Community health nursing 25/4/2024
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π A.Define health team – 03marks.
ANSWER:-
A health team is a group of many individuals who work together to maintain good health in the community and hospital in which each member of the team has different knowledge, qualifications, skills, abilities, personality. The health team consists of medical and Includes non-medical personnel who work in tandem. Which works according to the policies and rules applicable by the government.
Eg :- Health team of PHC including Medical Officer, Pharmacist, Laboratory Technician, Male Health Supervisor, Female Health Supervisor, Female Health Worker, Male Health Worker etcβ¦
π b. Write down objectives of community health nursing 0.4
ANSWER:-
π C. Discuss principles of community health nursing Write the principles of community health nursing. 05
Since community health nursing is focused on the community where nursing care is to be provided in the community, it is important to map and establish good and working relationships.
Providing care according to community and individual needs. Health programs and resources should address health problems
Working with doctors, female health workers, female health supervisors, multipurpose workers and other health workers in the community health team, nurses help in planning, evaluation of health programs, home visits, sanitation problems, nutritional problems, maternal and child health. To maintain and provide health education.
Health worker authorized, health authority responsible for each health worker. Each health worker is appointed by the state, municipality, local or private body or agency. A nurse who works in the area. He was observed to be in contact with the Public Health Authority
Planning and organization of one’s work should be done. All this is necessary to maintain harmony and cooperation in the health program. Because the health authority is held personally liable.
Health services should be available to people according to their age, caste, religion, nationality, social, political or economic status. Everyone should have good personal health and environment. Health workers should be non-political and non-partisan. A public health worker should not interfere with the national, religious belief of two people but she should be able to explain all other beliefs and manners of social affairs.
A public health worker should never accept any gift or bribe. But if some charges are fixed by the government for some health care, it should be taken honestly
Family and community are considered as a unit for working in public health work. Teaching is an important part of every health.
Periodic evaluation of nursing care provided in the community is very important for planning and progress of services.
Community health nursing requires a professional relationship and discipline with the community
There should be arrangements for guidance and supervision of public health nurse services
A systematic record and report of every work done in the community should be maintained
Providing continuous health services is effective.
Family and community are considered as a unit for working in Bleak health work. Teaching is an important part of every health.
Health should be met according to individual and convenience.
Other members who work with Village People. They can also help with health programs
A work schedule should be met for a fully satisfactory performance.
A person’s interest in the profession should be developed and maintained.
OR
π a. Family is a Unit of health, explain it – Explain that family is a unit of health. 03
The family is the unit when practicing health care in the community
Community health nursing practices depend on the type of family that can be identified by family members or family needs. This depends on how the family is represented as a unit in community health nursing services.
For any family, maintaining the standard of health or well-being of the family depends on the capacity of the family.
Health depends on the interplay between many outside and inside factors that will have a beneficial or detrimental effect on the family. Its full effect can be considered in terms of positive and negative attitudes over a period of time. Apart from this many issues are as follows.
(1) Family is a natural and basic unit of society.
(2) Corrects problems arising between family members and resolves them together.
(3) Family health problems are interrelated.
(4) Family cooperates in times of crisis.
(5) Family has limitations for health decisions and personal care.
(6) The family is an effective and available channel for many genuine community health nursing efforts.
π b. Write health assessment of antenatal mother- .04
Antinatal History :-
(1) General Health History :-
A complete prenatal examination including general history of the mother including tuberculous chlorosis, anemia and malnutrition, heart diseases, diabetes, sexually transmitted diseases, kidney diseases or any other complications.
(2) Family History :-
Inquiring about husband’s occupation, his health, age of future children and his health, whether there is any illness in the family or close relatives.
(3) Environmental and Social History :-
In which the type of house, how many rooms, from where they bring drinking water. Asking about how h disposes waste, personal hygiene, domestic hygiene, what kind of food he eats, etc.
(4) Past Obstetrics History :-
Inquiring about previous gynecological eg delivery including previous pregnancy, caesarean section, abortion, blood transfusion, ectopic pregnancy, etc. Toxemia of pregnancy etc.
(5) History of current pregnancy :-
(i) To collect data:
Including mother’s name, address, age, number of living children, age of the youngest child, date of LMP (Last Menstrual Period), E.D.D (Expected Delivery Date) thereof.
(ii) Whether the pregnancy is unwanted or not.
(iii) Whether the mother has persistent vomiting, headache, vaginal bleeding or discharge? Is the mother currently breast feeding the child?
(iv) What she takes in food.
(v) What daily work does.
(vi) Whether the mother can feel the movement of the baby etc. Antenatal
Take history and record it in Mamta card
(2) Prenatal Examination :-
Prenatal examination after hysterilisation of the mother including,
(1) Routine Examination:-
Including T.P.R, B.P, Height, Weight, Urine Sugar Albumin, Blood Group., Hemoglobin (Hb%), RH Factor, Stool Examination, VDRL Test- For Venereal Disease Syphilis Garnaria.
(2) Physical Examination
In this a head to toe examination is done. Eg: Facial puffiness3 (swelling) pallor (ficas), pitting edema on leg examination are all important to look for during facial exam.
(3) Obstetrics Examination:-
To see the baby’s position, presentation, if there is one or more babies, euthrasma and any other abnormality. This examination also includes a pelvimetry exam. Also an abdominal exam including inspection, palpation and auscultation is done for fetal heart sound. Inspection of the vulva and vaginal examination are performed.
π C. Describe the routes of transmission of disease. 05
Pathogen through which it enters from one person to another is called transmission of infection. It has two types,
(1) Direct transmission
(2) Indirect transmission
(1) Direct transmission of infection
(i) Through actual body contact :-
Due to skin to skin contact, contact with the body of a person who is discharging an organism from a patient, another person who has cuts, abrasion, the organism can easily enter that person.
ii) Through infected hands
Human hands come in contact with another person or environment, they come in contact with faecal matter. Harmless staphylococcus and streptococcus are permanently on hand. But many times Pathogen also comes to hand. D. T. While handling the host’s urine, body secretions or fecal matter, a person acquires a pathogen in his own body or in another person’s body. Intestinal and respiratory tract diseases are spread by infection hands. Therefore, direct handling of infection materials should be avoided
E.g. Trachoma, Gonorrhoea and Syphilis are spread by direct sexual intercose.
iii) Trough Droplets:- A person also acquires infection by inhaling the droplets released by coughing, laughing or sneezing from the speaking of an infected person. The pathogen of Diphtheria, influenza, T.B., Whooping cough, Measles, Mumps is in nasal discharge or saliva.
(iv) Trough Contaminated fomites :- Diphtheria, Trachoma, Small pox, Measles, Pneumonia etc. are spread through eating or drinking utensils, handkerchiefs, towels, clothes, Sputum cups etc. Respiratory, digestive and skin infections also spread from beddings, clothes etc. v) From mother to fetus:- (Before birth, congenital inf.) Pathogen can pass from mother to fetus through very thin tissues between mother and fetus. Hence baby is born with infection. E.g. Syphilis, Aids, measles (vi) Through laboratories + hospitals:- If aseptic techniques are not used with caution, the infection can be acquired from laboratories or hospitals. Syphilis, Viral hepatitis, Aids etc. are examples of it. Indirect infection is transmitted from one person to another. And transfer time is usually long. i) Through contaminated water and sewage :-
As domestic or industrial waste is mostly mixed in the well, lake or river, it is polluted-infected. The pathogen in it enters a person’s body by drinking or using it and causes infection. Since the sewage system adopted there is not safe, infection can also be transferred from it.
As a result of dumping raw sewage into water, many water born diseases occur.
Examples are Amoebic dysentery, Typhoid, bacillary dysentery etc.
ii) Through food other than milk Food can be infected in different ways. Even today in many parts of the world, polluted water and manure (animal waste) are used for agriculture. Typhoid bacilli and other pathogens and hookworm, round worm can spread in such soil. Anthrax and tetanus spores can survive in soil for a long time.
iii)Utensils:- Utensils used in the kitchen may be contaminated with rat faeces. Insects like flies and cockroaches contaminate food.
Milk and water:- Both these elements are used in the preparation of food. Since Jaina is infected, the infection can be transmitted.
Many different substances are made from infected milk. Hence, milk provides a major means of infection transmission. It is difficult to get milk bacteria free even after taking great care. Many bacteria live permanently in the milk duct and tears.Contaminate containers, atmosphere and flies also do their work. (Streptococcus lactis is responsible for curdling milk.) Bacillary dysentery, typhoid are examples of this. T.B. and Brucellosis spread through the milk of infected cow. (4) Through Air :-
Organisms spread through air. Pathogens from soil, water and human excreta also mix in the air. These germs exist in the air as droplets or dust particles. It causes infection by breathing in a person.
Diseases like Pul kochs, diphtheria spread. That his infection is transmitted.
These droplets often settle in floors, clothes, beddings, uncovered food and milk.
5) Through vectors :-
Insects such as mosquitoes, flies, fleas, mites and ticks Arthropods transmit infection from one person to another or from animal to human. They are carriers.
They spread by skin inoculation or biting or by depositing infected material on food.
Vector infections are mostly seen in warm climates because there are a large number of insects and infected humans or animals. Vector diseases are transmitted in two ways.
Diseases caused by bacteria are mechanically transmitted.
Insect all flies, cockroaches etc. get food from faeces. As their feet get infected, they deposit infected agents on food.
Biological transmission :-
In the spread of Malaria, Filaria, Yellow fever, Plague, micro-organisms multiply in the insect vector (plague bacilli in Rat flea) and complete the development cycle in the body of the vector.
Q-2 Define epidemiology and explain spectrum of disease 08 marks.
The study of the distribution and determinants of health-related conditions in a specified population and the use of these studies to control for health-related problemsβ β¦β¦β¦β¦β¦.John M. Last (1988) )
Or
“Epidemiology is the study of diseases that occur in large numbers”
Green Wood (1934)
Spectrum of Disease
According to the severity of the disease, the signs and symptoms of the disease are more or less, i.e. less in one person and more or more in another. This concept is known as spectrum of disease. Which can be seen as below.
(1) Sub clinical : which can be treated in clinic.
(2) Mild case :– Which can be cured by taking medicine at home.
(3) Moderate :– which has moderate severity of disease
(4)Severe :– having a severe condition, which can infect others and is more harmful. He should be kept under close observation.
(5) Death: This includes patients with a fatal diagnosis. It is necessary to do hospitality. So that efforts can be made to save their lives in the hospital.
Any one disease is very mild in one person and very severe in another person, while in some persons the disease remains in subclinical stage and in others it is very much. In which subclinical and mild cases spread communicable disij than other caches. Thus considered more harmful.
b) Write down functions of ASHA. 04
Health Education
To create awareness in the community and provide health education to the community about health, nutrition, personal hygiene and sanitation
M.C.H and family planning services provided
Advise the woman on safe pregnancy, delivery, breastfeeding and complementary feeding and prevention of common infections including vaccination, contraception and reproductive tract infections and care of the young child. Advise the woman to adopt small family norms.
Necessary medicines were given
Depot holder for essential medicines like ORS, iron and folic acid tablets, chloroquine tablets, oral pills, condoms and disposable delivery kits.
First aid given
Provides primary medical care for minor problems such as fever, diarrhea and first aid.
Referral Service
Mobilize the community to seek health services at sub-centres and primary health centers to provide the treatment required to pregnant women etc.
Health Program
Participation in National Health Programme. DOTS therapy administered
Vital Statistics:-
Inform about births and deaths in the village and outbreaks of unusual health problems to the sub-centre and primary health centre
Sanitation
Promote the use of household toilets under the Purana Swachhata Abhiyan It will formulate a village health plan comparable to the village health and sanitation committee of the village panchayat.
OR
π a) List out the indicators of health and write advantages of health indicators .08
There are many indicators of health according to different concepts of health
Indicators influence health directly or indirectly
Mortality indicator
Morbidity indicator
Disability Indicator
Health Policy Indicators
Health Care Delivery Indicator
Mortality indicator
Morbi DT Indicator
Disability Indicator
Health Care Delivery Indicator
Health Policy Indicators
Social and Mental Indicators
Socio Economic Indicators
Nutritional Status Indicator
Utilization rate indicator
Environmental Indicators
An indicator of quality life
β£ Advantages of Health Indicator :-
To know the health level of the community
To compare the health status of a country with another country
To assess the need for health care services
To make necessary use of resources
Health indicators are very necessary to assess the performance of whatever health services are being provided, to set targets and to evaluate the performance.
To take proactive steps
To know the probability and prognosis of a disease in a population
Which health program is needed in the country and can be evaluated after its implementation
Convenience in working with target
For monitoring health services, programs and activities
b) Write dowa prevention and control of malnutrition in community .04
Rickets, goiter, anemia, beriberi, pellagrana, scurvy, etc. are nutritional diseases.
A. Family Level Prevention
In which encourage exclusive for infant from four to five years
Add additional nutrients to food supplementation at four to five years of age
Offer the family nutritious foods like milk, eggs, etc. according to their biological value.
Distribute equally nutritious food to both males and females
Malnutrition can be prevented by providing nutritional care to the mother beforehand during ANC and PNC visits
Lone formal health education can be given to full s children and latest mothers
Early diagnosis and intervention of malnutrition
To promote family planning
To make efforts to increase income
To try to make food available to children and mothers through ICDS
Iodine salt vitamin anthocometric examination especially of children whose height mid am circle
See Head Circumference Height and Weight
B. National Level Prevention
Planning implementation and evolution of nutritional programs
Construction of Krishna Rehabilitation Centre
Developing nutritional intervention programs such as distribution of iron and folic acid to children and pregnant mothers for anemia control
Creating a strategy for good nutritional supplementation
Rural Development and Population and Stabilization
To conduct diet and nutrition surveys
To know the extent of the problem as well as to know its character and nutritional surveillance etc
Q.3 Write short answer any two) 12
π A.Write down advantages and disadvantages of home visit.
Advantages of home visits:
Disadvantages of Home Visit :-
b) Describe millennium development goal.
Millennium Development Goals (MDGs)
π c) Exposin purification of water at large scale.
Large-scale water purification can be done by sand filtration. This filtration is of two types, namely slow sand filtration or biological sand filtration. 2) Rapid sand filtration or mechanical sand filtration.
In this the raw water is first purified, it is stored in the settlement tank for two days and in this short period of time, a large amount of water is purified and 90% of the impurities are removed from it. This happens naturally. Anxiety is reduced.
In the second stage, this water is introduced into a slow sand filter called the filter bed. This bed is structured like this from top to bottom
It has 1.4 meters of water, 1.2 liters of fine sand, and 0.4 meters of large pebbles.
Sand is the main filtering medium in the sand bed. Its thickness is 1.2 m. At the bottom, there is sand, which is a layer of sand that supports the sand bed. At the bottom of the send bed, there is a pipe with holes through which the filtered water is collected. There are many other mechanisms responsible for purifying the water through the filter, which is as follows:
All these things play their small part in water purification but the important part is above the send bed or jugular layer or vital layer. This is a thin and sticky layer which contains many types of alkali protozoa and bacteria. This layer takes two to three days to form. It takes time for the vital layer to destroy harmful bacteria through the slow layer and the water becomes 98% pure, so it is not necessary to use the filtered water on the new send bed until the vital layer is ready. 2+ in slow sand filtration 03 million gallon water filter can filter 2 gallons of water every 1 hour. If the thickness of the vital lamer on the filter bed increases, water cannot be properly filtered from it and the amount of filtration decreases.
The capacity of the filter bed decreases after a few weeks or days. Which is called loss of bed. When this amount exceeds 4 feet. Water filtration is not beneficial. In this case, from the upper part of the vital layer. As much as 2 to 3 am is scratched. This scratching action is called cleaning the filter. Which should be done frequently in bed. When the thickness of the sand bed is reduced to 30 to 40 cm, it is closed. And after constructing the bed, the process is restarted. The main disadvantage of slow sand filtration is that it requires frequent bed changes!
Note :-Rapid Sand Filtration (Read from Paper-1)
π D) Write down principles and methods of cooking
Following are the different methods used to cook food.
(1) Boiling:-
Water is heated to 100* C. Grades are boiled and food is cooked in it. Dal, rice, vegetables, pulses, tubers and other vegetables are prepared by this method.
As water is used more in this method, vitamins and salts are destroyed. So enough water is used in the boiling method.
(2)Steaming:-
In this, food is cooked with hot steam. A pressure cooker works on this principle. It has more steam than a pressure cooker. It retains all the nutrients. This saves time and fuel. So this method is excellent.
(3) Faying (Palate) :-
Inside this, thepla, dosa, all kinds of pudla, are made by drying oil. Similarly, puri, bhajiya, vada, kachori etc. can also be fried in oil.
(4) Rousting
Made with little oil or ghee. After that it is placed on direct heat. Chicken is prepared by this method. This method is also good.
(5) Baking
In this food is cooked by dry hit. An oven is used to cook food through its hot air. This method is good. Biscuits, breads and cakes are made in it.
(6) Grilling
In this, dry heat is used to cook food by heating it on a metal grate.
Q.4 Write short notes. (any three)
a. Kitchen garden –
Advantages of kitchen garden:-
π b. Importance of records and reports –
π c) Determinants of health –
Determinants of health:
Environment determinants political system
Biological determinants Behavioral determinants
Socio economic determinants of health care delivery system determinants
β² Environmental determinants:
The environment has a direct impact on the health of individuals, families and communities.
Both external and internal environmental factors influence our health.
Air, water, noise, radiation, housing, waste management etc. all affect health status and quality of life.
β² Political System:
The political system has a great impact on the social environment we live in. No health program can be implemented properly without strong political.
Socio-political environment, economic development, law and order, public health regulation and good level of performance.
β² Biological determinants:
Hereditary and genetic determinants affect physical and mental retardation, metabolic disorders, chromosomal abnormalities etc. which are of genetic origin. It is the nurse’s responsibility to provide proper genetic counseling to those at risk of being genetically impaired.
β² Behavioral determinants
Health is a mirror of a person’s lifestyle. Because defects and bad habits have an adverse effect on a person’s health.
Community health nurses must be aware of patient or individual behavior patterns to improve their health status.
Risk-taking behavior based on carelessness and misconceptions affects people’s health.
β² Socio Economic Determinants
Socio economic status has a major impact on the health status of any country. Education, economy, occupational opportunities, housing, nutritional level of per capita income etc. determine health care system and health resources.
β² Health or delivery system determinants
Health care delivery system plays a major role in the field of health. Equal distribution of facilities, emphasis on acute care, availability of health personnel in rural areas, inadequate referral services, lack of resources etc. determine the health status of individual family and community.
π d) Classification of Minor ailments –
Minor ailments can be broadly classified under two minor headings:
(1). General minor ailments:
It includes common accidents and emergency conditions that require immediate primary care.
In this category, injuries and fall down, fracture, burns, dog bite, high fever, heart stroke, diarrhea, fainting etc. Included.
(2). Systemic minor ailments:
It includes diseases that affect various body systems.
Some of them are listed here as follows:
Systemic minor ailments:
Eyes:
Eye accident, foreign bodies, infections, poor eye sight, dry eyes, blindness, etc..
Ear:
Earache, foreign body in ear, otitis media, discharge from ear, temporary deafness, etcβ¦
Respiratory Tract:
Allergic rhinitis/common cold, sinusitis, sore throat, cough, dyspnoea, chest pain, asthmatic attack, etcβ¦
Cardiovascular system:
Hypertension, anemia, Rheumatic heart
Disease, etc..
Digestive system:
Toothache, stomatitis, soreness in mouth, constipation, diarrhea, indigestion, vomiting, abdominal distension and pain, intestinal obstruction, haemorrhoids, etc..
Urinary system:
Burning micturition, retention of urine, urinary infection, renal stones.
Neuromuscular system:
Headache backache, convulsions, epileptic fits etc.
Reproductive system:
Dysmenorrhoea, heavy bleeding, sore and discharge from genitals, breast pump, etc.
Along with the above ailments, behavioral problems like maladjustment or emotional disturbance etc. can also be included in the category of minor ailments.
All these require proper diagnosis and proper management.
π E.) Methods of health education
(1) Personal Health Education:-
Doctors and health workers provide health education in person when a person is admitted to the hospital and after discharge from the hospital.
(2) Group Health Education :-
Our society is divided into different groups. This approach is effective in student groups, pregnant mothers etc.
There are two types of group health education
ex. :- Lecture Method
ex. Group Discussion, Seminar, Symposium etc
Q.5. Deline following any six)
π A. Disease
It is a pathological process that affects body health with specific signs of abnormality in body function.
π b) Pandemic
Pandemic means any disease that spreads from one state to another state and from one country to another country and is seen all over the world is called a pandemic for example swine flu covid 19 etc.
π c) Fomite
Infected person is also infected with the used items like worn clothes, used utensils furniture etc. which can spread the infection which is known as fomites.
π e) Kilocalorie –
The amount of heat energy required to raise the temperature of one kg of water by 1*C is called kilocalorie
π f) Cold chain –
“The system of storing and transporting the vaccine at low temperature from the place of manufacture of the vaccine to the actual vaccination or to the beneficiary is called cold chain”.
π g) Communication –
Communication is a process in which two or more persons exchange or share their ideas, suggestions and feelings i.e. exchange of ideas is called communication.
Q-6(A) Fill in the blanks. 05
π 1. Deficiency of vitamin c causes disease. disease.
Answer:- Scurvy
π 2. diet is given to peptic ulcer patient.
Answer:-Bland Diet
π 3.B M.I stands forβ¦β¦.
Answer:-Body Mass Index
π 4 Another name of chicken pox is
Answer:- Varicella
π 5.Oral pills are method of family planning.
Answer:- Hormonal Temporary Method (Hormonal Temporary)
Answer:- Temporary Hormonal
π (B) Match the following –
A B
(A) Dehydration (A) Home visit
(B) Eradication (B) Hydrogen
(C) Sputum slide (C) lodine
(D) Bag technique (D) Diarrhea
(E) Gaiter (E) Elimination
(F) Leprosy
(G) Tuberculosis Tuberculosis
Answer:-
(A) Dehydration β (D) Diarrhea
(B) Eradication β (E) Elimination
(C) Sputum slide β (G) Tuberculosis Tuberculosis
(D) Bag technique β (A) Home visit Home visit
(E) Goiter β (C) lodine
(C) Multiple choice questions Write the correct option from the following
()
π 1. Best source of iron is the best source of iron
(a) Milk
(b) Rice
(c) Wheat
(d) Jaggery
π 2. Inflammation of tongue is known as
(a) Mastitis
(b) Gingivitis Gingivitis
(c) Glossitis
(d) Stomatitis
π 3.Coloum is essential for the formation of – Calcium is essential for the formation of this
(a) Bones
(b) Kidney
(c) Spleen
(d) Liver
π 4.Fat soluble vitaminis are fat soluble vitamins
(a) Vitamin C
(b) Vitamin A
(c) Vitamin B1
(d) Vitamin B12
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