GNM-F.Y-CHN-1-F.Y.- 2018 -PAPER SOLUTION

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) The 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.

🔸b. Write the health assessment of antenatal mother. 04 –

Antinatal History :-

(1) General Health History :– General history of mother including complete prenatal examination including tuberculous closis, 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, ages of future children and his health, whether there is any disease in the family or near relatives.

(3) Environmental and Social History :– Including type of house, how many rooms, where drinking water is brought from. 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 deliveries, caesarean section, abortion, blood transfusion, ectopic pregnancy, etc. toxemia of pregnancy etc.

(5) History of current pregnancy :-

• (i) To collect data : Name, address, age of mother, number of living children, age of minor 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) Take the antenatal history whether the mother can feel the movement of the child etc. and record it in the Mamta card.

(6) Prenatal Examination :– Prenatal examination after hysterilisation of the mother in which,

(7) 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.

(8) Physical Examination:- Head to toe examination is done in this. Eg: Facial puffiness3 (swelling) pallor (ficas), pitting edema on leg examination are all important to look for during facial exam.

(9) Obstetrics Examination:- To see the position of the baby, presentation, if there is one or more babies, uterus 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.

🔸c. Describe the direct transmission of disease. 05

• (1) Direct contact :- Some diseases are transmitted from one person to another by direct contact. E.g. Kissing, sexual contact, contaminated cloth. Diseases which are caused by direct contact. It includes STDs like Syphilis, Gonorrhea, AIDS etc. Skin diseases etc. are also calculated.

• (2) Droplet infection :– Coughing, sneezing, saliva etc. contain large amount of bacteria which are spread in the environment through respiratory tract. These micro-organisms enter the body through a person’s breath and cause disease. Common cold, whooping cough, tuberculosis, diphtheria etc.

• (3) Through direct contact of soil :- Infection is also spread through infected soil. eg tetanus.

• (4) By direct entry through the mucosa of the skin :– Micro-organisms also spread infection by entering directly through the mucosa of the skin. Dat. Rabies caused by dog ​​bite. Hepatitis-B etc. caused by inoculation of contaminated needle.

• (5) Vertical transmission :- Diseases are transmitted from mother to child during intra-uterine life through placenta of mother, which is known as vertical transmission, Dat. Rubella, toxoplasmosis etc. are spread in this way.

OR

🔸 a. Write the diseases spread by mosquito, 03

• Malaria
• Filaria
• Dengue
• Yellow fever
• Chikungunya
• Zika virus
• West Nile virus
• Japanese encephalitis

🔸b. Write the functions of primary health center. 04 –

• The functions of Primary Health Center are as follows
• According to Alma Ata, PHCA is as follows
• There are tasks to be done.

• (1) Medical Care :– In this, the patient is treated according to the disease in which injections or drugs are used, apart from this, preventive, promotive, curative treatment is given and minor diseases are treated.
• (2) M.C.H. Service and Family Planning:– Maternal and child health care which includes all services of child health from antenatal period to immunization, antenatal checkup, post natal checkup, nutrition etc.
• (3) Safe Water Supply and Busy Sanitation:– Chlorination of wells, running sanitation programs etc. to provide safe water for people to drink.
• (4) Prevention and Control of Locally Endemic Diseases:– It is important to control the diseases that are frequently seen in the community.
• (5) Collection and Reporting of Vital Statistics:– Collection and reporting of vital statistics like birth, death, delivery, notification of epidemic disease etc.
• (7) National Health Programme:- The implementation of each health program is done from the primary health center itself, such as participation in school health programme, malaria, filariasis, leprosy, tuberculosis, AIDS etc.
• (8) Provision of referral services.:- Provision of referral services as required.
• (9) Training of health guides, health workers and health assistants.:- Facilitation for training of health workers.
• (10) Providing basic laboratory services:- Providing basic laboratory services like hemoglobin test, urine test, blood smear for malaria etc.

🔸c. Write the principles of home visit.. 05

The principles of home visit are as follows.

• (1) Planning should be done according to the needs of the people. Eg: A certain area has some kind of health problem. Accordingly, it should be according to the health need.
• (2) Accurately collecting all the information of the family as well as general information of the community. In which to ask about family size, income, religion, customs etc.
• (3) Being sensitive to the person’s feelings and needs during the visit.
• (4) Always use nursing procedures safely and with technical skill.
• (5) Giving more importance to quality than quantity of work.
• (6) Approach with family should always be polite and trusting should

▶️Q.2 🔸a. Define community and explain the principles of community health nursing- 08

The definition of community is as follows.

Community means a society in which a large group of people living in a certain geographical area provide their basic needs, such a group includes women, men, youth, children etc. and they have different attitudes and have different beliefs and religions. The community says.

Principles of Community Health Nursing:

The principles of community health nursing are as follows.

1. Since community health nursing is focused on the community, mapping out and establishing good practice guidelines for where nursing care is to be provided in the community.
2. Providing care according to community and individual needs. Health programs and resources should address health problems
3. 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 Maintaining child health and imparting health education.
4. Health worker authorized, health authority is 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 should 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.

5. Health services should be available to people according to their age, caste, religion, nationality, social, political or economic level. 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.
6. 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
7. Family and community are considered as a unit for working in public health work. Teaching is an important part of every health.
8. Periodic evaluation of nursing care provided in the community is very important for planning and progress of services.
9. Community health nursing should maintain professional relationship and discipline with the community

10 There should be arrangements for guidance and supervision of public health nurse services

11. Regular record keeping and reporting of every work done in the community should be carried out.
12. Providing continuous health services is considered effective.
13. Family and community are considered as one unit to work in Bleak health work. Teaching is an important part of every health.

14 Health should be met according to individual and convenience.

15. Other members who work with Village People. They can also help with health programs
16. Agenda should be received for fully satisfactory performance.
17. One’s interest in the profession should be developed and maintained.

🔸b. Write the function of ASHA. Write the works of hope. 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: Counsel 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. Counsel the woman to adopt small family norms.

• Supply of essential medicines: Depot holder for essential medicines like ORS, iron and folic acid tablets, chloroquine tablets, oral pills, condoms and disposable delivery kits.

• First aid administered: Provides primary medical care for minor problems like 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 Programme: Participation in National Health Programme. DOTS therapy administered

• Vital Statistics:-:Provide information about births and deaths in the village and outbreaks of unusual health problems to sub-centres and primary health centres.

• Sanitation: Promote the use of household toilets under the Complete Sanitation Campaign It will formulate a village health plan comparable to the village health and sanitation committee of the village panchayat.

OR

🔸 a. Define epidemiology and write the spectrum of disease. . 08

Definition of Epidemiology:

“The study of the distribution and determinants of health-related conditions in a specified population. Using this study to control health-related problems” …………….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 person. 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 the immunization schedule up to one year of child. 04 –

▶️Q.3 Write Short Answers (Any Two) 6×2=12

🔸 a. Write the advantages and disadvantages of home visit.

Advantages of home visits:

• (1) The nurse can understand the actual situation of the home and family.
• (2) As family members have enough faith in us, they are more interested in our program at home and more relaxed at home.
• (3) The social, economic background of the family house can be known. So moral measure can be given good teaching.
• (4) New health problems of the family can be known.
• (5) avails health services available to him by visiting family members
• No it is known.
• (6) An opportunity to see whether the services of other health agencies reach the family.

Disadvantages of Home Visit :-

• (1) Home visits are time-consuming, requiring time for traveling to meet the essential needs of the people.
• (2) Health professionals do not have emergency equipment for emergency situations
• (3) In many community visits there are issues of safety of nursing staff.
• (4) As home care is given, the nurse has very little control over the care setting eg clinic, noise, privacy, distraction etc.

🔸b, Describe Millennium development goal.

Millennium Development Goals (MDGs)

• [1] Eradicate extreme poverty and hunger.
• [2] Achieve universal primary education.
• [3] Promote gender equality and empower women.
• [4] Reduction in infant mortality.
• [5] Improved maternal health.
• [6] Fighting HIV/AIDS, malaria and other diseases.
• [7] Ensure environmental sustainability.
• [8] Global Partnership for Development.

🔸c. Explain 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:

• 1) mechanical
• 2) Sedimentation
• 3) Absorption
• 4) Oxidation of impurity
• 5) bacterial action

All these things play their part in water purification. But the important part is above send bed or jugular layer or vital layer. This is a thin and sticky layer. It contains many types of alkali protozoa and bacteria. It takes two to three days to form this layer.

The vital layer is destroyed by the slow layer of harmful bacteria and the water becomes 98% pure, so it is not necessary to consume the filtered water on the new send bed until the vital layer is ready. In slow sand filtration, 2+03 million gallons A 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 started again. The main disadvantage of slow sand filtration is that it requires frequent bed changes!

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

🔸d. Write the principles of cooking, food.

• 1) Meals should be nutritious as far as possible. “
• (r) Avoiding fried foods for meals as far as possible.
• (3) Cook vegetables after washing them well.
• (4) Keeping vegetables in a covered vessel.
• (5) Eat fresh vegetables daily.
• (6) Use sprouted beans as much as possible.
• (7) Do not discard the leaves of vegetables like radish, onion and use them in food. (
• 8) Use more sardha leaves and flowers than sardha seeds. Because it is more nutritious.
• (9)Rice should be added to the rice or poured into dal or used as a vegetable stew.
• (10) Oil once used for frying should not be used for frying again.
• (11) One should always keep one’s fingernails trimmed while cooking food.
• (12) Hands should be washed with soap water while cooking.
• (13) After cooking, cover all the cooking properly and put it on gas.
• (14) Cooking should not be wasted.
• (15) Always proportion the cooking so that it does not have to be used again in the evening,
• (16) Food should always be rotated so that eating is enjoyable.
• (17) Do not cook if the cook has contracted an infectious disease like measles, eczema, shingles.
• (18) A cook should always keep his hair tied
• (19) A cook should always wear an apron.

▶️Q.4 Write short notes. (Any Three) 4×3=12

🔸 a. Kitchen garden Kitchen garden

Kitchen Garden:- Kitchen garden can be made by raising plants required for kitchen in the yard of the house. A kitchen garden can be made near the kitchen and wherever there is open space.

• It should be close to home and where it can be easily taken care of.
• There should be a system where water can flow.
• There should be a wire fence around the garden.
• There should be a system of gardeners to preserve the garden.

Advantages of kitchen garden:-

• (1) Use of time
• (2) Atmospheric nature is maintained.
• (3) Obtainable in vegetables in quality and quantity,
• (4) Increases in the adornment of the house.
• (5) Economic condition of Dhar should be maintained.
• (6) The interest of the members of the household can be known.
• (7) The diet of the family is improved.
• (8) Unhealthy disposal of kitchen waste and water.

🔸 b. Importance of Records and Reports.

• It is an effective medium for communication,
• Helps to provide good service to individual and family and community
• Time and energy can be saved.
• Health workers can plan their work and use their time effectively.
• It can be used as a medium of health education. eg for growth
• Useful for research.
• Nurses are useful in long term and short term planning for health.
• Useful for evaluating the care and teaching provided by nurses themselves,
• The doctor is informed of the progress of the disease, usually through a record that is maintained. Its working method
• To diagnose the health condition of the family and give an accurate judgment
• Records provide legal protection
• Through the medium of record, one can understand whether the treatment is being given correctly and acts as a guide between the health worker and the patient.
• Every employee is aware of his responsibility through the record
• To get information through anything recorded from the past

🔸c. Determinants of health, criteria of health.

Many factors affect health, including the society in which a person lives.

(1) Biological Determinants :–:The physical and mental health of an individual depends on the genes inherited by him. Many diseases are hereditary. Like diabetes, hyper tension mental retardation etc.

Healthy genes are an important factor in good health. Apart from this, viruses, bacteria, animals, etc. around a person also affect the health of a person as an agent of diseases.

(2) Behavioral and Socio-Cultural :-How a person behaves with family and society. It also affects health. Cultural and behavioral patterns and personal habits like smoking, alcoholism, etc. also affect health. A person’s parents, group, friends and mass media etc. also affect the life style. A healthy lifestyle is essential to stay healthy. Many problems are related to a person’s lifestyle. Eg: Coronary heart diseases, drug addiction etc…

In India, where there is a traditional lifestyle, poor sanitation, poor nutrition, poor personal hygiene and customs and habits are responsible for illness and death.

(3) Environmental :–:These are internal and external. Internal environment means body part, cell. TSU etc. while external environment includes physical, mental, sociological.

It is a fact that environment is directly related to physical, mental and social well-being. These three are interrelated when we talk about the health status of the population. If the environment is suitable then the physical and mental strength of the person develops.

(4) Socio-Economic Condition :–: This is an important factor affecting human health, the health status of most people of the world can be known from their Socioeconomic condition. Nutrition, housing, education and politics system of the country,

(1) Economic System:-: Economic progress in most developing areas has reduced morbidity and increased life span, and improved quality of life while improving their purchasing power, living conditions. The economic level of the people is determined based on how they live, the quality of life.

(2) Education : This is another important factor affecting health status. In a world where poverty, malnutrition, and high infant and child mortality rates are high, ignorance is high: this also affects health,

(3) Occupation: People who have no occupation cause health or death. Loss of work leads to reduced income, which reduces social status and causes psychological and social damage.

(4) Political Health System: Health is also associated with the political system of the country. Political reasons are more responsible than technical ones for the implementation of health technology.

(5) Health and Family Welfare Service: Health and Family Welfare Service The purpose of health services is to maintain the health of the people by maintaining the health of the individual as well as the community, treating people and preventing illness. E.g. Immunization of children protects against smallpox.

(6) Population: 2/3 of which people will be in developing countries. Most of them are in good health, but rapid population growth and chronic diseases and disabilities require special attention.

(7) Gender (caste):–Since 1990, more attention has been given to females. Since 1993, there has been a greater awareness of women’s health in making policies related to women’s health, such as nutrition, reproductive status, etc. Also every plan related to its development was given importance

8.)Other Factors: We know that information and communication technology has come a long way. Due to this revolution people can get medical information easily. In this, the services of rich physicians, health professionals, biomedical, scientists and researchers from all over the world are availed to the public through mass media. Other health care systems also play a very important role in maintaining the health of people

🔸d. Classification of minor ailments. Classification of Minor Illnesses

Minor illnesses are classified in two main ways

1. General illness
   Including accidents and emergencies requiring immediate first aid like falls, dog bites, burns, heat stroke, diarrhea and dizziness etc.
2. Systematic Minor Illnesses

Eye

• I accident
• Foreign body
• infection
• Dry eye
• Night blindness

Ear

• Ear pain
• Discharge from ear
• Foreign body
• Otitis media
• Deafness

Respiratory Tract

• Allergic rhinitis
• Common cold
• Sore Thront
• Cough
• Chest pain
• Asthma

Cardio Vascular System

• Hyper tension
• Anemia
• RHD

Digestive system

• Diarrhea
• Vomiting
• Constipation.
• Tooth one
• Somatitis
• INDIIGATION

Urinary system

• Renal stone
• Burning maturation (burning in urine)
• Retention urine
• Urinary infection

Neuromuscular system

• Head one
• Back one
• Convulsions

• Reproductive system
• Dysmenorrhea (pain in period)
• Discharge
• Breast lump

🔸 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.

• Health education can be given when the patient comes for treatment of his illness.
• Personal hygiene can give an understanding of the treatment and prevention of diseases.
• Public health nurses provide health education and discussions in person at homes. And gives true understanding.
• Flip books are used to provide personalized health education. The limitations of personalized education are such that health education can be imparted 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 etc.

• The subject of group teaching should be of interest to the group. Only then do they listen carefully. – Group teaching can be given with the help of visual, audio, equipment.
• Student, pre school, children, ANC, PNC, body care, nutrition, industrial workers group and special type of health education can be given to children and elderly like prevention of accident, nutrition etc.

There are two types of group health education

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

Da. T :- Lecture Method

2. Two way method: There is audience interaction with the group speaker or health education provider. Both have active participation.

Da. T. Group Discussion, Seminar, Symposium etc

▶️Q.5 Define the following (Any Six) 6×2=12

1.Disease: It is a pathological process that affects body health with specific signs of abnormality in body function.

2. Communication-: Communication is a process in which two or more persons exchange or share their thoughts, suggestions and feelings i.e. exchange of ideas is called communication.
3. 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.
4. Cold Chain: The process adopted to maintain the temperature of the vaccine from where it is produced till it reaches the beneficiary is called cold chain.
5. K-calorie–The amount of heat energy required to raise the temperature of one kg of water by 1* C is called kilo calorie.
6. Isolation: To prevent the spread of infection in the community, the system of isolating an infectious patient for as long as he is capable of spreading the infection is called isolation.
7. Carrier – Carrier means those who carry the pathogen have the presence of the pathogen inside them but some of them do not show any sign symptoms of the disease but can infect another person who is called carrier.
8. Community Health Nursing: Community health nursing is a special light field of nursing that focuses on the health of the individual, family and community that provides preventive, promotive and curative care in the community.

▶️c . Mateh the following Connect the following links

“A” “B”

a. .dehydration i. tuberculosis

b. Eradication ii. home visit

c. sputum slide iii. lodine

d. bag technique iv. diarrhoea

e. goiter v. elimination

Answer :-

a. .dehydration iv. diarrhoea

b. eradication v. elimination

c. sputum slide i. tuberculosis

d. bag technique ii. home visit

e. goiter iii. iodine

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