p.4
Nutritional Assessment and Management
What is a sign of severe acute malnutrition with complications?
Edema of both feet or WFH/L less than -3 z-scores.
p.4
Nutritional Assessment and Management
What is the first treatment step for severe acute malnutrition with complications?
Treat the child to prevent low blood sugar and keep the child warm.
p.2
Emergency Protocols for Severe Conditions
What does AVPU stand for in assessing a child's condition?
Alert, Verbal response, Pain response, Unresponsive.
p.9
Counseling and Follow-Up Care
What is the recommended breastfeeding frequency for infants?
At least 8 times in 24 hours.
p.4
Treatment Protocols for Common Illnesses
What is the first treatment for mastoiditis?
Give the first dose of Ceftriaxone Antibiotic.
What is the primary goal of the IMCI strategy?
To reduce mortality and morbidity associated with major causes of childhood illness.
p.9
HIV Exposure and Management in Children
What advice should be given to an HIV positive mother who has chosen not to breastfeed?
Provide feeding advice and give Vitamin A.
p.1
Major Components of IMCI
What are the major components of IMCI?
1. Improving case management skills of health workers. 2. Improving the health system to deliver IMCI. 3. Improving family and community health practices.
p.7
Assessment and Classification of Childhood Illness
What should you ask to check for jaundice in a young infant?
Does the young infant have yellow discoloration of eyes, palms, or soles? If yes, for how long?
p.7
Assessment and Classification of Childhood Illness
What are the signs of jaundice to look for in a young infant?
Look for yellow eyes or skin, and check if the palms and soles are yellow.
p.4
Nutritional Assessment and Management
What should be assessed for acute malnutrition?
Look for edema of both feet, determine weight for height/length, and measure MUAC.
p.5
Nutritional Assessment and Management
What should be given if a child's growth is faltering for 2 consecutive months?
Vitamin A, and further assessment or referral to hospital.
p.9
HIV Exposure and Management in Children
What should be done if a mother is positive for HIV?
Follow actions on recommendations from the Nutrition Unit.
p.1
Case Management Principles
What are the major steps in the IMCI process?
1. Assessment 2. Classification 3. Identify Treatment 4. Treat the child or young infant 5. Counsel the Mother 6. Follow Up Care.
p.4
Nutritional Assessment and Management
What should be checked for in children with malnutrition?
Screen for possible TB disease and check for HIV.
p.2
Treatment Protocols for Common Illnesses
What is the management for a child with no dehydration?
Give fluid and food to treat diarrhea at home (Plan A), vitamin A, ORS, and Zinc Sulphate.
p.2
Assessment and Classification of Childhood Illness
What is considered severe persistent diarrhea?
Diarrhea lasting 14 days or more.
p.5
HIV Exposure and Management in Children
What is the protocol for children whose mothers are HIV positive?
Conduct DNA PCR for the baby at 6 weeks or at first contact.
p.8
HIV Exposure and Management in Children
What prophylaxis should be initiated for a child confirmed with HIV?
Initiate ART and Cotrimoxazole prophylaxis.
p.7
Assessment and Classification of Childhood Illness
What should be done if jaundice appears within the first 24 hours of age?
Refer urgently to the hospital.
p.6
HIV Exposure and Management in Children
What should be done if a child under 18 months is HIV exposed with a positive antibody test and negative DNA PCR?
Treat, counsel, and follow up existing infections; initiate or continue Cotrimoxazole prophylaxis; give Zidovudine and Nevirapine prophylaxis as per national PMTCT guidelines.
p.6
HIV Exposure and Management in Children
What is the follow-up protocol for a child exposed to HIV with a negative DNA PCR test?
Repeat DNA PCR test at 6 months, again at 12 months if negative, and repeat antibody test at 18 months.
p.2
Emergency Protocols for Severe Conditions
What is the treatment for hypovolemic shock from dehydration?
Give Ringer's Lactate 20mls/kg and assess for severe acute malnutrition and anemia.
p.5
Nutritional Assessment and Management
What is the treatment for severe anemia in children?
Admit or refer urgently to hospital, treat to prevent low blood sugar, and keep the child warm.
p.3
Assessment and Classification of Childhood Illness
What should be done for suspected measles?
Give Vitamin A, notify and take a blood sample for confirmation.
p.1
Treatment Protocols for Common Illnesses
What is included in the treatment of a child in a health center?
Teaching caregivers how to give fluids during illness and recognizing signs that require immediate return to the health facility.
p.1
Assessment and Classification of Childhood Illness
What are the signs of very severe disease in a child?
Convulsions, inability to drink, lethargy, and unconsciousness.
p.8
Nutritional Assessment and Management
What should be done for children with feeding problems or low weight?
Advise the mother to breastfeed as often and for as long as possible.
p.9
Counseling and Follow-Up Care
What should be done if an infant is not well attached or not suckling effectively?
Teach and show correct positioning and attachment.
p.4
Assessment and Classification of Childhood Illness
What indicates a chronic ear infection?
Pus seen draining from the ear or discharge reported for 14 days or more.
p.2
Emergency Protocols for Severe Conditions
What should be done if a child's oxygen saturation is less than 90%?
Start oxygen therapy and refer or admit the child.
p.3
Treatment Protocols for Common Illnesses
What treatment should be given for dysentery?
Ciprofloxacin, Vitamin A, ORS and Zinc Sulphate, and follow-up in 2 days.
p.3
Assessment and Classification of Childhood Illness
What questions should be asked if a child has a fever?
If the child has traveled to a high-risk area, if fever has been present every day for more than 7 days, and signs of measles in the last 3 months.
p.8
Treatment Protocols for Common Illnesses
What is the first step in treating diarrhea at home?
Give fluids and continue breastfeeding (Plan A).
p.6
HIV Exposure and Management in Children
What vaccinations should be given to a child at 6, 9, and 18 months?
Immunize for measles at 6 months and 9 months, and boost at 18 months.
p.10
HIV Exposure and Management in Children
What is the protocol if there is a history of TB treatment in the mother?
Withhold BCG if the child has not been given it, screen for possible TB disease, and give Isoniazid prophylaxis if TB is ruled out.
p.10
Counseling and Follow-Up Care
What should be done for infants not breastfed due to the mother's death or sickness?
Counsel about feeding, identify caregiver concerns, and advise on keeping the low weight infant warm at home.
p.5
Nutritional Assessment and Management
What should be assessed if a child shows palmar pallor?
Assess the child’s feeding and counsel the mother on feeding.
p.4
Assessment and Classification of Childhood Illness
What are the signs to ask about for an ear problem?
Ear pain and ear discharge.
p.7
Counseling and Follow-Up Care
What advice should be given to a mother if her infant has jaundice?
Advise her to give home care and return immediately if the eyes, palms, and soles appear yellow.
p.7
Assessment and Classification of Childhood Illness
What are the signs of severe dehydration in an infant?
Movement only when stimulated, sunken eyes, skin pinch goes back very slowly, not passing urine, and not able to feed.
p.7
Treatment Protocols for Common Illnesses
What should be done for an infant with severe dehydration?
Give fluid for severe dehydration (Plan C) and admit/refer urgently to the hospital.
p.5
Nutritional Assessment and Management
What indicates a child is at risk of acute malnutrition?
WFH/L > -2 to < -1 z-scores or MUAC 12.5 to 13.5 cm.
p.7
Emergency Protocols for Severe Conditions
What should be done if an infant has a severe eye infection?
Give the first dose of Benzyl Penicillin and Gentamicin, and refer urgently to the hospital.
p.9
Treatment Protocols for Common Illnesses
What treatment should be given for clinical severe infection in a young infant?
Once daily IM gentamicin for 2 days and oral amoxicillin dispersible tablet twice a day for 7 days.
p.3
Assessment and Classification of Childhood Illness
What are the signs of severe complications of measles?
Clouding of cornea and deep or extensive mouth ulcers.
p.9
Emergency Protocols for Severe Conditions
What action should be taken if referral is refused or not feasible for a sick young infant?
Reinforce urgent referral and provide necessary treatment until referral is possible.
p.1
Emergency Protocols for Severe Conditions
What should be done if a child shows general danger signs?
Provide immediate treatment and refer urgently.
p.4
Treatment Protocols for Common Illnesses
What should be done for a child with acute ear infection?
Give Amoxicillin dispersible tablet for 5 days and paracetamol for pain.
p.5
Nutritional Assessment and Management
What z-score range indicates moderate acute malnutrition in children?
WFH/L > -3 to < -2 z scores.
p.10
Assessment and Classification of Childhood Illness
What should be checked regarding the mother within 2 weeks of delivery?
Fever >38°C, infection treated with antibiotics, membranes ruptured >18 hours before delivery, foul smelling liquor, and VDRL positive test.
p.10
Assessment and Classification of Childhood Illness
What is the risk if a baby is less than 1 day old and the mother has a fever >38°C?
Risk of bacterial infection.
p.10
Treatment Protocols for Common Illnesses
What is the first line treatment for a baby at risk of bacterial infection?
Give the baby the 1st dose of Benzyl Penicillin and Gentamicin.
p.10
Treatment Protocols for Common Illnesses
What should be done if the mother tested VDRL positive?
Give the baby a single dose of benzathine penicillin and ensure the mother and partner are treated.
p.9
Emergency Protocols for Severe Conditions
What are the signs indicating a critical illness in a young infant?
Convulsions, inability to feed, weight <1.5 kg, respiratory issues, and severe abdominal distension.
p.8
Counseling and Follow-Up Care
When should a mother return to seek further medical help for her child?
If the child is not improving after 2 days.
p.9
Counseling and Follow-Up Care
What should be advised to mothers regarding home care for young infants?
Teach the mother how to keep the young infant warm at home.
p.3
Treatment Protocols for Common Illnesses
What treatment should be given for eye or mouth complications of measles?
Vitamin A, first dose of Ceftriaxone, and treat eye infection with tetracycline eye ointment if necessary.
p.6
Counseling and Follow-Up Care
What advice should be given if no signs of very severe disease or local bacterial infection are present?
Advise the mother to give home care for the young infant and when to return immediately if conditions worsen.
p.8
Nutritional Assessment and Management
What should be assessed in the child confirmed with HIV?
The child’s feeding and provide appropriate counseling.
p.8
HIV Exposure and Management in Children
What should be done for children exposed to HIV but with a negative DNA PCR?
Treat existing infections and initiate Cotrimoxazole prophylaxis.
p.3
Treatment Protocols for Common Illnesses
What should be given for persistent diarrhea?
Vitamin A, ORS and Zinc Sulphate, Multivitamin/Mineral supplements, and advice on feeding.
p.2
Treatment Protocols for Common Illnesses
What is the first-line antibiotic for pneumonia?
Amoxicillin Dispersible Tablet.
p.2
Treatment Protocols for Common Illnesses
What should be given if wheezing is present in a child?
A trial of rapid-acting bronchodilator up to 3 cycles.
p.2
Assessment and Classification of Childhood Illness
What are the signs of severe dehydration?
Weak/absent pulse, AVPU < A, cold hands with temperature gradient, capillary refill > 3 seconds, sunken eyes.
p.7
Treatment Protocols for Common Illnesses
What is the appropriate action for an infant showing signs of eye infection?
Apply the first dose of Tetracycline Eye Ointment and teach the mother to treat at home.
p.2
Treatment Protocols for Common Illnesses
What should be done for a child with some dehydration?
Give fluid and food for some dehydration (Plan B), vitamin A, ORS, and Zinc Sulphate.
p.5
HIV Exposure and Management in Children
What should be done for a child with confirmed HIV infection?
Initiate ART, provide counseling, and follow up for growth, nutrition, and development.
p.8
HIV Exposure and Management in Children
What is the first question to ask regarding HIV exposure?
Has the mother and/or young infant had an HIV test?
p.1
Counseling and Follow-Up Care
What is the importance of counseling the mother during IMCI?
To assess feeding, advise on foods and fluids, and inform when to return to the health center.
p.5
Nutritional Assessment and Management
What action should be taken if a child is less than 2 years old and has growth faltering?
Assess the child’s feeding and counsel the mother on feeding recommendations.
p.9
Emergency Protocols for Severe Conditions
What should be done for a very low birth weight infant?
Treat to prevent low blood sugar and refer urgently to the hospital.
p.1
Assessment and Classification of Childhood Illness
What should be assessed during the evaluation of a sick child?
History, physical examination, danger signs, and main symptoms such as cough, diarrhea, fever, and ear problems.
p.6
Assessment and Classification of Childhood Illness
What are the signs to check for serious bacterial infection in a young infant?
Convulsions, inability to feed, blood in stool, gasping or not breathing, severe chest indrawing, grunting, nasal flaring, central cyanosis, bulging anterior fontanelle, red umbilicus, severe abdominal distension, high-pitched cry, and low or high body temperature.
p.7
Assessment and Classification of Childhood Illness
What signs indicate a congenital condition or eye infection is unlikely?
No signs to classify for congenital condition or eye infection.
p.8
HIV Exposure and Management in Children
What should be done if the mother is HIV positive and the child has no positive DNA PCR test?
Check if the mother is on ART and if the young infant is on ARV prophylaxis.
p.3
Treatment Protocols for Common Illnesses
What should be done if malaria test is positive?
Treat with Artemether + Lumefantrine, give paracetamol for high fever, and follow up in 3 days.
p.8
Treatment Protocols for Common Illnesses
What should be given to a child with diarrhea?
ORS (Oral Rehydration Solution) and Zinc sulphate.
p.1
Assessment and Classification of Childhood Illness
How is a child's illness classified in IMCI?
Using a color-coded triage system: PINK for severe, YELLOW for specific treatment, and GREEN for not serious.
p.6
Emergency Protocols for Severe Conditions
What immediate actions should be taken for a young infant showing signs of very severe disease?
Resuscitate using a bag and mask if gasping or not breathing, give Phenobarbitone if convulsing, administer Benzyl penicillin & Gentamicin, treat to prevent low blood sugar, and urgently admit or refer to hospital.
p.6
Emergency Protocols for Severe Conditions
What should be done if a young infant has a local bacterial infection but no signs of very severe disease?
Give Flucloxacillin Syrup, teach the mother to treat local infections at home, and advise follow-up in 2 days.
p.6
Emergency Protocols for Severe Conditions
What should be done for a young infant with low body temperature?
Re-warm the infant and reassess after 1 hour, treat to prevent low blood sugar, and advise home care.
p.4
Nutritional Assessment and Management
What should be done for severe malnutrition without complications?
Give oral Amoxicillin DT for 5 days and ready-to-use therapeutic food.
p.3
Emergency Protocols for Severe Conditions
What is the immediate treatment for very severe febrile disease or severe malaria?
First dose of Artesunate for severe malaria, first dose of Ceftriaxone, and treat to prevent low blood sugar.
p.2
Emergency Protocols for Severe Conditions
When should a child with diarrhea be referred urgently to the hospital?
If they show signs of severe dehydration or hypovolemic shock.
p.8
HIV Exposure and Management in Children
What action is taken if the mother is not available for testing?
Do an antibody test on the child; if positive, do a DNA PCR test.
p.10
Treatment Protocols for Common Illnesses
What treatment should be given for very severe febrile disease/malaria with malaria risk?
Give the first dose of Artesunate.
