mechanical ventilation as prescribe maintain the PaCO2 at 30 to  35 mm hg will result in vasoconstriction of the cerebral blood vessels , decease blood flow ,and then decrease in IVP.
• ·       For the client with increase ICP elevate the head of the bed 30-40 degree , avoid the trendelenburg  position ,and prevent flexion of the neck and hip.
• ·       VP shunt use for the surgical intervention for ICP, and in which divert CSF  from the ventricles into the  peritoneum. After  procedure provide supine position and turn from the back to the non-operating side.
• ·       CONCUSSION – is a jarring of the brain with in the skull ,with no loss of consciousness.
• ·       CINTUSSION-  it is a bruishing type of injury to the brain tissue and it occur with other  neurological injury .sub dural and epidural hemotoma.
• ·       EPIDURAL HEMOTOMA – it form rapidly , result from arterial rupture.(meningeal artery) between dura and skull.it is a surgical emergency condition ,temporary loss of consciousness.
• ·       SUBDURAL HEMOTOMA  slow and result from venous blood.it occure under the dura.
• ·       CSF can be distinguished from other fluid by the presence of  concentric  ring (bloody fluid surrounding by yellowish stain , halo ring) when the fluid is place on a white sterile backgroung ,such as a gauze pad. CSF  also test positive for glucose when tested using a strip test.
• ·       In hematoma condition maintain patent airway because increase co2 level increase cerebral edema .give morphine sulphate if prescribe to decrease agitation and control restlessness caused by pain but it administer with caution because it cause respiratory depression.
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