ASSESS & CLASSIFY THE SICK CHILD AGE 2 MONTHS TO 5 YEARS OLD Flashcards
Ask the caregiver about the 4 main symptoms which are
cough/difficult breathing
diarrhea
fever
ear problem
Check ALL sick children for?
General Danger Signs (GDS)
general danger sign is present if the child:
→ Not able to drink or breastfeed,
→ Vomits everything
→ Has had convulsions
→ Is lethargic or unconscious, or the child
is abnormally sleepy or difficult to
awaken
A child with cough or difficult breathing is
assessed for:
- How long the child has had cough or difficult breathing?
- Fast breathing
- Chest Indrawing
- Stridor or wheeze in calm child
- Oxygen saturation (thru pulse oximeter)
A child who has cough or difficult breathing
for more than 30 days have a chronic
cough, this may be a sign of
tuberculosis
asthma
whooping cough
If coughing is for more than 14 days, then
assess for
TB
If the child is 2 months – 12 months
fast breathing is
50 breaths/mi
If the child is 12 months – 5 years? Fast breathing is
40 breaths/min
LOOK for Chest Indrawing what chest wall?
Lower ribs
If you only see chest indrawing when the
child is crying or feeding,what can be concluded?
the child does not have chest indrawing
If only the soft tissue between the ribs goes
in when the child breath in, which is also
called intercoastal indrawing or
intercoastal retractions, what can be concluded?
the child does not have chest indrawing
If the child has abdominal distention and
malnutrition, what appears to be chest
indrawing, what can be concluded?
May not e the real chest indrawing
is the hoarse noise made by the child, when the child breaths in
Stridor or Wheeze
Stridor or wheeze happens when there is a
swelling in the
larynx
trachea
epiglottis
The child with stridor or wheeze when calm is?
In dangerous condition
where do you listen for strider or wheezing?
Your ear near the child’s mouth
you hear a wet noise if the nose is blocked, clear the nose and listen again
Strider or wheezing
You may hear a wheezing noise when the
child breaths out, what can be concluded?
Notstridor
The 3 position classifications for a
child with cough or difficult breathing.
- Severe pneumonia or very severe disease
- Pneumonia
- Cough or cold (no pneumonia)
an infection of the lungs, both bacteria and viruses can cause
Pneumonia
the most commo pneumonia are
streptococcus pneumoniae
haemophilus influenzae
Children with bacterial pneumonia may
die from
hypoxia or sepsis
When children develop pneumonia, their lungs become
Stiff
Chest indrawing is a sign of severe
Pneumonia
2 possible classifications for a child with
Wheeze:
- Recurrent wheeze
- Wheeze (1st episode)
• Occurs when stools contain more water than
normal
• Defined as 3 or more loose watery stools in
24-hour period
Diarrhea
The best criteria for diarrhea is the
consistency of the stool – watery than normal
lose of watery stools, only
small proportion of all water proportion
is due to cholera
Cholera
diarrhea in less than 14 days,
causes dehydration and
contributes to malnutrition, death in this
case is due to malnutrition
Acute Diarrhea
last 14 days or
more, up to 20% of episodes of
diarrhea becomes persistent, often that
causes nutritional problems and
contributes to death
Persistent diarrhea
a diarrhea with blood in
stool with or without mucus, most common
cause of this is shigella bacteria,
this is not common in young
children, but a child may have both
watery diarrhea
Dysentery
A child with diarrhea is assessed for
A. How long the child has had diarrhea
B. Blood in the stool to determine if the child has dysentery, and
C. Signs of dehydration
Skin goes back longer than 2
seconds
Very slow
In what child the skin may go back
slowly even if the child is not dehydrated
Marasmus
In what child’s does the
skin may go back immediately even if the
child is dehydrated
Overweight children and child with edema
Severe dehydration
• If two or more of the signs in the pink row is
present, then classify the child as having
severe dehydration
• If two or more of the signs are not present,
then look at the yellow or middle row
• If two or more of the signs in the yellow
row is present, then classify the child as
having some dehydration
• If two or more of the signs are not
present, then no enough signs to classify
severe or some dehydration, then classify
it with no visible dehydration
Some dehydration
If the has had diarrhea for 14 days or
more, or has had dehydration or losing
weight
Severe Persistent Diarrhea
If the has had diarrhea for 14 days or
more, or has had dehydration or losing
weight
Severe Persistent Diarrhea
If no visible dehydration but has diarrhea
for 14 days or more, then classify the
child with persistent diarrhea
Persistent Diarrhea
With diarrhea and blood in the stool
Severe Dysentery
caused nearly all of life-
threatening dysentery
Shigella
Finding the actual cause of the dysentery
requires what , it can take at least
2 days obtain the laboratory results
Stool culture
