Name: NOJARA APRIL L.

BSN2B Group 3

EXERCISE 1

Read the following case study. Assess the child’s signs and symptoms and
classify the illness. Then record your assessment and classifications in the child’s
recording form.

Beverly is 6 months old. She weighs 4 kg. Her temperature is 38.7 degree
centigrade. Her mother brought her to the clinic because Beverly has a cough. Her mother
is also concern that Beverly looks thin. It is her initial visit for the problem.

The health worker checks for general danger signs. Beverly is not able to breastfeed. The
health worker assesses Beverly’s cough. The mother says that Beverly has had cough for
4 days now. The health worker counts 52 breaths per minute. Beverly does not have chest
indrawing and there is no stridor when the child is calm but there is a wheeze.

Beverly does not have diarrhea. Because Beverly’s temperature is 38.7 degree
centigrade, the health worker assesses her for fever. She lives in an area where many cases
of malaria occur all year long. Her mother thinks that she felt hot on and off for 2 days
now. She does not have a stiff neck or a runny nose.

Beverly has general rashes. Her eyes are red. She has mouth ulcers. They are not
deep and extensive, though. There is no pus draining from the eye. There is no clouding of
the cornea. The dengue risk is high but there are no signs suggesting dengue hemorrhagic
fever.

1
 MANAGEMENT OF THE SICK CHILD AGED 2 MONTHS UP TO 5 YEARS

Child’s Name: Beverly__________________ Age: _6 mos.____ Sex: ____F___ Weight (kg): ___4 kg______ Height/Length (cm): _________________ Temperature (˚C): __38.7__________
ASK: What are the child’s problems? _Cough, fever___________________ Initial visit: __/__ Follow-up visit: ______________ Date: __________________________
ASSESS: (Encircle all signs present)
CLASSIFY

CHECK FOR GENERAL DANGER SIGNS General danger sign

• NOT ABLE TO DRINK OR BREASTFEED • LETHARGIC OR UNCONSCIUS Present?
• VOMITS EVERYTHING • CONVULSING NOW YES__/_NO____
• CONVULSIONS Remember to use Danger
sign when selecting
classifications
DOES THE CHILD HAVE COUGH OR DIFFICULT BREATHING? YES___/______NO________
 For how long? __4__days  Count the breaths in one minute: __52____ breaths per minute.
Fast breathing? SEVERE PNEUMONIA
 Look for chest indrawing.
 Look and listen for stridor.
 Look and listen for wheezing.
DOES THE CHILD HAVE DIARRHEA? YES________NO_____/____
 For how long? _____days  Look at the child’s general condition. Is the child:
 Is there blood in the stools? Abnormally sleepy or difficult to awaken?
Restless or irritable?
 Look for sunken eyes.
 Offer the child fluid. Is the child:
Not able to drink or drinking poorly?
Drinking eagerly, thirsty?
 Pinch the skin of the abdomen. Does it go back:
Very slowly (longer than 2 seconds) Slowly?
DOES THE CHILD HAVE FEVER? (by history/feels hot/temperature 37.5°C or above) YES____/______NO_________
Decide malaria risk LOOK and FEEL:
 Does the child live in a malaria area?  Look or feel for stiff neck.
 Has the child visited/travelled or stayed overnight in a  Look for runny nose.
malaria area in the past 3 weeks? VERY SEVERE FEBRILE
If malaria risk, obtain a blood smear DISEASE
(+) (Pf) (Pv) (-) (not done)
Look for signs of MEASLES
 For how long has the child have fever? ___3_days  Generalized rash and
 If more than 7 days, has fever been present every day?  One of these: cough, runny nose or red eyes
 Has the child had measles within the past 3 months?
If the child has measles now or within the last 3 months.  Look for mouth ulcers. If yes, are they deep and extensive?
SEVERE COMPLICATED
 Look for pus draining from the eyes.
MEASLES
 Look for clouding of the cornea.

ASSESS DENGUE HEMORRHAGIC FEVER YES________NO____/____

THEN ASK: LOOK AND FEEL: FEVER: DENGUE
 Has the child had any bleeding from the nose or gums or in the vomitus  Look for bleeding from the nose or gums. HEMORRHAGIC FEVER
or stools?  Look for skin petechiae. UNLIKELY
 Has the child had black vomitus or black stools?  Feel for cold and clammy extremities.
 Has the child had persistent abdominal pain?  Check capillary refill. _____ seconds
Has the child had persistent vomiting?  Perform tourniquet test if child is 6 months or older AND has no
other signs AND has fever for more than 3 days.
DOES THE CHILD HAVE AN EAR PROBLEM? YES ________NO___________
 Is there ear pain?  Look for pus draining from the ear.
 Is there ear discharge?  Feel for tender swelling behind the ear.
If yes, for how long? ___days
THEN CHECK FOR ACUTE MALNUTRITION  Look for edema of both feet
AND ANEMIA  Determine WFH/L z-score:
*Less than -3? Between -3 and -2? -2 or more?
 Child 6 months or older measure MUAC _____mm
 Look for palmar pallor.
* Severe palmar pallor? Some palmar pallor?
If child has MUAC less than 115 mm or WFH/L • Is there any medical complication: General danger sign?
Less than -3 z-scores: Any severe classification? Pneumonia with chest indrawing?
• Child 6 months or older: Offer RUTF to eat. Is the child:
* Not able to finish? Able to finish?
• Child less than 6 months: Is there a breastfeeding problem?
CHECK THE CHILD’S IMMUNIZATION STATUS (Encircle immunizations needed today), Vitamin A
status, deworming status, Dental Check-up (Circle if needed today) Return for next
BCG Pentavalent 1 Pentavalent 2 Pentavalent 3 Measles MMR Vitamin A immunization on:
Hep B0 OPV-1 OPV-2 OPV -3 Mebendazole/Albendazole __________________
RTV-1 RTV-2 IPV Dental check-up (Date)
PCV-1 PCV-2 PCV-3

2
EXERCISE 2

Read the following case study. Assess the child’s signs and symptoms and
classify the illness. Then record your assessment and classifications in the child’s
recording form.

Rose is 3 years old. She weighs 10 kg. Her axillary temperature is 38⁰C. Her mother
brought her to the health center because she has cough. She also has rashes. This is Rose’s
initial visit for this problem. The health worker checks Rose for danger signs. She is not
able to drink, has not been vomiting, and has not had convulsions. She is lethargic.

The health worker then assesses Rose’s cough. The mother tells the health worker
that Rose has been coughing for 2 days now. The health worker counts 42 breaths per
minute. The health worker does not see chest indrawing. He does not hear stridor or wheeze
when Rose is calm. When the health worker asked if Rose has diarrhea, the mother said,
“No.”

Next, the health worker assesses Rose’s fever. It is dry season, and the risk of
malaria is low. She has felt hot for 3 days, the mother says. She does not have a stiff neck.
She does not have a runny nose either. Rose has general rashes, though, and her eyes are
red. Rose does not have mouth ulcers. There is no pus draining from her eye. There is no
clouding of her cornea. No sign of DHF was noted.

3
 MANAGEMENT OF THE SICK CHILD AGED 2 MONTHS UP TO 5 YEARS

Child’s Name: Rose___________________________ Age: ___3 yrs. old_______ Sex: ___F____ Weight (kg): ___10 kg_____ Height/Length (cm): __________ Temperature (˚C): _38_________
ASK: What are the child’s problems? ___Cough, rashes, fever_________________ Initial visit: ______/___________ Follow-up visit: ______________ Date: _March 15, 2022______________
ASSESS: (Encircle all signs present)
CLASSIFY

CHECK FOR GENERAL DANGER SIGNS General danger sign

• NOT ABLE TO DRINK OR BREASTFEED • LETHARGIC OR UNCONSCIUS Present?
• VOMITS EVERYTHING • CONVULSING NOW YES_/_NO____
• CONVULSIONS Remember to use Danger
sign when selecting
classifications
DOES THE CHILD HAVE COUGH OR DIFFICULT BREATHING? YES____/____NO________
 For how long? __2__days  Count the breaths in one minute: ___42__ breaths per minute.
Fast breathing? VERY SEVERE DISEASE
 Look for chest indrawing.
 Look and listen for stridor.
 Look and listen for wheezing.
DOES THE CHILD HAVE DIARRHEA? YES________NO___/______
 For how long? _____days  Look at the child’s general condition. Is the child:
 Is there blood in the stools? Abnormally sleepy or difficult to awaken?
Restless or irritable?
 Look for sunken eyes.
 Offer the child fluid. Is the child:
Not able to drink or drinking poorly?
Drinking eagerly, thirsty?
 Pinch the skin of the abdomen. Does it go back:
Very slowly (longer than 2 seconds) Slowly?
DOES THE CHILD HAVE FEVER? (by history/feels hot/temperature 37.5°C or above) YES___/______NO_________
Decide malaria risk LOOK and FEEL:
 Does the child live in a malaria area?  Look or feel for stiff neck.
 Has the child visited/travelled or stayed overnight in a  Look for runny nose.
malaria area in the past 3 weeks? VERY SEVERE FEBRILE
If malaria risk, obtain a blood smear DISEASE
(+) (Pf) (Pv) (-) (not done)
Look for signs of MEASLES
 For how long has the child have fever? _3__days  Generalized rash and
 If more than 7 days, has fever been present every day?  One of these: cough, runny nose or red eyes
 Has the child had measles within the past 3 months?
If the child has measles now or within the last 3 months.  Look for mouth ulcers. If yes, are they deep and extensive?
SEVERE COMPLICATED
 Look for pus draining from the eyes. MEASLES
 Look for clouding of the cornea.

ASSESS DENGUE HEMORRHAGIC FEVER YES________NO___/____

THEN ASK: LOOK AND FEEL:
 Has the child had any bleeding from the nose or gums or in the vomitus  Look for bleeding from the nose or gums. FEVER: DENGUE
or stools?  Look for skin petechiae. HEMORRHAGIC FEVER
 Has the child had black vomitus or black stools?  Feel for cold and clammy extremities. UNLIKELY
 Has the child had persistent abdominal pain?  Check capillary refill. _____ seconds
Has the child had persistent vomiting?  Perform tourniquet test if child is 6 months or older AND has no
other signs AND has fever for more than 3 days.
DOES THE CHILD HAVE AN EAR PROBLEM? YES ________NO___________
 Is there ear pain?  Look for pus draining from the ear.
 Is there ear discharge?  Feel for tender swelling behind the ear.
If yes, for how long? ___days
THEN CHECK FOR ACUTE MALNUTRITION  Look for edema of both feet
AND ANEMIA  Determine WFH/L z-score:
*Less than -3? Between -3 and -2? -2 or more?
 Child 6 months or older measure MUAC _____mm
 Look for palmar pallor.
* Severe palmar pallor? Some palmar pallor?
If child has MUAC less than 115 mm or WFH/L • Is there any medical complication: General danger sign?
Less than -3 z-scores: Any severe classification? Pneumonia with chest indrawing?
• Child 6 months or older: Offer RUTF to eat. Is the child:
* Not able to finish? Able to finish?
• Child less than 6 months: Is there a breastfeeding problem?
CHECK THE CHILD’S IMMUNIZATION STATUS (Encircle immunizations needed today), Vitamin A
status, deworming status, Dental Check-up (Circle if needed today) Return for next
BCG Pentavalent 1 Pentavalent 2 Pentavalent 3 Measles MMR Vitamin A immunization on:
Hep B0 OPV-1 OPV-2 OPV -3 Mebendazole/Albendazole __________________
RTV-1 RTV-2 IPV Dental check-up (Date)
PCV-1 PCV-2 PCV-3

4
EXERCISE 3

Read the following case study. Assess the child’s signs and symptoms and
classify the illness. Then record your assessment and classifications in the child’s
recording form.

Kristof is 3 years old. He weighs 9.4 kg. His temperature is 37⁰C. His mother says
he feels hot. He also has cough, she says. This is his initial visit for this problem.

The health worker checks for general danger signs. Kristof is able to drink, has not
been vomiting, has not had convulsions, and is not lethargic or unconscious.

The mother says Kristof had been coughing for 3 days now. The health worker
counts 51 breaths per minute. He does not see chest indrawing. There is no stridor or
wheeze when Kristof is calm.

Kristof does not have diarrhea. The health worker also thinks that Kristof feels hot.
He assesses the child further for signs of fever. The risk of malaria is high. He has felt hot
for 5 days now, the mother says. He has not had measles within the last 3 months. He does
not have a stiff neck, a runny nose, and general rashes. Since Kristof have fever, the health
worker assesses him for signs of DHF, but no signs were noted.

5
 MANAGEMENT OF THE SICK CHILD AGED 2 MONTHS UP TO 5 YEARS

Child’s Name: Kristof_________________________ Age: _3 yrs. old____ Sex: ___M__ Weight (kg): ___9.4 kg____ Height/Length (cm): _________________ Temperature (˚C): __37__________
ASK: What are the child’s problems? _fever, cough__________________________ Initial visit: _____/_____________ Follow-up visit: ______________ Date: ___March 15, 2022____________
ASSESS: (Encircle all signs present)
CLASSIFY

CHECK FOR GENERAL DANGER SIGNS General danger sign

• NOT ABLE TO DRINK OR BREASTFEED • LETHARGIC OR UNCONSCIUS Present?
• VOMITS EVERYTHING • CONVULSING NOW YES____NO_/__
• CONVULSIONS Remember to use Danger
sign when selecting
classifications
DOES THE CHILD HAVE COUGH OR DIFFICULT BREATHING? YES___/______NO________
 For how long? __3__days  Count the breaths in one minute: __51__ breaths per minute.
Fast breathing? PNEUMONIA
 Look for chest indrawing.
 Look and listen for stridor.
 Look and listen for wheezing.
DOES THE CHILD HAVE DIARRHEA? YES________NO____/___
 For how long? _____days  Look at the child’s general condition. Is the child:
 Is there blood in the stools? Abnormally sleepy or difficult to awaken?
Restless or irritable?
 Look for sunken eyes.
 Offer the child fluid. Is the child:
Not able to drink or drinking poorly?
Drinking eagerly, thirsty?
 Pinch the skin of the abdomen. Does it go back:
Very slowly (longer than 2 seconds) Slowly?
DOES THE CHILD HAVE FEVER? (by history/feels hot/temperature 37.5°C or above) YES___/______NO_________
Decide malaria risk LOOK and FEEL:
 Does the child live in a malaria area?  Look or feel for stiff neck. FEVER
 Has the child visited/travelled or stayed overnight in a  Look for runny nose. NO MALARIA
malaria area in the past 3 weeks?
If malaria risk, obtain a blood smear
(+) (Pf) (Pv) (-) (not done)
Look for signs of MEASLES
 For how long has the child have fever? _5_days  Generalized rash and
 If more than 7 days, has fever been present every day?  One of these: cough, runny nose or red eyes
 Has the child had measles within the past 3 months?
If the child has measles now or within the last 3 months.  Look for mouth ulcers. If yes, are they deep and extensive?
 Look for pus draining from the eyes.
 Look for clouding of the cornea.

ASSESS DENGUE HEMORRHAGIC FEVER YES________NO___/_____

THEN ASK: LOOK AND FEEL: FEVER: DENGUE
 Has the child had any bleeding from the nose or gums or in the vomitus  Look for bleeding from the nose or gums. HEMORRHAGIC FEVER
or stools?  Look for skin petechiae. UNLIKELY
 Has the child had black vomitus or black stools?  Feel for cold and clammy extremities.
 Has the child had persistent abdominal pain?  Check capillary refill. _____ seconds
Has the child had persistent vomiting?  Perform tourniquet test if child is 6 months or older AND has no
other signs AND has fever for more than 3 days.
DOES THE CHILD HAVE AN EAR PROBLEM? YES ________NO___________
 Is there ear pain?  Look for pus draining from the ear.
 Is there ear discharge?  Feel for tender swelling behind the ear.
If yes, for how long? ___days
THEN CHECK FOR ACUTE MALNUTRITION  Look for edema of both feet
AND ANEMIA  Determine WFH/L z-score:
*Less than -3? Between -3 and -2? -2 or more?
 Child 6 months or older measure MUAC _____mm
 Look for palmar pallor.
* Severe palmar pallor? Some palmar pallor?
If child has MUAC less than 115 mm or WFH/L • Is there any medical complication: General danger sign?
Less than -3 z-scores: Any severe classification? Pneumonia with chest indrawing?
• Child 6 months or older: Offer RUTF to eat. Is the child:
* Not able to finish? Able to finish?
• Child less than 6 months: Is there a breastfeeding problem?
CHECK THE CHILD’S IMMUNIZATION STATUS (Encircle immunizations needed today), Vitamin A
status, deworming status, Dental Check-up (Circle if needed today) Return for next
BCG Pentavalent 1 Pentavalent 2 Pentavalent 3 Measles MMR Vitamin A immunization on:
Hep B0 OPV-1 OPV-2 OPV -3 Mebendazole/Albendazole __________________
RTV-1 RTV-2 IPV Dental check-up (Date)
PCV-1 PCV-2 PCV-3

6
EXERCISE 4

Read the following case study. Assess the child’s signs and symptoms and
classify the illness. Then record your assessment and classifications in the child’s
recording form.

Francine is 5 months old. She weighs 5 kg. Her temperature is 36.5⁰C. Her family
brought her to the clinic because she feels hot and has had cough for 2 days. This is
Francine’s initial visit for this problem.

She is able to drink. She has not vomited, has not had convulsions, and is not
lethargic or unconscious. The health worker says, “I am going to check her cough now.”
The health worker counts 43 breaths per minute. There is neither chest indrawing, stridor
nor wheeze when Francine is calm.

Francine does not have diarrhea. “Now, I will check her fever,” says the health
worker. Francine lives in an area where many cases of malaria occur all year long. Her
mother says, “Francine has felt hot off and on for 2 days now.” She has not had measles
within the last 3 months. She does not have a stiff neck or runny nose.

Francine has general rashes. Her eyes are red. She has mouth ulcers. They are not
deep and extensive, though. There is no pus draining from her eye. There is no clouding of
cornea. No signs of dengue hemorrhagic fever were noted.

7
 MANAGEMENT OF THE SICK CHILD AGED 2 MONTHS UP TO 5 YEARS

Child’s Name: Francine_______________________ Age: __5 mos._____ Sex: __F____ Weight (kg): ___5kg_____ Height/Length (cm): _________________ Temperature (˚C): ____36.5____
ASK: What are the child’s problems? __Cough, feels hot, rashes________________ Initial visit: _____/______________ Follow-up visit: ______________ Date: _March 15, 2022__________
ASSESS: (Encircle all signs present)
CLASSIFY

CHECK FOR GENERAL DANGER SIGNS General danger sign

• NOT ABLE TO DRINK OR BREASTFEED • LETHARGIC OR UNCONSCIUS Present?
• VOMITS EVERYTHING • CONVULSING NOW YES____NO_/__
• CONVULSIONS Remember to use Danger
sign when selecting
classifications
DOES THE CHILD HAVE COUGH OR DIFFICULT BREATHING? YES___/______NO________
 For how long? __2___days  Count the breaths in one minute: ___43___ breaths per minute.
Fast breathing? Cough or Cold
 Look for chest indrawing.
 Look and listen for stridor.
 Look and listen for wheezing.
DOES THE CHILD HAVE DIARRHEA? YES________NO___/____
 For how long? _____days  Look at the child’s general condition. Is the child:
 Is there blood in the stools? Abnormally sleepy or difficult to awaken?
Restless or irritable?
 Look for sunken eyes.
 Offer the child fluid. Is the child:
Not able to drink or drinking poorly?
Drinking eagerly, thirsty?
 Pinch the skin of the abdomen. Does it go back:
Very slowly (longer than 2 seconds) Slowly?
DOES THE CHILD HAVE FEVER? (by history/feels hot/temperature 37.5°C or above) YES__/___NO_________
Decide malaria risk LOOK and FEEL:
 Does the child live in a malaria area?  Look or feel for stiff neck.
 Has the child visited/travelled or stayed overnight in a  Look for runny nose.
malaria area in the past 3 weeks? FEVER
If malaria risk, obtain a blood smear NO MALARIA
(+) (Pf) (Pv) (-) (not done)
Look for signs of MEASLES
 For how long has the child have fever? _2_days  Generalized rash and
 If more than 7 days, has fever been present every day?  One of these: cough, runny nose or red eyes
 Has the child had measles within the past 3 months?
If the child has measles now or within the last 3 months.  Look for mouth ulcers. If yes, are they deep and extensive?
MEASLES WITH MOUTH
 Look for pus draining from the eyes. COMPLICATION
 Look for clouding of the cornea.

ASSESS DENGUE HEMORRHAGIC FEVER YES________NO____/____

THEN ASK: LOOK AND FEEL:
 Has the child had any bleeding from the nose or gums or in the vomitus  Look for bleeding from the nose or gums. FEVER: DENGUE
or stools?  Look for skin petechiae. HEMORRHAGIC FEVER
 Has the child had black vomitus or black stools?  Feel for cold and clammy extremities. UNLIKELY
 Has the child had persistent abdominal pain?  Check capillary refill. _____ seconds
Has the child had persistent vomiting?  Perform tourniquet test if child is 6 months or older AND has no
other signs AND has fever for more than 3 days.
DOES THE CHILD HAVE AN EAR PROBLEM? YES ________NO___________
 Is there ear pain?  Look for pus draining from the ear.
 Is there ear discharge?  Feel for tender swelling behind the ear.
If yes, for how long? ___days
THEN CHECK FOR ACUTE MALNUTRITION  Look for edema of both feet
AND ANEMIA  Determine WFH/L z-score:
*Less than -3? Between -3 and -2? -2 or more?
 Child 6 months or older measure MUAC _____mm
 Look for palmar pallor.
* Severe palmar pallor? Some palmar pallor?
If child has MUAC less than 115 mm or WFH/L • Is there any medical complication: General danger sign?
Less than -3 z-scores: Any severe classification? Pneumonia with chest indrawing?
• Child 6 months or older: Offer RUTF to eat. Is the child:
* Not able to finish? Able to finish?
• Child less than 6 months: Is there a breastfeeding problem?
CHECK THE CHILD’S IMMUNIZATION STATUS (Encircle immunizations needed today), Vitamin A
status, deworming status, Dental Check-up (Circle if needed today) Return for next
BCG Pentavalent 1 Pentavalent 2 Pentavalent 3 Measles MMR Vitamin A immunization on:
Hep B0 OPV-1 OPV-2 OPV -3 Mebendazole/Albendazole __________________
RTV-1 RTV-2 IPV Dental check-up (Date)
PCV-1 PCV-2 PCV-3