• Identify adverse events after vaccination.
• Differentiate between mild and severe reactions.
• Keep an emergency kit ready.
• Follow the AEFI reporting and referral process.

6.Recording and Reporting:

• Updating the immunization register.
• Making entries in the mother-child card.
• Preparing monthly reports and sending them to the higher authorities.
• Making due list and defaulter tracking.

7.Surveillance and Monitoring :

• Surveillance of vaccine-preventable diseases.
• Reporting outbreaks.
• Coverage evaluation.

8. Community Mobilization :

• Coordinating with ASHA Workers and Anganwadi Workers.
• Organizing vaccination camps and outreach sessions.
• Finding dropout cases and bringing them for vaccination.

In the immunization program, the Community Health Nurse performs multiple responsibilities such as planning, education, safe vaccination, cold chain maintenance, AEFI management, recording and community mobilization.

Through her work, the incidence of disease in the community decreases, child mortality decreases and public health standards improve. Therefore, the role of community health nurses in immunization is extremely important and responsible.

OR

a) Explain role of community health nurse in family health services. Explain the role of community health nurse in family health services. 08

(A) Community health nurse in survey work:-

• i) Collecting demographic facts-Collecting demographic data
• ii) Making list of homes- Making a list of homes, identifying housing location.
• iii) Collecting information about pregnant mothers, eligible couples, infants and children below the school going age.

(B) Function of CHN in Educations functions and motivation:

• i) To encourage the adoption of small family norms.
• ii) To explain the importance and necessity of family planning to the masses effectively.
• iii) To use various techniques of teaching and communication.
• iv) To eligible couples contraceptives  To motivate and educate people about the use of family planning services and permanent methods.
• v) To motivate people for family planning services operation or permanent methods.

(C) Function of CHN in managerial function;

• i) Conducting clinics-Conducting clinics
• ii) Deciding the date and place of clinics-Deciding the date and place of clinics-Deciding the date and place of clinics
• iii) Arranging equipment and other resources at clinic
• iv) Arrangement and distribution of contraceptive-
• v) Insertion and removal of IUD’s
• In which the IUCD is inserted. And its follow-up is taken. And when necessary, it is also removed.

(D) Organizing family planning camps

• Organizing family planning camps in the community and providing the necessary family planning facilities to the people, especially efforts to ensure that people adopt the method of permanent family planning To organize such camps whenever necessary and reach out to the beneficiaries. (E) Maintaining Records. After providing health care services to the family, keep all records of the care provided to them, including all the details in the family folder. How many eligible couples are there in the community and keep proper data of ANC, PNC etc. and keep all the services provided in the record so that they can be used properly in the future.

(F) Liaison work-

• The community health nurse will work as a link between the health care services and the people who need the health services while providing health services to the family so that they will make efforts to benefit them in the mainstream of the health care system.

i) Ask NGOs and voluntary organizations to co-operate.

• Health services or the health needs of the family cannot be provided by the government or by themselves, so often such services are provided by different NGOs and cooperative organizations, so they should cooperate in this.

b) Explain communicable disease triad. 04

The epidemiological triad or epidemiological triangle is a traditional model for explaining how infectious diseases occur and are transmitted in a community. This model is very simple and is used to explain the mechanisms for the occurrence of infectious diseases and their control and eradication. It is very necessary for.

These three factors are responsible for the occurrence of disease: agent, host, and environment. If any one of them is absent, the disease does not occur. Therefore, this model is used for the emergence and treatment of diseases.

The Epidemiological Triad is a basic model for understanding the occurrence of communicable diseases. This triad is made up of three main components: agent, host, and environment.

1. Agent:

•    – An agent is the entity that causes a disease process (infection or noninfection). This includes bacteria, viruses, parasites, fungi, etc.
•    – Example: Hepatitis B virus is the agent that causes Hepatitis B disease.

2. Host:

•    – A host is a person or organism that is susceptible to an agent of a communicable disease. The host’s innate or acquired characteristics, such as age, sex, immune power, and heredity, can affect the effectiveness of the agent.
•    – Example: A person with a weakened immune system may be more susceptible to fungal infections.

3. Environment:

•    – Environment is the set of external factors that influence the transmission between the host and the agent. These include physical, biological, social and economic factors.
•    – Example: A dirty environment and lack of water are environmental factors that can help spread cholera.

Epidemiological Triad:

  / \

             /   \

            /     \

         Host — Environment

Example: Malaria

– Agent:* Plasmodium parasite

– *Host:* Human

– *Environment:* Areas with water storage (where mosquito populations are high)

Importance:

Epidemiological The trio is important for the prevention and control of communicable diseases. Based on this model, various practical measures are taken for the prevention of communicable diseases, such as:

– Use of medicine to kill the agent.

– Vaccine to increase the host’s immune power.

– Management of organic waste and water to keep the environment clean.

This model helps healthcare professionals to effectively understand and control the spread of communicable diseases.

Q-3 Write short answer (any two) Write a short answer. (Any two) 6×2-12

a) Write down methods of cooking. Write the methods of cooking.

The following different methods are used to cook food.

(1) Boiling

(2) Steaming

(3) Frying

(4) Rousting

(5) Baking

(6). Grilling

(1) Boiling:-

Food is cooked by boiling water at 100* C. This method is used to prepare lentils, rice, vegetables, beans, tubers, and other vegetables.

Since more water is used in this method, vitamins and salts are destroyed. Therefore, sufficient water is used in the boiling method.

(2)Steaming (steaming):- 

In this, food is cooked with hot steam. Pressure cooker works on this principle. There is more steam in the pressure cooker. Through this, all the nutrients are preserved. This saves time and fuel. So this method is excellent. 

 (3) Faying (Frying) :- 

In this, thepla, dosa, all types of pudla, are made by drying them in oil. Similarly, puri, bhajiya, vada, kachori etc. can also be fried in oil. 

(4) Rousting (Roasting):

It is made by adding a little oil or ghee. After that it is placed on direct heat. Chicken is made by this method. This method is also good.

(5) Baking (baking): 

In this, food is cooked by dry heat. In this, food is cooked by using an oven and its hot air. This method is good. Biscuits, bread, and cakes are made in it.

(6) Grilling :

In this, dry heat is used to cook food by heating it on a metal grid.

b) Explain purification of water at large scale. Explain water purification on a large scale.

Large scale water purification can be done by sand filtration. This filtration is of two types which are respectively called slow sand filtration or biological sand filtration and 2) rapid sand filtration or mechanical sand filtration.

In this first raw water is purified, it is stored in a settlement tank for two days and in this short period a large quantity of water is purified and 90% of the impurities are removed from it. This happens naturally. In other words, in this stage, the turbidity of raw water is reduced.

In the second stage, this water is The slow sand introduced into the filter is called the filter bed. The bed is structured from top to bottom in this way:
In which there is water in 1.4 meters, below it there is 1.2 liters of fine sand, below it there are large pebbles in 0.4 meters.

Sand is the main filtering medium in the sand bed. Its thickness is 1.2 meters. There is sand at the bottom, which is a layer of sand that supports the sand bed. There is a pipe at the bottom of this sand bed, which is hollow, through which the filtered water collects and comes out through the pipe to the main tank. In this way, many other mechanisms are responsible for purifying the water through the sand filter, which are as follows.

1) mechanical (mechanical)
2) sedimentation (sedimentation)
3) absorption (absorption)
4) oxidation of impurities
5) bacterial action (bacterial action)

All these things play their part in water purification but the important part is on the sand bed or the jugular layer or the vital layer. This is a thin and oily layer which contains many types of alkaline protozoa and bacteria. This layer takes two to three days to form. The vital layer destroys harmful bacteria through the slow layer and the water becomes 98% pure. Therefore, it is not advisable to use the filtered water until the new sand bed is ready. In slow sand filtration, 2+03 million gallons of water can be filtered in the filter at a rate of 2 gallons of water per hour. If the thickness of the vital layer on the filter bed increases, then the water cannot be filtered properly and the filtration rate decreases.

The capacity of the filter bed decreases after a few weeks or days. This is called loss of bed. When this amount increases to 4 feet. Water filtration is not considered beneficial. At such a time, from the top of the vital layer. 2 to 3 am is scratched. This scratching action is called cleaning the filter. Which should be done repeatedly in the bed. When the thickness of the sand bed decreases to 30 to 40 CM, it is closed. And the process is started again by constructing the bed. The main disadvantage of slow sand filtration is that it requires changing the bed at frequent intervals!

Note:-Rapid Sand Filtration (Read from Paper-1)

c) Describe methods of health education. Describe the methods of health education.

(1) Personal health education:-

•      When a person is admitted to the hospital and discharged from the hospital, the doctor and health worker provide personal health education. 
• – Health education can be provided when the patient comes for treatment of his illness.
• – Personal hygiene Treatment due to illness And can be explained about prevention.
• – Public health nurses provide health education and discussions in homes in a personal manner. And provide correct understanding.
• – Flip books are used to provide personal health education. The limitations of individual education are such that health education can be given to a very small number of people.
• – True, accurate, precise information that they adopt.

(2) Group Health Education :-

•  Our society is divided into different groups. This approach is effective in student groups, pregnant mothers’ groups, etc.
• – The topic of group teaching should be of interest to the group. Only then will they listen attentively. – Group teaching can be given with the help of visual, auditory, equipment.
• – Health education can be given to groups of students, pre school, children, ANC, PNC, body care, nutrition, industrial workers and special types of health education such as prevention of accident, nutrition etc. among children and elderly people.

There are two types of group health education

1. One-way method: In which there is no interaction of the audience with the group speaker or health education provider.

Ex. T :- Lecture method

2. Two Way Method: There is interaction between the audience and the group speaker or health education provider. Both have active participation.

Eg. Group discussion, seminar, symposium etc.

Q-4 Write short notes. Write short notes. (Any three) 12

a ) Advantages and disadvantages of home visit.- Write the advantages and disadvantages of home visit.

Advantages of home visit:

• (1 ) The nurse can get an idea of ​​the actual situation of the home and family.
• (2) Since family members have enough faith in our words, they are more interested in our programs at home and are more relaxed at home.
• (3) The social and economic background of the family home can be known. So that moral teaching can be given.
• (4) New health problems of the family can be known.
• (5) By meeting the family members, it is known whether they are taking advantage of the health services available to them or not.
• (6) It is an opportunity to see whether the services of other health agencies are available to the family or not.

Disadvantages of home visits:-

• (1) Home visits are time consuming and require time to travel to meet the needs of the people.
• (2) Health professionals do not have emergency equipment for emergency situations.
• (3) In many communities, visits create issues, raising questions about the safety of nursing staff.
• (4) Since home visits are provided, nurses are very much involved in the care setting. There is less control over things like clinic, noise, privacy, distractions etc.

b) Role of nurse in referral system. – Nurse’s contribution to the referral system.

• Make observations and collect information about the situation, factors related to the illness, etc.
• Identify the type of illness and its severity
• Provide immediate treatment care within its competence, standing orders and available resources.
• It is very important for every nurse working in a PHC/CHC or district hospital to have knowledge of the referral system Is. The patient for referral should be carefully selected
• The nurse should know his responsibility and limitations in the referral system
• Whenever there is an emergency, the first thing to do is to attend to the patient, save his life, then provide treatment as per the standing order and only then refer him/her.
• Before referring the patient, make all the entries in the record, including his/her provisional diagnosis, treatment given and the reason for the referral, along with a referral note
• If possible, Help in arranging transportation
• Consoling and guiding the patient’s relatives
• Finding out whether there are doctors and facilities available for the patient at the place of referral
• Whenever a serious patient is referred, provide him with necessary life-saving equipment such as oxygen cylinder, ambu etc.
• If necessary, accompany the patient and continue to provide care until he is stable
• Recording – Reporting of each work done

c) Process of communication.

Sender / Source: This person is the one who arranges the message. An effective communicator should have the following qualities: Its purpose should be clear. The message should be according to the needs and interests of the audience. The effectiveness of the message is seen based on its own social status, its knowledge and its vestige in the community.

Message: The message means the information that the communicator has that people want to understand and act on. A good message should always have the following things. The message should have a specific purpose. The message should be clear and understandable. The message should have an outline. The message should be time-sensitive and demand-driven. It should be based on the basis of need.

Coding: To convert information or ideas into code, for example, words, pictures, actions, etc., it is called coding. is

Channel of Communication: Channel is the medium of communication between sender and receiver. The whole communication is seen through its three media system such as interpersonal communication for example counseling and traditional media such as puppet shows, news etc. Apart from this, mass media such as radio, telephone, television, poster, film, video etc. Mass media can be used for a very large number of people. In the present high-tech era, mobile, email, voice mail, internet and blogs etc. can also be used as channels.

Receiver: In every communication, there must be a receiver. Without an audience, communication has no meaning, it is just noise.

Decoding: Opening the code is called decoding, which means that it gives meaning to the content that they have received.

Feedback: This is a flow of information from the receiver or audience to the center, which is the audience’s reaction to the message. If the message is not clear, then it is not acceptable, then the audience will reject it. The feedback system gives the center an opportunity to increase the acceptability of its message. Usually, feedback is taken through polls, interviews, surveys, etc.

d) Importance of nutrition in nursing –

Importance of Nutrition in Nursing

1. To maintain the health of the patient:
The main function of nutrition in nursing is to maintain the health of the patient. Providing proper nutrition increases the patient’s immunity, which makes the body more capable of fighting diseases.

2. Help in getting rid of diseases:
A good nutrition system helps the body recover faster. Generally, proper nutrition after surgery or serious illnesses speeds up the process of patient recovery.

3. Fulfilling the requirement of high nutritive value:
In the field of nursing, high nutritional value is required, especially for the elderly, children, and pregnant women (ANC). The nurse identifies minor nutritional deficiencies and advises on appropriate food.

4. Energy Supply:
Nutrition is very important to help the patient regain strength after illness or surgery. Protein, carbohydrates, vitamins, and minerals provide the body with the necessary energy.

5. Improve physical and mental health:
Getting the right nutrition improves mental and physical health. It reduces pain, stress, and fatigue, which allows the patient to recover better.

6. Prevention of diseases: Many chronic diseases such as diabetes, heart disease, and hypertension can be prevented by adopting good nutritional practices.

7. Building a healthy lifestyle

The nurse helps the patient improve their lifestyle by spreading knowledge about nutrition. She teaches the patient to choose healthy foods, be careful about eating, and adopt a balanced diet.

8. Nutritional use in treatment:
Some diseases like mal-nutrition, anemia etc. require special nutrition. Nurses help in improving the condition of the patient by providing special food and nutritional value in these diseases.

The importance of nutrition in nursing plays a very important role in the treatment and well-being of the patient.

Q-5 Define following (any six) Write the following definition. (Any six) 12

a) Cold Chain

• The process adopted to maintain the temperature of the vaccine from the point of production until it reaches the beneficiary is called cold chain.

b) Standing order Order

• When a health worker visits a home or goes to a school or industry, he can provide treatment in the absence of a doctor. The authority may provide treatment as permitted in these instructions. This instruction is given by the Medical Officer or Authorizing Committee and is called a Standing Order.

c) Noise

• The word noise comes from the Latin word noise, an unpleasant sound that disturbs the balance of human or animal life is called noise.

d) Epidemic

• Epidemic is a condition in which the number of cases of a disease suddenly exceeds the normally expected number in a specific area or community during a specified period of time.

Examples

• (Cholera)
• (Dengue)
• (Dengue)
• (Measles)

e) Balanced diet

• A balanced diet is a diet that includes all the nutrients needed for the body’s growth, development, energy production, and overall health in the right amounts. This diet should include a balanced intake of nutrients such as proteins, carbohydrates, fats, vitamins, minerals, and water. Proteins are essential for cell growth and repair, carbohydrates provide energy for the body, fats are important for long-term energy and cellular function, while vitamins and minerals support the immune system and are essential for metabolic processes. Adequate water is essential for hydration. A balanced diet supports the body’s growth and development, strengthens the immune system, and helps prevent chronic diseases.

f) Nutrition

• Nutrition is the process by which living beings obtain the necessary nutrients from food, which are necessary for their growth, development, energy production, and overall health. This process involves the ingestion, digestion, absorption, and metabolism of nutrients from food. The process of nutrition supports various physical functions of the body, such as cellular function, immune response, and tissue repair. Proper nutrition provides the body with nutrients such as proteins, carbohydrates, fats, vitamins, minerals, and water, which are essential for a healthy lifestyle and immune system.

g) Health

In 1948, the W.H.O. (World Health Organization) defined health as follows.

• ” Health is a state of complete physical, mental, social and spiritual well being and not merely an absence of disease or infirmity.

As per WHO

• “Health is a state of complete physical, mental, social and spiritual well being and not merely an absence of disease or infirmity.”

h) Health education

• Health Education is a process through which individuals and communities are encouraged to bring about positive changes in health-related knowledge, attitude and practice, so that they can maintain and improve their health and make appropriate use of health services as needed.

Q-6(A) Fill in the blanks – 05

1.WHO stands for …… WHO’s full name is …… World Health Organization

2.Vitamin C is also known as …… Ascorbic Acid

3.Child less than 1 year is called …… Infant

4.The causative organism of tetanus is …… The organism responsible for tetanus is ……. Clostridium tetani ( Clostridium tetani )

5.1 gm fat gives …… calorie. Nine kilocalories

B) True or False – Tell the truth. 05

1.Only immunization is provided in mamata clinic. False Correct Answer : Mamata Clinic not only provides immunization, but also provides other services like maternal and child health services, prenatal check-ups, nutritional guidance.

2.Oral pills are temporary family planning method. True

3.Month of June is celebrated as anti-malaria month. June is known as anti-malaria month. True

4.One ASHA is for every 1000 population. Every 1000 people have one hope. True

5.AIDS day is celebrated on 1st April AIDS Day is celebrated on the first of April. False Correct Answer : World AIDS Day is celebrated every year on 1st December, not on 1st April.

(C) Multiple choice questions – Write the correct option from the following. 05

1.The referral chain is – referral chain a ……

(a) Village-Sub center-PHC-CHC-State level

(b) Sub centre-PHC-CHC-Village-State level

(c) CHC-PHC-Village-Sub center-State level

(d) Village-PHC-CHC-Sub center-State level

2.BCG vaccine is given to prevent – BCG vaccine is given to prevent ……

(a) Tetanus

(b) T.B

(c) Pertussis

(d) Diphtheria

3.Which one of the following is not the component of physical environment……

(a) Air

(b) Soil

(c) Water

(d) Microorganism

4. Fat soluble vitamin is …..

(a) Vitamin B Vitamin B

(b) Vitamin B12 Vitamin B12

(c) Vitamin C Vitamin C

(d) Vitamin A Vitamin A

5.Normal BMI range is ……

(a) 19-25

(b) 17-19

(c) 16-17

(d) 18-20