UNIT 16: CARE OF THE CHILD APPLYING INTEGRATED MANAGEMENT OF CHILDHOOD

ILLNESSES (IMCI)

General Instructions:

 Handwritten on a long bond paper.

I. Case management

Create a PROCESS FLOW of managing these cases showing how to (1) ASSESS AND CLASSIFY THE SICK
CHILD, (2) TREAT THE CHILD, (3) FOLLOW-UP AND (4) COUNSEL THE MOTHER. Fill in the Recording
Form, specific to each age group, found in the IMCI chart.

Situation 1:

You are a barangay health nurse and a mother with 3-month-old infant arrived in your clinic for their
initial visit. Upon assessment you note the following: lethargy, increase sleepiness, rashes in his buttocks
with watery yellow stool, abdominal skin turgor of less than two seconds and minimal nasal drainage.
The mother claimed that her baby sucks poorly when breast fed and was just introduced to a new
formula milk 2-days ago. She also reported her son to breathe deeply most of the time with chest
drawing in since that morning. Upon chest auscultation, you noted wheezing, temperature of 102.2
degrees Fahrenheit per axilla, weight of 14lbs and height of 61.5cm. No rashes or stiff neck was
observed upon assessment. Immunization record shows BCG, DPT+HIB 1, DPT+HIB 2, OPV 0, OPV 1, Hep
B0, Hep B1, Hep B2, RTV1, RTV2, PCV1 & PCV2.

Situation 2:

A mother with her 4-week old infant arrived in the barangay health center for an initial visit complaining
about icterus noted recently, irritability, loose watery stool, sunken eyeballs and poor skin turgor. You
have identified that the infant was born from an HIV positive through a serological test, without virologic
test, mother; but the baby has negative virologic test result. The mother claimed that she has been
absolutely breastfeeding her infant since delivery until the child has been irritable and refuses to feed.
Per observation, the mother does not know how to properly carry and attach her child to her breast
while feeding and does not suck effectively. Infant weighs 4 week 4 kgs and 50cms tall, afebrile and
lethargic at times. Mother said that her child just received an immunization that scarred her deltoid area
and the other once was injected through his upper arm since birth.