CHALLENGING

BEHAVIORS
APPLY RESPONSES
RESPOND TO DIFFICULT OR
CHALLENGING BEHAVIOR
BEHAVIOR – is an act of conduct which can be
observed and measured in any living creature. Which
means that every individual specifically the human
being has different attitudes that needs strategies to
overcome the difficult one.

What are the causes of challenging behavior?

1. Poor communication ability
 Failure to express their needs or what they want
Lack of ability to use the language
Speech defect
2. Environmental Factors
Temperature of the environment
Noise
3. Self – centeredness
Boredom
Frustrations
Lack of attention
4. Social and Economic Factors
Lack of social skills
Poor skills of parenting
Economic status
5. Medical Reasons
Illnesses
Physical pain
Involuntary movements on some parts of the
body

There are a lot of reasons which can be

considered why a sudden change of behavior
occurs among individual. Identifying the
causes will also be a way of finding the best
solution to respond and understand those
people with difficult behaviors.
Strategies in Dealing with Challenging
Behavior

1. Transform the setting

2. React calmly
3. Teach them how to communicate
4. Suggest some choices
5. Appreciate their activities
6. Be constant
7. Avoid unexpected activities
8. Entertain them
Institutional Policies and Procedure in
Dealing with Challenging Behaviors
A comprehensive training all staff can be one
of the most effective way in preparing them to
respond with their client’s who has difficult
behaviors. There are indicators or warning that
a person’s behavior is in crisis and
uncontrolled of his emotions.
The guidelines below can help in an early
intervention before any incident becomes
dangerous.
1. Respect the personal space needed by each
individual
2. Check your body position
3. Comprehend to others feelings
4. Use nonverbal and non threatening cue
5. Avoid challenging questions
6. Enforce and set limits
7. Allow the client to have his verbal venting
when possible
8. Find the real reason for the behavior
9. Avoid overreacting, keep yourself
composed
10. Apply physical technique if necessary
 PERFORMANCE TASK
Group the class into 4 groups. Each
group will perform one types of
challenging behavior.
The performance will present in the
class with the graded rubric, which the
teachers presented.
REPORT AND
REVIEW
INCIDENTS
 Today different incidents are very important in
almost all parts of the world. In cases of
emergencies, healthcare professionals are visible
to help and assist the victims of each incidents. It
is very important that these people are
knowledgeable and well trained in performing
their tasks and at the same time they are skilled in
assessing and reporting the incidents. The
incidents reports are made to make all the
information available to agencies who will be
needing the reports.
Relay Incidents according to
Institutional Policies and Procedures
Reporting any incident that occurs in any
institution must follow the proper procedures of
filling an incident report. These is a general rule
that will guide every institution in conducting the
incidents reports. First aiders should try to make
notes, if possible during the first aid provision and
fill out the official reports forms as soon as
possible after attending any incident.
What are the things that should be
included in the incident report?

Who is responsible in relaying the incident

reports?
Here are the correct way in relaying an incident that
occurs in any institutions:

Incident reports should include:

1. The personal information about the client and the
name of the hospital.
2. Date, time and place where the incident occurs
must be recorded.
3. Describe the incident based on how it occurs.
Do not make any personal conclusion or
assessment. It should be reported according to how
you were able witness the occurrence of the
incident.
4. Include the client’s assessment based on his/her
personal experience.
5. List down and identify all the personnel's who
witnessed the occurrence of the accident.
6. List down and identify all the medications used,
include the dosage and the type of the medication.
Equipment's used must also be included.
When do we file the incident report?
The incident report must be filed within
24 to 48 hours or as soon as possible. This
should follow the agency procedure in filling
an incident report and must be reviewed by the
agency risk management committee who
decides whether further investigation is needed
in the incident.
Incident reports are required in the following
situations:
1. If it involves pressured equipment.
2. It involves flood, fire or any explosion
3. Injury in the elevator
4. Incident involving crane or derrick
5. Incident that involves any structure that
collapse
6. Any work related incident that causes
serious injuries
7. An incident that causes death
 APPLY
BASIC
FIRST AID
First aid is one of the most important skills that
we need to know especially in cases of
emergencies. It help us to assist individuals by
giving them the temporary treatment until
he/she receives the competent medical
treatment. Simple skills when emergency
occurs can save lives. Sometimes there are
cases of heart attack, choking, and drowning
whose lives are saved because of some
bystanders who are well trained and knows
what to do.
First Aid – is a fast and temporary care
applied to an individual who had been victims
of accident, injury or suddenly in a dangerous
situation.

First Aid Management – can be defined as a

method of preparing an individual to be
equipped with the basic skills and knowledge
about the health related situations and
conditions.
Principles of First Aid
1. Save and removal of the casualty as soon as
possible without annoying the existing
health situation.
2. First aid should be limited to those who
needed it only.
3. Immediate treatment of hemorrhage.
4. Retrieval of respiration and circulation.
5. Prevention of impending shock and
treatment of shock if the victim is already
in such a state.
6. Checking of simple and compound fractures
and dislocations.
7. Relief of pain using basic procedures and
medication.
8. Guarantee of getting well immediately to the
client.
Ancient Greek Symbol of Healing
VITAL SIGNS
- refers to the function of the body that
indicates the condition of the bodys’ pulse
rate, temperature, blood pressure, respiratory
and the degree of pain if any. The main
purpose of taking the vital sign is to monitor
and determine the condition of the body.
What is the purpose of taking the vital
signs?
1. Vital Signs will regulate the condition of the
patient.
2. Vital Signs help in the diagnosis and
treatment of the patient.
How do we take Vital Signs of the person?
Vital signs are taken when the body is not
functioning normally. Healthcare personnel and
persons who are knowledgeable is taking the
vital signs must be accurate and careful.
 AVERAGE NORMAL ADULT RATES

Temperature 98.6 F or 37 C

Pulse 60 to 80 beats per minute

Respiration 16 to 20 regular breaths per minute

Blood Pressure
Infants
Under 18 yrs. old 50/40 to 80/58 mm of mercury
below
18 to 50 years and 120/80 mm of mercury
above Below 140/90 mm of mercury

These rates serves as a guide to check if the person is

healthy based on the normal body rates.
Body Temperature
Body Temperature is the amount of heat inside
the body. It is measured using the instrument
known as thermometer.
Thermometer is a hollow glass tube with a
liquid sealed inside the tube.
Types of Thermometer:
1. Battery-Operated Electronic Thermometer
2. Glass Thermometer
3. Chemically treated paper Thermometer
4. Infrared Thermometer
Each thermometer is used in the different
parts of the body.
Digital Thermometer - are commonly used in
oral, rectal, and axillary.
Please do remember that the thermometer
used in oral thermometer is different used in
rectal.
 Chemically Treated Paper
Glass thermometer Thermometer

Infrared
thermometer
Battery operated electronic
thermometer
 Normal Temperature Readings
Age Route/Site Average Temperature
Newborn Axilla 36.1 C – 37.7 C
1 year old Oral 37.7 C
3 years old Oral 37.2 C
5 years old Oral 37.0 C
Adult Oral 37.0 C
Rectal 36.4 C
Forehead 37.6 C
Tympanic 37.7 C
Elderly (over 70 yrs. old) Oral 36.0 C

Another vital signs that signifies our life is the pulse rate. If
the person is healthy, the rate of his pulse reflects the beat of
his heart.
PULSE RATE
Pulse – is the wave of blood made through
beating of the heart and passing along the
artery.
Pulse Rate – means the number if times the
heart beats per minute which migth be
altered by emotions, activity, pain and
temperature.
Where and what is the normal heart rate?
Where is the best place to find the pulse rate of
the person?
A. Wrists
B. Inside the elbow
C. Side of the neck
D. Top part of the foot
Body Pulse Site
What are the factors that affects the Pulse Rate?
1. Air temperature – if the temperature is a little
biy=t humid, the heart releases more blood,
which causes the pulse rate to increase.
2. Body position – while resting, standing or
sitting there is no change in your pulse rate.
Bit if you remain standing for 20 to 30
seconds the pulse rate may increase a bit.
3. Size of the body – normally the body size does
not change the pulse rate. But if a person is
obese, the pulse rate may increase but not
more than 100 per minute.
4. Medication used – medication that blocks
the adrenaline may cause your pulse rate to
beat a little slow, while taking too much
medication for thyroid will increase the pulse
rate.
 RESPIRATION RATE
The respiration rate is the amount of breaths a
person takes per minute. It is normally counted
when the person is at rest. If the respiration is
over 25 breaths per minute or under 12 breaths
per minute, it is also considered abnormal.
The respiratory rate of the person increases if
he is suffering from illness, fever, and other
medical conditions.
 Factors Affecting the Respiratory
1. Age
2. Gender
3. Alterations in acid-base balance
4. Lesions of the brain
5. Respiratory diseases
6. Anemia
7. Anxiety
8. In take of medication
9. Severe pain which may increase the
respiratory rate.
The respiratory rhythm and depth varies from
shallow to deep. The depth of each respiration
is similar when the person is resting or
sleeping. Each individual is inhaling deeply
which fills the lungs with air compared with
the usual depth of respiration.
 BLOOD PRESSURE
- is the pressure is the amount of force
exerted by the blood as it flows against the
walls of the arteries.
SPHYGMANOMETER &
STETHOSCOPE
 Health and safety hazards exist every
workplace or institutions.
Physical Hazards are one of the most common
which is easily identified, while some are in
dangerous situations that could put the life of
other people at risk.
The best thing to do is to protect ourselves as
well as the victims, and recognize how to
prevent the physical hazards.
When an accident occurs assess the casualty’s
mobility status like their ability to communicate,
their level of awareness and their sensory
perception during initial physical examination.
1. Inspect the scene of the incident
2. Do the primary and crucial assessment on the
victim.
A – Airway – the air passage that allows the
victim to breath
B – Breathing – is the person breathing?
C – Circulation – is the heart of the person
breathing? Check also the pulse rate of the
victim.
3. Call the emergency medical assistance for
help.
4. Make a secondary assessment on the
victim.
Applying Basic First Aid Techniques
Accidents every now and then are
unpredictable.
First Aid management will help you to
know the basic knowledge about different
health related conditions, following the
different contributing factors in the
application of immediate remedy in order to
save the lives of the victims. Diagnosing the
health status of the victim is very important
before applying the appropriate.
 First-Aid Principles
First aid is defined as the care that we
extend to injured person. Application of the
immediate care to any ill person is
important. It also requires certain rules or
guidelines to maintain the calmness of the
casualty.
1. To alleviate suffering
2. To prevent added/further injury or danger
3. To prolong the life
1. Keep Calm
2. Avoid harm
3. Apply CPR if necessary
4. Time counts
5. Avoid using hydrogen peroxide on open
wounds
6. If there is unconscious casualty but
continuously breathing
7. High blood pressure is dangerous
8. The casualty can, talk
9. Some seizures are not emergencies
10. Drowning is not what we think how it looks
like
 First Aid Procedure & Management of
the Casualty
1. Bleeding
- is the loss of blood. It can be external, or
outside the body, like when you get a cut or
wound. It can also be internal, or inside the
body, like when you have an injury to an
internal organ.
2. Poisoning
- is injury or death due to swallowing,
inhaling, touching or injecting various drugs,
chemicals, venoms or gases.
Many substances - such as drugs and
carbon monoxide - are poisonous only in
higher concentrations or dosages.
3. Shock
- is a critical condition brought on by the
sudden drop in blood flow through the body.
Shock may result from trauma, heatstroke,
blood loss, an allergic reaction, severe
infection, poisoning, severe burns or other
causes. When a person is in shock, his or her
organs aren't getting enough blood or oxygen.
BURNS
- are tissue damage that results from heat,
overexposure to the sun or other radiation, or
chemical or electrical contact. Burns can be
minor medical problems or life-threatening
emergencies. The treatment of burns depends
on the location and severity of the damage.
SCALDS
- are caused by hot water or steam.
SPRAINS
◦ - is a stretch or tear of ligament, the band of
connective tissues that joints the end of one bone
with another. Sprains are caused by trauma such
as a fall or a blow to the body that knocks a joint
out of position and, in the worst case, ruptures
the supporting ligaments.
STRAIN
- is a twist, pull or tear of a muscle or tendon a
cord of tissue connecting muscle to bone. It is an
acute, non-contact injury that results from
overstretching or over-contraction.
BONE FRACTURES
- is a break in the bone that can occur from
either a quick, one-time injury to the bone.
DISLOCATIONS
- when the two bones come together to
form a joint become separated, the joint is
described as being dislocated.
 Home Treatment
 Apply the R.I.C.E method
 Do not apply heat during the first 2 days as
this will only increase swelling
 Remove rings immediately if the injury is
to hand or finger
 After 48 hrs, start moving the limb gently,
but only enough not to cause the pain.
 Gradually increase the range of movement.
 R.I.C.E METHOD
REST the injured part.
Avoid any activity that causes pain or makes
it worse
Use crutches if the leg, foot or ankle is
injured
 support an injured wrist, arm or shoulder
with a sling
ICE is an excellent anti- flammatory and
reduces swelling pain. Apply ice pack or
cold compress for 10-15 minutes.
Protect your skin with a thin cloth.
COMPRESS
- reduces swelling.
- use elastic bandages for at least 2 days
ELEVATE
- drains fluids from injured tissues
- try to keep the injured area at or above
the level of the heart.
Common Methods of Communication

1. Face to Face Method

a. Messages can be delivered immediately
b. Messages can be made clear if there are
questions to be asked.
2. Telephone Method
a. Messages can be delivered immediately
b. Messages can be made clear if there are
questions to be asked.
3. Written Method
a. Messages can be exchanged most of the
time
b. Records are readily available
c. Messages often times is understood
4. Computer Method
a. Massages cab delivered immediately even
to those at far distance
b. No need to be present for both parties
during clarification
c. Two way communication is available
through e-mail
d. Records are readily available
e. People can participate in exchanging their
ideas.
COMMUNICATE
APPROPRIATELY
WITH PATIENTS
 Health Care Providers
What is a Health care?
Healthcare is the services offered with
different types of facilities to provide the
needs of the people.
Healthcare providers refers to doctors with
different specialization like clinical social
worker who is authorized to practice their
scope of specialization.
 Kinds of Healthcare Agencies
Health care agencies offers their services in
different settings. A hospital for exam[le may
provide services like inpatient, outpatient
clinic and emergency room services.
Healthcare services are classified as;
1. Public Health Clinics
Public health clinics are established by
government officials at their local and
provincial state to make health services
available for their constituents.
2. Hospitals
Hospitals in every state can be classified in
two categories, one is public and another one
is private which can be found in every local
vicinity.

3. Ambulatory Care Services

- offers treatment and diagnostic in
different communities, hospitals, malls where
most of the clients find in convenient to go to
4. Primary Care Center
- most of the physician’s offices are located
in all parts of the country where most of the
people go for diagnosis, consultation and
treatment.

5. Home Health Care

- is one of the most widespread and
growing business in the world.

6.