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Mga Kasanayan sa Pangangalaga ng Kalusugan

Mga Kasanayan sa Pangangalaga ng Kalusugan

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<stro<strong>ng</strong>>Mga</stro<strong>ng</strong>> <stro<strong>ng</strong>>Ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>nayan</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

<stro<strong>ng</strong>>Pa<strong>ng</strong>a<strong>ng</strong>alaga</stro<strong>ng</strong>> <strong>ng</strong> <strong>Kalusugan</strong><br />

Pagpigil <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> Impeksyon . . . . . . . . . . . . . . . . . . . 525<br />

Paghuhugas <strong>ng</strong> kamay . . . . . . . . . . . . . . . . . 526<br />

Paano magdisimpekta (disinfect) . . . . . . . . . 526<br />

Pagsukat <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> Temperatura,<br />

Pulso, Paghi<strong>ng</strong>a at Presyon <strong>ng</strong> Dugo . . . . 530<br />

Temperatura . . . . . . . . . . . . . . . . . . . . . . . . . 530<br />

Pulso . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 531<br />

Bilis <strong>ng</strong> paghi<strong>ng</strong>a . . . . . . . . . . . . . . . . . . . . . 531<br />

Presyon <strong>ng</strong> dugo . . . . . . . . . . . . . . . . . . . . . . 532<br />

Paano Mag-ek<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>min <strong>ng</strong> Tiyan . . . . . . . . . . . . . 534<br />

Paano Mag-ek<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>min <strong>ng</strong><br />

Ari <strong>ng</strong> Babae (Pelvic Exam) . . . . . . . . . . . . . 535<br />

<stro<strong>ng</strong>>Pa<strong>ng</strong>a<strong>ng</strong>alaga</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> Pagkapaso o Sunog . . . . . . 538<br />

Pagpigil <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> Impeksyon<br />

Sa marami<strong>ng</strong> bahagi <strong>ng</strong> libro<strong>ng</strong> ito, may sina<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bi kami<strong>ng</strong> mga ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>nayan na makakatulo<strong>ng</strong><br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tao na bigyan <strong>ng</strong> pinakamahu<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>y na pa<strong>ng</strong>a<strong>ng</strong>alaga a<strong>ng</strong> may<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit. Ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ma <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga<br />

ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>naya<strong>ng</strong> ito a<strong>ng</strong> pag­iwas <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> impeksyon, pagsusuri at pagkuha <strong>ng</strong> impormasyon tu<strong>ng</strong>kol<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> katawan <strong>ng</strong> tao, pagbibigay <strong>ng</strong> pan<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>gip na likido, at pag­iniksyon.<br />

Na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> seksyo<strong>ng</strong> ito a<strong>ng</strong> mas kumpleto<strong>ng</strong> impormasyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>nayan. Baka<br />

isipin mo na ito’y pa<strong>ng</strong>­‘doktor o nurse’, pero lahat ito’y kaya<strong>ng</strong> matutunan ninuman<br />

ku<strong>ng</strong> may <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>pat na panahon at praktika. May mga ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>nayan, tulad <strong>ng</strong> paginiksyon<br />

o ek<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>minasyon, na pinakamahu<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>y ipakita at ituro <strong>ng</strong> tao<strong>ng</strong> biha<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

na. Kapag natutunan, mas ligtas na matutulu<strong>ng</strong>an <strong>ng</strong> mai<strong>ng</strong>at na tao a<strong>ng</strong> iba.<br />

Pagpigil <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> Impeksyon<br />

Paano Magbigay <strong>ng</strong> Likido<br />

para Luna<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n a<strong>ng</strong> Shock . . . . . . . . . . . . . . . 540<br />

Paano gumawa <strong>ng</strong> oresol . . . . . . . . . . . . . . . 540<br />

Paano magbigay <strong>ng</strong> likido <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> puwit . . . . . . . 541<br />

Paano Mag-iniksyon . . . . . . . . . . . . . . . . . . . . . . 542<br />

Saan magbibigay <strong>ng</strong> iniksyon . . . . . . . . . . . . 542<br />

Paano maghanda <strong>ng</strong> heri<strong>ng</strong>gilya . . . . . . . . . 543<br />

Paano mag-iniksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kalamnan . . . . . . . . 544<br />

Paano mag-iniksyon<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ilalim <strong>ng</strong> balat (subcutaneous) . . . . . . . . . 544<br />

Maghanda na luna<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n a<strong>ng</strong><br />

allergic na reaksyon at allergic shock . . . . . 545<br />

Acupressure na Ma<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>he . . . . . . . . . . . . . . . . . . 546<br />

Marami<strong>ng</strong> klase <strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit a<strong>ng</strong> mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga impeksyon. Madalas mas<br />

na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pa<strong>ng</strong>anib na ma­impeksyon a<strong>ng</strong> mga tao<strong>ng</strong> may <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit o pin<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>la na, at<br />

mas lalala pa sila ku<strong>ng</strong> mai­impeksyon. Kaya mahalaga<strong>ng</strong> gawin a<strong>ng</strong><br />

lahat <strong>ng</strong> makakaya para pigilan a<strong>ng</strong> pagtubo nito. Mahalaga ri<strong>ng</strong><br />

protektahan mo a<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>rili na hindi ka mahawa <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> inaalagaan mo.<br />

Gali<strong>ng</strong> a<strong>ng</strong> impeksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga mikrobyo, tulad <strong>ng</strong> mga bacteria at virus, na sobra<strong>ng</strong><br />

liit para makita. Lahat <strong>ng</strong> tao ay palagi<strong>ng</strong> may dala<strong>ng</strong> bacteria <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> balat at <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob <strong>ng</strong><br />

bibig, bituka at ari. Madalas ay wala ito<strong>ng</strong> dinudulot na problema, pero kaya<strong>ng</strong> magbu<strong>ng</strong>a<br />

<strong>ng</strong> impeksyon ku<strong>ng</strong> maipapa<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> may<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit. Nabubuhay rin a<strong>ng</strong> mga mikrobyo <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga<br />

instrumento<strong>ng</strong> ginamit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> may<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit at madali<strong>ng</strong> maipapa<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> iba<strong>ng</strong> tutulu<strong>ng</strong>an mo.<br />

Maaari<strong>ng</strong> mapigilan a<strong>ng</strong> impeksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pamamagitan <strong>ng</strong> pagsunod <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga patnubay <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

kabanata<strong>ng</strong> ito. Para <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> iba pa<strong>ng</strong> paraan <strong>ng</strong> pagpigil <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> impeksyon, ti<strong>ng</strong>nan a<strong>ng</strong> pahina 149.<br />

MAHALAGA Dapat sundin mo a<strong>ng</strong> mga patnubay na ito tuwi<strong>ng</strong> may tutulo<strong>ng</strong>an ka,<br />

gumamit ka man <strong>ng</strong> kamay, instrumento o ispesyal na kagamitan. Ku<strong>ng</strong> hindi, maaari<br />

ka<strong>ng</strong> mahawahan <strong>ng</strong> mapa<strong>ng</strong>anib <strong>ng</strong> impeksyon, o magpa<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <strong>ng</strong> impeksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> iba.<br />

525


526 <stro<strong>ng</strong>>Mga</stro<strong>ng</strong>> <stro<strong>ng</strong>>Ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>nayan</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <stro<strong>ng</strong>>Pa<strong>ng</strong>a<strong>ng</strong>alaga</stro<strong>ng</strong>> <strong>ng</strong> <strong>Kalusugan</strong><br />

PAGHUHUGAS NG KAMAY<br />

Maghugas <strong>ng</strong> kamay bago at pagkatapos ma<strong>ng</strong>alaga <strong>ng</strong><br />

iba<strong>ng</strong> tao. Pinakamahalaga<strong>ng</strong> paraan ito <strong>ng</strong> pagpatay <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

mga mikrobyo<strong>ng</strong> nabubuhay <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> balat mo. Kaila<strong>ng</strong>an mo<strong>ng</strong><br />

maghugas <strong>ng</strong> kamay na<strong>ng</strong> mas mai<strong>ng</strong>at at mas matagal:<br />

• bago at pagkatapos tumulo<strong>ng</strong> magpaanak.<br />

• bago at pagkatapos humipo <strong>ng</strong> sugat o punit na balat.<br />

• bago at pagkatapos mag­iniksyon, o humiwa o bumutas<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> bahagi <strong>ng</strong> katawan.<br />

Gumamit <strong>ng</strong><br />

dumadaloy<br />

na tubig .<br />

Patuyuin a<strong>ng</strong> kamay<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ha<strong>ng</strong>in <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> halip<br />

na gumamit<br />

<strong>ng</strong> tuwalya .<br />

Huwag<br />

humipo <strong>ng</strong><br />

anuma<strong>ng</strong><br />

bagay ha<strong>ng</strong>ga’t<br />

hindi tuyo a<strong>ng</strong> kamay<br />

mo .<br />

• matapos makahipo <strong>ng</strong> dugo, ihi, dumi, mucus o likido <strong>ng</strong> puwerta.<br />

• matapos magta<strong>ng</strong>gal <strong>ng</strong> guwantes.<br />

Mag­<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bon para ta<strong>ng</strong>galin a<strong>ng</strong> dumi at mikrobyo. Magbila<strong>ng</strong> ha<strong>ng</strong>ga<strong>ng</strong><br />

30 haba<strong>ng</strong> kinukuskos a<strong>ng</strong> buo<strong>ng</strong> kamay <strong>ng</strong> mabula<strong>ng</strong> tubig. Gumamit<br />

<strong>ng</strong> brush o malambot na patpat para linisin a<strong>ng</strong> ilalim <strong>ng</strong> kuko. Tapos<br />

magbanlaw. Gumamit <strong>ng</strong> dumadaloy na tubig. Huwag maghugas <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

nagamit na<strong>ng</strong> tubig ku<strong>ng</strong> kaila<strong>ng</strong>a<strong>ng</strong> malinis na malinis a<strong>ng</strong> iyo<strong>ng</strong> kamay.<br />

Subuka<strong>ng</strong> gumawa <strong>ng</strong> Tippy Tap. Makakatipid ito <strong>ng</strong> tubig at magpapadali na magimbak<br />

<strong>ng</strong> suplay <strong>ng</strong> malinis na tubig para <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> paghuhugas <strong>ng</strong> kamay.<br />

Gumamit <strong>ng</strong><br />

malaki at<br />

malinis na<br />

plastik na<br />

botelya<strong>ng</strong> may<br />

hawakan .<br />

4 . Punuin<br />

a<strong>ng</strong> botelya<br />

<strong>ng</strong> malinis<br />

na tubig at<br />

takpan .<br />

1 . Ipitin <strong>ng</strong><br />

mainit na plais<br />

o kutsilyo<br />

a<strong>ng</strong> hawakan<br />

ha<strong>ng</strong>ga<strong>ng</strong><br />

magdikit ito .<br />

5 . Kapag pinatumba<br />

paharap a<strong>ng</strong> botelya,<br />

dadaloy palabas a<strong>ng</strong> tubig, kaya<br />

makakapaghugas ka <strong>ng</strong> kamay .<br />

Huwag sobrahan <strong>ng</strong> laki a<strong>ng</strong> butas<br />

dahil mag<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ya<strong>ng</strong> la<strong>ng</strong> <strong>ng</strong> tubig .<br />

2 . Gumawa <strong>ng</strong> maliit<br />

na butas <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> hawakan,<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> banda<strong>ng</strong> itaas<br />

la<strong>ng</strong> ku<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>an mo<br />

pinagdikit .<br />

PAANO MAGDISIMPEKTA (DISINFECT) NG MGA KAGAMITAN AT INSTRUMENTO<br />

High-level disinfection a<strong>ng</strong> tawag <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> paglilinis <strong>ng</strong> mga instrumento at kagamitan para<br />

puk<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>in a<strong>ng</strong> halos lahat <strong>ng</strong> mikrobyo.<br />

Dapat huga<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n muna a<strong>ng</strong> mga instrumento at pagkatapos idaan <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

disimpeksyon ku<strong>ng</strong> gagamitin <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>:<br />

• paghiwa, pagbutas o pagtato <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> balat.<br />

• pag­iniksyon.<br />

• pagputol <strong>ng</strong> cord <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pa<strong>ng</strong>a<strong>ng</strong>anak.<br />

• ek<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>minasyon <strong>ng</strong> puwerta, laluna haba<strong>ng</strong> o matapos<br />

ma<strong>ng</strong>anak, makunan o magpalaglag.<br />

• pagpasok <strong>ng</strong> likido <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> puwit (<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tumbo<strong>ng</strong> o rectum).<br />

3 . Para mai<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bit<br />

a<strong>ng</strong> tippy tap,<br />

gumawa <strong>ng</strong> 2<br />

pa<strong>ng</strong> butas <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

kabila<strong>ng</strong> gilid<br />

<strong>ng</strong> lalagyan at<br />

suutan ito <strong>ng</strong> tali .<br />

Mai<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bit <strong>ng</strong>ayon<br />

ito <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong>a <strong>ng</strong><br />

puno o pako .<br />

Puwede ri<strong>ng</strong> mag<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bit<br />

<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bon .


High-level disinfection: 3 hakba<strong>ng</strong><br />

Pagpigil <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> Impeksyon<br />

Dapat gawin agad a<strong>ng</strong> una at ika­2 hakba<strong>ng</strong> kapag tapos na <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga instrumento. Sika pi<strong>ng</strong><br />

huwag matuyo <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga ito a<strong>ng</strong> dugo o mucus. Gawin a<strong>ng</strong> ika­3 hakba<strong>ng</strong> kapag gagamitin na<br />

uli a<strong>ng</strong> mga instrumento. Puwede<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ma­<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ma<strong>ng</strong> gawin a<strong>ng</strong> lahat <strong>ng</strong> hakba<strong>ng</strong> ku<strong>ng</strong> maitatago<br />

a<strong>ng</strong> mga gamit na mananatili<strong>ng</strong> disinfected (ti<strong>ng</strong>nan <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> susunod na pahina).<br />

1. Pagbabad: Ibabad na<strong>ng</strong> 10 minuto a<strong>ng</strong> mga instrumento. Ku<strong>ng</strong> kaya,<br />

gumamit <strong>ng</strong> 0.5% na solusyon <strong>ng</strong> bleach (chlorine). Tulo<strong>ng</strong> a<strong>ng</strong> pagbabad<br />

muna <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> bleach na protektahan ka mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> impeksyon kapag nililinis na a<strong>ng</strong><br />

mga ito. Ku<strong>ng</strong> wala<strong>ng</strong> bleach, ibabad a<strong>ng</strong> mga instrumento <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tubig.<br />

Paano gumawa <strong>ng</strong> 0.5% bleach na solusyon na pa<strong>ng</strong>-disimpeksyon:<br />

Ku<strong>ng</strong> nakalagay <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> bleach na: Gumamit <strong>ng</strong>:<br />

2% chlorine . . . . . . . . . . . . . . . . . . . . 1 bahagi<strong>ng</strong> bleach <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 3 bahagi<strong>ng</strong> tubig<br />

5% chlorine . . . . . . . . . . . . . . . . . . . . 1 bahagi<strong>ng</strong> bleach <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 9 na bahagi<strong>ng</strong> tubig<br />

10% chlorine . . . . . . . . . . . . . . . . . . . 1 bahagi<strong>ng</strong> bleach <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 19 na bahagi<strong>ng</strong> tubig<br />

15% chlorine . . . . . . . . . . . . . . . . . . . 1 bahagi<strong>ng</strong> bleach <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 29 na bahagi<strong>ng</strong> tubig<br />

Halimbawa:<br />

Ku<strong>ng</strong> nakalagay <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> bleach na<br />

5% chlorine, gumamit <strong>ng</strong><br />

ganito karami<strong>ng</strong> bleach:<br />

at ganito<br />

karami<strong>ng</strong><br />

tubig:<br />

Magtimpla <strong>ng</strong> solusyon na <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>pat la<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> araw. Huwag ito<strong>ng</strong> gamitin ulit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

susunod na araw. Kapos na a<strong>ng</strong> bi<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> nito <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagpatay <strong>ng</strong> mikrobyo.<br />

2. Paghuhugas: Huga<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n a<strong>ng</strong> mga instrumento <strong>ng</strong> brush at<br />

ma<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bon na tubig ha<strong>ng</strong>ga<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> magmukha<strong>ng</strong> napakalinis <strong>ng</strong><br />

bawat i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>. Tapos banlawan <strong>ng</strong> malinis na tubig. Mag­i<strong>ng</strong>at para<br />

hindi mahiwa o matusok. Ku<strong>ng</strong> maaari, gumamit <strong>ng</strong> makapal na<br />

guwantes, o anuma<strong>ng</strong> guwantes na mayroon ka.<br />

3. Pagdisimpeksyon: Pasi<strong>ng</strong>awan (steam) o pakuluan a<strong>ng</strong> mga<br />

instrumento <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob <strong>ng</strong> 20 minuto (kasi<strong>ng</strong>tagal <strong>ng</strong> pag<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>i<strong>ng</strong> <strong>ng</strong> kanin).<br />

Para magpasi<strong>ng</strong>aw, kaila<strong>ng</strong>an <strong>ng</strong> kaldero na may takip. Hindi<br />

kaila<strong>ng</strong>a<strong>ng</strong> malubog <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tubig a<strong>ng</strong> mga instrumento, pero gumamit<br />

<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>pat na tubig para tuloy­tuloy na lumabas a<strong>ng</strong> si<strong>ng</strong>aw <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> gilid<br />

<strong>ng</strong> takip <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob <strong>ng</strong> 20 minuto.<br />

Para magpakulo, hindi kaila<strong>ng</strong>a<strong>ng</strong> punuin a<strong>ng</strong> kaldero <strong>ng</strong> tubig.<br />

Pero kaila<strong>ng</strong>a<strong>ng</strong> tiyakin na nakalubog <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tubig a<strong>ng</strong> lahat <strong>ng</strong> instrumento <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

buo<strong>ng</strong> haba <strong>ng</strong> pagpapakulo. Ku<strong>ng</strong> maaari, lagyan <strong>ng</strong> takip a<strong>ng</strong> kaldero.<br />

Sa pagpapasi<strong>ng</strong>aw at pagpapakulo, simulan a<strong>ng</strong> pagbila<strong>ng</strong> <strong>ng</strong> 20 minuto<br />

kapag ganap na<strong>ng</strong> kumukulo a<strong>ng</strong> tubig. Huwag magdagdag <strong>ng</strong> anuma<strong>ng</strong> bago <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

loob kaldero kapag nagsimula ka na<strong>ng</strong> magbila<strong>ng</strong>.<br />

MAHALAGA Huwag na huwag gumamit <strong>ng</strong> instrumento <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> lampas<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> tao na hindi muna hinuhuga<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n at dinidisimpekta a<strong>ng</strong><br />

lahat <strong>ng</strong> bahagi <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagitan <strong>ng</strong> bawat paggamit.<br />

527


528 <stro<strong>ng</strong>>Mga</stro<strong>ng</strong>> <stro<strong>ng</strong>>Ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>nayan</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <stro<strong>ng</strong>>Pa<strong>ng</strong>a<strong>ng</strong>alaga</stro<strong>ng</strong>> <strong>ng</strong> <strong>Kalusugan</strong><br />

Pag-imbak <strong>ng</strong> mga instrumento<br />

Ku<strong>ng</strong> maitatago mo na<strong>ng</strong> wasto a<strong>ng</strong> mga instrumento, puwede mo<strong>ng</strong> gawin a<strong>ng</strong><br />

Hakba<strong>ng</strong> 1, 2 at 3 <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> panahon, at magigi<strong>ng</strong> handa <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> paggamit a<strong>ng</strong> mga instrumento<br />

kapag kaila<strong>ng</strong>an mo. Sa pag­imbak <strong>ng</strong> mga instrumento:<br />

• Matapos magpakulo, ibuhos a<strong>ng</strong> tubig at hayaa<strong>ng</strong> matuyo na<strong>ng</strong> mag­i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> a<strong>ng</strong> mga<br />

instrumento. Huwag patuyuin <strong>ng</strong> pampunas na tela. Ilagay a<strong>ng</strong> takip <strong>ng</strong> kaldero o<br />

takpan ito <strong>ng</strong> manipis at malinis na tela para hindi mapasok <strong>ng</strong> mga la<strong>ng</strong>aw o<br />

alikabok. Tiyaki<strong>ng</strong> matuyo na<strong>ng</strong> husto a<strong>ng</strong> mga instrumento. Kakalawa<strong>ng</strong>in<br />

a<strong>ng</strong> mga metal na bagay ku<strong>ng</strong> hindi tuyo.<br />

• Huwag hayaa<strong>ng</strong> madikit a<strong>ng</strong> instrumento <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kamay mo o <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> anuma<strong>ng</strong><br />

bagay.<br />

• Itago a<strong>ng</strong> instrumento <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> garapon o lalagyan na may takip<br />

na nadisimpekta rin. Puwede mo<strong>ng</strong> gamitin a<strong>ng</strong> pinagpakuluan<br />

na kaldero<strong>ng</strong> may takip, o a<strong>ng</strong> steamer na ginamit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

pagpapasi<strong>ng</strong>aw, o i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> botelya<strong>ng</strong> garapon na<br />

may takip na pinakuluan. Ku<strong>ng</strong> maaari, ilagay<br />

lahat <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> malinis na plastik na supot para<br />

maprotektahan mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> alikabok.<br />

Tiyaki<strong>ng</strong> a<strong>ng</strong> lalagyan at<br />

takip na pag-iimbakan<br />

<strong>ng</strong> mga instrumento ay<br />

nadisimpekta rin .<br />

Pagdisimpekta <strong>ng</strong> mga karayom at heri<strong>ng</strong>gilya, guwantes at bendahe<br />

Karayom at heri<strong>ng</strong>gilya. Ku<strong>ng</strong> puwede<strong>ng</strong> gamitin na<strong>ng</strong> higit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong><br />

beses a<strong>ng</strong> karayom at heri<strong>ng</strong>gilya (reu<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ble), magpapuswit <strong>ng</strong> bleach<br />

o tubig na ma<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> heri<strong>ng</strong>gilya 3 beses pagkagamit na<br />

pagkagamit nito. Tapos, kalasin a<strong>ng</strong> mga bahagi nito at<br />

sundin a<strong>ng</strong> ika­2 hakba<strong>ng</strong>, tapos a<strong>ng</strong> ika­3 hakba<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

pahina 527. Mai<strong>ng</strong>at na itago a<strong>ng</strong> heri<strong>ng</strong>gilya ha<strong>ng</strong>ga<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> susunod<br />

na paggamit. Tiyaki<strong>ng</strong> hindi mahawakan a<strong>ng</strong> karayom o plu<strong>ng</strong>er<br />

(bahagi <strong>ng</strong> heri<strong>ng</strong>gilya na tinutulak papaloob).<br />

Ku<strong>ng</strong> hindi kaya<strong>ng</strong> itago <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> malinis at tuyo<strong>ng</strong> lugar, pakuluan o pasi<strong>ng</strong>awan ito muli<br />

bago gamitin.<br />

Ku<strong>ng</strong> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> beses la<strong>ng</strong> puwede<strong>ng</strong> gamitin a<strong>ng</strong> karayom at heri<strong>ng</strong>gilya (dispo<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ble),<br />

mai<strong>ng</strong>at na ipasok ito <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> lalagya<strong>ng</strong> may takip na hindi mabubutas <strong>ng</strong> karayom, at<br />

ibaon na<strong>ng</strong> malalim a<strong>ng</strong> lalagyan. Ku<strong>ng</strong> hindi mo kaya<strong>ng</strong> idispat<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> na<strong>ng</strong> ligtas a<strong>ng</strong> karayom,<br />

papuswitan ito <strong>ng</strong> bleach na solusyon na<strong>ng</strong> 3 ulit.<br />

Delikado a<strong>ng</strong><br />

mga nagamit<br />

na<strong>ng</strong> karayom!<br />

MALI! TAMA!


Guwantes<br />

A<strong>ng</strong> guwantes ay proteksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> iyo at mga tao<strong>ng</strong> tinu tu lu<strong>ng</strong>an<br />

mo mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagkalat <strong>ng</strong> impeksyon. Ku<strong>ng</strong> wala<strong>ng</strong> guwantes, gumamit<br />

<strong>ng</strong> malinis na plastik na supot para balutin a<strong>ng</strong> mga kamay.<br />

Min<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n OK la<strong>ng</strong> na gumamit <strong>ng</strong> guwantes na malinis pero hindi<br />

nadisimpekta—basta hindi ito ginagamit uli. Pero kaila<strong>ng</strong>an palagi<br />

<strong>ng</strong> guwantes na dumaan <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> high-level disinfection kapag:<br />

• pinapasok <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> puwerta a<strong>ng</strong> kamay <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> paggawa <strong>ng</strong> emerhensiya<strong>ng</strong><br />

ek<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>minasyon bago o matapos a<strong>ng</strong> ma<strong>ng</strong>anak o magpalaglag.<br />

• humihipo <strong>ng</strong> balat na may hiwa o punit.<br />

Paggamit <strong>ng</strong> guwantes na dumaan <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> high-level disinfection:<br />

Ku<strong>ng</strong> may pares ka <strong>ng</strong> ‘isterili<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>do<strong>ng</strong>’ guwantes na nakapakete,<br />

itabi mo ito para <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> panahon na kaila<strong>ng</strong>an mo <strong>ng</strong> ispesyal na<br />

pag-ii<strong>ng</strong>at na hindi makapagkalat <strong>ng</strong> impeksyon .<br />

Sa pagsusuot <strong>ng</strong><br />

guwantes, i<strong>ng</strong>ata<strong>ng</strong><br />

wala<strong>ng</strong> anuma<strong>ng</strong><br />

bagay na dumikit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

bahagi <strong>ng</strong> guwantes<br />

na ihihipo <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tao .<br />

Pagpigil <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> Impeksyon<br />

Ku<strong>ng</strong> wala<strong>ng</strong> guwantes,<br />

puwede ka<strong>ng</strong> gumamit<br />

<strong>ng</strong> malinis na plastik na<br />

supot para pambalot <strong>ng</strong><br />

mga kamay .<br />

hawakan<br />

dito<br />

huwag hawakan<br />

a<strong>ng</strong> mga daliri<br />

hawakan<br />

dito<br />

Ku<strong>ng</strong> gagamitin mo a<strong>ng</strong> guwantes na<strong>ng</strong> higit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> beses, kaila<strong>ng</strong>an ito<strong>ng</strong> malinis,<br />

madisimpekta at maitago ayon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> direksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pahina 527 at 528. Suriin palagi a<strong>ng</strong><br />

nahuga<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> guwantes at itapon a<strong>ng</strong> may butas o punit.<br />

Ku<strong>ng</strong> maaari, pinakamahu<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>y na pasi<strong>ng</strong>awan a<strong>ng</strong> guwantes <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> halip na pakuluan dahil<br />

puwede<strong>ng</strong> iwan <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kaldero ha<strong>ng</strong>ga<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> matuyo. Ku<strong>ng</strong> hindi kaya<strong>ng</strong> pasi<strong>ng</strong>awan at kaila<strong>ng</strong>a<strong>ng</strong><br />

pakuluan, sikapi<strong>ng</strong> mapatuyo <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ilalim <strong>ng</strong> araw. Para gawin ito, malama<strong>ng</strong> kaila<strong>ng</strong>a<strong>ng</strong><br />

hawakan a<strong>ng</strong> mga guwantes, kaya hindi na ito disinfected. Pero magigi<strong>ng</strong> malinis naman.<br />

Itabi a<strong>ng</strong> mga ito <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> malinis at tuyo<strong>ng</strong> taguan.<br />

Bendahe na tela<br />

I<strong>ng</strong>atan na hindi mahawakan<br />

a<strong>ng</strong> iba<strong>ng</strong> guwantes<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagkuha mo <strong>ng</strong><br />

isusuot mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

imbakan na<br />

garapon o<br />

lalagyan .<br />

Ku<strong>ng</strong> wala<strong>ng</strong> isterili<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>do<strong>ng</strong> ga<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> (gauze), gumamit <strong>ng</strong> bendahe na tela. Sundin a<strong>ng</strong> patnubay<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> disimpeksyon at pag­iimbak <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pahina 527 at 528. Patuyuin a<strong>ng</strong> bendahe <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> araw,<br />

pero tiyaki<strong>ng</strong> malayo <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> lupa at protektado mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> alikabok, la<strong>ng</strong>aw at iba pa<strong>ng</strong> insekto.<br />

Dapat sunugin o idispat<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> na<strong>ng</strong> mai<strong>ng</strong>at a<strong>ng</strong> anuma<strong>ng</strong> bagay<br />

na nadikit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> dugo o likido <strong>ng</strong> katawan (ihi, dumi, tamod, likido<br />

mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> panubigan, nana) para hindi maabot <strong>ng</strong> mga bata o<br />

hayop . Ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ma dito a<strong>ng</strong> mga suplay na hindi na magagamit pero<br />

kontaminado, tulad <strong>ng</strong> heri<strong>ng</strong>gilya, punit na guwantes, guwantes<br />

na min<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n la<strong>ng</strong> ginagamit, ga<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> o bulak .<br />

529


530 <stro<strong>ng</strong>>Mga</stro<strong>ng</strong>> <stro<strong>ng</strong>>Ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>nayan</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <stro<strong>ng</strong>>Pa<strong>ng</strong>a<strong>ng</strong>alaga</stro<strong>ng</strong>> <strong>ng</strong> <strong>Kalusugan</strong><br />

Pagsukat <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> Temperatura, Pulso, Paghi<strong>ng</strong>a at Presyon <strong>ng</strong> Dugo<br />

Kapag may <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit o may problema <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kalusugan, maaari<strong>ng</strong> magbago a<strong>ng</strong> mga bataya<strong>ng</strong><br />

pisikal na palatandaan <strong>ng</strong> tao. Na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> susunod na ila<strong>ng</strong> pahina ku<strong>ng</strong> paano sukatin a<strong>ng</strong> mga<br />

palatandaa<strong>ng</strong> ito para malaman ku<strong>ng</strong> may problema a<strong>ng</strong> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> tao.<br />

TEMPERATURA<br />

Ku<strong>ng</strong> kaila<strong>ng</strong>an mo<strong>ng</strong> malaman a<strong>ng</strong> temperatura <strong>ng</strong> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> tao at<br />

wala ka<strong>ng</strong> thermometer, idampi a<strong>ng</strong> likod <strong>ng</strong> palad mo <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kanya<strong>ng</strong><br />

balat, at ikumpara <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> iyo<strong>ng</strong> balat. Ku<strong>ng</strong> mas mainit a<strong>ng</strong> balat niya<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pakiramdam mo, malama<strong>ng</strong> may lagnat siya. Para malaman ku<strong>ng</strong><br />

ano a<strong>ng</strong> gagawin para <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> lagnat, ti<strong>ng</strong>nan a<strong>ng</strong> pahina 297.<br />

Ku<strong>ng</strong> may thermometer, puwede<strong>ng</strong> sukatin a<strong>ng</strong> temperatura <strong>ng</strong> tao <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> bibig, kilikili o<br />

tumbo<strong>ng</strong>. Karaniwan mas mababa a<strong>ng</strong> temperatura <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kilikili, mas mainit­init <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> bibig, at<br />

pinamainit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tumbo<strong>ng</strong>. Narito a<strong>ng</strong> pagsukat <strong>ng</strong> temperatura <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> sentigrado (centigrade) na<br />

ginagamit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> Pilipinas:<br />

Centigrade (C) 34 35 36 37 38 39 40 41 42<br />

Para <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> bibig a<strong>ng</strong><br />

mga nakalista<strong>ng</strong><br />

sukat dito <strong>ng</strong> normal<br />

at may lagnat na<br />

temperatura .<br />

Paano sukatin a<strong>ng</strong> temperatura<br />

Sobra<strong>ng</strong><br />

Baba<br />

N<br />

O<br />

R<br />

M<br />

A<br />

L<br />

Kaunti<strong>ng</strong><br />

Lagnat<br />

Mataas na<br />

Lagnat<br />

1. Linisi<strong>ng</strong> maige a<strong>ng</strong> thermometer <strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bon at malamig na tubig o alkohol. Hawakan <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

dulo na wala<strong>ng</strong> kulay pilak (o pula) at kalugin na<strong>ng</strong> malakas at pabigla, ha<strong>ng</strong>ga<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

mas mababa <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 36 degrees a<strong>ng</strong> nababa<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> sukat.<br />

2. Ilagay a<strong>ng</strong> thermometer <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> . . .<br />

ilalim <strong>ng</strong><br />

dila (i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ra<br />

a<strong>ng</strong> bibig<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> palibot<br />

nito)<br />

o kaya o kaya<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kilikili ku<strong>ng</strong><br />

may pa<strong>ng</strong>anib<br />

na makagat<br />

<strong>ng</strong> tao a<strong>ng</strong><br />

thermometer<br />

3. Iwan <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob <strong>ng</strong> 3­4 na minuto.<br />

4. Ba<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>hin.<br />

Pihitin a<strong>ng</strong><br />

thermometer ha<strong>ng</strong>ga<strong>ng</strong><br />

makita a<strong>ng</strong> kulay pilak<br />

(o pula) na linya .<br />

A<strong>ng</strong> dulo <strong>ng</strong> kulay<br />

pilak (o pula) na linya<br />

a<strong>ng</strong> nagmamarka <strong>ng</strong><br />

temperatura .<br />

40 degrees C<br />

a<strong>ng</strong> marka <strong>ng</strong><br />

temperatura<br />

na ito .<br />

34 35 36 37 38 39 40 41 42<br />

Normal<br />

Lagnat Mataas na lagnat<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob <strong>ng</strong> puwit (<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tumbo<strong>ng</strong>)<br />

na<strong>ng</strong> mai<strong>ng</strong>at (ba<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>in o lagyan<br />

muna <strong>ng</strong> petroleum gel) .<br />

5. Huga<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n na<strong>ng</strong> mabuti<br />

a<strong>ng</strong> thermometer <strong>ng</strong><br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bon at malamig na<br />

tubig. Pagkatapos, ku<strong>ng</strong><br />

kakayanin, ibabad <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob<br />

<strong>ng</strong> 20 minuto <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> bleach<br />

na solution (ti<strong>ng</strong>nan a<strong>ng</strong><br />

pahina 523) at banlawan<br />

<strong>ng</strong> malinis na tubig.


PULSO (TIBOK NG PUSO)<br />

Pagsukat <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> Temperatura, Pulso, Paghi<strong>ng</strong>a at Presyon <strong>ng</strong> Dugo<br />

Malalaman <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pulso ku<strong>ng</strong> gaano kabilis tumitibok a<strong>ng</strong> puso at gaano kalakas ito nagtatrabaho.<br />

Matapos a<strong>ng</strong> mabigat na trabaho o ehersisyo, tumitibok na<strong>ng</strong> mabilis a<strong>ng</strong> puso <strong>ng</strong><br />

malusog na tao, pero bumabalik <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> normal pagkaraan <strong>ng</strong> ila<strong>ng</strong> minuto. Karaniwan nadadagdagan<br />

<strong>ng</strong> 20 tibok bawat minuto a<strong>ng</strong> puso <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> bawat 1 degree (C) na pagtaas <strong>ng</strong> lagnat.<br />

Na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagitan <strong>ng</strong> 60 at 90 na tibok bawat minuto a<strong>ng</strong> normal na pulso <strong>ng</strong> nakatatanda<br />

(adult). Maaari<strong>ng</strong> palatandaan a<strong>ng</strong> mabilis na pulso <strong>ng</strong>:<br />

• pagkawala <strong>ng</strong> dugo o pagkawala <strong>ng</strong> likido o shock (ti<strong>ng</strong>nan a<strong>ng</strong> pahina 254).<br />

• lagnat o impeksyon.<br />

• problema <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> baga at sistema<strong>ng</strong> hi<strong>ng</strong>ahan, o <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> puso.<br />

• problema <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> thyroid.<br />

Para kumuha <strong>ng</strong> pulso,<br />

ilapat a<strong>ng</strong> iyo<strong>ng</strong> daliri <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

pupulsuhan o wrist tulad<br />

nito (huwag gamitin a<strong>ng</strong><br />

hinlalaki) .<br />

BILIS NG PAGHINGA<br />

Ku<strong>ng</strong> hindi mo mahanap a<strong>ng</strong><br />

pulso <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> wrist, hanapin ito <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

leeg katabi <strong>ng</strong> babagti<strong>ng</strong>an o<br />

lalamunan . . .<br />

. . .o ilapat a<strong>ng</strong> iyo<strong>ng</strong> tai<strong>ng</strong>a direkta <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

dibdib at paki<strong>ng</strong>gan a<strong>ng</strong> tibok <strong>ng</strong> puso .<br />

Makakapagsiwalat a<strong>ng</strong> bilis <strong>ng</strong> paghi<strong>ng</strong>a <strong>ng</strong> kalusugan <strong>ng</strong> baga at sistema<strong>ng</strong> hi<strong>ng</strong>ahan.<br />

Makakabigay din ito <strong>ng</strong> impormasyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pa<strong>ng</strong>kalahata<strong>ng</strong> kalusugan <strong>ng</strong> tao. Para masukat,<br />

pagmasdan a<strong>ng</strong> pagtaas at pagbaba <strong>ng</strong> dibdib haba<strong>ng</strong> nagpapahi<strong>ng</strong>a a<strong>ng</strong> tao. Mula 12<br />

ha<strong>ng</strong>ga<strong>ng</strong> 20 bawat minuto a<strong>ng</strong> normal na paghi<strong>ng</strong>a <strong>ng</strong> nakatatanda (a<strong>ng</strong> kumpleto<strong>ng</strong><br />

paghi<strong>ng</strong>a ay katumbas <strong>ng</strong> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> hi<strong>ng</strong>a papasok at i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> hi<strong>ng</strong>a palabas).<br />

Karaniwan bumibilis a<strong>ng</strong> paghi<strong>ng</strong>a (ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bay <strong>ng</strong> pulso) kapag may impeksyon, lagnat,<br />

pagtagas <strong>ng</strong> dugo, dehydration, shock, problema <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> baga o iba pa<strong>ng</strong> emerhensya.<br />

Para <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tao<strong>ng</strong> may malubha<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit, maaari<strong>ng</strong> paglapit <strong>ng</strong> kamatayan a<strong>ng</strong> kahulugan <strong>ng</strong><br />

masyado<strong>ng</strong> mabagal na pulso at paghi<strong>ng</strong>a.<br />

Maaari<strong>ng</strong> palatandaan <strong>ng</strong> impeksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> sistema<strong>ng</strong> hi<strong>ng</strong>ahan a<strong>ng</strong> mabilis at mababaw na<br />

paghi<strong>ng</strong>a. Maaari<strong>ng</strong> palatandaan <strong>ng</strong> pulmonya (ti<strong>ng</strong>nan a<strong>ng</strong> pahina 304) a<strong>ng</strong> paghi<strong>ng</strong>a <strong>ng</strong> higit<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 30 beses bawat minuto.<br />

531


532 <stro<strong>ng</strong>>Mga</stro<strong>ng</strong>> <stro<strong>ng</strong>>Ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>nayan</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <stro<strong>ng</strong>>Pa<strong>ng</strong>a<strong>ng</strong>alaga</stro<strong>ng</strong>> <strong>ng</strong> <strong>Kalusugan</strong><br />

PRESYON NG DUGO<br />

A<strong>ng</strong> presyon <strong>ng</strong> dugo ay sukat ku<strong>ng</strong> gaano kalakas a<strong>ng</strong><br />

puwer<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> o pagtulak <strong>ng</strong> dugo <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob <strong>ng</strong> mga daluyan nito.<br />

Mabuti<strong>ng</strong> malaman a<strong>ng</strong> presyon <strong>ng</strong> dugo <strong>ng</strong> babae <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

mga panaho<strong>ng</strong> ito:<br />

• kapag nagbubuntis, na<strong>ng</strong>a<strong>ng</strong>anak, nakunan o<br />

nagpalaglag.<br />

• ku<strong>ng</strong> gumagamit o plano<strong>ng</strong> gumamit <strong>ng</strong> pildoras na<br />

kontraseptibo.<br />

• <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> panahon <strong>ng</strong> emerhensya, tulad <strong>ng</strong> shock,<br />

matindi<strong>ng</strong> pananakit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tiyan, o mahirap na<br />

pa<strong>ng</strong>a<strong>ng</strong>anak.<br />

Ano a<strong>ng</strong> kahulugan <strong>ng</strong> mga numero<br />

May dalawa<strong>ng</strong> numero a<strong>ng</strong> sukat <strong>ng</strong> presyon <strong>ng</strong> dugo:<br />

120 a<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> taas (systolic) na sukat<br />

80 a<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ibaba (diastolic) na sukat<br />

Kadala<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n mga 120/80 a<strong>ng</strong> normal na presyon <strong>ng</strong> dugo <strong>ng</strong> nakatatanda, pero anuma<strong>ng</strong><br />

sukat mula 90/60 ha<strong>ng</strong>ga<strong>ng</strong> 140/85 ay maituturi<strong>ng</strong> na normal.<br />

Madalas mas marami<strong>ng</strong> impormasyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kalusugan a<strong>ng</strong> naibibigay <strong>ng</strong> ibaba<strong>ng</strong> numero.<br />

Halimbawa, ku<strong>ng</strong> 140/80 a<strong>ng</strong> presyon <strong>ng</strong> dugo <strong>ng</strong> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> tao, wala gaano<strong>ng</strong> dapat ipag­alala.<br />

Pero ku<strong>ng</strong> 140/110 ito, may seryoso<strong>ng</strong> altapresyon siya at dapat magbawas <strong>ng</strong> timba<strong>ng</strong><br />

(ku<strong>ng</strong> mataba) o maghanap <strong>ng</strong> panlunas. Ku<strong>ng</strong> higit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 100 a<strong>ng</strong> ibaba<strong>ng</strong> numero, madalas<br />

na<strong>ng</strong>a<strong>ng</strong>ahulugan na dapat bigya<strong>ng</strong> pansin na a<strong>ng</strong> taas <strong>ng</strong> presyon <strong>ng</strong> dugo (<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pamamagitan<br />

<strong>ng</strong> diyeta at baka gamot).<br />

Ku<strong>ng</strong> regular na mababa a<strong>ng</strong> presyon <strong>ng</strong> dugo <strong>ng</strong> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> tao, wala<strong>ng</strong> dapat ipag­alala.<br />

Sa katunayan, a<strong>ng</strong> presyon <strong>ng</strong> dugo na na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mababa<strong>ng</strong> bahagi <strong>ng</strong> normal—90/60 ha<strong>ng</strong>ga<strong>ng</strong><br />

110/70—ay na<strong>ng</strong>a<strong>ng</strong>ahulugan na mas malama<strong>ng</strong> mahaba a<strong>ng</strong> buhay at mas maliit a<strong>ng</strong><br />

pa<strong>ng</strong>anib na maatake <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> puso o ma­stroke.<br />

Palatandaan <strong>ng</strong> pa<strong>ng</strong>anib a<strong>ng</strong> biglaa<strong>ng</strong> pagbaba <strong>ng</strong> presyon <strong>ng</strong> dugo, laluna ku<strong>ng</strong><br />

bumaba pa <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 90/60. Magbantay <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> anuma<strong>ng</strong> biglaa<strong>ng</strong> pagbag<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>k <strong>ng</strong> presyon <strong>ng</strong> dugo <strong>ng</strong><br />

tao<strong>ng</strong> tinataga<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n <strong>ng</strong> dugo o na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pa<strong>ng</strong>anib<br />

na mag­shock. Ku<strong>ng</strong> makakuha ka <strong>ng</strong> hindi<br />

normal na ba<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <strong>ng</strong> presyon <strong>ng</strong> dugo at hindi ka<br />

nagdududa na na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> shock a<strong>ng</strong> tao, maghintay <strong>ng</strong><br />

ila<strong>ng</strong> minuto at sukatin muli.<br />

Madalas kaila<strong>ng</strong>an mo<strong>ng</strong> subaybayan a<strong>ng</strong><br />

presyon <strong>ng</strong> dugo <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob <strong>ng</strong> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> panahon<br />

(halimbawa, <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagbubuntis <strong>ng</strong> babae) para<br />

makita ku<strong>ng</strong> paano ito nagbabago.<br />

Makakatulo<strong>ng</strong> ku<strong>ng</strong> gagawa <strong>ng</strong> talaan:<br />

Sept 15 100<br />

60<br />

Oct 12 110 60<br />

Nov 15 90 58<br />

Dec 10 112 60<br />

Jan 12 110 70<br />

Bawat buwan,<br />

tumataas at<br />

bumababa na<strong>ng</strong><br />

kaunti a<strong>ng</strong><br />

presyon <strong>ng</strong> dugo<br />

<strong>ng</strong> babae<strong>ng</strong> ito .<br />

Normal la<strong>ng</strong> a<strong>ng</strong><br />

ganito .


Pagsukat <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> Temperatura, Pulso, Paghi<strong>ng</strong>a at Presyon <strong>ng</strong> Dugo<br />

Paano kumuha <strong>ng</strong> presyon <strong>ng</strong> dugo<br />

May iba’t iba<strong>ng</strong> klase <strong>ng</strong> gamit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagsukat <strong>ng</strong> presyon <strong>ng</strong> dugo.<br />

May pataas na sukatan o gauge a<strong>ng</strong> iba na mukha<strong>ng</strong> thermometer.<br />

May pabilog na dial naman a<strong>ng</strong> iba.<br />

Madalas may<br />

ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ma<strong>ng</strong><br />

stethoscope a<strong>ng</strong><br />

gamit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagkuha <strong>ng</strong><br />

presyon <strong>ng</strong> dugo.<br />

Sa pagkuha <strong>ng</strong> presyon <strong>ng</strong> dugo, <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bihin muna <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tao ku<strong>ng</strong> ano a<strong>ng</strong> gagawin mo.<br />

Pagkatapos, sundin a<strong>ng</strong> sumusunod na hakba<strong>ng</strong>:<br />

1. Ipalibot<br />

a<strong>ng</strong> cuff<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> itaas<br />

na braso<br />

na wala<strong>ng</strong><br />

damit.<br />

3. Kapain a<strong>ng</strong> pulso <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> banda<strong>ng</strong> ibaba<br />

la<strong>ng</strong> <strong>ng</strong> siko, <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob na bahagi<br />

<strong>ng</strong> braso, at ipato<strong>ng</strong> dito a<strong>ng</strong><br />

stethoscope. Min<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n maaari<strong>ng</strong><br />

hindi mo maramdaman a<strong>ng</strong><br />

pulso. Ku<strong>ng</strong> hindi <strong>ng</strong>a, ipato<strong>ng</strong><br />

la<strong>ng</strong> a<strong>ng</strong> stethoscope <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

sentro <strong>ng</strong> tiklop <strong>ng</strong> balat,<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kabila<strong>ng</strong> panig <strong>ng</strong> siko.<br />

5. Haba<strong>ng</strong> binobomba mo,<br />

gagalaw a<strong>ng</strong><br />

karayom <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

gauge. Kapag<br />

umabot ito<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 200,<br />

itigil a<strong>ng</strong><br />

pagbomba.<br />

6. Luwagan<br />

na<strong>ng</strong> kaunti<br />

a<strong>ng</strong> pihitan<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> valve para<br />

sumi<strong>ng</strong>aw<br />

na<strong>ng</strong> mabagal<br />

a<strong>ng</strong> ha<strong>ng</strong>in.<br />

Sa pagsi<strong>ng</strong>aw palabas <strong>ng</strong> ha<strong>ng</strong>in, magsisimula<strong>ng</strong><br />

marinig mo a<strong>ng</strong> pulso <strong>ng</strong> tao <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

stethoscope. Tandaan ku<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>an nakatapat<br />

a<strong>ng</strong> karayom o kulay pilak na bar <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> una<strong>ng</strong><br />

pagkarinig mo <strong>ng</strong> pulso (ito a<strong>ng</strong> itaas na<br />

numero) at kapag nawala a<strong>ng</strong> pulso o nagi<strong>ng</strong><br />

mahina<strong>ng</strong>­mahina (ito a<strong>ng</strong> ibaba<strong>ng</strong> numero).<br />

cuff<br />

2. Pihitin papunta<strong>ng</strong> kanan a<strong>ng</strong> balbula<br />

(valve) <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> goma<strong>ng</strong> pambomba para<br />

sumara. Iikli a<strong>ng</strong> ta<strong>ng</strong>kay <strong>ng</strong> balbula.<br />

4. Bombahan <strong>ng</strong> ha<strong>ng</strong>in a<strong>ng</strong> cuff<br />

gamit a<strong>ng</strong> goma na<br />

pambomba.<br />

Ku<strong>ng</strong>...<br />

pero una<strong>ng</strong> nakarinig ka<br />

<strong>ng</strong> pulso banda rito<br />

at pagkatapos nawala<br />

a<strong>ng</strong> tunog banda rito<br />

ibig <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bihin a<strong>ng</strong> presyon<br />

<strong>ng</strong> dugo ay 100/70.<br />

7. Babalik<br />

pababa a<strong>ng</strong><br />

karayom.<br />

(Ku<strong>ng</strong> naka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ra<br />

a<strong>ng</strong> valve,<br />

mananatili ito<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 200.)<br />

wala ka<strong>ng</strong> marinig kapag<br />

nakaturo a<strong>ng</strong> karayom dito...<br />

... o dito<br />

80<br />

100<br />

60<br />

120<br />

40<br />

20<br />

140<br />

160 180 200 220 240 260 280<br />

0<br />

gauge<br />

533


534 <stro<strong>ng</strong>>Mga</stro<strong>ng</strong>> <stro<strong>ng</strong>>Ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>nayan</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <stro<strong>ng</strong>>Pa<strong>ng</strong>a<strong>ng</strong>alaga</stro<strong>ng</strong>> <strong>ng</strong> <strong>Kalusugan</strong><br />

Paano Mag-ek<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>min <strong>ng</strong> Tiyan<br />

Ku<strong>ng</strong> may pananakit a<strong>ng</strong> babae <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> puson, ba<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>hin muna a<strong>ng</strong> kabanata<strong>ng</strong> “Pananakit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

Puson” at itano<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kanya a<strong>ng</strong> mga nakasulat <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pahina 357.<br />

Pagkatapos suriin a<strong>ng</strong> kanya<strong>ng</strong> tiyan:<br />

1. Hili<strong>ng</strong>in <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kanya na maghubad para makikita mo a<strong>ng</strong> kanya<strong>ng</strong> tiyan mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> gawi<strong>ng</strong><br />

ibaba la<strong>ng</strong> <strong>ng</strong> suso ha<strong>ng</strong>ga<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga buhok <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagitan <strong>ng</strong> kanya<strong>ng</strong> binti.<br />

2. Hili<strong>ng</strong>in <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kanya na humiga na<strong>ng</strong> lapat a<strong>ng</strong> likod <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> matigas­tigas na kama, lame<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>,<br />

o malinis na <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>hig. Ipabaluktot a<strong>ng</strong> tuhod at ilapit a<strong>ng</strong> paa <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> puwitan. Hili<strong>ng</strong>in <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kanya<br />

na irelaks a<strong>ng</strong> kanya<strong>ng</strong> kalamnan <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tiyan <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> makakaya. Maaari<strong>ng</strong><br />

mahirap ito <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tao<strong>ng</strong> na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ktan.<br />

3. Ilapat a<strong>ng</strong> tai<strong>ng</strong>a <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tiyan at makinig <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

bumubula­bula o lumalaguklok<br />

(gurgli<strong>ng</strong>) na i<strong>ng</strong>ay. Ku<strong>ng</strong> wala<br />

ka<strong>ng</strong> anuma<strong>ng</strong> marinig <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

loob <strong>ng</strong> 2 minuto, palatandaan<br />

ito <strong>ng</strong> pa<strong>ng</strong>anib<br />

(ti<strong>ng</strong>nan a<strong>ng</strong> p. 354).<br />

4. Hili<strong>ng</strong>in <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kanya<strong>ng</strong> ituro ku<strong>ng</strong><br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>a<strong>ng</strong> banda pinakama<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit.<br />

Pagkatapos, mai<strong>ng</strong>at na diinan<br />

a<strong>ng</strong> kabila<strong>ng</strong> panig. Ituloy a<strong>ng</strong><br />

mai<strong>ng</strong>at na pagdiin haba<strong>ng</strong><br />

ginagalaw <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> palibot <strong>ng</strong> tiyan<br />

para makita mo ku<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>an<br />

pinakama<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit.<br />

5. Haba<strong>ng</strong> dinidiinan a<strong>ng</strong><br />

tiyan, kapain ku<strong>ng</strong> may mga<br />

bumubukol. Dagdag pa, kapain<br />

ku<strong>ng</strong> malambot o matigas a<strong>ng</strong><br />

tiyan, at ku<strong>ng</strong> kaya niya<strong>ng</strong> irelaks<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ilalim <strong>ng</strong> iyo<strong>ng</strong> kamay.<br />

6. Para matiyak na wala siya<strong>ng</strong> iba pa<strong>ng</strong> problema tulad <strong>ng</strong> appendicitis, impeksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

bituka, o PID (pelvic inflammatory disease), dahan­dahan pero matatag na diinan a<strong>ng</strong><br />

kanya<strong>ng</strong> puson <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kaliwa<strong>ng</strong> bahagi, <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> banda<strong>ng</strong> taas <strong>ng</strong> si<strong>ng</strong>it. Diinan ha<strong>ng</strong>ga<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ma<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit<br />

na<strong>ng</strong> kaunti. Pagkatapos bigla<strong>ng</strong> alisin a<strong>ng</strong> kamay. Ku<strong>ng</strong> makadama siya <strong>ng</strong> napakatindi<strong>ng</strong><br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit (rebound pain) pagkaalis <strong>ng</strong> kamay, maaari<strong>ng</strong> may malubha<strong>ng</strong> impeksyon. Dalhin<br />

siya agad <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> health center o ospital para malaman ku<strong>ng</strong> kaila<strong>ng</strong>a<strong>ng</strong> operahan. Ku<strong>ng</strong><br />

wala<strong>ng</strong> rebound pain, patuloy siya<strong>ng</strong> iek<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>min <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pamamagitan <strong>ng</strong> pagti<strong>ng</strong>in <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> labas<br />

<strong>ng</strong> ari ku<strong>ng</strong> may mga pagsusugat, discharge, pagdurugo, o iba pa<strong>ng</strong> palatandaan <strong>ng</strong><br />

impeksyon na naihahawa <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagtatalik (INP). Para <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> palatandaan at panlunas <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga<br />

INP, ti<strong>ng</strong>nan a<strong>ng</strong> pahina 261. Ku<strong>ng</strong> alam mo<strong>ng</strong> ku<strong>ng</strong> papaano, mag­pelvic exam (ti<strong>ng</strong>nan<br />

a<strong>ng</strong> sususod na pahina).


Paano Mag-ek<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>min <strong>ng</strong> Ari <strong>ng</strong> Babae (Pelvic Exam)<br />

Paano Mag-ek<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>min <strong>ng</strong> Ari <strong>ng</strong> Babae (Pelvic Exam)<br />

Makakapagligtas <strong>ng</strong> buhay a<strong>ng</strong> kakayaha<strong>ng</strong> mag­ek<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>min <strong>ng</strong> ari <strong>ng</strong> babae. Kaila<strong>ng</strong>an ito<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagbibigay <strong>ng</strong> ila<strong>ng</strong> paraan <strong>ng</strong> pagpaplano <strong>ng</strong> pamilya at para alamin a<strong>ng</strong> marami<strong>ng</strong><br />

seryoso<strong>ng</strong> problema <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kalusugan <strong>ng</strong> kababaihan, tulad <strong>ng</strong> ectopic pregnancy, kanser <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

cervix at <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> matris, marami<strong>ng</strong> mga INP, at kumplikasyon mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagpapalaglag. Hindi ito<br />

mahirap matutunan, at <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pag<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><stro<strong>ng</strong>>sa</stro<strong>ng</strong>>nay at paggawa, makakaya <strong>ng</strong> karamihan <strong>ng</strong> kababaihan o<br />

health worker na:<br />

• mag­ek<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>min <strong>ng</strong> panlabas na ari.<br />

• kapain a<strong>ng</strong> bahagi<strong>ng</strong> reproduktibo <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob <strong>ng</strong> tiyan.<br />

Pero mag­pelvic exam la<strong>ng</strong> ku<strong>ng</strong> talaga<strong>ng</strong> kaila<strong>ng</strong>an. Tuwi<strong>ng</strong> magpapasok <strong>ng</strong> bagay <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

puwerta <strong>ng</strong> babae, tinataas mo a<strong>ng</strong> pa<strong>ng</strong>anib niya na maimpeksyon.<br />

MAHALAGA Huwag mag-pelvic exam:<br />

• ku<strong>ng</strong> a<strong>ng</strong> babae ay buntis, nagdurugo o naba<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>g a<strong>ng</strong> panubigan.<br />

• matapos a<strong>ng</strong> normal na pa<strong>ng</strong>a<strong>ng</strong>anak o pagpapalaglag na wala<strong>ng</strong> kumplikasyon.<br />

Bago magsimula:<br />

1. Paihiin muna a<strong>ng</strong> babae.<br />

2. Huga<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> mabuti a<strong>ng</strong> kamay <strong>ng</strong><br />

malinis na tubig at <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bon.<br />

3. Hili<strong>ng</strong>in <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kanya<strong>ng</strong> luwagan a<strong>ng</strong> damit.<br />

Gumamit <strong>ng</strong> kumot o kanya<strong>ng</strong> damit<br />

para takpan siya.<br />

4. Pahigain siya<strong>ng</strong> lapat a<strong>ng</strong> likod, malapit<br />

a<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ko<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> puwitan, at nakataas a<strong>ng</strong><br />

tuhod. Ipaliwanag a<strong>ng</strong> gagawin mo.<br />

5. Magsuot <strong>ng</strong> malinis na guwantes <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

kamay na ipapasok mo <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> puwerta.<br />

Ti<strong>ng</strong>nan a<strong>ng</strong> panlabas na ari:<br />

ti<strong>ng</strong>gil (clitoris)<br />

bukana <strong>ng</strong><br />

puwerta<br />

puwit<br />

Palagi<strong>ng</strong> mag-ek<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>min <strong>ng</strong><br />

babae <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> lugar na wala<strong>ng</strong> iba<strong>ng</strong><br />

makakakita .<br />

Gamit a<strong>ng</strong> may guwantes na kamay para<br />

mai<strong>ng</strong>at na kapain a<strong>ng</strong> babae, maghanap<br />

<strong>ng</strong> mga bukol, lumolobo o namamaga, hindi<br />

karaniwa<strong>ng</strong> discharge, pagsusugat, punit, at<br />

peklat <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> palibot <strong>ng</strong> ari at <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagitan <strong>ng</strong> mga<br />

tiklop <strong>ng</strong> balat <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> vulva. A<strong>ng</strong> ila<strong>ng</strong> mga <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit<br />

ay may palatandaan na lumilitaw <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> labas <strong>ng</strong><br />

ari (ti<strong>ng</strong>nan a<strong>ng</strong> kabanata <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga INP).<br />

535


536 <stro<strong>ng</strong>>Mga</stro<strong>ng</strong>> <stro<strong>ng</strong>>Ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>nayan</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <stro<strong>ng</strong>>Pa<strong>ng</strong>a<strong>ng</strong>alaga</stro<strong>ng</strong>> <strong>ng</strong> <strong>Kalusugan</strong><br />

Paano gumawa <strong>ng</strong> speculum exam<br />

Mahu<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>y na gamit a<strong>ng</strong> speculum para makita a<strong>ng</strong><br />

cervix at puwerta. Ku<strong>ng</strong> mayroon ka nito, sundin<br />

a<strong>ng</strong> mga hakba<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ibaba at pagkatapos ituloy <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

ek<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>minasyon na na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> susunod na pahina. Ku<strong>ng</strong> wala<br />

ka<strong>ng</strong> speculum, makukuha a<strong>ng</strong> marami <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pareho<strong>ng</strong><br />

impormasyon ku<strong>ng</strong> susundin a<strong>ng</strong> mga hakba<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

susunod na pahina.<br />

1. Tiyaki<strong>ng</strong> dumaan <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> disimpeksyon a<strong>ng</strong> speculum<br />

bago ito gamitin (ti<strong>ng</strong>nan a<strong>ng</strong> p. 527). Ba<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>in a<strong>ng</strong><br />

speculum <strong>ng</strong> malinis na tubig bago gamitin.<br />

blade<br />

speculum<br />

hawakan<br />

2. Ipasok a<strong>ng</strong> hintuturo <strong>ng</strong> kamay mo<strong>ng</strong> may guwantes <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> puwerta <strong>ng</strong> babae. Haba<strong>ng</strong><br />

pinapasok a<strong>ng</strong> daliri, mai<strong>ng</strong>at na idiin pababa a<strong>ng</strong> kalamnan na nakapalibot <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

puwerta. (Dahan­dahanin ito; hintayin na irelaks <strong>ng</strong> babae a<strong>ng</strong> kanya<strong>ng</strong> kalamnan.)<br />

Gamitin a<strong>ng</strong> daliri<strong>ng</strong> ito para hanapin a<strong>ng</strong> cervix, na para<strong>ng</strong> dulo <strong>ng</strong> ilo<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kapa.<br />

3. Gamit a<strong>ng</strong> kabila<strong>ng</strong> kamay, hawaka<strong>ng</strong> pa<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ra a<strong>ng</strong> mga speculum blade <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagitan <strong>ng</strong><br />

hintuturo at pa<strong>ng</strong>gitna<strong>ng</strong> daliri. Ipihit patagilid a<strong>ng</strong> mga blade at ipasok <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> puwerta.<br />

(I<strong>ng</strong>ata<strong>ng</strong> hindi madiinan a<strong>ng</strong> butas <strong>ng</strong> ihian o a<strong>ng</strong> ti<strong>ng</strong>gil, dahil napakasensitibo <strong>ng</strong><br />

mga lugar na ito.) Kapag na<strong>ng</strong>a<strong>ng</strong>alahati na a<strong>ng</strong> pasok <strong>ng</strong> speculum, pihitin ito para<br />

nakaturo pababa a<strong>ng</strong> hawakan. Ta<strong>ng</strong>galin a<strong>ng</strong> daliri mo na may guwantes.<br />

4. Mai<strong>ng</strong>at na buk<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n na<strong>ng</strong> kaunti a<strong>ng</strong> speculum blade at hanapin a<strong>ng</strong> cervix. Galawin<br />

a<strong>ng</strong> speculum na<strong>ng</strong> mabagal at mai<strong>ng</strong>at ha<strong>ng</strong>ga<strong>ng</strong> makita mo a<strong>ng</strong> cervix <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagitan <strong>ng</strong><br />

mga blade. Higpitan a<strong>ng</strong> turnilyo <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> speculum para manatili ito <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> puwesto.<br />

5. Suriin a<strong>ng</strong> cervix, na dapat kulay ro<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>s, mabilog at makinis a<strong>ng</strong> hitsura. Ti<strong>ng</strong>nan ku<strong>ng</strong><br />

bukas o <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>rado a<strong>ng</strong> buka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n, at ku<strong>ng</strong> may anuma<strong>ng</strong><br />

discharge o pagdurugo. Ku<strong>ng</strong> ineek<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>min<br />

mo a<strong>ng</strong> babae dahil nagdurugo siya<br />

mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> puwerta matapos ma<strong>ng</strong>anak,<br />

magpalaglag o makunan, maghanap<br />

ku<strong>ng</strong> may laman na lumalabas<br />

mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> buka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n <strong>ng</strong> cervix. Ku<strong>ng</strong><br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ti<strong>ng</strong>in mo maaari<strong>ng</strong> may<br />

impeksyon siya, maghanap <strong>ng</strong><br />

kulay berde o dilaw na discharge,<br />

o pagdurugo mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> cervix. Ku<strong>ng</strong><br />

may tumatagas na ihi o dumi<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> babae, mai<strong>ng</strong>at na pihitin a<strong>ng</strong><br />

speculum para makita a<strong>ng</strong> di<strong>ng</strong>di<strong>ng</strong> <strong>ng</strong><br />

puwerta. Paglapitin a<strong>ng</strong> mga blade para<br />

magawa ito.<br />

6. Para ta<strong>ng</strong>galin a<strong>ng</strong> speculum, mai<strong>ng</strong>at na hatakin ito papunta <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> iyo ha<strong>ng</strong>ga<strong>ng</strong> may<br />

pagitan na a<strong>ng</strong> dulo <strong>ng</strong> blade at cervix. Tapos, pagdikitin a<strong>ng</strong> mga blade at mai<strong>ng</strong>at na<br />

hatakin pabalik. Tiyaki<strong>ng</strong> idaan muli <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> disimpeksyon a<strong>ng</strong> speculum.


Paano Mag-ek<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>min <strong>ng</strong> Ari <strong>ng</strong> Babae (Pelvic Exam)<br />

Paano kapain a<strong>ng</strong> mga bahagi<strong>ng</strong> reproduktibo <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob <strong>ng</strong> tiyan<br />

1. Ipasok a<strong>ng</strong> hintuturo <strong>ng</strong> kamay na may guwantes <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob<br />

<strong>ng</strong> puwerta. Haba<strong>ng</strong> pinapasok, mai<strong>ng</strong>at na idiin pababa<br />

a<strong>ng</strong> mga kalamnan <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> palibot <strong>ng</strong> puwerta. Kapag nagrelaks<br />

na a<strong>ng</strong> katawan <strong>ng</strong> babae, ipasok din a<strong>ng</strong> pa<strong>ng</strong>gitna<strong>ng</strong><br />

daliri. Ipihit a<strong>ng</strong> kamay para na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> taas a<strong>ng</strong> palad.<br />

2. Kapain a<strong>ng</strong> bukana <strong>ng</strong> matris (cervix) para malaman<br />

ku<strong>ng</strong> matatag ito at pabilog. Tapos maglagay <strong>ng</strong> daliri<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> magkabila<strong>ng</strong> gilid <strong>ng</strong> cervix at mai<strong>ng</strong>at na igalaw a<strong>ng</strong><br />

cervix. Dapat madali ito<strong>ng</strong> maigalaw, na hindi ma<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit.<br />

Ku<strong>ng</strong> ma<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit, maaari<strong>ng</strong> may impeksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> matris, tubo o<br />

obaryo. Ku<strong>ng</strong> malambot a<strong>ng</strong> cervix, maaari<strong>ng</strong> buntis siya.<br />

Ku<strong>ng</strong> a<strong>ng</strong> matris ay:<br />

• malambot at malaki <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kapa,<br />

malama<strong>ng</strong> buntis siya.<br />

• bukol­bukol at matigas <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kapa,<br />

maaari<strong>ng</strong> may fibroid o iba pa<strong>ng</strong><br />

tumutubo (ti<strong>ng</strong>nan a<strong>ng</strong> p. 380).<br />

• ma<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit kapag hinipo, malama<strong>ng</strong><br />

may impeksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob.<br />

• hindi naigagalaw na<strong>ng</strong> madali,<br />

maaari<strong>ng</strong> may mga peklat mula<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> luma<strong>ng</strong> impeksyon (PID—<br />

pelvic inflammatory disease,<br />

ti<strong>ng</strong>nan a<strong>ng</strong> p. 274).<br />

3. Kapain a<strong>ng</strong> matris <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

pamamagitan <strong>ng</strong> mai<strong>ng</strong>at<br />

na pagtulak <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kanya<strong>ng</strong><br />

Laki <strong>ng</strong> matris kapag buntis<br />

12 li<strong>ng</strong>go<br />

10 li<strong>ng</strong>go<br />

8 li<strong>ng</strong>go<br />

Mai<strong>ng</strong>at<br />

na galawgalawin<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

magkabila<strong>ng</strong><br />

gilid a<strong>ng</strong><br />

cervix .<br />

puson gamit a<strong>ng</strong> kamay mo<strong>ng</strong> na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> labas. Igagalaw nito<br />

a<strong>ng</strong> mga bahagi<strong>ng</strong> na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob (matris, tubo at obaryo)<br />

na<strong>ng</strong> papalapit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kamay mo<strong>ng</strong> na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob. Maaari<strong>ng</strong><br />

naka kili<strong>ng</strong> paharap o palikod a<strong>ng</strong> matris. Ku<strong>ng</strong> hindi mo<br />

makapa <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> harap <strong>ng</strong> cervix, mai<strong>ng</strong>at na ial<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> a<strong>ng</strong> cervix<br />

at kapain <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> palibot nito a<strong>ng</strong> katawan <strong>ng</strong> matris. Ku<strong>ng</strong><br />

makapa mo <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ilalim <strong>ng</strong> cervix, nakakili<strong>ng</strong> ito palikod.<br />

4. Kapag nahanap mo na a<strong>ng</strong> matris, kapain a<strong>ng</strong> laki at<br />

hugis nito. Ipuwesto a<strong>ng</strong> mga daliri<strong>ng</strong> na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> gilid<br />

<strong>ng</strong> cervix, tapos “palakarin” <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> palibot <strong>ng</strong> matris a<strong>ng</strong> mga<br />

daliri mo<strong>ng</strong> na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> labas. Dapat matatag, makinis, at mas<br />

maliit ito <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> dalandan.<br />

537


538 <stro<strong>ng</strong>>Mga</stro<strong>ng</strong>> <stro<strong>ng</strong>>Ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>nayan</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <stro<strong>ng</strong>>Pa<strong>ng</strong>a<strong>ng</strong>alaga</stro<strong>ng</strong>> <strong>ng</strong> <strong>Kalusugan</strong><br />

5. Kapain a<strong>ng</strong> mga tubo at obaryo. Ku<strong>ng</strong> normal, mahirap makapa a<strong>ng</strong> mga ito. Pero ku<strong>ng</strong><br />

may makapa ka<strong>ng</strong> anuma<strong>ng</strong> bukol na mas malaki pa <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> malaki<strong>ng</strong> mani (ganito<strong>ng</strong> laki),<br />

o na nagdudulot <strong>ng</strong> matindi<strong>ng</strong> pananakit, maaari<strong>ng</strong> may impeksyon siya o<br />

iba<strong>ng</strong> emerhensya. Ku<strong>ng</strong> may ma<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit na bukol, at huli a<strong>ng</strong> dati<strong>ng</strong> <strong>ng</strong><br />

regla, maaari<strong>ng</strong> may ectopic pregnancy siya. Kaila<strong>ng</strong>an niya agad <strong>ng</strong><br />

tulo<strong>ng</strong> medikal.<br />

<stro<strong>ng</strong>>Pa<strong>ng</strong>a<strong>ng</strong>alaga</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> Pagkapaso o Sunog<br />

Karaniwa<strong>ng</strong> pin<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>la <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kababaihan at mga bata a<strong>ng</strong> pagkapaso<br />

(ti<strong>ng</strong>nan a<strong>ng</strong> p. 394). Lahat <strong>ng</strong> paso ay dapat muna<strong>ng</strong> palamigin<br />

<strong>ng</strong> 15 minuto <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> yelo, malamig na tubig, o tela na binabad <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

malamig na tubig. Matapos lumamig, depende a<strong>ng</strong> panlunas<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tindi <strong>ng</strong> pagkapaso. Napakahalaga<strong>ng</strong> panatilihi<strong>ng</strong> malinis<br />

a<strong>ng</strong> paso <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> abot <strong>ng</strong> makakaya. Proteksyunan ito mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

madumi<strong>ng</strong> bagay, alikabok, la<strong>ng</strong>aw at iba pa<strong>ng</strong> insekto.<br />

Para <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mas mabuti<strong>ng</strong> paghilom, huwag na huwag lagyan<br />

a<strong>ng</strong> paso <strong>ng</strong> gra<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>, taba, balat <strong>ng</strong> hayop, kape, halama<strong>ng</strong><br />

gamot o tae. Napakahalaga <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tao<strong>ng</strong> napaso na kumain<br />

<strong>ng</strong> protina, a<strong>ng</strong> sustansya<strong>ng</strong> nagbubuo <strong>ng</strong> katawan.<br />

Wala<strong>ng</strong> klase <strong>ng</strong> pagkain na kaila<strong>ng</strong>a<strong>ng</strong> iwa<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n.<br />

May tatlo<strong>ng</strong> bataya<strong>ng</strong> klase <strong>ng</strong> pagkapaso o sunog:<br />

1. Bahagya<strong>ng</strong> pagkapaso (1st degree)<br />

6. Galawin a<strong>ng</strong> iyo<strong>ng</strong> daliri at kapain a<strong>ng</strong> di<strong>ng</strong>di<strong>ng</strong><br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob <strong>ng</strong> puwerta. Ku<strong>ng</strong> may problema siya <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

pagtagas <strong>ng</strong> ihi o dumi, hanapin ku<strong>ng</strong> may punit<br />

(ti<strong>ng</strong>nan a<strong>ng</strong> p. 370). Tiyaki<strong>ng</strong> wala<strong>ng</strong> kakaiba<strong>ng</strong><br />

bukol o pagsusugat.<br />

7. Paubuhin a<strong>ng</strong> babae o pairihin na para<strong>ng</strong><br />

dumudumi. Ti<strong>ng</strong>nan ku<strong>ng</strong> may bubukol palabas<br />

<strong>ng</strong> puwerta. Ku<strong>ng</strong> mayroon, maaari<strong>ng</strong> may buwa<br />

(prolapsed uterus) siya o nalaglag na pantog<br />

(ti<strong>ng</strong>nan a<strong>ng</strong> p. 131).<br />

8. Ku<strong>ng</strong> tapos ka na, maglinis at magdisimpeksyon <strong>ng</strong><br />

guwantes (ti<strong>ng</strong>nan a<strong>ng</strong> p. 527). Huga<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> mabuti<br />

a<strong>ng</strong> iyo<strong>ng</strong> kamay <strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bon at tubig.<br />

Hindi nagpapaltos a<strong>ng</strong> balat mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagkapaso na ito, pero nagigi<strong>ng</strong> mas madilim o<br />

mapula a<strong>ng</strong> kulay. Matapos palamigin, wala na<strong>ng</strong> kaila<strong>ng</strong>an na iba<strong>ng</strong> panlunas. Gumamit <strong>ng</strong><br />

aspirin o paracetamol para <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pananakit.<br />

MAHALAGA Huga<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> mabuti a<strong>ng</strong> iyo<strong>ng</strong> kamay bago ma<strong>ng</strong>alaga <strong>ng</strong> paso para<br />

maiwa<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n a<strong>ng</strong> impeksyon.


2. Pagkapaso na nagpapaltos (2nd degree)<br />

<stro<strong>ng</strong>>Pa<strong>ng</strong>a<strong>ng</strong>alaga</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> Pagkapaso o Sunog<br />

Matapos palamigin, huwag paputukin a<strong>ng</strong> paltos. Huwag buta<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n a<strong>ng</strong> paltos o alisin a<strong>ng</strong><br />

likido <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob—kahit gamit a<strong>ng</strong> karayom at heri<strong>ng</strong>gilya na nadisimpekta. Ku<strong>ng</strong> ku<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> mapunit<br />

a<strong>ng</strong> paltos, mai<strong>ng</strong>at na ta<strong>ng</strong>galin <strong>ng</strong> gunti<strong>ng</strong> na nadisimpekta a<strong>ng</strong> lahat <strong>ng</strong> patay na balat.<br />

Tapos, mai<strong>ng</strong>at na linisin a<strong>ng</strong> paso. Gumamit <strong>ng</strong> banayad na <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bon at tubig na pinakuluan at<br />

pinalamig na na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> isterili<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>do<strong>ng</strong> bulak o ga<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>, o nadisimpekta<strong>ng</strong> tela. Puwede ri<strong>ng</strong> gumamit<br />

<strong>ng</strong> hydrogen peroxide. Ta<strong>ng</strong>galin a<strong>ng</strong> anuma<strong>ng</strong> natitira<strong>ng</strong> sunog na balat <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> taas o paligid <strong>ng</strong><br />

paso, ha<strong>ng</strong>ga<strong>ng</strong> lumabas a<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>riwa at kulay ro<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>s na balat <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ilalim. Takpan a<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>riwa<strong>ng</strong><br />

balat <strong>ng</strong> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> piraso <strong>ng</strong> isterili<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>do<strong>ng</strong> ga<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> o nadisimpekta<strong>ng</strong> tela. Ku<strong>ng</strong> dumikit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> paso a<strong>ng</strong><br />

tela na gusto mo<strong>ng</strong> alisin, ba<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>in muna <strong>ng</strong> tubig na pinalamig matapos pakuluan.<br />

Para mapigilan a<strong>ng</strong> impeksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> bahagi<strong>ng</strong> napaso, lapatan ito <strong>ng</strong> isterili<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>do<strong>ng</strong> ga<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

o nadisimpekta<strong>ng</strong> tela na nababad <strong>ng</strong> 15 minuto <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> timpla <strong>ng</strong> tubig at asin, 3 beses bawat<br />

araw. Tuwi<strong>ng</strong> magpapalit <strong>ng</strong> tela, mai<strong>ng</strong>at na alisin a<strong>ng</strong> patay na balat at laman gamit a<strong>ng</strong><br />

malinis na malinis na tiyani (tweezers), ha<strong>ng</strong>ga<strong>ng</strong> lumabas a<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>riwa<strong>ng</strong> balat na kulay ro<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>s.<br />

Paggawa <strong>ng</strong> timpla <strong>ng</strong> asin at tubig:<br />

Gumamit <strong>ng</strong> 1 kut<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>rita<strong>ng</strong> asin <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 1 litro<strong>ng</strong><br />

tubig . Pakuluan a<strong>ng</strong> tela at tubig bago<br />

gamitin, at palamigin bago ilagay <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

paso .<br />

Ku<strong>ng</strong> maimpeksyon <strong>ng</strong>a a<strong>ng</strong> paso, mas titindi a<strong>ng</strong> pananakit at pamamaga nito. Titigas<br />

at pupula a<strong>ng</strong> balat na nakapalibot <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> paso. Gumamit <strong>ng</strong> antibiotic, tulad <strong>ng</strong> penicillin<br />

o ampicillin, 250 mg, 4 na beses bawat araw <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 7 araw. Pero ku<strong>ng</strong> hindi mawala a<strong>ng</strong><br />

impeksyon matapos a<strong>ng</strong> 5 araw, lumipat <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> dicloxacillin o erythromycin, 250 mg, 4 na beses<br />

bawat araw <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 7–10 araw. Painumin a<strong>ng</strong> tao<strong>ng</strong> napaso <strong>ng</strong> marami<strong>ng</strong> likido.<br />

3. Malalim na pagkasunog (3rd degree)<br />

<stro<strong>ng</strong>>Mga</stro<strong>ng</strong>> pagkasunog ito na sumisira <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> balat at naglalantad <strong>ng</strong> maitim at naihaw na laman.<br />

Palagi<strong>ng</strong> malubha a<strong>ng</strong> ganito<strong>ng</strong> pagkasunog. Dalhin agad a<strong>ng</strong> tao <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tulo<strong>ng</strong> medikal.<br />

Samantala, balutin a<strong>ng</strong> sunog na bahagi <strong>ng</strong> ba<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> tela o tuwalya na nadisimpekta. Tiyaki<strong>ng</strong><br />

napakuluan at napalamig a<strong>ng</strong> pinamba<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> na tubig. Bigyan siya <strong>ng</strong> marami<strong>ng</strong> likido.<br />

Ku<strong>ng</strong> imposible<strong>ng</strong> makahanap <strong>ng</strong> tulo<strong>ng</strong> medikal, luna<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n ito na pareho <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 2nd degree na<br />

paso. Para maproteksyunan a<strong>ng</strong> sunog mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> alikabok at insekto, takpan ito <strong>ng</strong> maluwa<strong>ng</strong><br />

at isterili<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>do<strong>ng</strong> tela o <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>pin na yari <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> cotton. Palitan a<strong>ng</strong> tela <strong>ng</strong> hindi bababa <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 4 na<br />

beses bawat araw, o 2 beses ku<strong>ng</strong> mananatili<strong>ng</strong> tuyo a<strong>ng</strong> tela.<br />

Painumin <strong>ng</strong> oresol o ‘rehydration drink’ (ti<strong>ng</strong>nan a<strong>ng</strong> p. 540) <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pinakamadalas<br />

na makakaya, ha<strong>ng</strong>ga<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> dumalas a<strong>ng</strong> pag­ihi niya. Ku<strong>ng</strong> wala siya<strong>ng</strong> malay o hindi<br />

makalunok, ibigay a<strong>ng</strong> oresol <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tumbo<strong>ng</strong> (ti<strong>ng</strong>nan a<strong>ng</strong> p. 541 ku<strong>ng</strong> paano ito gawin).<br />

Madali<strong>ng</strong> tumu<strong>ng</strong>o <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> shock a<strong>ng</strong> sinuma<strong>ng</strong> nasunog na<strong>ng</strong> malubha. Dulot ito <strong>ng</strong> pagkawala<br />

<strong>ng</strong> likido <strong>ng</strong> katawan na tumatagas mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> nasunog na bahagi.<br />

Alu­aluhin at palakasin a<strong>ng</strong> loob niya, at luna<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n para <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> shock ku<strong>ng</strong> kinakaila<strong>ng</strong>an.<br />

Magbigay <strong>ng</strong> anuma<strong>ng</strong> matapa<strong>ng</strong> na gamot <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pananakit na mayroon ka. Makakabawas din<br />

<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit a<strong>ng</strong> pagpaligo <strong>ng</strong> mga bukas na sugat <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> malamig na tubig na medyo maalat.<br />

539


540 <stro<strong>ng</strong>>Mga</stro<strong>ng</strong>> <stro<strong>ng</strong>>Ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>nayan</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <stro<strong>ng</strong>>Pa<strong>ng</strong>a<strong>ng</strong>alaga</stro<strong>ng</strong>> <strong>ng</strong> <strong>Kalusugan</strong><br />

Paano Magbigay <strong>ng</strong> Likido para Luna<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n a<strong>ng</strong> Shock<br />

Ku<strong>ng</strong> mawalan <strong>ng</strong> marami<strong>ng</strong> dugo a<strong>ng</strong> babae—halimbawa <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pa<strong>ng</strong>a<strong>ng</strong>anak,<br />

matapos makunan o magpalaglag na may kumplikasyon, o ku<strong>ng</strong> nasunog<br />

na<strong>ng</strong> malubha—maaari<strong>ng</strong> tumu<strong>ng</strong>o siya <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> shock (ti<strong>ng</strong>nan a<strong>ng</strong> p. 254).<br />

Kapag na<strong>ng</strong>yari ito, kaila<strong>ng</strong>an agad <strong>ng</strong> babae <strong>ng</strong> likido para<br />

maligtas a<strong>ng</strong> kanya<strong>ng</strong> buhay. Ku<strong>ng</strong> gisi<strong>ng</strong> siya at nakakainom,<br />

hayaan siya<strong>ng</strong> uminom. Ku<strong>ng</strong> alam mo ku<strong>ng</strong> paano, puwede<br />

ka ri<strong>ng</strong> magsimula <strong>ng</strong> intravenous drip (IV). Sa i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong><br />

emerhensya, maaari<strong>ng</strong> gumamit <strong>ng</strong> enema o labatiba<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> halip (ti<strong>ng</strong>nan a<strong>ng</strong> susunod na pahina). Pero<br />

dapat pa<strong>ng</strong>­emerhensya la<strong>ng</strong> gamitin a<strong>ng</strong> labatiba.<br />

Maaari<strong>ng</strong> maka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ma a<strong>ng</strong> sobra<strong>ng</strong> dami nito.<br />

PAANO GUMAWA NG ORESOL O REHYDRATION DRINK<br />

Dalawa<strong>ng</strong> paraan <strong>ng</strong> paggawa<br />

Ku<strong>ng</strong> kaya, dagdagan <strong>ng</strong> kalahati<strong>ng</strong> puswelo <strong>ng</strong> katas <strong>ng</strong> prutas, tubig <strong>ng</strong> niyog, o hinog na <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>gi<strong>ng</strong><br />

na mina<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> a<strong>ng</strong> alinman <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> dalawa . May potassium a<strong>ng</strong> mga ito, i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> mineral na tumutulo<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

tao<strong>ng</strong> may <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit na makata<strong>ng</strong>gap <strong>ng</strong> mas marami<strong>ng</strong> pagkain at inumin .<br />

1. Asukal at asin.<br />

(Puwede ka<strong>ng</strong> gumamit <strong>ng</strong> hilaw na asukal o<br />

molasses <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> halip na asukal na puti .)<br />

Sa 1 litro <strong>ng</strong><br />

malinis na<br />

TUBIG<br />

lagyan <strong>ng</strong><br />

kalahati<strong>ng</strong><br />

kut<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>rita<br />

(pinantay) <strong>ng</strong><br />

ASIN<br />

at 8 kut<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>rita<br />

(pinantay) <strong>ng</strong><br />

ASUKAL<br />

INGATAN: Bago idagdag a<strong>ng</strong> asukal, la<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>han a<strong>ng</strong><br />

inumin at tiyakin na hindi mas maalat <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> luha .<br />

2. Pinulbos na cereal at asin.<br />

(Pinakamahu<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>y a<strong>ng</strong> pinulbos na bigas . Pero<br />

puwede rin a<strong>ng</strong> harina, pinulbos na mais, o niluto<br />

at mina<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> patatas .)<br />

Sa 1 litro <strong>ng</strong><br />

malinis na<br />

TUBIG<br />

lagyan <strong>ng</strong><br />

kalahati<strong>ng</strong><br />

kut<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>rita<br />

(pinantay) <strong>ng</strong><br />

ASIN<br />

Pakuluan <strong>ng</strong> 5–7<br />

minuto ha<strong>ng</strong>ga<strong>ng</strong><br />

makabuo <strong>ng</strong><br />

matubig na<br />

lugaw . Palamigin<br />

ito na<strong>ng</strong> mabilis<br />

at simula<strong>ng</strong><br />

ibigay <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> may<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit na tao .<br />

at 8 umaapaw<br />

na kut<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>rita<br />

<strong>ng</strong> pinulbos na<br />

CEREAL<br />

INGATAN: La<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>han a<strong>ng</strong> inumin bago ibigay para<br />

matiyak na hindi pa panis . Maaari<strong>ng</strong> mapanis ito<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob <strong>ng</strong> ila<strong>ng</strong> oras <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mainit na panahon .<br />

Makakatulo<strong>ng</strong> din a<strong>ng</strong> rehydration drink na panlunas at pampigil <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> dehydration, laluna<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga kaso <strong>ng</strong> matindi<strong>ng</strong> pagtatae na matubig.


PAANO MAGBIGAY NG LIKIDO SA PUWIT<br />

Kakaila<strong>ng</strong>anin mo:<br />

• i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> malinis na bag na pa<strong>ng</strong>­labatiba, o lata na may<br />

tubo.<br />

• i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> tela na mai<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><stro<strong>ng</strong>>sa</stro<strong>ng</strong>>pin <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ilalim <strong>ng</strong> tao.<br />

• 600 ml (sobra na<strong>ng</strong> kaunti <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kalahati<strong>ng</strong> litro) <strong>ng</strong><br />

maligamgam (hindi mainit) na inumi<strong>ng</strong> tubig. Ku<strong>ng</strong><br />

may asukal at asin na oresol o bag <strong>ng</strong> IV solution<br />

(‘dextrose’), puwede<strong>ng</strong> ito a<strong>ng</strong> gamitin.<br />

Ano a<strong>ng</strong> gagawin:<br />

1. Sabihin <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> babae ku<strong>ng</strong> ano a<strong>ng</strong> gagawin mo at bakit.<br />

2. Hugas a<strong>ng</strong> iyo<strong>ng</strong> kamay.<br />

3. Sabihan siya na humiga <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kanya<strong>ng</strong> kaliwa<strong>ng</strong> gilid ku<strong>ng</strong><br />

kaya. Ku<strong>ng</strong> maaari, dapat mas mataas na<strong>ng</strong> kaunti a<strong>ng</strong><br />

katawan niya kay<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ulo.<br />

4. Ku<strong>ng</strong> mayroon ka, magsuot <strong>ng</strong> malinis na guwantes.<br />

5. Padaluyin a<strong>ng</strong> tubig ha<strong>ng</strong>ga<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> dulo <strong>ng</strong> tubo para<br />

lumabas a<strong>ng</strong> ha<strong>ng</strong>in. Tapos ipitin a<strong>ng</strong> tubo para<br />

huminto a<strong>ng</strong> pagdaloy.<br />

6. Ba<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>in a<strong>ng</strong> dulo <strong>ng</strong> tubo <strong>ng</strong> tubig at<br />

ipasok ito <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> butas <strong>ng</strong> puwit. Sabihan<br />

siya na humi<strong>ng</strong>a na<strong>ng</strong> mabagal at<br />

malalim para matulu<strong>ng</strong>a<strong>ng</strong> magrelaks.<br />

Paano Magbigay <strong>ng</strong> Likido para Luna<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n a<strong>ng</strong> Shock<br />

Huwag ipasok a<strong>ng</strong> tubo na<strong>ng</strong> sobra pa rito<br />

(4 na pulgada o inches)<br />

Tiyaki<strong>ng</strong> mas<br />

mataas a<strong>ng</strong><br />

katawan niya<br />

kay<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ulo .<br />

7. Hawakan a<strong>ng</strong> bag o lata na <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>pat la<strong>ng</strong> a<strong>ng</strong> taas para dumaloy na<strong>ng</strong> mabagal na mabagal<br />

papasok a<strong>ng</strong> tubig (mga kasi<strong>ng</strong>taas <strong>ng</strong> balaka<strong>ng</strong> <strong>ng</strong> babae). Dapat tumagal <strong>ng</strong> mga 20<br />

minuto. Ku<strong>ng</strong> tumatagas palabas <strong>ng</strong> katawan a<strong>ng</strong> tubig, maaari<strong>ng</strong> masyado<strong>ng</strong> mataas a<strong>ng</strong><br />

bag. Ibaba a<strong>ng</strong> bag para mas mabagal a<strong>ng</strong> daloy <strong>ng</strong> tubig.<br />

8. Mai<strong>ng</strong>at na alisin a<strong>ng</strong> tubo. Sabihan siya na sikapi<strong>ng</strong> panatilihin <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob a<strong>ng</strong> tubig, at<br />

mawawala rin agad a<strong>ng</strong> pakiramdam na napapadumi. Ku<strong>ng</strong> wala<strong>ng</strong> malay a<strong>ng</strong> babae,<br />

puwede mo<strong>ng</strong> hawakan pa<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ra a<strong>ng</strong> kanya<strong>ng</strong> pigi.<br />

9. Linisin at patuyuin a<strong>ng</strong> babae. Pagkatapos ta<strong>ng</strong>galin a<strong>ng</strong> iyo<strong>ng</strong> guwantes at maghugas <strong>ng</strong><br />

kamay.<br />

10. Ihatid agad a<strong>ng</strong> babae <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagamutan. Ku<strong>ng</strong> na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> shock pa rin siya, puwede mo<strong>ng</strong> bigyan<br />

ulit <strong>ng</strong> enema pagkatapos <strong>ng</strong> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> oras. Ku<strong>ng</strong> wala na <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> shock, subuka<strong>ng</strong> bigyan <strong>ng</strong><br />

pakaunti­kaunti<strong>ng</strong> rehydration drink haba<strong>ng</strong> nagbibiyahe.<br />

541


542 <stro<strong>ng</strong>>Mga</stro<strong>ng</strong>> <stro<strong>ng</strong>>Ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>nayan</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <stro<strong>ng</strong>>Pa<strong>ng</strong>a<strong>ng</strong>alaga</stro<strong>ng</strong>> <strong>ng</strong> <strong>Kalusugan</strong><br />

Paano Mag-iniksyon<br />

Hindi madalas kaila<strong>ng</strong>an a<strong>ng</strong> iniksyon. Marami<strong>ng</strong> gamot na min<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n binibigay <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> iniksyon<br />

a<strong>ng</strong> mas ligtas ku<strong>ng</strong> pinapainom. Pero maaari<strong>ng</strong> kaila<strong>ng</strong>an na mag­iniksyon:<br />

• ku<strong>ng</strong> wala<strong>ng</strong> anyo o pormulasyon a<strong>ng</strong> gamot na puwede<strong>ng</strong> ipainom.<br />

• ku<strong>ng</strong> hindi makalunok a<strong>ng</strong> tao o hindi mapatagal a<strong>ng</strong> gamot dahil <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagsusuka.<br />

• <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ila<strong>ng</strong> emerhensya, tulad <strong>ng</strong> pagdurugo o impeksyon matapos ma<strong>ng</strong>anak o magpalaglag.<br />

Mahalaga<strong>ng</strong> wasto a<strong>ng</strong> pagbibigay <strong>ng</strong> iniksyon. Puwede<strong>ng</strong> magi<strong>ng</strong> mapa<strong>ng</strong>anib a<strong>ng</strong> mga ito<br />

ku<strong>ng</strong> binigay <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mali<strong>ng</strong> lugar, mali<strong>ng</strong> paraan, o ku<strong>ng</strong> hindi nilinis na<strong>ng</strong> tama a<strong>ng</strong> heri<strong>ng</strong>gilya,<br />

kamay at lugar na tinarakan. Mai<strong>ng</strong>at na sundin a<strong>ng</strong> lahat <strong>ng</strong> direksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ‘Paano maginiksyon,’<br />

pahina 544.<br />

Pagpigil <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> impeksyon<br />

A<strong>ng</strong> mga karayom at heri<strong>ng</strong>gilya na hindi nalinis at nadisimpekta na<strong>ng</strong> tama ay maaari<strong>ng</strong><br />

magpa<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit tulad <strong>ng</strong> HIV/AIDS o <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> atay (hepatitis) <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> iba<strong>ng</strong> tao. Maaari din ito<strong>ng</strong><br />

magdulot <strong>ng</strong> maluha<strong>ng</strong> impeksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pinagtarakan o <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> dugo.<br />

• Huwag na huwag gumamit <strong>ng</strong> pareho<strong>ng</strong> karayom at heri<strong>ng</strong>gilya para mag­iniksyon <strong>ng</strong><br />

higit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> tao na hindi muna nililinis at dinidisimpekta a<strong>ng</strong> karayom at heri<strong>ng</strong>gilya.<br />

Sundin a<strong>ng</strong> mga hakba<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pahina 528.<br />

• Matapos pakuluan a<strong>ng</strong> karayom, huwag idikit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> anuma<strong>ng</strong> bagay na hindi nadisimpekta.<br />

• Ku<strong>ng</strong> pa<strong>ng</strong>­i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> gamit la<strong>ng</strong> a<strong>ng</strong> karayom, na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pahina 528 a<strong>ng</strong> ligtas na pagdispat<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> nito.<br />

SAAN MAGBIBIGAY NG INIKSYON<br />

May dalawa<strong>ng</strong> bataya<strong>ng</strong> klase <strong>ng</strong> iniksyon:<br />

• iniksyon na pumupunta <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kalamnan (intramuscular o IM)<br />

• iniksyon na pumupunta <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mataba<strong>ng</strong> layer o <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>pin <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ilalim <strong>ng</strong> balat (subcutaneous)<br />

Nakabatay a<strong>ng</strong> pipilii<strong>ng</strong> lugar na iiniksyonan <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> dami <strong>ng</strong> gamot na ibibigay, laki <strong>ng</strong> tao<strong>ng</strong><br />

bibigyan, at klase <strong>ng</strong> gamot na gagamitin. Ti<strong>ng</strong>nan a<strong>ng</strong> pahina 544 para <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> impormasyon<br />

ku<strong>ng</strong> paano ibigay a<strong>ng</strong> 2 klase <strong>ng</strong> iniksyon.<br />

Sa kalamnan dapat pumunta (IM) a<strong>ng</strong> karamihan <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga de­iniksyon na gamot na na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

libro<strong>ng</strong> ito. A<strong>ng</strong> IM na iniksyon ay puwede<strong>ng</strong> itusok <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> malaki<strong>ng</strong> kalamnan <strong>ng</strong> pigi, braso o<br />

hita. Pinakamahu<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>y na gamitin a<strong>ng</strong> pigi o hita <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> halip na braso ku<strong>ng</strong>:<br />

• mahigit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 2 ml (2 cc) a<strong>ng</strong> ibibigay. (Pero huwag na huwag ibigay <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ii<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> pagturok a<strong>ng</strong><br />

sobra <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 3 ml (3 cc). Sa halip ay hatiin <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 2 pag­iniksyon.)<br />

• malama<strong>ng</strong> magdudulot <strong>ng</strong> pananakit a<strong>ng</strong> gamot kapag itinurok.<br />

• masyado<strong>ng</strong> maliit o ma<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ma a<strong>ng</strong> nutrisyon <strong>ng</strong> tao<strong>ng</strong> tuturukan.<br />

Sa pigi,<br />

palagi<strong>ng</strong><br />

mag-iniksyon<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> gawi<strong>ng</strong><br />

itaas at labas<br />

na hati .<br />

Iparelaks<br />

a<strong>ng</strong> braso<br />

na nakadikit<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> katawan .<br />

Magsukat <strong>ng</strong> 2<br />

lapad <strong>ng</strong> daliri<br />

mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> gilid <strong>ng</strong><br />

buto <strong>ng</strong> balikat .<br />

Sa hita, mag-iniksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

gawi<strong>ng</strong> itaas at labas na hati .<br />

(Ito a<strong>ng</strong> pinakamahu<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>y na<br />

pag-iniksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong>gol .)


PAANO MAGHANDA NG HERINGGILYA PARA PANG-INIKSYON<br />

Paano Mag-iniksyon<br />

Bago maghanda <strong>ng</strong> heri<strong>ng</strong>gilya, huga<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n a<strong>ng</strong> iyo<strong>ng</strong> kamay <strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bon at tubig. Ku<strong>ng</strong><br />

puwede<strong>ng</strong> gamitin ulit (reu<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ble) a<strong>ng</strong> heri<strong>ng</strong>gilya, magsimula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> una<strong>ng</strong> hakba<strong>ng</strong>. Ku<strong>ng</strong> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong><br />

gamitan la<strong>ng</strong> a<strong>ng</strong> heri<strong>ng</strong>gilya (dispo<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ble), buk<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n na<strong>ng</strong> mai<strong>ng</strong>at a<strong>ng</strong> pakete at magsimula<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ika­2 hakba<strong>ng</strong>.<br />

1. Sundin a<strong>ng</strong> direksyon<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pag­disimpekta <strong>ng</strong><br />

heri<strong>ng</strong>gilya <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pahina 528.<br />

2. Pagkabitin a<strong>ng</strong> karayom at heri<strong>ng</strong>gilya na<br />

paanan <strong>ng</strong> karayom at dulo <strong>ng</strong> plu<strong>ng</strong>er<br />

la<strong>ng</strong> a<strong>ng</strong> hinahawakan.<br />

HUWAG hawakan dito.<br />

plu<strong>ng</strong>er<br />

pansukat<br />

na linya<br />

3. May mga gamot na handa na agad gamitin.<br />

Ku<strong>ng</strong> ganito a<strong>ng</strong> gamot mo, sundin<br />

a<strong>ng</strong> hakba<strong>ng</strong> 4, 5 at 10. Ku<strong>ng</strong> kaila<strong>ng</strong>an<br />

pa<strong>ng</strong> ihalo a<strong>ng</strong> gamot <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> distilled water,<br />

sundin a<strong>ng</strong> mga hakba<strong>ng</strong> 4–10.<br />

4. Linisin a<strong>ng</strong><br />

botelya<strong>ng</strong><br />

lalagyan<br />

(ampule) <strong>ng</strong><br />

gamot o distilled<br />

water. Tapos<br />

baliin a<strong>ng</strong> tuktok.<br />

5. Punuin a<strong>ng</strong><br />

heri<strong>ng</strong>gilya.<br />

I<strong>ng</strong>atan na hindi<br />

madikit a<strong>ng</strong><br />

karayom <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

labas <strong>ng</strong> ampule.<br />

PUWEDE hawakan dito.<br />

paanan <strong>ng</strong><br />

karayom<br />

karayom<br />

6. Puna<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n a<strong>ng</strong><br />

takip na goma<br />

<strong>ng</strong> botelya <strong>ng</strong><br />

gamot. Gumamit<br />

<strong>ng</strong> malinis na<br />

tela o bulak na<br />

ba<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> alkohol o<br />

pinakulua<strong>ng</strong> tubig.<br />

7. Iiniksyon a<strong>ng</strong> distilled<br />

water <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> botelya<br />

na may pulbos na<br />

gamot.<br />

8. Kalugin ha<strong>ng</strong>ga<strong>ng</strong><br />

lubos na humalo<br />

a<strong>ng</strong> gamot <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

tubig.<br />

9. Punuin muli a<strong>ng</strong><br />

heri<strong>ng</strong>gilya.<br />

10. Palabasin a<strong>ng</strong> lahat <strong>ng</strong><br />

ha<strong>ng</strong>in <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> heri<strong>ng</strong>gilya.<br />

Para magawa ito, patayuin<br />

a<strong>ng</strong> heri<strong>ng</strong>gilya na<br />

na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> taas a<strong>ng</strong> karayom<br />

at pitik­pitikin dito<br />

para kumawala pataas<br />

a<strong>ng</strong> anuma<strong>ng</strong> bula <strong>ng</strong><br />

ha<strong>ng</strong>in. Tapos, dahandaha<strong>ng</strong><br />

itulak na<strong>ng</strong><br />

kaunti a<strong>ng</strong> plu<strong>ng</strong>er<br />

ha<strong>ng</strong>ga<strong>ng</strong> makalabas<br />

a<strong>ng</strong> lahat <strong>ng</strong> ha<strong>ng</strong>in <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

karayom.<br />

I<strong>ng</strong>atan na<strong>ng</strong> husto na hindi madikit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kahit ano a<strong>ng</strong> karayom —kahit na tela o bulak<br />

na ba<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <strong>ng</strong> alkohol. Ku<strong>ng</strong> madikit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kahit ano a<strong>ng</strong> karayom, pakuluan ito muli.<br />

543


544 <stro<strong>ng</strong>>Mga</stro<strong>ng</strong>> <stro<strong>ng</strong>>Ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>nayan</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <stro<strong>ng</strong>>Pa<strong>ng</strong>a<strong>ng</strong>alaga</stro<strong>ng</strong>> <strong>ng</strong> <strong>Kalusugan</strong><br />

PAANO MAG-INIKSYON SA KALAMNAN (INTRAMUSCULAR O IM)<br />

Pinapakita <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga larawan <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ibaba ku<strong>ng</strong> paano mag­iniksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pigi. Pareho a<strong>ng</strong> mga<br />

hakba<strong>ng</strong> mula ika­2 ha<strong>ng</strong>ga<strong>ng</strong> ika­6 para <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> iniksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> braso o hita.<br />

1. Dapat umupo o humiga a<strong>ng</strong> tao. Ku<strong>ng</strong><br />

pagdidikitin na paturo a<strong>ng</strong> mga daliri<br />

<strong>ng</strong> paa, magrerelaks a<strong>ng</strong> kalamnan na<br />

iiniksyonan.<br />

2. Linisin a<strong>ng</strong> balat <strong>ng</strong> alkohol, o <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>bon<br />

at tubig (mas kaunti a<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit ku<strong>ng</strong><br />

hahayaan muna<strong>ng</strong> matuyo a<strong>ng</strong> alkohol<br />

bago mag­iniksyon).<br />

3. Itusok a<strong>ng</strong> karayom na<strong>ng</strong> diretso papasok.<br />

Ipasok na<strong>ng</strong> buo. Ku<strong>ng</strong> gagawin ito <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong> mabilis na kilos, mas kaunti a<strong>ng</strong><br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit.<br />

PAANO MAG-INIKSYON SA ILALIM NG BALAT<br />

(SUBCUTANEOUS)<br />

• Hawakan na<strong>ng</strong> paipit a<strong>ng</strong> ilalim na bahagi<br />

<strong>ng</strong> braso na <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>gana <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> taba. Ganito a<strong>ng</strong><br />

paghawak <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> balat:<br />

• Ipasok a<strong>ng</strong> karayom <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ilalim <strong>ng</strong> balat.<br />

Gayahin a<strong>ng</strong> pahilis na a<strong>ng</strong>gulo <strong>ng</strong><br />

pagpasok na nakalarawan. Tiyakin na<br />

hindi matusok <strong>ng</strong> karayom a<strong>ng</strong> kalamnan.<br />

4. Bago iiniksyon a<strong>ng</strong> gamot, mai<strong>ng</strong>at<br />

na hugutin na<strong>ng</strong> kaunti a<strong>ng</strong> plu<strong>ng</strong>er<br />

(huwag sobrahan<br />

na mata<strong>ng</strong>gal na<br />

ito). Ku<strong>ng</strong> may<br />

papasok na dugo<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> heri<strong>ng</strong>gilya,<br />

hugutin<br />

palabas a<strong>ng</strong><br />

karayom at<br />

itusok muli <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

iba<strong>ng</strong> lugar na malapit<br />

la<strong>ng</strong>, <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob <strong>ng</strong> nalinis na bahagi.<br />

5. Hugutin muli a<strong>ng</strong><br />

plu<strong>ng</strong>er. Ku<strong>ng</strong><br />

wala<strong>ng</strong> dugo<br />

na papasok,<br />

iiniksyon na<strong>ng</strong><br />

mabagal a<strong>ng</strong><br />

gamot.<br />

6. Ta<strong>ng</strong>galin a<strong>ng</strong><br />

karayom at<br />

linisin muli a<strong>ng</strong> balat.


Paano Mag-iniksyon<br />

MAGHANDA NA LUNASAN ANG ALLERGIC NA REAKSYON AT ALLERGIC SHOCK<br />

May mga gamot, laluna mga antibiotics tulad <strong>ng</strong> penicillin at ampicillin, na nakaka pagdulot<br />

<strong>ng</strong> allergic na reaksyon, kadala<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob <strong>ng</strong> 30 minuto matapos mag­iniksyon.<br />

Puwede<strong>ng</strong> tumuloy a<strong>ng</strong> allergic na reaksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> allergic shock, na i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> na<strong>ng</strong> emerhensya. Para<br />

maiwa<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n a<strong>ng</strong> allergic na reaksyon at allergic shock, tanu<strong>ng</strong>in a<strong>ng</strong> tao bago mag­iniksyon:<br />

“Nagkaroon ka na ba <strong>ng</strong> reaksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> gamot na ito—tulad <strong>ng</strong> pamamantal, pa<strong>ng</strong>a<strong>ng</strong>ati, pagumbok<br />

o paglobo o kahirapa<strong>ng</strong> humi<strong>ng</strong>a?” Ku<strong>ng</strong> oo a<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>got, huwag gamitin a<strong>ng</strong> gamot<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> anuma<strong>ng</strong> anyo, o anuma<strong>ng</strong> gamot na kapamilya nito. Tuwi<strong>ng</strong> mag­iiniksyon <strong>ng</strong> gamot,<br />

magmatyag <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga palatandaan <strong>ng</strong> allergic na reaksyon at allergic shock at magtabi <strong>ng</strong><br />

gamot na panlunas.<br />

Banayad na allergic na reaksyon<br />

Palatandaan: • pa<strong>ng</strong>a<strong>ng</strong>ati • pagbahi<strong>ng</strong> • pantal o butlig (rashes)<br />

Panlunas:<br />

Magbigay <strong>ng</strong> 25 mg diphenhydramine, iinumin 3 bese bawat araw ha<strong>ng</strong>ga<strong>ng</strong> mawala a<strong>ng</strong> mga<br />

palatandaan .<br />

Maaari<strong>ng</strong> mas tiisin <strong>ng</strong> buntis o nagpapasuso<strong>ng</strong> babae a<strong>ng</strong> gambala na dulot <strong>ng</strong> banayad na allergic<br />

na reaksyon kumpara <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pa<strong>ng</strong>anib <strong>ng</strong> paggamit <strong>ng</strong> antihistamine.<br />

Katamtaman ha<strong>ng</strong>ga<strong>ng</strong> matindi<strong>ng</strong> allergic na reaksyon<br />

Palatandaan: • pa<strong>ng</strong>a<strong>ng</strong>ati<br />

• pamamantal<br />

• lumolobo na bibig<br />

at dila<br />

• kahirapa<strong>ng</strong> humi<strong>ng</strong>a<br />

Panlunas:<br />

1 . Mag-iniksyon agad <strong>ng</strong> 0 .5 mg <strong>ng</strong> epinephrine <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ilalim <strong>ng</strong> balat . Ti<strong>ng</strong>nan a<strong>ng</strong> drawi<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pahina<br />

544 . Mag-iniksyon ulit matapos a<strong>ng</strong> 20 minuto ku<strong>ng</strong> hindi bumuti a<strong>ng</strong> mga palatandaan .<br />

2 . Magbigay <strong>ng</strong> 25 mg diphenhydramine o promethazine, iinumin o iiniksyon <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kalamnan . Ulitin<br />

matapos a<strong>ng</strong> 8 oras o mas maaga pa ku<strong>ng</strong> hindi bumuti a<strong>ng</strong> mga palatandaan .<br />

3 . Bantayan siya na<strong>ng</strong> hindi bababa <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 4 na oras para matiyak na hindi tumuloy <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> allergic shock .<br />

Allergic shock<br />

Palatandaan: • pa<strong>ng</strong>a<strong>ng</strong>ati o • lumolobo na bibig<br />

pamamantal<br />

at dila<br />

• biglaan na pamumutla • kahirapa<strong>ng</strong> humi<strong>ng</strong>a<br />

o malamig, namama<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

na balat (malamig na<br />

pawis)<br />

• mahina at mabilis na<br />

pulso o tibok <strong>ng</strong> puso<br />

(higit <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> 100 bawat<br />

minuto)<br />

• pagkawala <strong>ng</strong> malay<br />

Panlunas:<br />

1 . Mag-iniksyon agad <strong>ng</strong> 0 .5 mg <strong>ng</strong> epinephrine <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ilalim <strong>ng</strong> balat . Ti<strong>ng</strong>nan a<strong>ng</strong> drawi<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pahina<br />

544 . Mag-iniksyon ulit matapos a<strong>ng</strong> 20 minuto ku<strong>ng</strong> hindi bumuti a<strong>ng</strong> mga palatandaan .<br />

2 . Mag-iniksyon <strong>ng</strong> 50 mg diphenhydramine o promethazine <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kalamnan . Ulitin matapos a<strong>ng</strong> 8 oras<br />

o mas maaga pa ku<strong>ng</strong> hindi bumuti a<strong>ng</strong> mga palatandaan .<br />

3 . Mag-iniksyon <strong>ng</strong> 500 mg hydrocortisone (cortisol) <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kalamnan at ulitin matapos a<strong>ng</strong> 4 na oras<br />

ku<strong>ng</strong> kaila<strong>ng</strong>an . O kaya, mag-iniksyon <strong>ng</strong> 20 mg dexamethasone <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kalamnan at ulitin matapos<br />

a<strong>ng</strong> 6 na oras ku<strong>ng</strong> kaila<strong>ng</strong>an .<br />

4 . Bantayan siya <strong>ng</strong> 8–12 oras para matiyak na hindi na bumalik a<strong>ng</strong> mga palatandaan . Iwanan siya<br />

<strong>ng</strong> steroid na gamot na iinumin ku<strong>ng</strong> babalik a<strong>ng</strong> palatandaan . Dapat uminom siya <strong>ng</strong> 500–1,000<br />

mg <strong>ng</strong> hydrocortisone at ulitin matapos a<strong>ng</strong> 4 na oras ku<strong>ng</strong> kaila<strong>ng</strong>an . O kaya uminom siya <strong>ng</strong> 20<br />

mg <strong>ng</strong> dexamethasone at ulitin matapos a<strong>ng</strong> 6 na oras ku<strong>ng</strong> kaila<strong>ng</strong>an .<br />

545


546 <stro<strong>ng</strong>>Mga</stro<strong>ng</strong>> <stro<strong>ng</strong>>Ka<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>nayan</stro<strong>ng</strong>> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> <stro<strong>ng</strong>>Pa<strong>ng</strong>a<strong>ng</strong>alaga</stro<strong>ng</strong>> <strong>ng</strong> <strong>Kalusugan</strong><br />

Accupressure na Ma<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>he<br />

A<strong>ng</strong> pagdiin <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ila<strong>ng</strong> ispesyal na mga “tuldok” o punto (points) <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> katawan ay makakatulo<strong>ng</strong><br />

na maib<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n a<strong>ng</strong> ila<strong>ng</strong> karaniwa<strong>ng</strong> problema <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kalusugan <strong>ng</strong> kababaihan. Gali<strong>ng</strong> a<strong>ng</strong><br />

mga tuldok na ito <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> napakatanda na<strong>ng</strong> paraan <strong>ng</strong> paghilom <strong>ng</strong> mga Intsik na tinatawag na<br />

accupressure. Maari<strong>ng</strong> may iba pa<strong>ng</strong> ma<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>he na alam a<strong>ng</strong> mga lokal na ma<strong>ng</strong>gagamot.<br />

Gamitin a<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>>rili<strong>ng</strong> pakiramdam ku<strong>ng</strong> gaano kahaba at kadalas didiinan a<strong>ng</strong> mga ito<br />

(karaniwa<strong>ng</strong> haba a<strong>ng</strong> 3–10 minuto). Marami<strong>ng</strong> babae a<strong>ng</strong> sensitibo o na<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><stro<strong>ng</strong>>sa</stro<strong>ng</strong>>ktan <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga<br />

tuldok na ito. Ku<strong>ng</strong> masyado<strong>ng</strong> ma<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit, i<strong>ng</strong>atan na hindi mairita. Ku<strong>ng</strong> may pin<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>la <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>><strong>ng</strong><br />

bahagi, huwag iyon gamitan <strong>ng</strong> accupressure.<br />

Min<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n may ila<strong>ng</strong> punto na nakakatulo<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pareho<strong>ng</strong> problema. Puwede mo<strong>ng</strong> subukan<br />

lahat. Ku<strong>ng</strong> sensitibo a<strong>ng</strong> i<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> o nakakaginhawa <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> iyo, doon ka tumutok. Ku<strong>ng</strong> hindi, gamitin<br />

a<strong>ng</strong> lahat <strong>ng</strong> tuldok <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> anuma<strong>ng</strong> pagkakasunod­sunod.<br />

MAHALAGA Ku<strong>ng</strong> nagbubuntis, maari<strong>ng</strong> makapagdulot <strong>ng</strong> problema a<strong>ng</strong> pagdiin <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

ilan <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> mga tuldok na ito. Ku<strong>ng</strong> buntis ka, bantayan a<strong>ng</strong> mga babala <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> ibaba.<br />

Pa<strong>ng</strong>kalahata<strong>ng</strong> pananakit mula <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagregla<br />

(Para <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> impormasyon tu<strong>ng</strong>kol <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> regla, ti<strong>ng</strong>nan a<strong>ng</strong> pahina 48.)<br />

1. Para makatulo<strong>ng</strong> na maiwa<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n a<strong>ng</strong><br />

karaniwa<strong>ng</strong> mga hinai<strong>ng</strong> haba<strong>ng</strong><br />

nagreregla, tulad <strong>ng</strong> namamaga<strong>ng</strong> suso,<br />

pagkapagod, at pakiraramdam na puno<br />

a<strong>ng</strong> puson:<br />

Puwede ri<strong>ng</strong><br />

diinan a<strong>ng</strong> mga<br />

punto na ito <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

loob na bahagi<br />

<strong>ng</strong> hita at paa .<br />

diinan dito<br />

2. Para mabawa<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n a<strong>ng</strong> pananakit haba<strong>ng</strong><br />

may regla, hawakan at ima<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>he na<strong>ng</strong><br />

mabuti a<strong>ng</strong> punto <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> palad <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagitan <strong>ng</strong><br />

hintuturo at hinlalaki. Makakatulo<strong>ng</strong> a<strong>ng</strong><br />

malakas na pagdiin dito na mabawa<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n<br />

a<strong>ng</strong> marami<strong>ng</strong> klase <strong>ng</strong> pananakit.<br />

Pero huwag masyado<strong>ng</strong><br />

diinan a<strong>ng</strong> tuldok na<br />

ito dahil magdudulot<br />

<strong>ng</strong> pin<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>la . Huwag<br />

diinan ku<strong>ng</strong> buntis a<strong>ng</strong><br />

babae—puwede ito<strong>ng</strong><br />

magpasimula <strong>ng</strong> paglabor .


Accupressure na Ma<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>he<br />

Magagamit din a<strong>ng</strong> sumusunod na ma<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>he <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagbawas <strong>ng</strong> pananakit at pulikat, pati na<br />

a<strong>ng</strong> palatandaan <strong>ng</strong> pre­menstrual syndrome (PMS). Ti<strong>ng</strong>nan a<strong>ng</strong> pahina 51.<br />

Magma<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>he <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pagitan <strong>ng</strong> mga daliri <strong>ng</strong> paa, <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> palibot <strong>ng</strong> buto <strong>ng</strong> buko<strong>ng</strong>­buko<strong>ng</strong>,<br />

at <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> banda<strong>ng</strong> itaas nito <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> labas na bahagi <strong>ng</strong> paa. Maghanap <strong>ng</strong> mga lugar na sensitibo<br />

at ima<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>he iyon na<strong>ng</strong> mas matagal. Sa buntis na babae, huwag ima<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>he a<strong>ng</strong> labas na<br />

bahagi <strong>ng</strong> malaki<strong>ng</strong> daliri <strong>ng</strong> paa, a<strong>ng</strong> gitna <strong>ng</strong> talampakan, o a<strong>ng</strong> banda<strong>ng</strong> itaas at<br />

labas na bahagi <strong>ng</strong> buko<strong>ng</strong>-buko<strong>ng</strong>. Puwede<strong>ng</strong> pasimulan <strong>ng</strong> mga ito a<strong>ng</strong> pag-labor.<br />

Makakatulo<strong>ng</strong> din a<strong>ng</strong> ma<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>he <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> kamay, pulsuhan at tai<strong>ng</strong>a <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> pananakit o palatandaan<br />

<strong>ng</strong> PMS.<br />

Pagbubuntis at pa<strong>ng</strong>a<strong>ng</strong>anak<br />

(Ti<strong>ng</strong>nan a<strong>ng</strong> kabanata <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> “Pagbubuntis at Pa<strong>ng</strong>a<strong>ng</strong>anak,” pahina 67.)<br />

Para maib<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n a<strong>ng</strong><br />

pagkaduwal (morni<strong>ng</strong><br />

sickness), diinan dito<br />

Para makatulo<strong>ng</strong> <stro<strong>ng</strong>>sa</stro<strong>ng</strong>><br />

mahirap o ma<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>kit na<br />

pa<strong>ng</strong>a<strong>ng</strong>anak, diinan dito<br />

Para makatulo<strong>ng</strong><br />

pahintuin a<strong>ng</strong> pagdurugo<br />

matapos ma<strong>ng</strong>anak,<br />

diinan dito<br />

Menopause<br />

(Ti<strong>ng</strong>nan a<strong>ng</strong> kabanata <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> “Pagtanda.”)<br />

Para maib<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n a<strong>ng</strong> karaniwa<strong>ng</strong> mga karai<strong>ng</strong>an, diinan a<strong>ng</strong> sumusunod na mga punto min<stro<strong>ng</strong>>sa</stro<strong>ng</strong>>n<br />

bawat araw <stro<strong>ng</strong>>sa</stro<strong>ng</strong>> loob <strong>ng</strong> 10 minuto.<br />

diinan dito<br />

diinan dito<br />

Para pasimulan a<strong>ng</strong><br />

paglabor o palakasin<br />

a<strong>ng</strong> mahina<strong>ng</strong><br />

paglabor, diinan dito<br />

Makakatulo<strong>ng</strong> din<br />

ku<strong>ng</strong> didiinan a<strong>ng</strong><br />

mga punto na ito<br />

<stro<strong>ng</strong>>sa</stro<strong>ng</strong>> tai<strong>ng</strong>a .<br />

547

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