I. COMMUNICABLE DISEASES A. Tuberculosis a highly infectious chronic diseases caused by the TB bacilli.

. It is primarily a respiratory disease common among malnourished individuals living in crowded areas. It often occurs among children in underdeveloped and developing countries. The Strengthened National Tuberculosis Control rogra! "eneral Ob#ecti$e To control tuberculosis, which is a public health problem, by the year 2000 through the reduction of: Annual is! of Infection from 2."# to $.0# %revalence ate from &.& to $.' per $000 population (ortality ate due to Tuberculosis from )'.* to $'.2 per $00,000 population S%eci&ic Ob#ecti$es' $. To vaccinate with B+, the eligible population under the -.panded %rogram for Immuni/ation scheme in towns, schools, clinics and hospitals with at least '0# coverage. 2. To identify at least *"#, the prevalence of infectious cases annually. ). To treat effectively and ade0uately all sputum positive cases including those with moderate and far advanced radiographic abnormalities with cavitary lung lesion for a period of & months with the use of the short course chemotherapy. Nursing (es%onsibilities' $. B+, vaccination of newborn, infants and grade I1school entrants. 2. -ducate the public in mode of spread and methods of control and the importance of early diagnosis. ). Improve social conditions, which increase the ris! of becoming infected, such as overcrowding. *. (a!e available medical, laboratory and .2ray facilities for e.amination of patients, contacts and suspects and facilities for early treatment of cases and persons at high ris! of infection and beds for those needing hospitali/ation. ". %rovide public health nursing and outreach services for home supervision of patients to supervise therapy directly and to arrange for e.amination and preventive treatment of contacts. B. neu!onias an acute infectious disease of the lings usually caused by the pneumococcus resulting in the consolidation of one or more lobes of either one or both lungs.

Control o& Acute (es%irator) In&ections *CA(I+ Acute espiratory Infections 3A I4 especially pneumonia remains to be the leading cause of illness and death among 5ilipino children. In $'6', which was the launching year of the %rogram for the +ontrol of Acute espiratory Infections 3+A I4, almost 2",000 children aged under five died de to pneumonia alone. "eneral Ob#ecti$e The +A I program is mandated to reduce mortality due to pneumonia among under fives by 2"# from baseline levels by year 2000. It hopes to accomplish this through the following strategies: $. Training government and private health wor!ers in the standard management of A I. 2. -nabling B78s to identify pneumonia cases, refer cases for treatment and educating patients and careta!ers. ). Assuring the ade0uate supply of antibiotics and other essential drugs. *. Teaching parents and communities on how to recogni/e symptoms of pneumonia and other A I. ". (obili/ing non2government organi/ations and field wor!ers to communicate with parents and communities. &. Advocacy and social mobili/ation to gain the support of local government officials, 9,:s, private and educational institutions. Nursing (es%onsibilities $. Bedrest 2. Ade0uate salt, calorie and vitamin inta!e. 8ater re0uirement increases because of fever, sweating and increased respiratory rate. %lasma chlorides tend to fall in pneumonia, hence sodium chloride should be given by mouth or by vein if necessary. ). Ade0uate urine output is essential for e.cretions of to.ins and for avoidance of serious urinary complications due to medications. *. Ade0uate caloric and vitamin 3;itamin +4. ". Tepid sponge for fever &. 5re0uent turning from side to side <. Antibiotics based on +A I of =:7. C. Diarrheal Diseases , a ma>or cause of mortality in the %hilippines. :ver the past 20 years, it has ran!ed $st to *th leading cause of morbidity and mortality. Among children under the age of five, it is a ma>or cause of illness and death. Control o& Diarrheal Diseases *CDD+

 =iarrheal disease in general and in particular among children under five is a serious public health and development problem. In view of this, the =:7 launched a national program to control diarrheal disease 3+==4 in $'60. Ob#ecti$es' To reduce mortality from diarrhea particularly among children under five through e.tensive case management utili/ing oral rehydration therapy 3: T4, environmental sanitation, maternal and child health, nutrition and health education activities. Nursing (es%onsibilities $. Assist mothers in breastfeeding 2. Improved weaning practices ). ?se plenty of clean water *. 5acilitate %roper 7andwashing ". ?se of latrines &. %roper disposal of babies@ stools <. (easles immuni/ation 6. +onvince and help community members to adopt the practices and to continue the practice them on an on2going basis.

D. Malaria continues to be a ma>or health problem in the country having an annual parasite incidence of ".$1$000 population, In $''*, it was aimed that there be a 20# reduction in morbidity annually. The nature of malaria as a public health problem re0uires sustained and systematic efforts towards two ma>or strategies, namely prevention and transmission through

vector control and the detection and early treatment of cases to reduce morbidity and prevent mortality. Malaria Control Ser$ice Sustainable re$enti$e and -ector Control Measures refer to the adoption of measures for the prevention and control against the malaria parasite and the mos0uito vector. Auch measures being affordable, applicable and appropriate under our local conditions so that these measures can be sustained throughout the duration of malaria control operations. Ob#ecti$e' To reduce the source of infection in the human populations2vector contact and the density of the mos0uito vector population. Nursing (es%onsibilities' $. 8earing of clothing that covers arms and legs in the evening. 2. Avoiding outdoor night activities, particularly during vector@s pea! biting hours from ' pm to ) am. ). ?sing mos0uito repellents such as mos0uito coils, soap lotion, or other personal application measures advocated by =:71(+A *. %lanting of 9eem tree which are mos0uito repellents. ". Booprophyla.is2typing of domestic animals near human dwellings to deviate mos0uito bites from man to these animals. &. All cases should be given drug treatment and followed2up until clinically found negative. <. +ontinuous surveillance measures should be implemented.

E. Measles an acute highly communicable infection characteri/ed by fever, rashes and symptoms referable to upper respiratory tract. =eath is due to complication, e.g. secondary pneumonia usually in children under 2 yrs. old. (easles is severe among malnourished children with fatality '"2$00#.

E.%anded rogra! on I!!uni/ation *E I+ was launched in Culy $'<& by =:7 in cooperation with 87: and ?9I+-5. %residential %roclamation 9o.* 3Culy 2',$''64 D E declaring the period from Aeptember $& D :ctober $*,$''6 as the Figtas Tigdas (onthG and launching the %hilippines (easles -limination +ampaign. Ob#ecti$e' To reduce the morbidity and mortality among infants and children caused by the si. childhood communicable diseases. 3measles, diphtheria, polio, hepatitis, etc.4 rinci%les ' $. The program is based in epidemiological situationH the schedules are drawn on the basis of the occurrence and characteristic epidemiological features of the disease. 2. The whole community rather than >ust the individual is to be protected, thus mass approach is utili/ed. ). Immuni/ation is a basic health service and such it is integrated in to the health services being provided for by the 7?. Ele!ents' Target Aetting +old chain logistic management Information, -ducation and +ommunication Assessment and -valuation of the %rogram@s :verall %erformance Aurveillance, studies and research Nursing (es%onsibilities' $. -mphasi/e the need for immediate isolation when early catarrhal symptoms appear. 2. If immune serum globulin is available 3 gamma ,lobulin4, e.plain this to the family and refer to the physician or clinic giving the service. ). :bserve closely the patient for complications during and after the acute stage. *. Teach, demonstrate, guide and supervise ade0uate nursing care indicated. ". -.plain proceedings in proper disposal of nose and throat discharges. &. Teach concurrent and terminal disinf

II. NON,COMMUNICABLE DISEASES A. Cardio$ascular Diseases *C-D+ have become the greatest threat to 5ilipinos today. +;= have varied and multi causes and ris! factors, ranging from infectious agents, environmental and constitutional causes, some inherited and some ac0uired. A.0 Congenital 1eart Disease *C1D+ D by far the most prevalent type of heart disease among children. They may involve the heart and its great vessels alone or may e.ist together with abnormalities in other systems. A.2 (heu!atic 3e$er4(heu!atic 1eart Disease *(1D4 2 an auto2immune disease, that is, the patient develops antibodies which react to the body@s own antigens in the connective tissues of the heart, as well as in other systems. A.5 1)%ertension D is a persistent elevation of the arterial blood pressure. 7ypertension is very common chronic condition which affects a significant proportion of adult population and which ma!es an important contribution to human mortality. A.6 Ische!ic 1eart Disease2 usually caused by the occlusion of the coronary arteries by thrombus formation in areas of narrowing and hardening in these arteries. Cardio$ascular Disease Control rogra! "eneral Strategies o& Disease Control' $. promote the factors that prevent the occurrence of impede the progression of the disease, and 2. remove1diminish the factors that cause or contribute to the occurrence and progression of the disease. In +ardiovascular =isease +ontrol, efforts should be concentrated on primary prevention. Prevention of CVD occurrence: $. Apare the individual from a lifetime of pain, suffering and limited activity, from unfulfilled dreams, or early death because of the progressive nature of the disease. 2. Apare the family from tremendous e.pense, abnormal family life and anguish. ). Apare the community from huge capital and operating e.penses for medical facilities for the chronically ill +;= patients and from unhealthy and unproductive members who otherwise can contribute to community development. Apecific protection from +;= is also achieved by the removal of the ris! factors or reduction in their levels. Nursing (es%onsibilities $. (aintenance of Ideal Body 8eight 8eight control is useful for preventing and correcting high blood pressure and diabetes. The goal of the body weight should be within $"# of desirable weight. 2. =iet and (odification of =ietary 5ats =ietary education must be initiated. =ietary changes recommended for obese individuals with or without hypertension. ). Amo!ing1Tobacco Avoidance

 +omplete cessation of cigarette smo!ing should be advised to all individuals, whether he1she is hypertensive or not and particularly those with special ris! of +7=. 9icotine increases blood pressure activity *. -.ercise regular e.ercise programs, facilitate weight control and increase cardiopulmonary stamina. ". (onitor non2pharmacological methods and drug administration.

B. Cancer ran!s third in leading cause of morbidity and mortality in the %hilippines. A disturbance of growth characteri/ed primarily by an e.cessive proliferation of cells without apparent relation to the physiological demands of the organ involved. Cancer Control rogra! *CC + presently the two most important modes recogni/ed in the reduction of cancer incidence are prevention and early detection.:ne2third of all cancers are curable if detected early and treated properly. Treatment of cancer needs a multi2disciplinary team approach. There are three ma>or forms of treatment of cancer: $. Aurgery 2. adiation Therapy ). +hemotherapy +ancer that cannot be detected early, which is usually present at an advanced stage at diagnosis and which can be cured, can be offered supportive or palliative care. This is the active, holistic care of patients and their families given by a multi2disciplinary team of physicians, nurses, nutritionists, etc. The =:72%++% has supported the %alliative +are of 5ilipino +ancer %atients by providing free morphine tablets to indigent patients, particularly in government hospitals. The =:72%++% also support %hilippine +ancer Aociety, Inc.27ospice +are %rogram, recogni/ing at as the first and lead agency. Nursing (es%onsibilities $. efer immediately any case of suspected disease to physician. 2. Ahare with patient and family !nowledge on available resources for accurate diagnosis and ade0uate treatment.

). Assist and guide families in availing of e.isting health resources and facilities. *. ecord history of symptoms , which will help physician arrive at an accurate diagnosis. ". Assist physician in the performance of e.aminations and diagnosis test as aids to diagnosis and treatment. &. +onduct nursing demonstrations to patient or families on proper nursing care, particularly on post2operative care of discharged hospital cases and terminal cancer patients who have to be ta!en care of at home. <. Assist the patient and family in ma!ing necessary ad>ustment and developing proper attitudes towards prescribed treatment. 6. %rovide guidance, counseling and supervision in the management of case at home. '. %articipate in the planning and implementation of rehabilitation program for post2op and other cases in need of this service. $0. 7elp patient and family understand the most important facts about cancer. $$. +onduct and participate in health education programs on cancer for allied health wor!ers and the general public. C. 7idne) Diseases there are about &,"00 yearly deaths in the country secondary to various !idney diseases. enal diseases threaten to be one of the leading causes of death if there will not be an effective prevention and control programs to address the problem. re$enti$e Ne%hrolog) rogra! reduce the occurrence of !idney diseases and end2stage renal diseases to )000 cases a year. Increase awareness and practice of preventing renal diseases among high ris! groups to 60#. Increase awareness on signs and symptoms of !idney diseases. Improve access and median waiting time for renal transplantation. Nursing (es%onsibilities $. Increase awareness and practice of preventing renal disease through: ade0uate water inta!e balanced diet good personal hygiene regular e.ercise regular B% chec!2up complete immuni/ation for infants and children proper management of throat and s!in infections yearly urinalysis 2. Increase awareness of signs and symptoms of !idney disease as edema and high blood pressure. ). outine screening for urinary tract infection, diabetes and !idney diseases.