COMMUNITY HELTH NURSING -II Seventh Sem

o    Abdominal pain

o    Nausea and vomiting

o    Diarrhea

o    Constipation

o    Jaundice

o    GI bleeding

o    Abdominal distension

o    Dysphagia and dyspepsia

o    Aphthous ulcers

Unit 1: Management of Common Conditions and Emergencies including First Aid

1.1.

Standing Orders

17

1.2.

Screening, Diagnosing/Identification, Primary Care and Referral of Gastrointestinal System

19

1.2.1.

Abdominal Pain

19

1.2.2.

Nausea and Vomiting

20

1.2.3.

Diarrhoea

23

1.2.4.

Constipation

25

1.2.5.

Jaundice

26

1.2.6.

GI Bleeding

31

1.2.7.

Abdominal Distension

34

1.2.8.

Dysphagia (Difficulty Swallowing)

36

1.2.9.

Dyspepsia

38

1.2.10.

Aphthous Ulcers (Canker Sore)

40

1.3.

Screening, Diagnosing/Identification, Primary Care and Referral of Respiratory System

42

1.3.1.

Acute Upper Respiratory Infections

42

1.3.2.

Acute Lower Respiratory Infections

52

1.3.3.

Hemoptysis

60

1.3.4.

Acute Chest Pain

61

1.4.

Screening, Diagnosing/Identification, Primary Care and Referral of Heart & Blood

63

1.4.1.

Common Heart Diseases

63

1.4.2.

Common Blood Diseases

74

1.5.

Screening, Diagnosing/Identification, Primary Care and Referral of Eye Conditions

85

1.5.1.

Introduction

85

1.5.2.

Local Infections

85

1.5.3.

Redness of Eye (Red Eye)

86

1.5.4.

Conjunctivitis (Pink Eye)

87

1.5.5.

Stye (Hordeolum)

90

1.5.6.

Trachoma

91

1.5.7.

Refractive Errors

92

1.6.

Screening, Diagnosing/Identification, Primary Care and Referral of ENT Conditions

95

1.6.1.

Introduction

95

1.6.2.

Epistaxis (Nosebleed)

95

1.6.3.

ASOM (Acute Suppurative Otitis Media)

97

1.6.4.

Sore Throat (Pharyngitis)

98

1.6.5.

Deafness

100

1.7.

Screening, Diagnosing/Identification, Primary Care and Referral of Urinary System

102

1.7.1.

Urinary Tract Infections

102

1.7.2.

Cystitis (Bladder Infection)

104

1.7.3.

Pyelonephritis (Kidney Infection)

105

1.7.4.

Prostatitis

106

1.7.5.

UTIs in Children

108

1.8.

First Aid in Common Emergency Conditions

110

1.8.1.

High Fever

110

1.8.2.

Low Blood Sugar

110

1.8.3.

Minor Injuries - Cuts and Wounds

111

1.8.4.

Fractures

113

1.8.5.

Fainting

116

1.8.6.

Bleeding

117

1.8.7.

Shock

119

1.8.8.

Stroke

120

1.8.9.

Bites

122

1.8.10.

Burns

124

1.8.11.

Choking

126

1.8.12.

Seizures

128

1.8.13.

RTAs (Road Traffic Accidents)

129

1.8.14.

Poisoning

130

1.8.15.

Drowning

131

1.8.16.

Foreign Bodies

133

1.9.

Exercise

134

Unit 2: Reproductive, Maternal, Newborn, Child and Adolescent Health

2.1.

Present Situation of Reproductive, Maternal and Child Health in India

138

2.2.

Antenatal Care (ANC)

140

2.3.

Screening/Early Identification and Primary Management of Complications

158

2.3.1.

Antepartum Haemorrhage

158

2.3.1.1.

Placenta Previa (Unavoidable Haemorrhage)

159

2.3.1.2.

Abruptio Placenta (Accidental Haemorrhage)

160

2.3.2.

Pre-eclampsia

162

2.3.3.

Eclampsia

164

2.3.4.

Anaemia

166

2.3.5.

Gestational Diabetes Mellitus

169

2.3.6.

Hypothyroidism

174

2.3.7.

Syphilis

176

2.3.8.

Referral and Follow-up of Antenatal Care

178

2.3.9.

Maintenance of Records and Reports in Antenatal Care

178

2.4.

Intra Natal Care

179

2.5.

Early Identification, Primary Management, Referral and Follow Up

194

2.5.1.

Preterm Labour

194

2.5.2.

Foetal Distress

196

2.5.3.

Prolonged Labour

197

2.5.4.

Obstructed Labour

200

2.5.5.

Vaginal & Perennial Tears

202

2.5.6.

Ruptured Uterus

204

2.5.7.

Care of Newborn Immediately After Birth

206

2.5.8.

Maintenance of Records and Reports

209

2.5.9.

Use of Safe Child Birth Check List

209

2.5.10.

SBA Module - Review

211

2.5.11.

Organisation of Labour Room

212

2.6.

Postpartum Care

215

2.7.

Early Identification, Primary Management, Referral and Follow Up of Complications, Danger signs

225

2.7.1.

Post-Partum Haemorrhage (PPH)

225

2.7.2.

Shock

228

2.7.3.

Puerperal Sepsis

231

2.7.4.

Breast Conditions

233

2.7.5.

Postpartum Depression (Baby Blues)

237

2.7.6.

Postpartum Visit by Health Care Provider

238

2.8.

Newborn and Child Care

239

2.8.1.

Essential New-born Care (ENC)

239

2.8.2.

Management of Common Neonatal Problems

239

2.8.2.1.

Skin Infections

240

2.8.2.2.

Sore Buttocks

240

2.8.2.3.

Conjunctivitis

240

2.8.2.4.

Hyperbilirubinemia or Neonatal Jaundice

241

2.8.2.5.

Hypothermia

241

2.8.2.6.

Hyperthermia

242

2.8.2.7.

Neonatal Infections

243

2.8.2.8.

Neonatal Seizures

243

2.8.2.9.

Low Birth Weight Babies

244

2.8.2.10.

Cephalohematoma

245

2.8.2.11.

Caput Succedaneum

245

2.8.2.12.

Torticollis

245

2.8.3.

Management of Common Child Health Problems

246

2.8.4.

Screening for Congenital Anomalies and Referral

252

2.8.5.

IMNCI Module - Review

255

2.8.6.

Under-five Clinics

258

2.9.

Adolescent Health

259

2.9.1.

Common Health Problems in Adolescent Girls and Boys

259

2.9.2.

Common Risk Factors in Adolescent Girls and Boys

260

2.9.3.

Common Gynecological Conditions

260

2.9.4.

Teenage Pregnancy

269

2.9.5.

Awareness about Legal Age of Marriage

270

2.9.6.

Nutritional Status of Adolescents

271

2.9.7.

National Menstrual Hygiene Scheme

272

2.9.8.

Youth Friendly Services (YFS)

273

2.9.9.

Counseling for Parents and Teenagers (BCS - Balanced Counseling Strategy)

277

2.10.

National Programs

278

2.10.1.

RMNCH+A Approach

278

2.10.2.

Universal Immunisation Program (UIP) as per Government of India Guidelines

284

2.10.3.

Rashtriya Bal Swasthya Karyakaram (RBSK) - Children

287

2.10.4.

Rashtriya Kishor Swasthya Karyakram (RKSK) - Adolescents

289

2.10.5.

Any Other New Programs

290

2.11.

Exercise

292

Unit 3: Demography, Surveillance and Interpretation of Data

3.1.

Demography

297

3.2.

Vital Statistics

299

3.2.1.

Introduction

299

3.2.2.

Purpose of Vital Statistics

300

3.2.3.

Importance of Vital Statistics

300

3.2.4.

Uses of Vital Information

300

3.2.5.

Major Indicators

300

3.2.6.

Sex Ratio and Child Sex Ratio

301

3.3.

Sources of Vital Statistics

305

3.4.

Mortality Indicators

308

3.5.

Morbidity Indicators

313

3.6.

Surveillance

314

3.7.

Integrated Disease Surveillance Program (IDSP)

316

3.8.

Mother and Child Tracking System (MCTS) in India

318

3.9.

Data

320

3.9.1.

Introduction

320

3.9.2.

Collection of Data

321

3.9.3.

Analysis, Interpretation, and Use of Data

324

3.10.

Sampling

331

3.10.1.

Introduction

331

3.10.2.

Purposes of Sampling

331

3.10.3.

Importance of Sampling

332

3.10.4.

Common Sampling Techniques

332

3.10.5.

Random/Probability Sampling Techniques

332

3.10.6.

Non-Random/Non-Probability Sampling Techniques

338

3.11.

Disaggregation of Data

342

3.12.

Exercise

343

Unit 4: Population and its Control

4.1.

Population Explosion

346

4.2.

Population Control

348

4.3.

Limiting Family Size - Small Family Norm

351

4.4.

Family Planning Methods

352

4.5.

Counseling in Reproductive, Sexual Health, including Problems of Adolescents

366

4.6.

Medical Termination of Pregnancy (MTP) Act

370

4.7.

National Population Stabilization Fund/JSK (Jansankhya Sthirata Kosh)

373

4.8.

Family Planning 2020

375

4.9.

National Family Welfare Programme (NFWP)

377

4.10.

Exercise

380

Unit 5: Occupational Health

5.1.

Occupational Health

382

5.2.

ESI (Employees’ State Insurance) Act

388

5.3.

National/State Occupational Health Programs

393

5.3.1.

Rajiv Gandhi Shramik Kalyan Yojana

394

5.3.2.

Rashtriya Swasthya Bima Yojana (RSBY)

396

5.3.3.

Aam Aadmi Bima Yojana (AABY)

397

5.4.

Role of a Nurse in Occupational Health Services

398

5.5.

Exercise

402

Unit 6: Geriatric Health Care

6.1.

Health Problems of Older Adults

404

6.2.

National Programme for Health Care of Elderly (NPHCE)

420

6.3.

State Level Programs/Schemes for Older Adults

423

6.3.1.

Atal Vayo Abhyuday Yojana (AVYAY)

423

6.3.2.

Integrated Programme for Senior Citizens (IPSrC) or Integrated Programme for Older People (IPOP)

424

6.3.3.

State Action Plan for Senior Citizens (SAPSrC)

425

6.3.4.

Rashtriya Vayoshri Yojana (RVY)

427

6.3.5.

Senior Citizen Opportunities for Productive Engagement (SCOPE)

428

6.3.6.

Seniorcare Ageing Growth Engine (SAGE)

428

6.4.

Role of a Community Health Nurse in Geriatric Health Services

429

6.5.

Exercise

431

Unit 7: Mental Health Disorders

7.1.

Mental Health Disorders

433

7.2.

Depression

434

7.3.

Anxiety

436

7.4.

Acute Psychosis

438

7.5.

Schizophrenia

440

7.6.

Dementia

442

7.7.

Suicide

442

7.8.

Alcohol Abuse

444

7.9.

Substance Abuse

446

7.10.

Drug De-Addiction Program

448

7.11.

National Mental Health Programme (NMHP)

449

7.12.

National Mental Health Policy, 2014

450

7.13.

National Mental Health Act

453

7.14.

Role of a Community Health Nurse in Screening, Initiation of Treatment and Follow Up of Mentally Ill Clients

456

7.15.

Exercise

459

Unit 8: Health Management Information System (HMIS)

8.1.

Health Management  Information System (HMIS)

461

8.2.

Basic Demography

467

8.3.

Exercise

471

Unit 9: Management of Delivery of Community Health Services

9.1.

Planning, Budgeting and Material Management

473

9.1.1.

Planning in CHC, PHC, SC/HWC

473

9.1.2.

Budgeting in CHC, PHC, SC/HWC

475

9.1.3.

Material Management in CHC, PHC, SC/HWC

477

9.2.

Manpower Planning as per IPHS Standards

479

9.3.

Health Care Delivery System

486

9.4.

Organization, Staffing and Material Management of Rural Health Services provided by Government

487

9.4.1.

Introduction

487

9.4.2.

At Village Level

488

9.4.3.

At Sub-Centre (SC)

490

9.4.4.

At Primary Health Centre (PHC)

490

9.4.5.

At Community Health Centre (CHC)

493

9.4.6.

District Hospital (DH)

496

9.4.7.

State Hospitals

497

9.4.8.

Central Hospitals

500

9.5.

Organisation, Staffing and Material Management of Urban Health Services provided by Government

505

9.6.

Defense Services

512

9.7.

Institutional Services

512

9.8.

Indian System of Medicine

516

9.9.

Other System of Medicine - Allopathic System of Medicine

524

9.10.

Alternative Health Care System

525

9.11.

Referral Systems

526

9.12.

Indigenous Health Services

528

9.13.

Exercise

529

Unit 9: Leadership, Supervision and Monitoring

10.1.

Understanding Work Responsibilities /Job Description

532

10.1.1.

District Public Health Nurse (DPHN)

532

10.1.2.

Health Visitor

533

10.1.3.

Public Health Nurse (PHN)

534

10.1.4.

Multipurpose Health Worker - MPHW (Female)

536

10.1.5.

Multipurpose Health Worker - MPHW (Male)

539

10.1.6.

Anganwadi Workers (AWWs)

541

10.1.7.

Accredited Social Health Activist (ASHA)

543

10.1.8.

Mid-Level Health Care Providers (MLHPs)

544

10.2.

Village Health Sanitation and Nutrition Committees (VHSNC)

547

10.3.

Health Team Management

551

10.4.

Leadership

556

10.5.

Supervision

558

10.6.

Leadership in Health

562

10.6.1.

Introduction

562

10.6.2.

Leadership Approaches in Healthcare Setting

563

10.6.3.

Taking Control of Health of Community

565

10.6.4.

Health Camps

566

10.6.5.

Village Clinics

567

10.7.

Training, Supportive Supervision and Monitoring – Concepts, Principles and Process

569

10.8.

Financial Management and Accounting & Computing at Health Sub-Centers (SC)

574

10.9.

Records & Reports

587

10.10.

Exercise

607

Unit 11: Disaster Management

11.1.

Disaster Management

611

11.2.

Common Problems During Disasters and Methods to Overcome

621

11.3.

Basic Disaster Supplies Kit

623

11.4.

Disaster Response

625

11.5.

Exercise

641

Unit 12: Bio-Medical Waste Management

12.1.

Bio-Medical Waste Management

643

12.2.

Biomedical Waste Management Rules, 2016

662

12.3.

Bio-Medical Waste Management Guidelines, 2018

665

12.4.

Exercise

666

Unit 13: Health Agencies

13.1.

International Health Agencies

668

13.1.1.

WHO (World Health Organization)

668

13.1.2.

UNFPA (United Nations Population Fund)

670

13.1.3.

UNDP (United Nations Development Programme)

671

13.1.4.

World Bank

673

13.1.5.

FAO (Food and Agriculture Organization)

674

13.1.6.

UNICEF (United Nations International Children’s Emergency Fund)

675

13.1.7.

European Commission (EU)

677

13.1.8.

International Red Cross

678

13.1.9.

USAID (United States Agency for International Development)

679

13.1.10.

UNESCO (United Nations Educational, Scientific and Cultural Organization)

680

13.1.11.

ILO (International Labour Organization)

681

13.1.12.

CARE (Cooperative for Assistance and Relief Everywhere)

684

13.1.13.

SIDA (Swedish International Development Agency)

686

13.1.14.

JHPIEGO

686

13.1.15.

Any Other NGOs

687

13.2.

National Health Agencies

690

13.2.1.

Indian Red Cross  Society (IRCS)

690

13.2.2.

Indian Council for Child Welfare (ICCW)

691

13.2.3.

Family Planning Association of India (FPAI)

693

13.2.4.

TAI (Tuberculosis Association of India)

693

13.2.5.

Central Social Welfare Board (CSWB)

694

13.2.6.

AIWC (All India Women Conference)

695

13.2.7.

Blind Association of India

696

13.2.8.

Any Other NGOs

697

13.3.

Voluntary Health Association of India (VHA)

698

13.4.

Exercise

700