3 elements ensures adequate tissue perfusion 1. Functioning pump (myocardial contractility) 2. Rate of Myocardial contraction 3. Adequate volume of blood (preload) 4. Normal vascular tone, SVR (Afterload) • In order for adequate tissue perfusion to occur, cardiac output must be sufficient to deliver nutrient- and oxygen rich blood to the tissues.

Disorders of hemostasis – hypercoagulability states Disorders occurring due to imbalance between procoagulants and anticoagulants. Pro-coagulant factors: Platelets clotting factors Ca2 PLUS molecules released by damaged tissues Anticoagulant factors Protein C Plasmin Antithrombin III

A group of malignant diseases of the bone marrow and lymphatic system. • Characterized by an unrestricted proliferation of immature white blood cells in the blood-forming tissues of the body. • Classified as malignant because the leukemic cells demonstrate the neoplastic properties of solid cancers.

A leukocyte and the most numerous of the white blood cells, accounting for 50–70% of the WBC population. • Range 1,500 to 8,000/mm3 • Are about twice as large as erythrocytes. • Also called polymorphonuclear neutrophils • Chemically attracted to sites of inflammation and are active phagocytes

By the end of the course, the students will be able to apply the principles of medical sociology and anthropology in day to day delivery of health services to all clients from different works of life.

The document provides a sample exam for community health nursing that covers topics like epidemiology, vital statistics, and health education. It includes multiple choice questions testing knowledge of investigating disease outbreaks, calculating health statistics, and understanding leading causes of mortality. The exam also addresses functions of nurses in epidemiology like surveillance, case finding, and properly reporting data.

This document contains a summary of a community health nursing exam with multiple choice questions covering various topics in community health and public health nursing.

ADHERENCE AND ASSOCIATED FACTORS TO TYPE 1 DIABETES MELLITUS CARE AMONG ADOLESCENTS AT KISII COUNTY the recommendations management is associated with better clinical outcomes. In Kisii County, the adherence of adolescents living with T1DM to diabetic care is not well known. The study had the purpose to assess the adherence of children suffering from T1DM to Diabetic care and its associated factors. The quantitative cross-section study was conducted in Kisii County Diabetic Association Centre in Nyamache Sub- County, Kisii County among a convenient sample of 108. The study was conducted from February to April (precise date). A structured questionnaire was used to collect data. Ethical approval was sought and obtained from UR-CMHS-IRB (number of ethics). Participation was voluntary and other ethical principles were observed throughout the study. Descriptive data were entered into the Statistical Package of Social Sciences (SPSS) version 21, and then analyzed using Pearson Chi-square, to determine association between variables. The significance level was set at p-value of < 0.05 A total of 106 (98%) participants who consisted of 40.6% male and 59.4% female completed the survey. The majority of participants were aged between 15-19 (79.2%) years while 22(20.8%) were between 10-14 years old. 79.2% were adherent to diabetic care while 20.8% were not adherent. (72.6%) had schooling while (27.4%) did not attend school. The majority of the participants (79.2%) were in boarding school and (20.8%) were living out of school. Moreover (63.2%) children were living with both parents and (61.3%) of parents were married. There is no association between adherence and Age, gender , Child in boding school, Duration of medication, or if there are causes delayed respect of nurse‘ instructions but the others factors are associated with adherence: schooling child( p:0.001) , Relationship with guardian p:0.001) Parent status(p:<001) ,Guardian‘ occupation(p:<001), education level of guardian( p:0.017) (p:),Ubudehe category(p:<001), Health insurance(p:0.025) Complication (p:0.001) and Co-morbidities

Mainintaiance of instruments

The purpose is to provide trainees with knowledge, skills, and attitudes in health service management. The expected learning outcomes are for trainees to understand key concepts like management principles and functions, human resource management, health care delivery systems, and health policy and planning.