Integrated Management

Integrated Management of
of Childhood
Childhood Illness
Illness

MALNUTRITION, ANEMIA
MALNUTRITION, ANEMIA &
&
EAR INFECTION
EAR INFECTION
GROUP 4 BSN 2-B
 Integrated Management
Integrated Management of
of Childhood
Childhood Illness
Illness

A. Etiology of Malnutrition [PINEDA]

1. INTRO: Integrated Management of Childhood
Illness (IMCI) [YBERA] 1. Malnutrition [BUSTINERA,TANON]
○ What is IMCI? 1. Level Management
2. Signs
○ What is the purpose of IMCI?
3. Classify as
○ What is the goal and objectives? 4. Identify Treatment
2. General Danger signs in the Assessment of IMCI
B.Etiology of Anemia [ESPEJO]
[CURITANA, QUISEL]
2. Anemia [PELAYO, HARON]
○ Cough and difficulty breathing
1. Level Management
○ Unable to feed, drink, or breastfeed 2. Signs
○ Vomits everything 3. Classify as
○ Abnormally Sleepy or To Awareness 4. Identify Treatment

C. Etiology of Ear Infection [BERGONIA]

3. Ear Infection [RIDAO, CURITANA]

1. Level Management
2. Signs

GROUP 4 BSN 2-B 3. Classify as

4. Identify Treatment
What is IMCI?
• IMCI is an integrated approach to a child’s health that focuses on the well-being of
the whole child and also addressing the common childhood illness based on the
statistics like pneumonia, diarrhea, dengue hemorrhagic fever, malaria, measles,
and malnutrition. It is a case management process and strategy for a first-level
facility such as a health care center.
• It also includes both preventive and curative elements that are implemented by
families and    communities as well as by health facilities

1995 - IMCI was developed by WHO-UNICEF to all developing countries

1997- IMCI was brought to the Philippines thru department of health
2001 - Integration of IMCI to Nursing and Midwifery Curriculum was implemented
What is the purpose of IMCI?
• WHO decided to make this kind of approach because of the 70%
deaths in children under 5 years of age. An approach (integrated) to
managing major killer diseases in children in a holistic manner
(developed by WHO & UNICEF)
• It prepares first level health workers to use simple signs, symptoms
and simple drug formulation, to identify, treat and refer sick children.
• It also promotes good health and management of common children
illnesses at home and in the community.
What are the goals and objectives?
• To contribute to the reduction of morbidity and mortality
associated with the common disease conditions
• It aims to reduce illness and disability under five years
of age 
• To promote improved growth and development
GENERAL DANGER SIGNS OF IMCI
• CONVULSION = Uncontrollable Muscle Contractions
• UNABLE TO FEED,DRINK OR BREASTFEED
= Feeding difficulties.
● VOMITS EVERYTHING = not able to hold down fluids or
oral drugs
● ABNORMALLY SLEEPY/DIFFICULT TO AWAKEN =
Drowsiness

CUVA
MALNUTRITION
ETIOLOGY OF MALNUTRITION
• Malnutrition = is when a person’s diet does not provide
enough nutrients or the right balance of nutrients for
optimal health.
ETIOLOGY OF MALNUTRITION
Malnutrition can occur for various reasons including
1. Lack of Food
2. Difficulty in eating or absorbing nutrients
3. Physical Problems
4. Mental health condition
5. Social and Mobility problems
6. Digestive Disorders
ETIOLOGY OF MALNUTRITION
2 TYPES OF MALNUTRITION
1. Under-malnutrition
2. Over-malnutrition
DOES YOUR CHILD…? (MALNUTRITION)
CLASSIFICATION TABLE OF MALNUTRITION
LEVEL OF SIGNS CLASSIFY AS IDENTIFY TREATMENT
MANAGEMENT AS
● Oedema of both fee ● Give first dose appropriate
REFER OR
SEVERE antibiotic
● WFH/L less than -3 z scores MALNUTRITION ● Treat the child to prevent low blood
OR sugar
● MUAC less than 115 mm AND ● Keep the child warm
any one of the following: ● Refer URGENTLY to hospital
● Medical complication present or
● Not able to finish RUTF
or
● Breastfeeding problem.

● WFH/L less than -3 z scores ● Give oral antibiotics for 5 days

SPECIFIC TREATMENT OR
UNCOMPLICATED ● Give ready-to-use therapeutic food
● MUAC less than 115 mm SEVERE ACUTE for a child aged 6 months or more
● Counsel the mother on how to feed
AND MALNUTRITION the child.
● Able to finish RUTF
● Assess for possible TB infection
● Advise mother when to return
immediately
● Follow up in 7 days
CLASSIFICATION OF MALNUTRITION
LEVEL OF SIGNS CLASSIFY AS IDENTIFY TREATMENT
MANAGEMENT AS
● Assess the child's feeding and
SPECIFIC MODERATE counsel the mother on the feeding
TREATMENT • WFH/L between -3 and - 2 MALNUTRITION recommendations
z-scores ● If feeding problem, follow up in 7
OR days
● Assess for possible TB infection.
• MUAC 115 up to 125 mm ● Advise mother when to return
immediately
● Follow-up in 30 days
● If child is less than 2 years old,
HOME MANAGEMENT NO MALNUTRITION assess the child's feeding and
• WFH/L - 2 z-scores or counsel the mother on feeding
more OR according to the feeding
recommendations
• MUAC 125 mm or ● If feeding problem, follow-up in
more. 7 days
WEIGHT FOR AGE [Z-Score] (pg. 68-69)
WEIGHT FOR AGE [Z-Score] (pg. 68-69)
Edema of both feet
ANEMIA
ETIOLOGY OF ANEMIA
● LACKING BLOOD
● decreasing of red blood cells circulating
through blood system
Anemia may be result of:
1) Decrease number of RBC
2) Lack hemoglobin in RBC
2.1) Abnormal hemoglobin in RBCs
DOES YOUR CHILD…? (ANEMIA)
 CLASSIFICATION TABLE OF ANEMIA
LEVEL OF SIGNS CLASSIFY AS IDENTIFY TREATMENT AS
MANAGEMENT
REFER • Severe palmar pallor Severe anaemia • Refer urgently to hospital

SPECIFIC • Some pallor Anemia • Give iron

TREATMENT • Give Mebendazole if child is 1 year or
older and has not had a dose in the
previous 6 months
• Advise mother when to return
immediately
• Follow-up in 14 days

HOME • No palmar pallor No Anemia • If child is less than 2 years old, assess
MANAGEMENT the child’s feeding and counsel the
mother according to the feeding
recommendations, if feeding problem,
follow-up in 5 days
Severe palmar pallor
EAR INFECTION
ETIOLOGY OF EAR INFECTION
● Bacteria, like Streptococcus pneumoniae and
Haemophilus influenzae (nontypeable) —the two most
common bacterial causes
● Viruses, like those that cause colds or flu
● Eustachian tube blockage - build fluid to the middle ear
that cause blockage
ETIOLOGY OF EAR INFECTION
Causes of Eustachian tube blockage include:
● allergies
● colds
● sinus infections
● excess mucus
● smoking
● changes in air pressure
ETIOLOGY OF EAR INFECTION
Adenoids
- Located : Top roof of our mouth
- Function : Helps our body to protect from infection
- Additional information : In this gland can develop ear
infections because it is nearby ends of
DOES YOUR CHILD…? (EAR INFECTION)
 CLASSIFICATION TABLE OF EAR INFECTION
LEVEL OF MANAGEMENT SIGNS CLASSIFY AS IDENTIFY TREATMENT AS

REFER • Tender swelling behind the ear. MASTOIDITIS • Give first dose of an appropriate antibiotic
• Give first dose of paracetamol for pain
• Refer URGENTLY to Hospital

SPECIFIC TREATMENT • Pus is seen draining from the ear and ACUTE EAR INFECTION • Give an antibiotic for 5 days
discharge is reported for less than 14 (OTITIS MEDIA) • Give paracetamol for pain
days or more • Dry ear by wicking
• Ear Pain • Follow-up in 14 days

• Pus is seen draining from the ear and CHRONIC EAR INFECTION • Dry the ear wicking
discharge is reported for 14 days or (OTITIS MEDIA) • Treat with treat quinolone ear drops for 14
more days
• Follow-up in 5 days

HOME MANAGEMENT • No ear pain and no pus seen NO EAR INFECTION • No Treatment
draining from the ear • Prevention is
MASTOIDITIS
PUS DISCHARGE
DRY WICKING

OTITIS MEDIA
 GROUP 4 BSN 2B
• RIDAO, Angel
• BERGONIA, Jun
• BUSTINERA, Kim
• CURITANA, Drex
• HARON, Hajar
• PELAYO, Daniela
• PINEDA, Adellaine
• QUISEL, Reah
• TANON, Marife
• YBERA, Kath