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EMERGENCY
Here we learned about different type of emergency drugs and also came to know how to give
immunization most of the cases in emergency unit were accidental injuries and high grade
fever.
In this department there are following department:
■ Treatment room
Male ward
■ Female ward
Labour room
They provide first aid treatment to them refers the patient to necessary government hospital.
HIV ICTC ROOM
In the HIV unit there's division into 2 rooms one is for counselling and another is for testing
Room no 18-testing room
Room no 25- Counselling room
Pretest counselling
Post test counselling
HIV-Human Immuno Deficiency Virus
AIDS - Acquired Immuno Deficiency Syndrome
There are four main causes :-
1. Multiple sex partner
2. Blood transfusion
3. Infected needles and syringes
4. Mother to the foetus
Pre-test counselling
>Person who came for testing are sent to the counselling room before testing.
> To provide all information about HIV/AIDS and collect data from the patient
and history collected, PID no. is also giving to test
Post-test counseling
If the patient is positive, the counseling provide health education
regarding the balance diet, personal hygiene and take precaution.
And help the person to cope up with situation and line happy and
healthy and prevent spread of HIV/AIDS.
MALARIA UNIT
In room no 28 there is a malaria unit.
Malaria
protozoaisfamily.
a febrile disease, caused by a unicellular parasite or
TREATMENT
1st 3 day - 10 tabs (150mg) i.e, chloroquine
1st or 2nd day - 4 tabs (150mg)
3rd day - 2 tabs (150mg)
PREVENTION
DPT vaccine
BHT (Butylated hydroxytoluene Vaccine)
LAB
Lab is in room no 15 whose incharge is Mrs. Sudesh Dogra (lab technician),
she taught us about the text which are being done, throughout the week
The list of test which are being done in this lab are:-
. Urine routine test
.Bile salt, rigment test
.Pregnancy test.B
Total urine test Hemoglobin test
TLC test
DLC test
ESR test
Blood grouping test
. APTT, PTT test
. Blood sugar test analysis
Test of stool for ova and cyst
CENTRIFUGATION
It is a technique which involves the application force to separate particles from
a solution according to their size, shape, density, viscosity of the medium and
speed.it is done after the urine sample is collected. After this urine is put into
the liquid in the urine from any solid component that may be present such as
blood cell, mineral, crystals and one through view under a microscope for
further investigation. The other test for finding an infection is the who stick test
to find out the level of albumin and ketone in the urine sample.
Different type of medicine available in pharmacy are :-
Syp. coughmate(100ml) Antiussive
amol (pediatric 600ml) Antipyretic
Syp.Cetrazine (50ml) Antihistamine
Syp. Paracetamol Antipyretic
Tab. Pental Antacid
Tab . Ciprafloxacin antibiotic
Syp. ParacetTab. Deriphyllin bronchodilator
Tab . Atenolol Antihypertensive
Tab. Amlodipine calcium channel
blocker
Tab. Ibuprofen Analgesic
Tab . Metformin hydrochloride Antidiabetic
Tab. Ascorbic Acid Vit. C supplement
Gel Diclofenac Analgesic (topical
application)
Nurse’s responsibilities
To check the physician’s order
To check the drug expiry
Before taking from the shelf
Before preparation of the drug
Before administer the drug to patient
ANTENATAL CLINIC
In room no.3 there is ANC Clinic where patient come with different complaint
such as abdominal pain, fever, vomiting with irregular menses.
There I learned about the and of examination of antenatal mother. I also learned
how to check the fetal heart sound.
Activities carried out in this unit:-
o chest tightness
o non-productive cough
o mucopurulent sputum with
haematopoiesis
o chest pain
Spine tuberculosis
o local pain
o local tenderness
o stiffness
o spasm of the muscles
o cold abscesses
o gibbous
o prominent spine deformity
Meningitis tuberculosis
o Fever and chills
o mental status changes
o nausea vomiƟng
o Photophobia
o Severe headache
o Stiff neck (meningiƟs)
o Agitation
o bulging fontanelle
o Decreased consciousness
o Poor feeding or irritability in children
o Unusual posture with the head and neck arched backward
Abdominal Tuberculosis
o Abdominal pain
o Diarrhoea
o BloaƟng and
o Unexplained weight loss
o Loss of appetite
o Fatigue and weakness
o Ascites
o Fever and night swea
o Enlarge lymph
o Hepatomegaly
Diagnosis of tuberculosis
1. Clinical evaluation
o Healthcare providers assess symptoms such as persistent cuff weight loss night
sweats
and fever
o They enquire about the patient medical history, travel history and potential exposure
to Tb
2. Tuberculosis skin test (tst) or Mantoux test
o A small amount of tb protein is injected under the skin under direction is absorbed
observed after 48 to 72 hours.
o Positive results indicate exposure to tb but do not distinguish between latent
injection
and active disease
DIRECTLY OBSERVED THERAPY SHORT
COURSE
INTRODUCTION
Directed observed treatment shortcourse is a programme to help to help cure tuberculosis
It is mainly to meet with client to help with TB medication , and provide support and
education
according to WHO “The most effective way to stop the spread of TB in communities with a
high incidence is by curing it
In 1993 , WHO declared tuberculosis a global emergency and began promoting a
management strategy called directly observed treatment short course [DOTS]
What is DOTS ?
DOTS is a comprehensive strategy recommended by WHO for the detection and cure of
tuberculosis
A trained health care worker or a designated individual provides the prescribes anti -
tuberculosis drugs and watches the patient swallow every dose
Why DOTS ?
Tuberculosis is a leading cause of death due to an infectious agent it is
both preventable and treatable
Globally , there are more cases of tuberculosis today and it affects one
third of the population
In response to this catastrope ,the world health organization ’s global
tuberculosis programme in 1993 declared tubercusis a global
emergency and began a management strategy called DOTS
OBJECTIVE OF DOTS
To ensure adherecence to treatment regimen
To check for side effects of any
To decrease the risk of drug resistance caused incomplete
treatment
To enforce standard protocol for the detection and treatment of
tuberculosis as recommended by WHO
For maintenance of proper recording and monitoring systems
Diagnose is simple and treatment cures over 95% of patient in
clinical trials
HISTORY
The strategy for DOTS was developed by karal styblo of the international
union against TB and Lung disease in 1970s and 80s , in Tanzania
In 1980 styblo defines international union against tuberulosis and lung
disease model to control TB in tanzania
In 1990 world bank asks styblo to create pilot project for china
In 1993 WHO declares TB as global emergency
In the fall of 1994 WHO TB advocacy officer kraig klaudt developed the
name and concept for marketing strategy to brand this complex public
health intervention turning the word ‘DOTS ’upside down to spell “stop”
praed a memorable shorthand that promoted stop TB. Use DOTS !
In 1995 , india’s joint effort to eradicate TB NGO observed that “DOTS
became a clarion call for TB control programmes around the world
On march 19,1997 WHO announced that “DOTS was the biggest health
breakthrough of the decade”
BENEFITS OF DOTS
It ensures that the patient completes an adequate regimen
It lets the health care worker moniter the patient regularly for
side effects and response to therapy
ELEMENT
Government commitment [including partial will let level and establishment of a cantralised priotized system of TB
monitering , recording and training
case detection by sputum smear microscopy
Standardized treatment regimen directly size to 9 month observed by healthcare worker for atleast the first 2 month
Drug supply
Standerized recording and reporting system that allow assessment of treatment result
99 DOTS
99 DOTS is an IIT- enabled ‘pill in hand’ adherence monitoring system
implemented by the national TB eliminated programme [NTEP] for all
drug - sensitive TB [DS-TB] patients on a daily regimen
99 DOTS is an approach for monitering and improving TB medication
aherence among TB/HIV co infected
BENEFITS
99 DOTS is an effective approach for improving TB medication
adherence , thereby increasing the compliance to TB treatment
It will be helpful for easy access of treatment to patients from remote
areas
ADVANTAGES OF 99 DOTS
Enables the NTEP staff to prioritize patients who need to visited to be
visited and counselled
Empowers patient to be able to take change of their own treatment
BACKGROUND
99 DOTS is a low cost , mobile phone based technology that
enables real- time remote monitering of daily intake and
treatment , first introduced by the revised national tuberculosis
programme under the national programme under the national
programme in 2015 in high burden antiretroviral therapy
[ART]centers
This project was launched foe the first time in 2016 in rajkot
district, gujarat, india and hence this was an effort to evaluate 99
DOTS
COLOUR CODING OF DOTS IN TB:
RED DOTS- to mark medications doors for active TB cases
content of TB treatment
monitering
PHASE 1 :
In 1978 BCG vaccination was shifted under the expanded programme on immunization
a joint review of NTP was done by government of india WHO , swedish international
development agency SIDA in 1992 around same time in 1993 the WHO declared TB as a
global emergency devised the DOTS and recommended to follow it by all countries the
govt. of india revctaised NTP as revised National TB control programme in same year
DOTS was official launched as RNTCP strategy in 1997 and by end of 2005 entire
country was covered under programme
PHASE 2 :
RNTCP improved the quality and reach of services and worked to reach global case
detection and cure target these targets were achieved by 2007-2008 Despite these
achievement undiagnosed and mistreated cases continued to drive the TB epidemic TB
was the leading causes of illness and among person living with HIV aids
PHASES 3:
During this period for achievement of the long ter visio of TB free India , national
strategic plan for TB control 2012-2017 was documented with the goal of universeral
access to availity TB diagnosis and treatment for all TB patient in the community
PHASE 4 :
To eliminate TB in india by 2025 , five year ahead of the global target , a frame work
to guide the activities of all the stokeholder including the national and state
government development partner civil society organisation , international agencies ,
research institution , private sector , anf others whose worl is relevant TB
eleimination india is formulated by RNTCP National strateguc pean for TB
elimination 2017--2025
NATIONAL STRATEGIC PLAN FOR TUBERCULOSIS
ELIMINATION 2017-2025 :
NSP is an innovative step required to eliminate TB in india by the year 2025 it is a
three year plan and eight year strategy document
VISION- TB free india with zero deaths, disease and poverty due to TB
GOAL- to achieve a rapid in burden of TB , morbidity and mortality while working
towards eliminated of TB by 2025
OBJECTIVES :
To find all drug sensitive TB and drug resistant TB cases
To initiate and sustain all the patients on appropriate anti TB
treatment
To prevent the emergence of TB in suspectible population
To build and strenghthen enabling policies , empowered ,institutions,
additional human resources with enhanced capacities and provide
adequate financial resources
STRATEGIC PILLARS
1. Detect
2.Treat
3.Prevent
4.Build
1. DETECT
Notofication of TB cases
NIKSHAY- A case based web based TB surveillance system for both govt.
and private health care facilities
Public private partnership- Private provides are provided incentives for TB
case notification and for ensuring treatment adherence and treatmet
completion the incentives to private sector TB care praiders are 05 follows
RS 250-on notification of TB case diagnosed as per STCI
RS250- on completion of every month treatment
RS500- on completion of entire course of TB treatment
RS 2750/- for notification and management of a drug sensitive patient over
6-9 months
RS 6750/- for notification and correct management of a drug resistant case
over 24 months
CONTROL TRACING
All close contact
isoniazid preventive therapy
BUILD
Health system strengthening for TB control under the national
strategic plan 2017-2025 is recommended in the form of building
and strenthening enabling policies , empowering institutions and
human resources with enhanced capacities
ROLE PLAY
narrator 1: tabiyat thi inki acchi khaasi, ab rukti nhi hai ye khansi ,
salha dedo koi acchi khasi
Latika 2 - good morning,nameste, sasriakal,aadab hum school of
nursing sir Ganga Ram hospital ke 3 Rd year ke chatra ap sabhi ko
TB ke baren main kuch jankari dene aaye hai jaise ki aap sabhi ko
pata he hai ki pradhan mantri dwara national tuberculosis
elemination programe jari kiya gya hai jiska udeshya 2025 tak tb
mukt bharat hai aj hum uski baat karenge
Himanshi singh 3- tb toh hai bimari purani phir kyu sune hum inki
kahani
Latika 4- niyantrit thi jo yeh bimari ab hone lagi hai isse or
pareshani
Diksha- 5Ha ha ha main hoon tb main khushi toh nahi deta mat
gam bhot deta hoon main ek Saal main lakhon logo ko apni
chapet m le leta hoon ..
Main 80% fefdo ko tatha 20% gurde dimag haddiyan aur aanto ko
prabhavit karta hoon ...
Ek tb ka rogi ek saath 10 se 15 logo ko Sankramit kar sakta hai
Itna hi nahi main har 3 minute main kya suna har 3 minute main 2 logo
ki maut ka Karan Banta hoon ...
Are tum log toh itne murkh ho jo na jaache time se karate h or ma
dawai time se khate ho mere pahele lakshan bukhar or khansi se pta
chal jate the par ab toh unka ka bhi Pata nahi chalta ha ha ha ha ....
Kanishka-6 Tb toh bhaut bhayank bimari lgti hai.lekin ye hoti kesse hai?
Iska hone ka karan kya hai?
Narrator 7 - main batati hu ,main batati hu .
Tb hone ke kehi karan hai .
Phela asantulit ahaar , aasamanya jivanshaili, bheed wala ilaka, mask
na pahenna khule me khasi krna or thukna .
Himanshi singh-08- aur agar kisi ko tb hogya toh uske lakshan ky ky
hoskte hai?
Vanshika - Dhundo ilaj tabyt ko sambhla, tb k symptoms ko dekho aur zindgi ko sawaro.
Raaton mein pasina, din mein bechani tb k symptoms ki hai ek alag hi khani.
Cough aur khaasi ho sakti hai aam, lekin 2hafte se jada khasi
Badan dard
Vjan khatana (weight loss)
Bhukh na lagna (loss of appetite)
Bukhar aana
Chati mein dard
Tb k ho skte hai lakshyan tamaam.
Sneha harichand - To ye hamne lakshan hai jane par TB hai ye kese pehchane
Archana - Tb k bachav k prakar k 4
1.balgum ki jach
2. Chest xray
3.monteux test
4.tb gold
Agar rakhna ho tb ki bimari durr samah rehte karaye jache zarur.
Deepali - Agar tb ho bhi gya toh ilaaj kese karvaye !
Nisha - DOTs centre dega tumko madad Puri TB ke ilaaj ke niyam hai jaruri
dots yani directly observe treatment short course ki sarkar dwara banai gai
ek aisi Yojana hai jiska mukhye uddeshy hai TV per niyantran pana ismein
DOTs karamchari prashikshit admit ya koi bhi namit aadmi apne samne hi tb
rogi toh dawai khilata h taki koi bhi dose miss na ho sath hi har rb rogi ko har
mahine ₹500 diye jate h taki uska aahaar acha ho . Unhe ye btaya jata h
kibapni dawaiyo ko samay se le or apna ilaj ka course pura kre .
..Agar naga hui koi dawaii Samjho bimari wapas ayi
.Har tab rogi ko h batana
6-8mahine dawaiya h khani
Jo krdi koi ana kani
Hogi jane kya kya pareshani
Mansi - dawaiya to le le
Lakin iske prabhawo ko kese jhele
Deepali-Tab ki davaio se ho skti h kuch preshani jese :
Lal rang ka peshab aana
Bhuk na lagna
Ulti hona
aankho ki drishti ka dhundla hona
Aur badan dard hona
Yeh hai sari aam samasya inse na tum ghabaraana
Aur apne ilaaj ko pura krvana
Vanshika- Apno ka kaise dhyaan rkhe
Tab se kaise bachav kare
Deepali-Harr saans maayne rkhta h
Harr saans maayne rkhta h
Ab tab ka rokthaam Krna h
Himanshi- logo ko denge jankari puri is banegi tb se duri
Deepali- Janam ke samay BCG ka tikakaran krnana h zaroori
isse bani rhegi tb se durri
Himanshi - khaste chikte baat krte wqt mask ka istemaal krna h
zruri ..alg h rehna sbse isme, apne or dujo ka dhyan h zruri
Deepali-Acha Khan pan bhi h bhot zaroori
Chinta aur kamzori se aati tb
Sharir na lad paye jab tb se
Agar na ho rokh
pratirodhak shakti hum mai
Archana- Toh rog pratirodhak shakti ko kesse badaye?
Mansi- ratishodhak shamta badahaye
protein se bharpur Khana khaye
Sneha- dal or protein ka Mel hai sehat ka khazana
Mansi- soyabean or mushroom bhi h sth m sehat ka khazana Sneha-
gosh Anda machali bhi sth protein ke sth
Mansi- inko khana se sehat banti aachi khasi
Sneha- dudh or dudh se bani chize h sehat ka pegam
Mansi- chane ka pyar , protein se bhara h ye sehat ka izhar
Sneha-Long adrak lashan halfi m hai gunh kafi
Mansi- aachi sas m madad kre dard ko kam kre khasi m Rahat de kaafi
Sneha- iske sth kuch falon ko lena h jaruri
taki rahe bimariyo se duri
Elina-iske sath sath kre vyayam taki mile sharir ko aaram
Jese ki
Anulom vilom, kapal bhati, trikon asan, or taad asan .
Aese krne se saans ki shamta ko bdaya ja sakta hai
Diksha-Ha ha ha ha ....
Are main tb hoon tb mujhe koi ni hara paya tum kese haraoge ....
Kaise karaoge mujhe tum log na dawai time se khate ho na jaache time se karate ho
are main toh chala jaunga lekin Mera bhai hai na MDR or XDR tumhare saath saath
tumhare gurde or liver ko bhi saath lekar jayega
ha ha ha ha ha ha ..........
Sneha(M)-ham bachayeinge !
Bahoot hui laparwahi ab dikhayenge samajhdaari .
Samay samay par hath dho kr ,
Santulit aahar pakar
Samay PR dawaiyan kha kr
Khanste waqat muh dhak kr or mask pehen kr
Bheed bhad Wale ilake m jyada na jakr or vyayam karke.
Latika- toh jaise ki hum sabhi ne apko bataya ki tb kya hai uske kya karan hai or kya
uska bachav hai toh aj se hum ye pran lete hai na toh khud ko tb hone denge na kisi
ke hone ka karan banenge or national tuberculosis elemination programe main apna
yogdan denge
Kanishka- Hai TB jo jadh se mitana
Apna or apno ka dhyaan
Rakhna Hai desh ko TB mukt
banana Hum sabko ye nara
apna na
THANKYOU
DATA ANALYSIS
TABLE - 01
FREQUENCY ,PERCENTAGE DISTRIBUTION OF DEMOGRAPHIC PROFILE
(n= 100)
S.NO DEMOGRADEMOGRAPHIC FREQUENCY (N)
DATA
1. Age
15-30 36
31-45 31
46-60 20
Above 60 15
2. Gender
Male 50
Female 50
3. Education
Illiterate 26
10th pass 14
12th pass 45
Graduate 10
Post graduate 05
4. Marital status
Married 72
Unmarried 22
Divorced 04
Widow 02
5. Socio economic status
Less than 10,000 26
10,000-20,000 33
20,000-30,000 23
Above 30,000 18
6. Type of diet
Vegeterian 35
Non vegeterian 55
7. Total meals in a day
3 meals 79
2 meals 15
Frequent meals 06