CHN Roles

Clinician
Focus: Population
Goal: Reduce disease, discomfort, disability, premature death

Advocate
* Speaks/acts for those who may not be able to speak/act for themselves
* Self-care
* Self-determination

Collaborator
* Works with people in the community toward a common goal
* Relies on joint or shaped decision making

Consultant
* Catalyst to bring change
* Help people understand processes & actions
* Assisting in decision making

Counselor
* Key tasks:
- Listening & providing feedback & information
- Strengthening & guiding people's own decision making skills
- Exploration of feelings & attitudes to help people understand themselves

Educator
* Provide S.K.A.
* Enable clients to make informed decision
* Identification of population at risk
* Exploring learning strategies

Researcher
* Reliable research foundation allows nurses to anticipate potential health problems & interventions
Tasks:
- Identify problem
- Working with data
- Conducting research

Case Manager
* Coordinating care in a system that is made up of many different program, which has different policies, services & missions.
- To avoid the gaps in services & breakdown in the care system

Herbal Medicines

Lagundi
(Vitex Negundo)
Focus: Mild Respiratory Problems
Alternative: Bronchodilator: Salbutamol
Treatment: Asthma, Cough, Fever, Aromatic bath for sick patients


Yerba (Herba) Buena
(Mentha Cordifelia)
F: pain
A: NSAIDS
Tx: Headache, Stomachache, Menstrual & Gas pain, Rheumatism & Athritis


Sambong
(Blumea Balsamifera)
F: Anti-edema, anti-urothiasis & Diuretics
A: Diuretic, Osmitrol (Mannitol)
Tx: Edema & Kidney stones


Tsaang Gubat
(Carmona Retusa)
F: Stomachache
A: Loperamide (Imodium)
Tx: Diarrhea


Niyug-Niyogan
(Quisqualis Indica)
F: Anti-Helminthic
A: Mebendazole
Tx: Intestinal Parasites
* Adult: 8-10 seeds
* 7-12 y/o: 6-7 seeds
* 6-7 y/o: 5-6 seeds
* 4-5 y/o: 4-5 seeds


Bayabas
(Psidium Guajava)
F: Washing wounds, Decrease peristalsis, mouthwash
A: Povidone Iodine
Tx: Wounds, diarhhea, toothache


Akapulko
(Cassia, Alata)
F: Anti-fungal
A: Ketoconazole (Nizoral)
Tx: Tinea Pedis, Ringworm, scabies


Ulasimang Bato or Pansit-Pansitan
(Peperonia Pellucida)
F: Lowers uric acid
A: Allupurinol
Tx: Gouty Arthritis, Rheumatism


Bawang (Garlic)
F: Decrease blood cholesterol level
A: Anti-hyperlipidemia
Tx: Tootheache, hypertension


Ampalaya
(Mamordica charantia)
F: decrease blood glucose level type II
A: OHA: Metformin
Tx: DM Type II

Pregnancy Process

* The developing cells are called a fetus from the 8TH WEEK TO THE TIME OF BIRTH

* The uterus rises out of the pelvis and becomes an abdominal organ about the 12TH WEEK OF PREGNANCY.

* First fetal movements felt by the mother is known as QUICKENING.

> Ballotment - Bouncing effect
> Lightening - Lowering of the Fundus

* In prenatal development, growth is most rapid in the 3RD TRIMESTER.

* A young couple in eager anticipation for their child's birth asks, when does the rudimentary foundation of the baby system such as a brain and heart beat are formed?" The nurse answers: 4 WEEKS.



* Prenatal Teachings:
1. 1st Trimester - Growth of fetus, interventions for nausea & vomiting, expectations for care.
2. 2nd Trimester - Growth of the fetus, personal hygiene, & nutritional guideline.
3. 3rd Trimester - Preparation for the baby, travel to the hospital, signs of labor, Danger signs of preeclampsia, relaxation breathing technique.

* A client is in her 2nd trimester, while listening to the fetal heart, the nurse hears heartbeat at the rate of 136 in the right upper quadrant and also at the midline below the umbilicus. The source of these sounds are FETAL RATE and FUNIC SOUFFLE.

* The nurse explains to a pregnant couple that in child birth classes the emphasis is on EDUCATION, BREATHING AND EXERCISE.

*When developing a series of parent classes on fetal development, The nurse will include EXTERNAL GENETALIA as being developed by the end of the 3rd month (9-12weeks).

The Prenatal Period: Anatomy & Physiology

Ms. Betty Stevens is 29 years old, pregnant for the first time, and attending a prenatal clinic. Ms. Stevens appears interested in facts about pregnancy and human reproduction. During Subsecuent visits to the clinic, she asks many questions about this subject.

* During a prenatal visit MS. Stevens asks questions about female hormones and the ovaries. To develop a teaching plan and answer questions, the nurse should know that the ovaries normally secrete ESTROGEN and PROGESTERONE.



* Ms. Stevens also asks about ovulation. The nurse can plan to answer her questions about ovulation knowing that this phenomenon occurs when the anterior pituitary gland releases LUTEINIZING HORMONE.

> posterior pituitary gland releases - ANTIDIURETIC HORMONE & OXYTOCIN
> production of milk in the mamary gland - PROLACTIN

* Another question asked by Ms. Stevens concerns male hormones and their influence on her husband's sperm count. The nurse can plan to explain in simple terms, the effect of hormones on the formation of sperm (spermatogenesis) by knowing that this process is under the influence of THE ANTERIOR PITUITARY GLAND.

* During a prenatal visit Ms. Stevens asks how the sex of the baby is determined. The correct explanation is based on the fact that the sex of a fetus is determined by an X or Y CHROMOSOME IN THE SPERM

* During a discussion of her pregnancy, Ms. Stevens asks about hormones and pregnancy. The nurse can develop a teaching plan for Ms. Stevens by knowing that the hormones that plays the most important role in preparing the uterus for pregnancy is PROGESTERONE.

* During a prenatal visit Ms. Stevens asks questions about human reproduction. To answer Ms. Stevens' questions a diagram can be used to display and described the uterus. The nurse can label the inner lining of the uterus as the ENDOMETRIUM.

> Outer Layer - PERITONEUM & PERIMETRIUM
> Middle Muscular layer - MYOMETRIUM



* Ms. Stevens asks how sperm travel. The nurse explains that after ejaculation of sperm into the vagina, sperm are propelled by MOVEMENTS OF THEIR TAIL - LIKE PORTIONS (Flagella)

> Cilia on their body - LUNGS
> Peristaltic-like cervical and uterine contractions - ORGASMIC PHASE

* Part of the explanation about human reproduction given to Ms. Stevens concerns conception and includes a brief discussion of chromosomes. When planning the explanation the nurse will include the fact that the total number of chromosomes in each mature germ cell (ovum or sperm) is 23.

* When explaining conception to Ms. Stevens, the nurse plans to name the anatomic structure where the egg (ovum) normally unites with the sperm. This structure is called the FALLOPIAN TUBES. (AMPULLA is the most common)

OB: Anatomy & Physiology

Figure 1 - Anatomy of the uterus and surrounding organs as seen in a section through the middle of the body.


Figure 2 - Uterus: Front View


Figure 3 - View of the uterus, ovaries, Fallopian tubes, and round ligament through a laproscope.

Chorion - The outermost membrane that helps form the placenta.

Corpus Luteum - Progesteron is normally secreted in relatively large quantities.

* The ischial spines are designated as an important landmark in labor & delivery because the distance between the spines is the narrowest diameter of the pelvis.

* The inner membrane that provides a fluid medium for the embryo is the AMNION.

* The Placenta DOES NOT produce FSH (Follicle Stimulation Hormone). (the anterior pituitary secretes FSH)

* After the first 3 months of pregnancy the chief source of estrogen and progesterone is the Placenta.