Laboratory 03: Integrated Management of Childhood Disease (IMCI) - FOCUS ON DISEASES

Question 1

What are the treatment options for cough or difficulty breathing in a sick child?

Answer 1

(A) Soothe the throat, relieve the cough with a safe remedy
(B) Safe remedies to recommend:
1. Breastmilk for exclusively breastfed infants
2. Tamarind, calamansi, ginger
(C) Harmful remedies to discourage:
1. Codeine cough syrup
2. Other cough syrups
3. Oral and nasal decongestants

Question 2

Explain the assessment process when assessing if the child have a cough or difficulty breathing.

Answer 2

(A) If NO: Proceed to the next symptom.
(B) If YES, ask: For how long?

Question 3

How do you assess cough or difficulty breathing?

Answer 3

LOOK, LISTEN, FEEL:
(A) Count the breaths in one minute.
(B) Look for chest indrawing.
(C) Look and listen for stridor.

Question 4

What should you do if the child is fast breathing?

Answer 4

Fast breathing is defined as:
(A) For 2 months to 12 months: 50 breaths/min or more
(B) For 12 months to 5 years: 40 breaths/min or more

Question 5

How do you classify the child’s illness?

Answer 5

Classify the illness using the color-coded classification table for cough or difficulty breathing.

Question 6

What are the signs that indicate the need to classify as SEVERE PNEUMONIA or VERY SEVERE DISEASE?

Answer 6

(A) Any general danger sign
(B) Chest indrawing
(C) Stridor in a calm child

Question 7

What is the treatment for SEVERE PNEUMONIA or VERY SEVERE DISEASE?

Answer 7

(A) First dose of an appropriate antibiotic
(B) Urgent referral to the hospital

Question 8

What are the signs that indicate PNEUMONIA?

Answer 8

Fast breathing

Question 9

What is the treatment for PNEUMONIA?

Answer 9

(A) Give an appropriate oral antibiotic for 5 days
(B) Soothe the throat and relieve the cough with a safe remedy
(C) Advise the mother when to return immediately
(D) Follow-up in 2 days

Question 10

What are the signs that indicate NO PNEUMONIA (COUGH OR COLD)?

Answer 10

No signs of pneumonia or very severe disease

Question 11

What is the treatment for NO PNEUMONIA (COUGH OR COLD)?

Answer 11

(A) If coughing for more than 30 days, refer for assessment
(B) Soothe the throat and relieve the cough with a safe remedy
(C) Advise the mother when to return immediately
(D) Follow-up in 5 days if not improving

Question 12

What is the treatment for PNEUMONIA OR VERY SEVERE DISEASE when the child is under ages 6 to 12 months old?

Answer 12

(A) Cotrimoxazole 1/2 tablet (80mg TMP, 400mg SMX) 2x daily for 5 days
(B) Amoxycillin 1/2 teaspoon (125mg/5ml) 3x daily for 5 days

Question 13

What is the treatment for PNEUMONIA OR VERY SEVERE DISEASE when the child is under ages 12 months old to 5 years old?

Answer 13

(A) Cotrimoxazole 1 tablet (80mg TMP, 400mg SMX) 2x daily for 5 days
(B) Amoxycillin 1 1/2 teaspoons (125mg/5ml) 3x daily for 5 days

Question 14

What is the Vitamin A supplementation for SEVERE PNEUMONIA or VERY SEVERE DISEASE based on age?

Answer 14

6 to 12 months:
(A) 100,000 IU: 1 capsule
(B) 200,000 IU: 1/2 capsule

12 months to 5 years:
(A) 100,000 IU: 2 capsules
(B) 200,000 IU: 1 capsule

Question 15

What do you do when the child shows NO symptoms of diarrhea?

Answer 15

(A) Classify the child’s illness using the color-coded classification tables for diarrhea.
(B) Ask about the next main symptoms: fever, ear problems, and check for malnutrition, anemia, immunization status, and other problems.

Question 16

What do you do when the child shows YES symptoms of diarrhea?

Answer 16

A) Ask:

How long has the child had diarrhea?
Is there blood in the stool?

Question 17

How do you assess the child’s general condition during diarrhea?

Answer 17

(A) Look for signs such as:

Is the child lethargic or unconscious?
Is the child restless or irritable?

Question 18

What do you check when assessing the child for signs of dehydration during diarrhea?

Answer 18

(A) Look for sunken eyes.
(B) Offer the child fluids:
Is the child unable to drink or drinking poorly?
Is the child drinking eagerly and thirsty?

(C) Pinch the skin on the abdomen and check if it returns:
Very slowly (longer than 2 seconds)?
Slowly?

Question 19

What do you do after assessing the child for diarrhea?

Answer 19

(A) Classify the child’s illness using the color-coded classification for diarrhea.
(B) Ask about the next main symptoms: fever, ear problems, and check for malnutrition, anemia, immunization status, and other problems.

Question 20

How do you classify a child with two of the following signs:

(A) Lethargic or unconscious
(B) Sunken eyes
(C) Not able to drink or drinking poorly
(D) Skin pinch goes back very slowly?

Answer 20

Severe Dehydration (Pink).

Question 21

What is the treatment for severe dehydration?

Answer 21

(A) If no other severe classification:
Give fluid for severe dehydration (Plan C).

(B) If the child has another severe classification:
Refer urgently to the hospital and give frequent sips of ORS on the way.

Question 22

How do you classify a child with two of the following signs:

(A) Restless, irritable
(B) Sunken eyes
(C) Drinks eagerly, thirsty
(D) Skin pinch goes back slowly?

Answer 22

Some Dehydration (Yellow)

Question 23

What is the treatment for some dehydration?

Answer 23

(A) Give fluid, zinc supplements, and food for some dehydration (Plan B).
(B) If the child has another severe classification:
(C) Refer urgently to the hospital with mother giving frequent sips of ORS on the way.
(D) Advise the mother when to return immediately and follow up in 5 days if not improving.

Question 24

What is the treatment for no dehydration?

Answer 24

(A) Give fluid, zinc supplements, and food to treat diarrhea at home (Plan A).
(B) Advise the mother when to return immediately and follow up in 5 days if not improving.

Question 24

What do you do if there are not enough signs to classify as severe or some dehydration?

Answer 24

No Dehydration: If there are not enough signs to classify as severe or some dehydration, classify the child as No Dehydration (Green).

Question 25

What do you do if the child has diarrhea lasting 14 days or more?

Answer 25

Classify the child under Persistent Diarrhea (Yellow)

Question 26

What is the treatment for persistent diarrhea?

Answer 26

(A) Treat dehydration before referral unless the child has another severe classification.
(B) Give multivitamins and minerals (including zinc) for 14 days.
(C) Follow up in 5 days.

Question 27

What should you do if blood is found in the stool?

Answer 27

Classify the child under Dysentery: If there is blood in the stool, classify as Dysentery (Yellow).

Question 28

What is the treatment for dysentry?

Answer 28

(A) If the child has no other severe classification:
Give fluid, zinc supplements, and food for diarrhea (Plan A).
Advise the mother when to return immediately and follow up in 5 days if not improving.

(B) If the child has another severe classification:
Refer urgently to the hospital.

Question 29

What do you do if the child has severe persistent diarrhea (pink)?

Answer 29

(A) Refer to the hospital.
(B) Give ciprofloxacin for 3 days.
(C) Follow up in 3 days.

Question 30

What should the nurse ask or assess for when the child has suspected measles?

Answer 30

(A) Does the child have a fever? (by history or feels hot or
temperature 37.5 C or above)
(B) Travel history to malaria prone places

Question 31

What if the child has been confirmed that he has measles?

Answer 31

If YES:

Ask:
(A) For how long?
(B) If more than 7 days, has fever been present every day?
(C) Has the child had measles within the last 3 months?

Look and feel:
(A) Look or feel for stiff neck
(B) Look for runny nose

Question 32

Does the child show signs of measles?

Answer 32

Signs of Measles:

(A) Generalized rash
(B) Cough
(C) Runny nose
(D) Red eyes

If the child has measles now or within the last 3 months, check for:
(A) Mouth ulcers: Are they deep and extensive?
(B) Pus draining from the eye
(C) Clouding of the cornea