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IMCI-REVIEWER-Prelims.pdf Flashcards
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What is IMCI?
IMCI is an integrated approach to child health that focuses on the well-being of the whole child, aiming to reduce death, illness, and disability, and promote improved growth and development among children under five years of age.
When did WHO and UNICEF start to develop the IMCI strategy?
WHO and UNICEF started to develop the IMCI strategy in 1992.
What are the factors of poor health mentioned in the text?
Factors of poor health mentioned include poor access to health facilities, lack of access to education, food insecurity, and lack of basic resources like clean water and sanitary toilets.
What is the benefit of Integrated Case Management (IMCI)?
IMCI helps in identifying health issues that may not have been identified otherwise, and it enables rapid and affordable interventions to be provided.
What does IMCI focus on improving?
IMCI focuses on improving case management skills of health care providers, overall health systems, and family and community health practices.
What are some barriers to accessing education for families in developing countries?
Poor roads, high transportation costs, lack of basic resources like clean water and sanitation, food insecurity, and limited access to education for the mother.
What is the benefit of Integrated Case Management (IMCI)?
IMCI helps identify health issues that may have gone unnoticed, provides rapid and affordable interventions, improves the skills of care providers, and enhances the management of childhood illnesses.
What are some key points about IMCI guidelines?
Assessing all young infants and children for common causes of illness and death, using charts to classify problems and guide treatment, and improving care provider skills, knowledge, and adherence to national health guidelines.
What is the purpose of the IMCI case management process?
To improve case management and counseling skills, knowledge of national health guidelines, facilities and health systems for managing childhood illnesses, as well as family and community practices in home treatment and disease prevention.
What are the components of the IMCI Chart Booklet and Recording Forms?
The IMCI Chart Booklet includes sections for recording notes on the IMCI process and critical health information about the child, with separate sections for sick children and sick young infants following the same order as the IMCI recording form.
What steps are involved in the IMCI case management process?
Follow national health guidelines, manage childhood illness, practice family and community practices, provide home treatment, prevent disease, and minimize health risks around the home.
What is the purpose of the Chart Booklet and Recording Forms in IMCI case management?
To record notes on the IMCI process and critical health information about the child, and to help assess, classify, identify treatment, and treat the child.
How are the charts in the Chart Booklet ordered?
They follow the same order as the IMCI recording form, with sections for a sick child and a sick young infant based on the child's age.
What are the two important points about the recording forms in IMCI case management?
There are separate recording forms for a sick child and a sick young infant, and a second recording form is used for follow-up visits.
What does the ASSESS AND CLASSIFY chart in IMCI case management describe?
It describes how to assess the child, classify the child's illnesses, and identify treatments based on the assessment column on the left side of the chart.
What are two important points about recording forms in the given text?
a) There are separate recording forms for the sick child and one for the sick young infant. b) A second recording form is used when the child or infant returns for a follow-up visit.
What does the ASSESS AND CLASSIFY chart describe and how is it used?
It describes how to assess the child, classify the child's illnesses, and identify treatments. The ASSESS column guides taking a history and performing a physical examination, noting symptoms and signs. The CLASSIFY column lists clinical signs and their classifications, with decisions made on the severity of the illness and treatments identified in the TREATMENT column.
How is the treatment information recorded in the recording form according to the text?
The treatments identified for each classification are written in the TREATMENT column on the reverse side of the recording form. When a child has multiple classifications, treatments for each classification are recorded.
What is the purpose of the IMCI chart titled TREAT THE CHILD as mentioned in the text?
The IMCI chart instructs on how to administer the identified treatments, either in the clinic or through teaching.
What should be written in the CLASSIFY column of the recording form for each symptom of the illness?
The classification selected for each symptom
What information is shown in the TREATMENT column of the ASSESS AND CLASSIFY chart?
The recommended treatment for each classification
Where should the treatments identified for each classification be written on the recording form?
On the reverse side of the recording form
What should be recorded when a child has more than one classification of illness?
Treatments for each classification should be recorded
What information does the IMCI chart titled TREAT THE CHILD provide?
Instructions on how to give the identified treatments in the clinic or at home, including medicines, doses, and timing of administration
What does the COUNSEL THE CAREGIVER chart include recommendations on?
Feeding, fluids, home treatment, and when to return to the clinic
Where should the results of any feeding assessment be recorded?
At the bottom of the case recording form
What information should be recorded on the reverse side of the case recording form regarding follow-up care?
The earliest date for the child to return for follow-up
During a sick child visit, what should the healthcare provider listen for regarding the caregiver?
Any problems the caregiver may be having that require treatment or referral for her own health problems
What should be advised to the caregiver if she is experiencing health problems during the sick child visit?
She should be advised to seek treatment or referral for her own health problems
When should you counsel all caregivers about certain topics if a child is going home from the clinic?
Before the child goes home from the clinic.
Where should you write the results of any feeding assessment?
On the back of the case recording form.
Where should you record the earliest date to return for follow-up?
On the reverse side of the case recording form.
What should you listen for during a sick child visit?
Any problems that the caregiver herself may be having.
What may a caregiver need during a sick child visit?
Treatment or referral for her own health problems.
What should be included in follow-up care charts?
Instructions for follow-up visits and conditions that require follow-up care.
What can you assess during a follow-up visit?
If the child is improving on the prescribed treatment.
Why is good communication important in healthcare?
To reassure caregivers, gather important information, and provide effective counseling and education.
What is crucial for the success of home treatment for a young child treated at a clinic?
Clear communication with the caregiver about the treatment and its importance.
What is the importance of using good communication and counseling skills in follow-up care for each condition?
Using good communication helps to reassure the caregiver that the child will receive good care, helps in obtaining important information about the child's situation, and assists in counseling and teaching caregivers on care procedures.
What is the APAC process in counseling and communication?
The APAC process stands for Ask, Praise, Advise, and Check understanding. It involves asking and listening to the child's problems, praising the caregiver for their efforts, advising on home care, and checking understanding.
What are the 3 basic teaching steps when teaching a caregiver how to do something?
1. Give Information: Explain how to perform the task. 2. Show an Example: Demonstrate the task. 3. Practice Together: Allow the caregiver to practice the task with guidance.
What are the 3 steps when teaching a caregiver how to do something?
1. Give information 2. Show an example 3. Let her practice
Why is letting a caregiver practice an important step in teaching a task?
Letting a caregiver practice is important because it allows you to assess their understanding, identify difficulties, and help them improve. Practice helps caregivers remember the task better than just hearing instructions.
What other important tips should be considered when teaching a caregiver?
1. Simplify language: Use words that the caregiver understands. 2. Use visual aids: Use familiar teaching aids to enhance understanding.
What is the most important part of teaching a task to a caregiver?
Caregiver practice
Why is caregiver practice important in teaching a task?
To understand what the caregiver understands and what is difficult, and to help them improve
What is a tip for teaching in simplifying language?
Use words that the caregiver understands
What is a tip for using visual aids in teaching?
Use familiar teaching aids, such as common containers
What should you do when the caregiver practices a task?
Praise what was done well, and make corrections if needed
Why is it important to encourage the caregiver to ask questions?
To ensure understanding and clarify any doubts
What should you do if a caregiver cannot answer checking questions correctly?
Provide more information or explain instructions more clearly
How should checking questions be phrased to be effective?
They should require more than a yes or no answer, and begin with question words like why, what, how, when
What are checking questions used for in caregiver training?
Checking questions are used to determine if the caregiver has understood and learned the treatment instructions given to them.
How should checking questions be phrased to be effective?
Checking questions should be open-ended, starting with question words like why, what, how, when, how many, and how much, to encourage detailed responses from the caregiver.
What is the purpose of using open-ended questions in checking questions?
Open-ended questions help gauge the caregiver's knowledge and understanding by prompting descriptive answers instead of simple yes or no responses.
Give an example of a checking question that prompts a detailed response.
A. When will you give your child the medicine? B. How many tablets will you give each time? C. For how many days will you give the tablets?
Why is it important to give time for a caregiver to ask questions after teaching?
Giving time for questions allows caregivers to seek clarification and address any concerns they may have about the treatment instructions.
How should you determine the priority of advice when a child has multiple problems to be treated?
When a child has several problems, limit the instructions to the most important ones to prioritize the advice given.
When will you give your child the medicine?
Give the medicine at the specified time intervals.
How many tablets will you give each time?
Provide the specific dosage of tablets to be given per dose.
For how many days will you give the tablets?
Administer the tablets for the prescribed duration.
Give time for a caregiver to ask questions
Allow the caregiver time to seek clarification or raise concerns.
Repeat information if needed
Reinforce important details or instructions if necessary.
Address concerns that the caregiver has
Listen to and resolve any worries or queries the caregiver may have.
How do you determine the priority of the advice?
Prioritize essential treatments based on the child's condition and caregiver's understanding.
When a child has only one problem to be treated
Provide all relevant treatment instructions and advice from the charts.
When a child has several problems
Limit instructions to the most critical treatments for the child's well-being.
Counsel about returning to the clinic for 3 situations
1. Scheduled follow-up visit for the child's current problems. 2. Next well-child visit and immunizations. 3. Immediately if the child shows signs of severe illness.
What are the essential treatments for a child's survival?
Giving antibiotics or antimalarial drugs and giving fluids to a child with diarrhea.
What are the three situations when a caregiver should return to the clinic?
1. Scheduled follow-up visit for the child's current problems. 2. Next well-child visit and immunizations. 3. Immediately if a child shows signs of severe illness.
When should a child return for a follow-up visit?
a. Some problems need follow-up to ensure that the treatment is working, such as pneumonia, dysentery, acute ear infection, and persistent diarrhea. b. Some problems only need follow-up if the problem persists, like fever or pus draining from the eye. c. Sometimes, an infant or child may need follow-up for more than one problem; in such cases, tell the caregiver the earliest definite time to return and mention any earlier follow-up needed if a problem persists.
When should a child return immediately to the clinic?
Caregivers should be counseled about signs that the infant or child will show if they have a serious illness, and they must know these signs.
When should a child return immediately for medical follow-up if they have a serious illness?
If they exhibit signs such as breastfeeding poorly, reduced activity, becoming sicker, developing a fever, feeling unusually cold, fast breathing, difficult breathing, or palms and soles appearing yellow.
What signs should prompt a caregiver to seek immediate medical attention for a sick young infant?
Breastfeeding poorly, reduced activity, becoming sicker, developing a fever, feeling unusually cold, fast breathing, difficult breathing, or palms and soles appearing yellow.
What signs should prompt a caregiver to seek immediate medical attention for a sick child?
Not able to drink or breastfeed, becoming sicker, developing a fever, fast breathing, difficult breathing, blood in stool, or drinking poorly.
When should a child return immediately if they have diarrhea?
If there is blood in the stool or if the child is drinking poorly.
Are there exceptions for when a child with fever or blood in the stool should return immediately?
If the child already has a fever or blood in the stool, they do not need to return immediately unless they are also drinking poorly.
What are the general danger signs for a sick child according to the IMCI process?
The child is not able to drink or breastfeed, becomes sicker, develops a fever, has fast breathing, difficult breathing, blood in stool, or is drinking poorly.
What are the signs indicating that a sick child needs to return for medical attention?
- Not able to drink or breastfeed - Becomes sicker - Develops a fever - Fast breathing - Difficult breathing - Diarrhea with blood in stool - Drinking poorly
When should a child not need to return immediately for fever and blood in the stool?
- If the child already has a fever, they do not need to return immediately for fever. - If the child already has blood in the stool, you do not need to tell the caregiver to return immediately for blood, just for drinking poorly.
What are the general danger signs for a sick child aged 2 months up to 5 years?
General danger signs include: - Not able to drink or breastfeed - Becomes sicker - Develops a fever - Fast breathing - Difficult breathing - Diarrhea with blood in stool - Drinking poorly
What section of the IMCI recording form is used for greeting the caregiver?
The top portion of the recording form is used for greeting the caregiver.
Why is it important to establish good communication with the caregiver when a mother brings her child to the clinic?
It is important to establish good communication to provide optimal care and understand the child's health condition.
What is the first thing you should do when a mother and the child come to the clinic according to the IMCI recording form?
Greet the caregiver (mother) and ask about the child.
IMCI-REVIEWER-Prelims.pdf Flashcards
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Why is good communication with a caregiver important?
1. Good communication helps to reassure the caregiver that her child will receive good care. 2. When treating the child's illness, you will need to teach and advise the caregiver about caring for the sick child at home, which requires good communication and trust from the beginning of the visit.
What are the components of good communication skills with a caregiver?
A. LISTEN: Listen carefully to what the caregiver tells you. B. SIMPLIFY WORDS: Use words the caregiver understands to ensure clear communication. C. GIVE HER TIME: Allow the caregiver time to answer questions and make decisions. D. BE CLEAR: Ask additional questions when needed to clarify the caregiver's answers. E. PRAISE: Praise the caregiver for providing information and being involved in the child's care.
How can you ensure that the caregiver understands the questions you ask?
Use words the caregiver understands
Why is it important to give the caregiver time to answer questions?
So she can provide the information needed to assess and classify the child correctly
What should you do if the caregiver is not sure about her answer to a question?
Ask additional questions to clarify
Why is it important to praise the caregiver during the assessment process?
To reinforce good practices
What important information should you gather during a greeting with the caregiver?
A) Age for determining which IMCI charts to use B) Child's problem/symptoms C) Weight and temperature
What information should the healthcare provider gather from the caregiver about the symptoms or health problems of the child?
Duration of symptoms, progression, and previous care given
Why is it important to check the child's weight and temperature during the assessment?
To assess the child's health status and monitor changes during the evaluation process
When should the child's weight and temperature be recorded, and how should the child be handled during this process?
Weight and temperature should be recorded later, without disturbing or undressing the child during the initial assessment
How can the healthcare provider distinguish between an initial visit and a follow-up visit for a child's health problem?
An initial visit is the child's first for the current illness episode, while a follow-up visit is when the child was seen previously for the same issue a few days ago
What are the key aspects of making contact and communication between the healthcare provider and the caregiver during a healthcare assessment?
Posturing at the same level, maintaining eye contact, and removing physical barriers for effective communication
What is the difference between an initial visit and a follow-up visit for a child's episode of illness?
An initial visit is the child's first visit for the episode of illness, while a follow-up visit is when the child was seen a few days ago for the same problem.
What are the key elements of making contact with the mother during a health visit?
Ensuring that the health worker and mother's heads are at the same level, maintaining eye contact, and removing any barriers between them like tables or notes.
What are the general danger signs to look out for in a child during a health visit?
1. Child is not able to drink or breastfeed 2. Child vomits everything 3. Child has had more than one convulsion or prolonged convulsions or is convulsing 4. Child is lethargic or unconscious
How can a health worker check for a general danger sign in a child?
By asking three questions and observing the child's actions: 1. Ask 'Is your child able to drink or breastfeed?' 2. Look for signs of the child's actions 3. Open the Chart Booklet to the chart for general danger signs
What are the four steps involved in assessing for general danger signs in a child?
Ask three questions and look to observe the child's actions.
When assessing if a child is able to drink or breastfeed, what signs indicate that the child is not able to suck or swallow?
The child is not able to suck or swallow when offered a drink or breast milk.
What should you do if a caregiver mentions that their child is not able to drink or breastfeed?
Ask the caregiver to describe what happens when they offer the child something to drink and observe if the child can swallow the fluid.
What should be done if a child who is breastfed has difficulty sucking when their nose is blocked?
Clear the child's nose, and if they can breastfeed after the nose is cleared, they do not have the danger sign of not being able to drink or breastfeed.
What does it mean if a child vomits everything and is not able to hold anything down at all?
The child has the danger sign of vomiting everything, where everything that goes down comes back up.
What should you look for to see if a child is swallowing water or breast milk?
Check to see if the child is swallowing the water or breast milk.
What is a possible difficulty a breastfed child may have if their nose is blocked?
Difficulty sucking when the nose is blocked.
What should you do if a child's nose is blocked?
Clear the child's nose if it is blocked.
If a child can breastfeed after the nose is cleared, does the child have the danger sign of not being able to drink or breastfeed?
No, the child does not have the danger sign if they can breastfeed after the nose is cleared.
What is the danger sign related to a child who vomits everything they consume?
The danger sign is that the child vomits everything they consume, where everything that goes down comes back up.
What does it indicate if a child is not able to hold anything down at all?
The child has the danger sign of vomiting everything they consume.
If a child vomits several times but can hold down some fluids, do they have the danger sign of vomiting everything?
No, they do not have the danger sign if they can hold down some fluids.
How should you ask about convulsions in a child?
Ask the caregiver if the child has had more than one convulsion or prolonged convulsions during the current illness.
What physical signs may indicate a child is having a convulsion?
During a convulsion, the child's arms and legs stiffen because the muscles are contracting.
What does it mean if a child is lethargic or unconscious?
A lethargic child is not awake and alert, often drowsy and showing no interest in their surroundings.
What happens to a child's arms and legs during a convulsion?
They stiffen because the muscles are contracting.
How may a child react during a convulsion?
The child may lose consciousness or not be able to respond to spoken directions.
How can a caregiver refer to convulsions in everyday language?
The caregiver may call convulsions fits or spasms.
What does it mean if a child is lethargic?
A lethargic child is not awake and alert, appears drowsy, and does not show interest in the surroundings or respond to stimuli.
How can you determine if a child is unconscious?
An unconscious child cannot be awakened, does not respond to touch, shaking, or verbal stimuli.
What signs indicate that a child needs urgent medical attention and referral to a hospital?
General danger signs indicate a serious problem and may require urgent referral to a hospital for potentially lifesaving treatments.
What should you do if a child shows one or more general danger signs?
Most children with general danger signs need urgent referral to a hospital for possible lifesaving treatment with injectable antibiotics, oxygen, or other treatments not available at the clinic.
How should the assessment proceed after checking for general danger signs?
A child with any general danger sign needs urgent attention. Complete the assessment, administer any pre-referral treatment immediately, and follow the IMCI instructions to ensure timely referral.
What are the main symptoms to assess for in a child under five years old?
Main symptoms include cough or difficult breathing, diarrhea, and fever, which could indicate serious illnesses like pneumonia, malaria, or infections.
What is the first step in the IMCI process according to the text?
Assess for main symptoms
What are the main symptoms that indicate a child could have a serious illness?
Cough or difficult breathing, diarrhea, fever
Why is assessing the child's nutritional status important in the IMCI process?
Undernutrition is a common underlying cause of child mortality and increases the risk of death even in mildly malnourished children
What should be checked after assessing for the main symptoms and nutritional status in the IMCI process?
Immunizations, HIV status, and other problems
What is the action required for children with general danger signs or a red classification in the IMCI process?
Urgent pre-referral treatment and referral
How to assess, classify, and treat malnutrition and anemia in children?
Assess for complaints related to malnutrition and anemia, classify the severity of the conditions, and provide appropriate treatment based on the assessment.
What should be checked in addition to assessing malnutrition and anemia in children?
Check immunizations, HIV status, and other potential health problems to provide comprehensive care.
What is the importance of urgent referral for children with general danger signs or red classification conditions?
Urgent referral is crucial for children with serious illnesses to receive immediate pre-referral treatment and be referred for further care.
How can urgent pre-referral treatment be determined for children with general danger signs?
Identify the bold pre-referral treatments specified in the classification charts in the chart booklet to determine the urgency of treatment before referral.
Why are some treatments specified as urgent pre-referral treatments?
Certain treatments are specified as urgent to prevent delays in referral and ensure that critical care is provided immediately, avoiding worsening of the condition.
What should not be given before referral according to the text?
Treatments that are not urgently needed will only delay referral
How many steps are there to refer a child or a sick young infant to a hospital according to the text?
Four steps
What is the first step in referring a child to a hospital according to the text?
Explain to the caregiver the need for referral and get her agreement to take the child
What should be included in the referral note according to the text?
The name
Why is it important to explain the need for referral to the caregiver when taking the child to the hospital?
To ensure the caregiver understands the seriousness of the child's condition and the importance of getting proper medical care.
How can you calm the caregiver's fears about taking their child to the hospital?
Reassure them that the hospital has physicians, supplies, and equipment to help cure the child's illness.
What information should be included in a referral note for the caregiver to carry to the hospital?
Name and age of the child, date and time of referral, description of the child's problems, reason for referral, signs/symptoms for classification, treatment given, earlier treatment of the illness, immunizations needed, your name, and the name of your clinic.
What supplies and instructions should be given to the caregiver to care for the child on the way to the hospital?
Provide additional doses of antibiotics if the hospital is far, teach the caregiver how to give them, and instruct on how to keep the child warm during the journey.
What are the instructions to give to a caregiver for caring for a child on the way to the hospital?
Provide supplies and instructions needed, give additional doses of antibiotics if the hospital is far, teach how to keep the child warm, advise to continue breastfeeding, give ORS solution if dehydrated and can drink.
What should be done if a referral is not possible for a child in need of medical attention?
Continue with pre-referral treatment, initiate treatment in the clinic if the child improves (YELLOW classification), advise on available treatments, arrange for the child to stay in or near the clinic for close monitoring if needed.
What should you do if a referral is not possible for a child in need of care?
Continue with pre-referral treatment until the child is able to leave for the hospital.
What should you do if a child improves on pre-referral treatment?
Initiate treatment in the clinic, e.g., YELLOW classification.
How can you reduce deaths in severely ill children who cannot be referred to a hospital?
Arrange for the child to stay in or near the clinic for frequent monitoring or arrange for home visits if staying near the clinic is not possible.
What is a common reason why a mother may bring a child to the clinic?
A cough or difficult breathing.
What are the major steps of the IMCI process for assessing and treating cough or difficult breathing?
Assess cough or difficult breathing, classify the condition, provide treatment, counsel the caregiver on home care and safe remedies, and plan follow-up care.
What can a child with a cough or difficulty breathing have, according to the text?
Pneumonia or another severe respiratory infection.
Major steps of the IMCI process
1. Assess cough or difficult breathing 2. Classify cough or difficult breathing 3. Treatment for cough or difficult breathing 4. Counsel caregiver on home care, oral antibiotics, safe remedies 5. Follow-up care for cough or difficult breathing
What is pneumonia?
Pneumonia is an infection of the lungs. Children with bacterial pneumonia may die from hypoxia (lack of oxygen) or sepsis (generalized infection). Both bacteria and viruses can cause pneumonia.
Common causes of pneumonia in low and middle-income countries
In low and middle-income countries, pneumonia is often caused by bacteria. The most common bacteria responsible for pneumonia are Streptococcus pneumoniae and Haemophilus influenzae.
Management of children with mild respiratory infections
Most children with a cough or difficulty breathing have only a mild infection and are not seriously ill. They do not need treatment with antibiotics and can be managed at home by their families.
Signs of serious respiratory infection in children
Some children with a cough or difficult breathing may have pneumonia or another serious respiratory infection. These children may require antibiotics and close monitoring to prevent complications.
Impact of pneumonia on child mortality
Pneumonia is one of the leading causes of child mortality worldwide. Children can die from bacterial pneumonia due to complications such as hypoxia and sepsis.
What can cause cough or difficult breathing in children?
Mild respiratory infections such as a cold or bronchitis
Do children with mild respiratory infections like a cold or bronchitis need antibiotics?
No, they can be treated at home without antibiotics
What is one of the greatest causes of child mortality in the world according to the passage?
Pneumonia
What can children die from due to bacterial pneumonia?
Hypoxia or sepsis (a generalized infection)
What is the most common cause of pneumonia in developing countries?
Bacteria
How can pneumonia be identified in children?
Checking for fast breathing and chest indrawing as clinical signs
What is one of the body's responses to stiff lungs and hypoxia?
Fast breathing
When does chest indrawing develop in pneumonia?
When the lungs become severe
What must be visible and present all the time for chest indrawing to be present?
Lower chest wall going in when the child breathes
IMCI-REVIEWER-Prelims.pdf Flashcards
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What should the caregiver do if the child's body is bent at the waist and it is hard to see the lower chest wall move?
Ask the caregiver to change the child's position so he is lying flat in her lap.
What are the three possible classifications for a child with cough or difficult breathing?
1. Severe pneumonia or very severe disease 2. Pneumonia 3. Cough or cold
What action should be taken if a pulse oximeter is available and the oxygen saturation is below 90?
Refer the child for further evaluation and management.
What treatment can be used for a child with fast breathing but no chest indrawing in low HIV settings?
Oral Amoxicillin for 3 days.
What should be done for a child classified as having severe pneumonia or very severe disease?
Urgently refer the child to a hospital for treatments such as oxygen, bronchodilator, or injectable antibiotics.
What treatment can be tried for very severe pneumonia or very severe disease in a child?
Oral salbutamol may be tried.
What actions should be taken for a child classified as having severe pneumonia or very severe disease?
Urgent referral to a hospital for treatments such as oxygen, a bronchodilator, or injectable antibiotics. Give the first dose of an appropriate antibiotic before the child leaves.
How should a child with pneumonia be treated?
Treatment with oral amoxicillin for 5 days. Begin treatment in the clinic and continue at home.
What additional treatment may be required for a child with wheezing?
Treatment with an inhaled bronchodilator.
What actions should be taken for a child classified as having cough or cold?
Provide appropriate treatment based on the absence of general danger signs, chest indrawing, stridor, or fast breathing.
What treatment is required for a child with wheezing?
Treatment with an inhaled bronchodilator is required for a child with wheezing.
What action should be taken for a child who is HIV exposed or infected and has chest indrawing?
The caregiver should give the first dose of amoxicillin and refer the child to the hospital.
What is the classification for a child with cough or difficult breathing but none of the general danger signs?
A child with cough or difficult breathing but none of the general danger signs is classified as COUGH OR COLD.
Does a child with COUGH OR COLD require an antibiotic?
No, a child with COUGH OR COLD does not need an antibiotic as it will not relieve the child's symptoms or prevent the cold from developing into pneumonia.
What should be done for a child with a chronic cough lasting more than 2 weeks?
A child with a chronic cough lasting more than 2 weeks should be referred to the hospital for further assessment.
What are the three pieces of critical information identified in the classification table for treating a child with cough or difficult breathing?
1. Appropriate treatment for each classification 2. Where treatment is given (clinic, home, or second-level facility) 3. Pre-referral treatments are identified in bold and required
What are some potential causes of a chronic cough lasting more than 2 weeks in a child?
Tuberculosis, asthma, whooping cough, or another problem
When should a child with a chronic cough be referred to a hospital for further assessment?
If the child needs urgent referral or has severe symptoms
What three pieces of critical information are identified in the classification table for treating a child with cough or difficult breathing?
1. Appropriate treatment for each classification 2. Where treatment is given (clinic, at home) 3. Pre-referral treatments needed for urgent referral
What are the three treatments identified for cough or difficult breathing in children?
1. Oral antibiotics like amoxicillin 2. Remedy for soothing sore throats 3. Inhaler treatment if wheezing
What are the general instructions for giving oral antibiotics to a child with cough or difficult breathing?
Review instructions for giving antibiotics with integrated management, follow guidelines for various classifications requiring antibiotics, such as pneumonia, severe pneumonia, severe dehydration, and dysentery
How should you give oral antibiotics according to the provided instructions?
Give the first line oral antibiotic if available, followed by the second line if the first line is not available or if the child's illness does not respond to it. If the child can drink, give an oral antibiotic that is appropriate for the specific illness.
What are the general instructions for giving antibiotics with integrated management?
The first time learning about antibiotic use within IMCI, review general instructions on giving antibiotics. Follow instructions in the section 'TREAT THE CHILD' for various classifications that require antibiotics listed in the instructions provided.
What illnesses are covered in the section for learning about antibiotics in the instructions provided?
Pneumonia, severe pneumonia, very severe disease, severe dehydration with cholera in the area, dysentery, very severe febrile disease, severe complicated measles, mastoiditis, and acute ear infection.
What should be done if the first line anbioc is not available or if the child's illness does not respond to the first line anbioc?
Give an oral antibiotic if the child is able to drink. The appropriate oral antibiotic for each illness varies by country.
What should be done if the chart identifies more than one illness requiring antibiotics?
If one antibiotic can treat multiple illnesses, use that antibiotic. If multiple antibiotics are needed, give each antibiotic based on the specific illnesses.
How should a child with dysentery and acute ear infection be treated with antibiotics?
They can be treated with a single antibiotic, such as co-trimoxazole, if it is the first or second line antibiotic for both dysentery and acute ear infection.
What caution should be taken when treating a child with more than one illness requiring the same antibiotic?
Do not double the size of each dose or give the antibiotic for a longer period of time. Follow the dosage and schedule indicated on the TREAT THE CHILD chart.
What should be done if more than one antibiotic is required to treat multiple health problems in a child?
Give each antibiotic separately based on the illnesses. Follow the dosage and schedule provided on the TREAT THE CHILD chart.
How should the appropriate dosage of antibiotics be decided when treating a child?
Refer to the TREAT THE CHILD chart for the schedule and dose of giving antibiotics. The schedule indicates how many days and how many times each day to administer the antibiotic.
What factors may require the administration of multiple antibiotics for a child with multiple illnesses?
More than one health problem requiring different antibiotics that are not effective against each other
How is the appropriate dosage of antibiotics determined for a child with multiple illnesses?
By identifying the type of tablets or syrup available, choosing the row for the child's weight or age, and referring to the correct dose on the chart
What does the 'TREAT THE CHILD' chart provide guidance on regarding antibiotics?
The schedule and dosage for giving antibiotics, including the number of days and times per day to administer them
How long is the usual duration for administering most antibiotics according to the 'TREAT THE CHILD' chart?
5 days, except for cholera cases which receive antibiotics for 3 days
What is emphasized when selecting soothing remedies for children with a sore throat or cough according to the guidelines?
Safety and effectiveness, whether the remedy is homemade, clinic-provided, or bought from a pharmacy
What should be used to choose the correct dose for a child's weight or age?
Choose weight over age
Where is the correct dose listed on the IMCI Chart?
At the intersection of the column and row
What is recommended as a safe soothing remedy for children with a sore throat or cough according to the TREAT THE CHILD chart?
Breast Milk
What should not be given to a child who is exclusively breastfed according to the guidelines?
Other drinks or remedies
What should never be used as remedies for children according to the guidelines?
Remedies containing harmful ingredients like atropine, codeine, codeine derivatives, or alcohol
What should not be used as medicated nose drops for children according to the guidelines?
Nose drops containing anything other than salt
What is an important opportunity during the treatment process to educate the caregiver on home treatment, feeding care, and when to return to the clinic?
Counseling the caregiver
How many basic teaching steps are involved in providing information to caregivers?
Three
What is the first basic teaching step in providing information to caregivers?
Give information using words the caregiver understands
What may interfere with the child's feeding and ability to cough up secretions from the lungs?
Medicated nose drops that contain anything other than salt
What should not be used for a child when it comes to medicated nose drops?
Nose drops that contain anything other than salt
What are the three basic teaching steps for counseling caregivers?
1. Give information using understandable words 2. Show an example with familiar objects 3. Let them practice with feedback and more practice as needed
What are the topics relevant to counseling a caregiver about cough or difficult breathing?
Giving oral antibiotics, giving soothing remedies, using an inhaler if necessary, when to return immediately, and when to follow up
What do the 'TREAT THE CHILD' charts include instructions for when it comes to giving oral medicines at home?
Counseling caregivers on giving oral medicines at home, for different reasons, in different doses, and on different schedules
What are some of the ways to treat a child at home for breathing issues?
Giving oral antibiotics, giving soothing remedies, using an inhaler if necessary for wheezing
What are the important steps to remember when giving oral medicines at home?
Determine appropriate medicine dosage, explain treatment, demonstrate how to measure a dose, let caregiver practice, ask caregiver to give first dose, explain drug carefully, then label and package
Why is it important to explain to the caregiver why you are giving the drug to the child?
To ensure understanding and compliance with the treatment plan.
What should you do after demonstrating how to measure a dose to the caregiver?
Let the caregiver practice measuring a dose by herself.
What should you do if the caregiver measures the dose incorrectly?
Show her again how to measure it correctly.
What should you ask the caregiver to do after practicing measuring the dose?
Ask the caregiver to give the first dose to the child.
What information should be clearly written on a drug label for the caregiver to understand?
- Full name of the drug - Total amount of tablets, capsules, or syrup for the treatment course - Daily dose and schedule - When to give the dose
How should the drug label instructions be written to ensure readability?
Clearly and in a way that a literate person can read and understand them.
What information should be included when writing the full name of a drug?
The full name of the drug
How should the total amount of tablets, capsules, or syrup required to complete the course of treatment be written?
Write the total amount of tablets, capsules, or syrup
How should the daily dose and schedule of medication be written?
Write the daily dose and schedule (e.g., tablet twice daily for 5 days)
What should be included in specifying the correct dose for the patient to take?
The number of tablets, capsules, drops, or spoonfuls to be taken
When specifying when to give the dose, what information should be provided?
The timing (e.g., early morning, lunch, dinner, before going to bed)
How should drugs be packaged for a patient?
Put the total amount of each drug into its own labeled drug container using clean containers (e.g., envelope, paper tube, bottle)
What should be done after labeling and packaging the drug for a patient?
Give it to the mother
What does the 'TREATMENT' column in a chart booklet designate?
How soon the child should return for follow-up care
When should a caregiver be advised to return to the clinic immediately?
When there are signs that the child needs immediate medical attention
What steps are involved in providing follow-up care for cough or difficult breathing in a child?
Assess previous classifications and check for general danger signs, assess for cough or difficult breathing, ask specific questions about the child's breathing
When should a child return for follow-up care immediately?
If they exhibit signs that require immediate attention, such as difficulty breathing or other danger signs.
What are the steps to providing follow-up care for a child with cough or difficult breathing?
1. Assess previous classifications 2. Use IMCI to fully reassess the child
What signs should be assessed during a follow-up visit for a child with cough or difficult breathing?
- Is the child breathing slower than on the first visit? - Is there less fever? - Is the child eating better?
When should a child with pneumonia follow up for care?
In 3 days
When should a child with cough or cold follow up for care if not improving?
In 5 days
When should a child with cough or difficult breathing return for follow up?
A child with pneumonia should follow up in 3 days. A child with cough or cold should follow up in 5 days if not improving.
What signs will be asked in the follow-up visit to determine if the child is improving, worsening, or the same?
General danger signs, chest indrawing or breathing rate, fever, and eating habits.
What should be done if a child has a general danger sign during the follow-up visit?
The child is getting worse and needs urgent referral to a hospital.
What does it mean if the child has chest indrawing or breathing rate, fever, and eating habits the same as 3 days before?
The child is not worsening but also not improving, requiring urgent referral to a hospital.
What does it indicate if the child is breathing slower without chest indrawing, eating better, and has less fever?
The child is improving, as most children who are improving will no longer have fast breathing, and the fever is lower or gone.
What action should be taken regarding antibiotics for a child showing signs of improvement?
Tell the mother that the child should finish taking the full 5 days of the antibiotics and review with her the importance of completing the entire course.
Why is it important to assess diarrhea in children during the clinic visit?
Diarrhea is a common problem in children, can be serious, and even lead to death if not properly managed.
What causes diarrhea to occur in children?
Diarrhea occurs when stools contain more water, leading to loose and watery bowel movements.
What are signs of improvement in a child with chest indrawing and fever?
Coughing may still occur but most children will no longer have fast breathing, lower or no fever
What advice should be given to the mother regarding antibiotic treatment for a child?
The child should finish taking the full 5 days of antibiotics for effective treatment
Why is assessing diarrhea important in children at the clinic?
Diarrhea can be a serious condition that can lead to death in children
Define diarrhea in children.
Diarrhea occurs when stools contain more water than normal, are loose, or watery. In many regions, it is defined as three or more loose or watery stools in a 24-hour period
What age group commonly experiences diarrhea?
Children between 6 months and 2 years old often experience diarrhea, especially in settings with poor sanitation and hygiene
What is the difference between acute and persistent diarrhea?
Acute diarrhea lasts less than 14 days, while persistent diarrhea lasts 14 days or more. Persistent diarrhea can lead to nutritional problems
What is the impact of acute watery diarrhea on children?
Acute watery diarrhea causes dehydration and contributes to malnutrition, with dehydration being a common cause of death in children with acute diarrhea
Which type of diarrhea is more likely to cause dehydration and malnutrition?
Most diarrhea that causes dehydration is loose or watery, with cholera being an example. However, only a small proportion of watery diarrhea is due to cholera
What is the definition of acute diarrhea?
An episode of diarrhea that lasts less than 14 days and causes dehydration.
What is the most common cause of dysentery?
Shigella bacteria.
What is persistent diarrhea?
Diarrhea that lasts 14 days or more, often leading to nutritional problems and contributing to death in children.
How would you assess a sick young infant for diarrhea?
First, ask all caregivers if the child has diarrhea and explain it as loose watery stools. Then inquire about fever as another main symptom.
What distinguishes a young infant's diarrhea from normal bowel movements?
A young infant has diarrhea if the stools have changed from the usual pattern to being many and watery, indicating more water than fecal matter.
How do you define diarrhea in a young infant?
Diarrhea in a young infant is when the stools have changed from the usual pattern and are many and watery, indicating more water than fecal matter.
What should you do first when assessing a sick young infant for diarrhea?
First, ask all caregivers if the child has diarrhea. Clarify the meaning of diarrhea as loose watery stools if needed.
If no diarrhea is reported, what is the next main symptom to ask about?
If no diarrhea is reported, ask about fever as the next main symptom.
What are the two parts of assessing a sick young infant for diarrhea?
The two parts are assessing the type of diarrhea, especially if it is persistent or dysentery, and checking for signs of dehydration.
What is important when explaining diarrhea to caregivers?
Use words for diarrhea that the caregiver understands and ensure they know it refers to loose watery stools.
What are the common signs and symptoms of diarrhea?
Frequent loose or watery stools, abdominal cramping, bloating, and nausea.
What are the common signs of dehydration?
Decreased urine output, dry mouth, sunken eyes, increased heart rate, and lethargy.
How is dehydration assessed in a patient with diarrhea?
Assess for decreased urine output, dry mucous membranes, poor skin turgor, tachycardia, and altered mental status.
IMCI-REVIEWER-Prelims.pdf Flashcards
Study
What should you examine about the infant's movements in the ASSESS chart for a sick young infant?
Additional detail about the infant's movements.
What is persistent diarrhea defined as?
Diarrhea that lasts 14 days or more.
What should you ask the mother in regards to the duration of diarrhea in a sick child?
Ask how long the diarrhea has been present.
What is dysentery and what is its most common cause?
Dysentery is diarrhea with blood in the stool, and the most common cause is Shigella bacteria.
What is dehydration in young infants and why is it dangerous?
Dehydration is when a child loses too much water and salt, which can lead to serious problems and even death.
What is Oral Rehydration Salts (ORS) and how can it help in treating dehydration?
ORS is a mixture of glucose and salts that can help restore the balance of water and salt in the body to treat dehydration.
What type of ORS should be used to treat dehydration?
Low osmolarity ORS should be used to treat dehydration.
What is dehydration and how does it affect the body?
Dehydration is when the child loses too much water and salt from the body, causing a disturbance of electrolytes which can affect vital organs.
How can dehydration be treated?
A child who is dehydrated must be treated to help restore the balance of water and salt. Many cases of diarrhea can be treated with Oral Rehydration Salts (ORS), a mixture of glucose and several salts. Extra fluids can be used as home treatment to prevent dehydration.
What type of ORS should be used to treat dehydration?
Low osmolarity ORS should be used to treat dehydration.
What are some signs that help assess the severity of dehydration in a child?
Signs include the child being restless or irritable, sunken eyes, loss of skin elasticity, lethargy, or unconsciousness.
How can you assess dehydration based on the child's general condition?
Check for general danger signs like lethargy or unconsciousness. Restlessness and irritability can also be indicators of dehydration.
What are the general danger signs to check for in a child?
Lethargic or unconscious
How is a child classified as restless and irritable?
If they are restless and irritable all the time, even when touched or handled
What is a sign of dehydration to look for in a child?
Sunken eyes
How can you confirm if a child's eyes appear sunken due to dehydration?
Ask the mother if she thinks her child's eyes look unusual
What can cause a child to be unable to drink?
Lethargy, unconsciousness, inability to suck or swallow
What can a mother's opinion help confirm when it comes to a child's eyes looking unusual?
It can help confirm signs of dehydration in a severely malnourished child who may appear wasted.
How can you classify dehydration in a child based on how they drink?
Watch how the child drinks by offering water in a cup or spoon. A child who drinks eagerly and acts thirsty shows signs of good hydration.
What are signs that a child is not able to drink when offered water?
A child may not be able to drink if they cannot suck or swallow, are lethargic, unconscious, weak, or need help to drink.
How can you determine if a child is drinking eagerly and acts thirsty when offered water?
Look to see if the child reaches out for the cup or spoon, wants more water when it's taken away, and drinks without needing encouragement to continue drinking.
What is the purpose of the skin pinch test in assessing dehydration?
The skin pinch test helps assess dehydration by checking the skin's elasticity. Dehydrated children may have less elastic skin.
How can you determine if a child is thirsty and eager to drink water?
Offer the child a cup or spoon of water and observe if they reach out for it. Take the water away and see if the child is unhappy because they want to drink more. If the child only drinks with encouragement and does not want more, they are not thirsty or eager to drink.
What is the skin pinch test used for in assessing dehydration in children?
The skin pinch test is used to assess dehydration in children by checking the elasticity of the skin. Dehydrated skin loses elasticity, indicating dehydration.
How is the skin pinch test performed to assess dehydration in children?
1. Ask the mother to place the child flat on the examining table or on her lap. 2. Use thumb and first finger to locate the area halfway between the umbilicus and the side of the abdomen. 3. Pick up all layers of skin and tissue underneath. 4. Hold the skin pinch for one second, then release. 5. Observe how quickly the skin pinch goes back: very slowly (>2 seconds), slowly (<2 seconds), but not immediately, or immediately.
What is the purpose of the skin pinch test described in the text?
To assess dehydration in children by checking how quickly the skin returns to normal after being pinched.
Where on the child's abdomen is the area located for performing the skin pinch test?
Halfway between the umbilicus and the side of the abdomen.
How long should you hold the pinch of skin during the skin pinch test?
For one second.
What should you observe after releasing the skin pinch during the test?
Observe how quickly the skin goes back to its normal position.
Is the skin pinch test always an accurate sign of dehydration? Why or why not?
No, it is not always accurate. In cases of severe malnutrition, the skin may go back slowly even if the child is not dehydrated. In overweight or edematous children, the skin may go back immediately even if dehydration is present.
What are the signs of severe dehydration in a child according to the text?
lethargic or unconscious, not able to drink or drinking poorly, sunken eyes, very slow skin pinch
How is dehydration classified in a sick child or young infant according to the text?
SEVERE DEHYDRATION is classified if the child has two or more signs of lethargy, unconsciousness, poor drinking, sunken eyes, or very slow skin pinch.
What is the recommended treatment for a child classified with severe dehydration according to the text?
Treat with IV (intravenous) fluids.
How is diarrhea classified for dehydration assessment according to the text?
All children with diarrhea are classified for dehydration. If the child has had diarrhea for 14 days or more, classify for persistent diarrhea. If the child has blood in the stool, classify for dysentery.
What signs classify a child as having SEVERE DEHYDRATION?
lethargic or unconscious, not able to drink or drinking poorly, sunken eyes or very slow skin pinch
How should a child with SEVERE DEHYDRATION be treated?
Treat with IV intravenous fluids, give fluids quickly
What signs classify a child as having SOME DEHYDRATION?
restless, irritable, drinks eagerly, thirsty, sunken eyes, skin pinch goes back slowly
How should a child with SOME DEHYDRATION be treated?
Treat with ORS solution, provide fluid, food, and zinc supplements
What classification is given to a child with NO DEHYDRATION?
GREEN
How is a child classified if they have one sign in the red top row and one sign in the yellow middle row?
Classified in the yellow row as SOME DEHYDRATION.
What treatment is recommended for a child classified with SOME DEHYDRATION?
Fluid foods and zinc supplements, treated with ORS solution.
What additional care does a child with SOME DEHYDRATION need aside from fluid and zinc supplements?
Food, breastfeeding for breastfed children, or nutritious food for other children after 4 hours of ORS treatment.
How is a child classified if they do not have two or more signs in the red or yellow row?
Classified as having NO DEHYDRATION and needs extra fluid and food to prevent dehydration.
What are the four rules of home treatment for a child classified with NO DEHYDRATION?
1. Give extra fluid 2. Give zinc supplements 3. Continue feeding 4. Return immediately if the child develops danger signs, drinks poorly, or has blood in stool.
What is the treatment box called for treating diarrhea at home?
Plan A - Treat Diarrhea At Home.
What does a child with NO DEHYDRATION need in addition to extra fluid and zinc supplements?
Food.
When should a child be classified for persistent diarrhea?
If the child has had diarrhea for 14 days or more.
When should a child be classified for dysentery?
If the child has diarrhea and any blood in the stool.
What should you do if the child develops danger signs, drinks poorly, or has blood in stool?
Return immediately
What fluids should you teach the mother to give a child with NO DEHYDRATION according to the treatment box Plan A Treat Diarrhea At Home?
Oral rehydration solution (ORS) and other fluids
After classifying for persistent diarrhea, what should be done if the child has had diarrhea for 14 days or more?
Treat the child for persistent diarrhea
How do you classify a child for dysentery?
If the child has diarrhea and any blood in the stool
What treatment is recommended for a child with dysentery?
Treatment for dehydration and an antibiotic recommended for Shigella in the area
What is the classification for diarrhea that lasts for 14 days or more in a child?
Persistent Diarrhea
How do you classify Severe Persistent Diarrhea in a child?
If a child has had diarrhea for 14 days or more and also has some or severe dehydration, it is classified as Severe Persistent Diarrhea
What is the classification for a child who has had diarrhea for 14 days or more with no signs of dehydration?
PERSISTENT DIARRHEA
What is the most important treatment for persistent diarrhea?
Special feeding
What are the identified treatments for persistent diarrhea according to the classification tables?
Giving ORS for dehydration, Zinc supplementation, Ciprofloxacin for dysentery
How many plans are there to provide fluid and replace water and salts lost in diarrhea?
Three (Plan A, Plan B, Plan C)
What is Plan A for treating dehydration?
Treat diarrhea at home
What is Plan B for treating dehydration?
Treat some dehydration with low osmolarity oral rehydration salts (ORS)
What is Plan C for treating dehydration?
Treat severe dehydration quickly with intravenous (IV) fluids
How is Plan C administered for severely dehydrated children and young infants?
Rapid hydration using IV fluids or a nasogastric (NG) tube
What is Plan A for treating diarrhea at home?
Treat diarrhea at home
What is Plan B for treating some dehydration with low osmolarity oral rehydration salts (ORS)?
Treat SOME DEHYDRATION with low osmolarity oral rehydration salts (ORS)
What is Plan C for treating severe dehydration quickly with intravenous (IV) fluids?
Treat SEVERE DEHYDRATION quickly with intravenous (IV) fluids
How is Plan C (IV fluids or nasogastric tube) given to severely dehydrated children and young infants?
Rapidly hydrate using IV fluids or a nasogastric (NG) tube
Where is Plan C recommended to be given for severely dehydrated children?
In a clinic or a nearby clinic or hospital, depending on the available equipment and training
When is rehydration therapy using IV fluids or a nasogastric tube recommended for children?
For children who have SEVERE DEHYDRATION
Where should severely dehydrated children be referred if IV or NG fluid cannot be given and the child cannot drink?
Refer urgently to the nearest hospital that can give IV or NG treatment
What should be done if IV intravenous treatment is available within a 30-minute drive for a severely dehydrated child?
Refer urgently to the hospital
Where is the safest place to give Plan C if IV or NG fluid cannot be given and the child cannot drink?
Refer the child urgently to the nearest hospital that can give IV or NG treatment
What should be offered to a sick child on the way to the hospital if IV intravenous treatment is available within a 30-minute drive?
Frequent sips of ORS (Oral Rehydration Solution)
What should be given to a child or young infant with some dehydration in addition to fluid and food?
Zinc supplementation
What should be done first if a child with some dehydration needs treatment for other problems as well?
Start treating the dehydration first, then provide other treatments
What is the next step after a 4-hour treatment period at the clinic for a child with some dehydration based on reassessment?
Classify the child's dehydration level and proceed accordingly with Plan A, B, or C
What should be done if a child who has some dehydration needs treatment for other problems at the clinic?
Start treating the dehydration first, then provide other treatments. Reassess after 4 hours and classify the child's dehydration.
What should be done if a child's signs of dehydration are gone after 4 hours at the clinic?
Put the child on Plan A for home treatment. If there is still some dehydration, repeat Plan B. If the child now has severe dehydration, put the child on Plan C.
What should be done if a child has a severe classification and needs Plan B at the clinic?
Urgently refer the child to the hospital. Do not try to rehydrate the child before they leave. Provide the mother with ORS solution and show her how to give frequent sips to the child on the way to the hospital.
How should a caregiver be taught to give ORS in the clinic?
1. Determine the amount of ORS to give during the first 4 hours. Use the chart in Plan B to determine the recommended amount. Find the amount below the child's weight or age. The child can drink as much as they need. If the child wants more or less than the estimated amount, give what the child wants. The mother should also breastfeed whenever the baby wants, then resume the ORS.
How can you teach the caregiver to determine the amount of ORS to give during the first 4 hours?
Use the chart in Plan B to determine the recommended amount by looking below the child's weight or age if the weight is unknown. Allow the child to drink as much as needed and adjust based on the child's preference.
What should be done to show the mother how to give ORS solution?
Inform the mother about the amount of ORS solution to give over the next 4 hours using local units. For children under 2 years, demonstrate how to give frequent spoonfuls; for older children, show how to give frequent sips from a cup. Sit with her during the initial feeding and address any questions she may have.
What steps should be taken while the mother gives ORS for 4 hours?
Guide the caregiver to handwashing facilities and areas for diaper changing or toilet use. Regularly check in with the mother for any issues and offer support if the child is not consuming the ORS solution effectively.
What should you do if the child is older and needs to drink ORS?
Show the caregiver how to give frequent sips from a cup and sit with her while she gives the child the first few sips from a cup or spoon.
What should you do while the mother gives ORS for 4 hours?
Show the caregiver where to wash her hands, where she can change the child's diaper, or where the child can use a toilet. Check with the mother for any problems.
What can you try if the child is not drinking the ORS solution well?
Try another method of giving the solution, such as using a dropper or a syringe without the needle.
What is the first concern when administering ORS to a child?
The first concern is to rehydrate the child.
What should you do when the child is obviously improving with ORS treatment?
Turn the mother's attention to learning about mixing and giving ORS solutions.
What is recommended to have for the mother to study while with her child?
It is a good idea to have printed information and posters on the wall that the mother can study.
What should you do after 4 hours of giving ORS to the child?
Reassess the child using the ASSESS AND CLASSIFY chart to determine the dehydration level and choose the appropriate plan for treatment.
What should be provided to the mother for studying while taking care of her child?
Printed information and posters on the wall to reinforce the information.
How should the child be reassessed after 4 hours of ORS solution?
Using the ASSESS AND CLASSIFY chart to classify dehydration and choose the appropriate treatment plan.
What further action should be taken if the child is not taking the ORS solution or getting worse before 4 hours?
Reassess the child and take appropriate action based on the classification of dehydration.
What should be done if the child has NO DEHYDRATION according to the classification?
Move to Plan A and counsel on home care.
What is recommended if the child has SOME DEHYDRATION according to the classification?
Choose Plan B, begin feeding the child in the clinic, and offer food, milk, or juice.
What should be done if the child is worse and now has SEVERE DEHYDRATION according to the classification?
Begin Plan C for severe dehydration treatment.
What should be done if a caregiver must leave before finishing 4 hours of ORS treatment?
Show the caregiver how to prepare ORS solution, give the amount needed to complete treatment at home, provide packets for rehydration, and explain the 4 rules of home treatment.
What is Plan A based on?
The four rules of home treatment.
What is the first rule of home treatment in Plan A?
Give extra fluid to replace the fluid lost in diarrhea and prevent dehydration.
What is the recommended approach if a caregiver must leave before finishing 4 hours of ORS treatment at home?
Show the caregiver how to prepare ORS solution, show her how much ORS to give to complete the treatment, and give her extra packets for rehydration.
What treatment plan is used for a child with diarrhea but no dehydration?
Plan A.
What does Plan A require the caregiver to do in terms of fluid intake for the child?
Give as much fluid as the child will take to replace lost fluids and prevent dehydration.
What is Plan A in the treatment of children with diarrhea?
Children with no dehydration are put on Plan A right away.
What is Plan B in the treatment of children with diarrhea?
Children with more serious dehydration are first treated with Plan B.
What is Rule 1 in the treatment of children with diarrhea?
Give extra fluid to replace the fluid lost in diarrhea and prevent dehydration.
IMCI-REVIEWER-Prelims.pdf Flashcards
Study
How should the caregiver give extra fluid when diarrhea starts?
Tell the mother to continue breastfeeding with the addition of ORS and clean water. If the child is exclusively breastfed, breastfeed more frequently than usual. Breastfed children under 4 months should be breastfed first, then given ORS. If the child is not breastfed, give ORS solution, food-based fluids, soup, rice water, yogurt drinks, and clean water.
What steps are involved in mixing Oral Rehydration Solution (ORS)?
a) Wash hands with soap and water b) Pour all the powder from one packet into a clean container c) Measure 1 liter of clean water or the correct amount for the packet used d) Pour the water into the container and mix well until the powder is dissolved e) Taste the solution to know how it tastes
What is step a in preparing ORS solution at home?
Wash your hands with soap and water
What is step b in preparing ORS solution at home?
Pour all the powder from one packet into a clean container. Use any available container such as a jar, bowl, or bole.
What is step c in preparing ORS solution at home?
Measure 1 litre of clean water or correct amount for packet used. It is best to boil and cool the water, but if this is not possible, use the cleanest drinking water available.
What is step d in preparing ORS solution at home?
Pour the water into the container. Mix well until the powder is completely dissolved.
What is step e in preparing ORS solution at home?
Taste the solution so you know how it tastes. The caregiver should mix fresh ORS every day in a clean container. She should keep the container covered. She should throw away any solution remaining from the day before.
How much fluid should be given in addition to the usual fluid intake for children up to 2 years after each loose stool when using ORS?
50-100 ml
How much fluid should be given in addition to the usual fluid intake for children 2 years or older after each loose stool when using ORS?
100-200 ml
What are the instructions for giving ORS to a child at home?
1. Give frequent small sips from a cup. 2. If a child vomits, wait 10 minutes. Then continue but more slowly. 3. Continue giving extra fluid until the diarrhea stops.
When is it especially important to give ORS at home according to the provided instructions?
When a child was treated with Plan B or C during this visit, in other words, the child has just been rehydrated.
How much additional fluid intake is recommended for children up to 2 years old after each loose stool?
50-100 ml
How much additional fluid intake is recommended for children 2 years or older after each loose stool?
100-200 ml
What are the caregiver instructions for giving ORS to a child?
1. Give frequent small sips from a cup. 2. If a child vomits, wait 10 minutes then continue but more slowly. 3. Continue giving extra fluid until the diarrhea stops.
Why is it important to give ORS at home after a child has been treated with Plan B or C during a visit?
To prevent dehydration from coming back.
When should zinc supplements be given to children with diarrhea?
Zinc supplements should be given to children 2 months up to 5 years old.
What is the purpose of giving zinc supplements to a child with diarrhea?
To reduce the duration and severity of the diarrheal episode, decrease stool output, and decrease the need for hospitalization.
At what age range is zinc treatment recommended for children with diarrhea?
Zinc treatment is recommended for children 2 months up to 5 years old.
What does Rule 3 'CONTINUE FEEDING' suggest to caregivers?
To continue feeding the child, following special feeding recommendations if the child has persistent diarrhea.
When should a caregiver return to a health worker immediately according to the information provided?
When specific signs indicate the need for immediate attention and intervention.
What is the recommended age range for giving zinc to children with diarrhea?
2 months up to 5 years
What are the signs that indicate a caregiver should return a child with diarrhea to a health worker immediately?
Not able to drink or breastfeed, becomes sicker, develops a fever, blood in stool, drinking poorly
How long should a child have persistent diarrhea before being referred to a hospital if signs of dehydration are present?
14 days or longer
What is the most important treatment for persistent diarrhea in children with no signs of dehydration?
Special feeding
What should you do if a child has persistent diarrhea for 14 days or longer and signs of dehydration?
Refer them to the hospital for special attention to prevent fluid loss and treat dehydration before referral.
What is the most important treatment for persistent diarrhea without signs of dehydration in children?
Special feeding, which may include more frequent and longer breastfeeding, fermented milk products, or nutrient-rich semi-solid foods.
What feeding recommendations should be followed for a child with persistent diarrhea?
Give small frequent meals at least 6 times a day, avoid very sweet foods or drinks, and follow age-appropriate feeding recommendations.
How long should a child with persistent diarrhea receive zinc supplementation?
For 14 days.
What treatment should a child with dysentery receive?
Ciprofloxacin for 3 days or another oral antibiotic recommended for Shigella in the area.
What feeding recommendation should be followed for the child?
Give small frequent meals at least 6 times a day and avoid very sweet foods or drinks.
How should the child's milk be prepared?
Half the milk with nutrient-rich semi-solid food.
How long should the child receive zinc supplements for dysentery treatment?
The child should receive zinc for 14 days.
When should the child follow up for dysentery treatment?
The child should follow up in 5 days.
What is the recommended duration of ciprofloxacin treatment for dysentery?
The child should receive ciprofloxacin for 3 days or another oral antibiotic recommended for Shigella in the area.
Why should antibiotics not be used routinely for diarrhea?
Antibiotics are not effective in treating most diarrhea, and unnecessary use may increase resistance of some pathogens. They are costly and may not provide practical benefits.
Which types of diarrhea should be treated with antibiotics?
Only dysentery and diarrhea with severe dehydration, including cholera in the area, should be treated with antibiotics.
Are anti-diarrheal drugs like loperamide and diphenoxylate beneficial for children with acute diarrhea?
No, anti-diarrheal drugs do not provide practical benefits for children with acute diarrhea.
Why should antibiotics not be given routinely for diarrhea in children?
Unnecessary use of antibiotics may increase pathogen resistance, antibiotics are costly, and money is wasted on ineffective treatment.
What are the only types of diarrhea that should be treated with antibiotics in children?
Dysentery and diarrhea with severe dehydration, particularly in areas with cholera outbreaks.
Which drugs should not be used for the treatment of acute diarrhea in children and why?
Anti-diarrheal drugs, motility agents (e.g., loperamide), adsorbents (e.g., kaolin), live bacterial cultures (e.g., Lactobacillus), and charcoal do not provide practical benefits and may have dangerous side effects in children under 5 years old.
What should caregivers focus on during home treatment for diarrhea in children with no dehydration?
Counseling caregivers to give extra fluids to children to prevent dehydration during illness.
Why is good teaching and advising skills important when treating dehydration and diarrhea in children?
Caregivers give many treatments in the clinic or at home, so it is important to teach them how to administer treatment and counsel them on the 4 rules of home treatment.
What is the first rule of home treatment for children with NO DEHYDRATION under Plan A?
Counseling a caregiver to give extra fluid
Why is it important to give extra fluid to a child during illness?
To replace the fluid lost due to fever, fast breathing, or diarrhea and prevent dehydration
What is the purpose of giving as much fluid as the child will take during diarrhea?
To replace the fluid lost in diarrhea and prevent dehydration
How can a caregiver give more fluid to a child with diarrhea?
By breastfeeding more frequently and for longer feeds, giving ORS or clean water, increasing fluid with food-based fluids like soup, rice water, yogurt drinks, or ORS
Why is ORS important at home for children treated on Plan B or C or unable to return to the clinic?
To prevent dehydration, especially if the child was treated on Plan B or C or cannot return to the clinic if diarrhea worsens
What can be done to prevent dehydration when diarrhea starts?
Give more fluid than usual by breastfeeding more frequently, giving ORS or clean water, increasing fluid with food-based fluids like soups, rice water, yogurt drinks, or ORS.
Why is ORS especially important at home in some cases?
It is important if the child was treated on Plan B or C, or if the child cannot return to the clinic if diarrhea gets worse.
What are the steps to mix and give ORS?
1. Wash hands with soap and water. 2. Pour the ORS powder into a clean container. 3. Measure 1 litre of water or specified amount (boil and cool water is recommended). 4. Pour water into the container, mix, and taste. 5. Give solutions to the child slowly by cup. If the child vomits, wait 10 minutes and continue slowly. 6. Make fresh ORS solutions daily and keep them covered.
Why is it important to counsel a caregiver to give zinc to a child with diarrhea?
Zinc is essential for children aged 2 months up to 5 years with diarrhea as described in the TREAT chart.
How should you measure 1 litre of water or a specified amount for an oral rehydration solution (ORS) preparation?
Boil and cool water before pouring it into the container with the powder
How should you give ORS solutions to a child?
Slowly, by cup; if the child vomits, wait for 10 minutes and then continue more slowly
Why is it important to make fresh ORS solutions each day and keep them covered?
To ensure the effectiveness and safety of the solution
How much zinc supplement should a child aged 2 months to 6 months take daily for 14 days?
Half a 20 mg tablet daily for 14 days
How much zinc supplement should a child aged 6 months or older take daily for 14 days?
A whole 20 mg tablet daily for 14 days
What special feeding needs do children with persistent diarrhea have?
They may have difficulty digesting milk other than breast milk
What is the recommended follow-up period for a child with persistent diarrhea?
5 days
What should be done if an infant with diarrhea has signs of improvement in 2 days follow-up?
Continue exclusive breastfeeding
What should be done if an infant with diarrhea has not improved in 2 days follow-up?
Reassess, classify dehydration, select a fluid plan, and refer if signs are the same or worse
What should be done if a young infant with persistent diarrhea has developed fever?
Give intramuscular antibiotics before referral
What feeding recommendations should be given if diarrhea has stopped and the child has less than 3 stools per day?
Follow the usual feeding recommendations for the child's age
What should be done if the diarrhea has not stopped in a young infant?
Reassess the young infant for diarrhea and classify the dehydration, select a fluid plan. If signs are the same or worse, refer the infant to hospital.
What should be done if a young infant with diarrhea has developed fever?
Give intramuscular antibiotics before referral for VERY SEVERE DISEASE. PERSISTENT DIARRHEA requires a follow up after 5 days.
What action should be taken if the young infant with diarrhea has less than 3 stools per day and diarrhea has stopped?
Tell the mother to follow the usual feeding recommendations for the child's age. If the child is not normally fed this way, teach her the feeding recommendations on the counsel chart.
What should be done if the young infant with diarrhea has more than 3 stools per day and diarrhea has not stopped?
Do a full reassessment of the child, identify and manage any problems that require immediate attention such as dehydration, then refer the child to the hospital.
What steps are involved in the follow-up for dysentery after 3 days?
Ask if there are fewer stools, less blood in stools, less fever, less abdominal pain, and if the child is eating better. If there are improvements in all these signs, continue the antibiotic ciprofloxacin.
What signs should you ask about after 3 days of treatment with ciprofloxacin for a child with Shigella?
Fewer stools, less blood in stools, less fever, less abdominal pain, better eating habits
What should you do if the child shows improvement after 3 days of treatment with ciprofloxacin?
Advise the mother to finish the 3 days of ciprofloxacin prescribed and review the importance of finishing the antibiotic
What signs indicate that the child is dehydrated and not improving on ciprofloxacin for Shigella?
More stools, blood in stools, fever, abdominal pain unchanged or worsened, eating is the same or worse
What should you do if the child is dehydrated and not improving on ciprofloxacin for Shigella?
Stop the first antibiotic, give the second line antibiotic for Shigella for 5 days, refer to the TREAT chart, advise the caretaker to return in 2 days
What actions should be taken when starting the second line antibiotic for Shigella?
Give the first dose of the new antibiotic in the clinic, teach the caregiver how and when to give the antibiotic, advise the caregiver to bring the child back after two more days
Why may the lack of improvement in a Shigella infection be caused by antibiotic resistance?
Chart Anbioc resistance of Shigella may be causing the lack of improvement.
What advice should be given to the caretaker regarding the child's condition?
Advise the caretaker to return in 2 days.
What actions should be taken when giving the first dose of a new antibiotic in the clinic?
a) Give the first dose of the new antibiotic in the clinic.
What guidance should be provided to the caregiver regarding administering the antibiotic to the child?
b) Teach the caregiver how and when to give the antibiotic and help her plan how to give it.
What advice should be given to the caregiver for the follow-up visit after two more days?
c) Advise the caregiver to bring the child back again after two more days.
What should be considered if the child has not improved after receiving the second line antibiotic for two days?
If the child has received the second line antibiotic for two days and has not improved, the child may have amoebiasis.
What is the recommended treatment for a child with suspected amoebiasis?
This child may be treated with metronidazole if it is available or can be obtained by the family or referred for treatment.
How can amoebiasis be diagnosed with certainty?
Amoebiasis can only be diagnosed with certainty when trophozoites of E. histolytica containing red blood cells are seen in a fresh stool sample.
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Prepare for your IMCI exam with this flashcard deck covering key concepts and definitions in child health.
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