Minor ailments and standing orders

treatment of minor ailments and managing the emergency is one of the component of PHC and essential for community nurse, in this ppt points are included like principles, classification, general and systemic minor ailment and its management, standing orders, role of CHN.

1. MINOR AILMENTS AND STANDING ORDERS PRESENTED BY Puja Sharma

2. INTRODUCTION Treatment of minor ailments and managing the emergencies is one of the components of Primary health care. Minor ailments indicate slight illness, emergencies of smaller nature, acute and chronic illness which need immediate care . Nurses should be capable to examine sign and symptoms of illnesses and treat them in case of minor ailments.

3. PRINCIPLES OF MANAGEMENT Ensure a safe & healthful environment for patients Treat the risk /injured person promptly to prevent the complication For infectious disease take appropriate measures to prevent the spread Continuous observation & check vital sign Help the client to perform her/his ADL Provide health education Remember the limitation in providing treatment Help the family members in care of the client and in adjustment Respect the belief of client In case of doubt about diagnosis or serious condition refer the patient without delay.

4. CLASSIFICATION

5. GENERAL MINOR AILMENTS Injury and fall Fractures Burns Dogbite High fever Heat stroke Diarrhea Fainting

6. SYSTEMIC MINOR AILMENTS EYE Eye accidents Foreign bodies Infection Poor eye sight Dry eyes Night blindness

7. Con… EAR Earache Foreign bodies Otitis media discharge Temporary deafness

8. Cont … RESPIRATORY TRACT Allergic rhinitis Common cold Sinusitis Sorethroat Cough Dyspnea Chest pain Asthmatic attack

9. Cont …. CARDIOVASCULAR SYSTEM Hypertension Anemia Rheumatic heart disease

10. Cont …. DIGESTIVE SYSTEM Toothache Stomatitis Soreness in mouth Constipation Diarrhea Indigestion Vomiting Abdominal distension Pain abdomen Intestinal obstruction haemorrhoid

11. Cont … URINARY SYSTEM Burning micturition Haematuria Retention of urine Urinary infection Renal stones

12. Cont …. NEUROMUSCULAR SYSTEM Headache Backache Convulsion Epileptic fits

13. Cont …. REPRODUCTIVE SYSTEM Dysmenorrhea Heavy bleeding Sores Discharge from genital Breast lump

14. Cont … BEHAVIOUR PROBLEM Maladjustment Emotional disturbances

15. GENERAL STEPS FOR MANAGEMENT OF MINOR AILMENTS

16. STANDING ORDER Standing order are the direction and order of specific nature In the nonavailability of doctors , the nurses and health workers can provide treatment to patient at home , hospital, or health institution in written form . This should be followed on temporary basis or in case of emergency or absence of doctor.

17. OBJECTIVE To maintain the continuity of the treatment of the patient To protect the life of patient / to resuscitate him To create the feeling of responsibility in the members of health team.

18. USES Providing treatment during emergency Enhance the quality and activity of health services Strengthening of primary health services in the community Decentralization of health responsibilities Developing the feeling of confidence and responsibility in nursing and other health worker Protecting the general public from quacks Enhancing the faith of general public in medical institution / community health services

19. TYPES OF STANDING ORDER

20. MANAGEMENT OF MINOR AILMENT AS PER STANDING ORDER

21. FEVER MEANING It is an abnormal rise of the temperature of the body above than 37*C ( 98.6*F ) Fever indicates some abnormalities in the body function and shows presence of infection or disease, disorder . PRIMARY INTERVENTION Assess the vital signs History collection including cause, any other symptoms like vomiting , shivering, cold allergy, cough etc. Provide rest and light meal. Prepare for blood slide to examine malaria parasite Give PCM Give more oral fluid Provide cold sponging if fever is >39*C(102.2*F) Monitor the patient and wait for two days If fever accompanied with rashes then keep in isolation or if necessary inform doctor In case of delirium, convulsion, unconsciousness, hyperpyrexia with fever ,refer the client

22. HEAT STROKE MEANING Heat stroke is a severe heat illness , defined as hyperthermia with a body temperature > 40*C( 104*F) due to environmental health exposure It is also known as sunstroke PRIMARY INTERVENTION K eep the client in shade and well ventilated place Monitor vital signs and record Remove the clothes W rap him/her in a wet sheet till the temperature falls 38*c If the client is conscious give him cold water mixed salt and other cold drinks Continuously observe the temperature As soon as there is improvement in the condition of client refer him to the hospital

23. DIARRHOEA MEANING Diarrhoea is defined as the passage of three or more loose motion or liquid stool per day ( or more frequent than normal) This is the leading cause of malnutrition in children under five years of age and it is the main cause of death . Usually it is a symptoms of an infection in the intestinal tract PRIMARY INTERVENTION History collection Monitor the symptoms of dehydration If dehydration is severe and shock is present immediately refer the client to hospital Provide ORS Give rice water, coconut water, lemon juice, banana, light tea, khichadi etc. If there is epidemic of vomiting and diarrhea, take sample and send for stool test If cholera is prevalent take appropriate action like protect food & water and inform physician Give Health education to control the flies , proper disposal and food hygiene Give medication as per need

24. BURN MEANING A burn is the injury to the skin or other organ tissue primarily caused by heat or due to radiation, radioactivity, electricity, friction, and contact with chemical Thermal burn occur when some or all of the cell in the skin of tissue is destroyed by Hot liquid( scald) Hot solid ( contact burn) Flames ( flame burn) PRIMARY INTERVENTION Check the spreading of burn &Stop the burning process Keep the burnt part of body immersed in water If the clothes has stuck on the burned part do not try to remove , though rings, bangles, shoes belts, and other tight fitted articles should be removed Do not touch the blister unnecessary Cover the burnt part with a clean clothes Assess the condition of client and percentage of burn If client is conscious and no vomiting give ORT If is in shock give primary treatment Provide analgesics if required Refer the client for further care

25. DROWING MEANING It is a process of experiencing respiratory impairment from submersion/ immersion in liquid. Males & children are at high risk Acc. To WHO it is a 3 rd leading cause of unintentional injury death worldwide PRIMARY INTERVENTION Loosen the clothes from chest Make the patient lie on his abdomen and get the water out of his lung Resuscitate the patient Immediately send him to the health center/hospital

26. ANIMAL BITE MEANING Rabies is a significant health concern following dog bite, cat bite, monkeys bite Every year 5 million are bitten by snakes PRIMARY INTERVENTION Monkey bite Wound dressing Inj. TT( if not adequately vaccinated) Antibiotics Anti rabies treatment

27. DOG BITE PRIMARY INTERVENTION Wash the wound thoroughly with soap and water . Use running water Apply betadine or tincture iodine, if available ARS can be used for dressing but serum sensitivity test is essential before use If wound is extensive Check for hemorrhage but stitches should be done after 24 hrs. Give inj. TT Do not kill the dog observe for 10 days Send patient to hospital for ARV therapy

28. CAT BITE PRIMARY INTERVENTION Wound dressing Administer TT vaccine ( if not vaccinated) Antibiotics ART

29. SNAKE BITE PRIMARY INTERVENTION Discourage the traditional first aid ( they do more harm than good) Reassure the client Movement or contraction increases the absorption of venom into blood and lymphatic. Immobilize the whole body by lying down in comfortable position Immobilize the bitten limb with splint and sling,use bandage or clothes to hold the splints. NEVER USE TOURNIQUATE to block the blood supply Don’t offer alchoholic beverages or stimulants( these are vasodialators ) Remove ring, watch , bracelet , footwear, from bitten part Incision or applying ice on bitten site is not recommended Transfer the client

30. SCORPION BITE PRIMARY INTERVENTION Remove the sting, if possible and apply pressure dressing Reassure the client For mild pain use ice packs For severe pain, inj. Lidnocain (without adrenaline) along with oral diazepam and any NSAIDs Observe client for at least 24hrs

31. FAINTING MEANING Fainting( syncope) is a sudden loss of consciousness that usually result in fall. Causes – Reduce blood flow and oxygen to the brain Pain Emotional stress Prolonged standing, laughing, weeping PRIMARY INTERVENTION Lie down the person. Head should be at a slightly lower level than the feet If person is sitting –keep his head bended between both legs Remove the crowd Once the person gets his consciousness ask him to take deep breath and offer liquids to drink If unconsciousness continues send immediately for treatment

32. INJURIES AND FRACTURE MEANING Fracture is the complete or partial break in bone PRIMARY INTERVENTION Clean the wound with soap & water Apply spirit around the wound Apply betadine lotion & bandage the wound Monitor the condition of client with fractured bones Treat the patient for shock Immobilize the fractured part of the patient body using splint Give analgesics and inj. TT Send him to hospital

33. WOUND MEANING Wound is an injury to living tissue caused by a cut blow, or other impact , typically one in which the skin is cut or broken PRIMARY INTERVENSION Wash the wound with clean boiled water and antiseptic lotion Apply spirit around the wound Remove all foreign bodies present in the wound like glass, peace of wood, stones or dirt etc. Bandage the wound using betadine . Give the injection TT. Check the bleeding from wound. If suture is needed send the patient to hospital

34. STANDING ORDER FOR MCH CARE MEANING Maternal & child health care is the health service provided to the mothers and the children. PRIMARY INTERVENTION GIVE TABLETS in case of vomiting and nausea. toxemia of pregnancy advised to take restricted salt diet and complete rest if there is edema refer the client. Send the mother to the hospital in case of APH or PPH. If the mother develops fever after delivery try to know the cost and give anti pyretic and refer to client. Provide comfort to the mother in case of excess of milk in the breast , stillbirth and refer the client etc. Observe the abnormality and deformaties and refer the client. Provide warmth Initiate breast feeding as early as possible.

35. CONVULSION IN CHILDREN MEANING Convulsion is a sudden uncontrollable muscle contraction or violent movement of the body . PRIMARY INTERVENSION LIE down The child safely on A Bed. Loosen his cloths from its chest Turn the head one side Clean the secretion from its mouth. In case of fever give him cold sponge Try to know cause an refer to client.

36. H emorrhage MEANING It is the release of blood from the broken vessels Blood loss inside the body called internal hemorrhage & blood loss outside the body is called external hemorrhage Primary intervention Lie down the person straight on his back Take the BP and vital signs. Press a pad on the point of bleeding. Till bleeding stop Bandage once bleeding under control Give him liquids Try to find out causes of bleeding Monitor the state of stroke If it is out of control send the person refer the client

37. UNCONSCIOUSNESS MEANING It is a state which occur when the ability to maintain an awareness of self and environment is lost PRIMARY INTERVENSION Lie the person in such a position his respiratory system works properly. Lie down the person in a well ventilated place Remove the dentures Clean the secretion from the mouth Loosen the cloth from his neck , chest and vest. Provide artificial respiration in case of blocked breathing Find out the cause refer the client.

38. ROLE OF COMMUNITY HEALTH NURSE HISTORY COLLECTION History of general health of the patient History of onset of disease Its intensity and symptoms of disease Family illness Pre medical history

39. Find out the action taken Complication and any specification Check vital sign and record Conduct urine test Identify problem Provide nursing service Consoling the individual and family Implement referral system Regular study and monitoring of standing order manual/ health book Inform health officer immediately . Notify communicable disease Keep medicine kit ready . In case of doubt about the standing order collecting complete information Careful about once limit and maintain faith Ensure a safe and healthful environment.