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02-02-2025 Community Health Nursing

Feb 02, 202511 min read2014 words

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  • Determinants of Health
  • Levels of Prevention
  • Levels of Clientele

Basic Concepts of CHN

  1. Timeframe: according to Maglaya, the timeframe of community health nursing should be continuous, with its contents inherently and inevitable changing. A primary example of this is the continuous improvement of the NIP into becoming the present-day EPI as present day health conditions change, such as changes in the trends of disease.
  2. Scope: according to Maglaya, the practice of community health nursing should be general and comprehensive. The nurse is a generalist and services all populations.
  3. Community Health Team: the members of the community health teach is made up of the following:
    1. Medical Practitioners (1:20,000) such as physicians/doctors/medical officers that often serve as the head of the group.
    2. Nurses (1:10,000) act as facilitators between the community health programs and uhhas coordinators between members of the community health team.
    3. Midwives (1:5,000)
    4. Registered medical technologists
    5. Pharmacists
    6. Radioactive technicians
    7. Dentists (1:50,000)
    8. Nutritionists which prevent disease through food, as opposed to dietitians who often promote recovery through food.
    9. Sanitary inspectors, and others based on the funding and requirements of a community.
  4. Community Health Problems: a primary goal of community health nursing is community independence.
    • The first step to allowing a community to stand on its own feet is to enable the community to recognize their problems.
    • The primary role of a nurse which aids this is health education— the nurse discusses the problems in order to transform the problem into a perceived need, to induce action.
    • Action must involve the people of the community.

Presenting Research in the Community Situation

The four main steps of presentation in the community is data collection, data collation, data presentation, and data analysis. An emphasis on placing analysis at the end is so that the people of the community are involved in the analysis of the data.

Public Health Nursing

Public health nursing is any nurse working outside of the hospital and in public health, such as in health centers as school nursing, occupational health nursing, and as community mental health nursing. According to Dr. E. Winslow, the core principle of public health nursing is “Health and Longevity as a Birthright of all People”.

  1. Population (2024): 114,000,000 - 115,000,000 in the latest census out of ~8.2 billion total population globally. The Philippines are among the highest populations in the world, ranking as the 13th most populous country.
  2. Life Expectancy: tallied at 73.4 years globally (WHO, 2024), and 71.6 years in the Philippines.

Basic Concepts of PHN

  1. Four Ps Program (4Ps):
    • Promotion of Health
    • Prevention of Disease
    • Promotion of Efficiency of Public Health Services
    • Prolonging Life
  2. Philosophy: According to Margarette Shetland, public health nursing is “based on worth and dignity of man”.
  3. Principles: (mn. EMPOWERMENT)
    1. Education as a primary tool. A community that is informed is a health community. The nurse’s primary responsibility is health education.
    2. Made available to all. Services must be comprehensive and general.
    3. People’s initiative. The community must be involved.
    4. Organizing for the health of family as a unit of service.
    5. Works as a member of the health team.
    6. Existing organizations can be used as machinery or manpower resources.
    7. Reporting and Recording
      • National Epidemic Sentinel Surveillance System (NESSS): the reporting system for communicable disease in the community. All institutions are required to report specific conditions to determine the presence of an outbreak. This is based on R.A. 11332 previously based on R.A. 3573.
      • Field Health Services Information System (FHSIS): the use of coded forms for the reporting of health service utilization, demographics, mortality, and morbidity.
    8. Monitoring and Evaluation
      • Sankap Pinoy: a food-grade certification seal placed on products that are fortified by micronutrients.
      • Sentrong Sigla Movement: a certification of health facilities under the Department of Health.
    9. Existing indigenous resources can be one of the following 4 Ms:
      1. Manpower: the most important; the people of the community
      2. Money
      3. Machinery: the methods or processes that may be utilized, such as the process of producing herbal medicine
      4. Materials: actual raw materials to use, such as the herbs to be used for herbal medicine.
    10. Needs recognized by the client: the community (client) must recognize their needs.
    11. Training opportunity: the nurse has the opportunity to be trained as a public health nurse.

Sample Questions

  1. The nurse acts as a facilitator to assist the community people towards self-reliance. Which among the following refers to the primary goal of community health nursing? a. Upholding the worth and dignity of man. (Philosophy) b. Raising the level of health of the citizenry. (Ultimate Goal) c. Health promotion and disease prevention. (Focus) d. Enhancing the health and capability of the people.

  2. The following are basic concepts of CHN. Which is incorrect? a. Promotive, preventive, curative, and rehabilitative aspects of care. b. Activities and programs related to both nursing and public health. c. Nurses are specialists in terms of their practice and applies their practice to any setting. d. Occurs over a long period of time for all ages and all types of health care.

  3. Community health nursing practice can be characterized as population-focused. Which activity of the nurse reflects this nature as “Greatest good for the greatest number” in the community?” a. Community diagnosis determining the health situation of the people b. Community assembly empowering the members of the CHO c. Immunization program following the principle of mass approach rather than the individual. d. Family planning program considering the reproductive rights of community couples.

  4. The goal of community health nursing is to help communities and families cope with the discontinuities and health and threats in such a way as to maximize their potential. Which of the following is not one of the principles that facilitate the achievement of this goal? a. Community health nursing is based on the recognized needs of communities, families, groups, and individuals. b. The community health nurse works as a leader of the health team. (Nurses serve as a Facilitator/Coordinator) c. There must be provision for the periodic evaluation of community health nursing services. d. Community health nursing is based on the already existing indigenous resources of the community.

  5. Which of the following is not a principle of community health nursing? a. Community health nursing is based on the recognized needs of communities, families, groups, and individuals as recognized by the community nurse. b. The family is the unit of service and care is based on their identified needs. c. The community health nurse makes use of available community health resources and already existing active organized groups in the community. d. The community health nurse, working as a member of the health team, is tasked to do health teaching as their primary responsibility.

  6. Nurse Lina is correct if she recognizes that the priority concern in community nursing is which of the following? a. Comfort and care during illness b. Recovery from disease c. Promotion and maintenance of health d. Curative care

  7. Which of the following principles is the demonstration of the preparation of the most available herbal medicines under? a. Resources made available to all b. People’s initiative c. Maximization of existing active organization d. Utilization of existing indigenous resources

  8. Which of the following is not a type of community health nurse? a. Nurse working at Maligaya Industrial Company b. Nurse working at Barangay Maligaya Integrated School c. Nurse working at Maligaya Medical Center d. Nurse working at Maligaya Rural Health Center

  9. Which of the following is the main concern of public health nursing? a. Promotion of mental health and alleviation of suffering. b. Treatment and management of disease of individuals by themselves, increasing the level of self-reliance. c. Preventing disease, prolonging life, promoting health/efficiency through organized community efforts. d. Prevention of illness, promotion, curative, and rehabilitative services.

  10. The following are the duties of the public health nurse, except? a. Conduct a pre- and post-consultation conference for clinic patients. b. Leave to the Barangay’s Health Workers the responsibilities of educating the people. c. Provision of nursing care to both sick and well individuals. d. Provision of technical and administrative support to rural health midwives.

  11. Which fo the following is classified as tertiary prevention? a. Doing a home visit to diabetic to follow-up compliance to self-injection of insulin. b. Applying the principles of bag technique to an adolescent during wound care. (Secondary) c. Conducting a heat and acetic acid test to a pregnant client suspected of having pregnancy-induced hypertension. (Secondary) d. Checking the immunization record of an infant. (Primary)

  12. The nurse called a community assembly to discuss disaster management to a disaster prone community. The nurse practices what type of health care service? a. Primordial Prevention b. Primary Prevention c. Secondary Prevention d. Tertiary Prevention

  13. A nurse is conducting a heat and acetic acid test to a pregnant client suspected of having pregnancy-induced hypertension. What level of prevention is the nurse performing? a. Primordial Prevention b. Primary Prevention c. Secondary Prevention d. Tertiary Prevention

  14. When the nurse conducts an appraisal of cost-benefit ratio among the equipment in the health center, in which type of evaluation standard should the test fall? a. Evaluation based on professional practice b. Evaluation based on structure c. Evaluation based on information d. Evaluation based on process

Rationalization

There are three types of evaluation in the community:

  1. Structural Evaluation: the structure itself— the facility’s infrastructure and equipment.
  2. Process/Method Evaluation: the methods used within the facility; if the persons in charge are following the protocols set in place.
  3. Output Evaluation: has the organization been able to reach its health goals; if the recipients of care have achieved its best effect.

  1. Which is not true about primary health care in the Philippines? a. It should be made accessible. b. It should be made acceptable. c. It should be made hospital-based. d. It should be made sustainable.

  2. Which statement does not meet the criteria set by primary health care? a. A Barangay Health Station that is at most requires a 45-minute travel time from the farthest community occupant. b. A Barangay Health Station that provides most services either free of charge or at an affordable cost. c. A Barangay Health Station that d. Health Programs conforming to local cultural beliefs

  3. The Four Pillars or Cornerstones of Primary Health Care are the following, except? a. Intra- and Inter-sectoral Linkages b. Support Mechanisms Made Available c. Passive Community Participation d. Use of Appropriate Technology

  4. Which of the following is the most important indigenous resource in the community? a. Manpower b. Money c. Machinery d. Materials

  5. Which of the following is not an intermediate level health worker as described in primary health care? a. A Medical Officer at Barangay Maligaya b. A Nurse II at Barangay Maligaya c. A Barangay Health Worker at Barangay Maligaya d. A Nutritionist at Barangay Maligaya

Rationalization

Workers are categorized as intermediate personnel, professionals, and auxillary personnel, volunteers.

  1. Which of the following is an example of a secondary level health care facility? a. Philippine General Hospital b. Manila City Health Office c. Barangay Maligaya Health Station d. Maria Basa Rural Health Unit

  2. Which of the following tests done in the community can be used to check for the presence of diabetes mellitus? a. Heat and Acetic Acid test b. Rumpel-Leed’s test c. Clinitest d. AFB test

  3. A child diagnosed with severe pneumonia from the presence of danger signs was given Vitamin A two months ago. He is brought in again. The nurse performs which action in relation to Vitamin A? a. Do not give a dose because it has been less than six months since the last dose was given. b. Give 200,000 IU now. c. Give 100,000 IU now. d. Give 10,000 IU now. (Twice a week starting on the fourth month/second trimester of pregnancy)

  4. Which dose of tetanus toxoid will provide protection to the fetus and provide 10 years of protection to the pregnant mother? a. TT3 b. TT5 c. TT2 d. TT4

  5. Which herbal medicine recommended by the Department of Health may be used for a patient with gouty arthritis? a. Sambong b. Pansit-pansitan c. Bayabas d. Niyog-Niyogan

  6. A program entitled “Operation Timbang” is being conducted. The nurse knows this program falls under which level of prevention? a. Primary Prevention b. Secondary Prevention c. Intermediate Prevention d. Tertiary Prevention

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