In Integrated Management of Childhood Illness, the nurse is aware that severe conditions generally require urgent referral to a hospital.

In Integrated Management of Childhood Illness, the nurse is aware that severe conditions generally require urgent referral to a hospital. Which of the following severe conditions DOES NOT always require urgent referral to a hospital?

a. Mastoiditis
b. Severe dehydration
c. Severe pneumonia
d. Severe febrile disease

Answer Key
The order of priority in the management of severe dehydration is as follows: intravenous fluid therapy, referral to a facility where IV fluids can be initiated within 30 minutes, Oresol or nasogastric tube. When the foregoing measures are not possible or effective, then an urgent referral to the hospital is done.

QUIZ START

Results

#1. Jim Agustin a public health nurse will conduct outreach immunization in a barangay Metro Lapaz with a population of about 1500. The estimated number of infants in the barangay would be:

45 infants

50 infants

55 infants

60 infants

To estimate the number of infants, multiply the total population by 3%.

#2. The community nurse is aware that the biological used in Expanded Program on Immunization (EPI) should NOT be stored in the freezer?

MMR

Measles vaccine

Oral polio vaccine

DPT

DPT is sensitive to freezing. The appropriate storage temperature of DPT is 2 to 8° C only. OPV and measles vaccines are highly sensitive to heat and require freezing. MMR is not an immunization in the Expanded Program on Immunization.

#3. It is the most effective way of controlling schistosomiasis in an endemic area?

Use of molluscicides

Building of foot bridges

Proper use of sanitary toilets

Use of protective footwear, such as rubber boots

The ova of the parasite get out of the human body together with feces. Cutting the cycle at this stage is the most effective way of preventing the spread of the disease to susceptible hosts.

#4. Several clients is newly admitted and diagnosed with leprosy. Which of the following clients should be classified as a case of multibacillary leprosy?

3 skin lesions, negative slit skin smear

3 skin lesions, positive slit skin smear

5 skin lesions, negative slit skin smear

5 skin lesions, positive slit skin smear

A multibacillary leprosy case has a positive slit skin smear and at least 5 skin lesions.

#5. Nurses are aware that diagnosis of leprosy is highly dependent on recognition of symptoms. Which of the following is an early sign of leprosy?

Thickened painful nerves

Macular lesions

Inability to close eyelids

Thickened painful nerves

The lesion of leprosy is not macular. It is characterized by a change in skin color (either reddish or whitish) and loss of sensation, sweating, and hair growth over the lesion. Inability to close the eyelids (lagophthalmos) and sinking of the nose bridge are late symptoms.

#6. RoseMarie Asuncion brought her 10 month old infant for consultation because of fever, started 4 days prior to consultation. In determining malaria risk, what will you do?

Ask if the fever is present every day.

Get a specimen for blood smear.

Ask where the family resides.

Perform a tourniquet test.

Because malaria is endemic, the first question to determine malaria risk is where the client’s family resides. If the area of residence is not a known endemic area, ask if the child had traveled within the past 6 months, where she was brought and whether she stayed overnight in that area.

#7. Jack Junas brought her 4 years old daughter to the RHU because of cough and colds. Following the IMCI assessment guide, which of the following is a danger sign that indicates the need for urgent referral to a hospital?

High grade fever

Signs of severe dehydration

Cough for more than 30 days

Inability to drink

A sick child aged 2 months to 5 years must be referred urgently to a hospital if he/she has one or more of the following signs: not able to feed or drink, vomits everything, convulsions, abnormally sleepy, or difficult to awaken.

#8. Jim Cabacungan a 2-year old child revealed “baggy pants”. As a nurse, using the IMCI guidelines, how will you manage Jim?

Assess and treat the child for health problems like infections and intestinal parasitism.

Make a teaching plan for the mother, focusing on menu planning for her child.

Coordinate with the social worker to enroll the child in a feeding program.

Refer the child urgently to a hospital for confinement.

Baggy pants” is a sign of severe marasmus. The best management is an urgent referral to a hospital.

#9. Sahil is using Oresol in the management of diarrhea of her 3-year old child. She asked you what to do if her child vomits. As a nurse you will tell her to:

Let the child rest for 10 minutes then continue giving Oresol more slowly.

Bring the child to the nearest hospital for further assessment.

Bring the child to the health center for intravenous fluid therapy.

Bring the child to the health center for assessment by the physician.

If the child vomits persistently, that is, he vomits everything that he takes in, he has to be referred urgently to a hospital. Otherwise, vomiting is managed by letting the child rest for 10 minutes and then continuing with Oresol administration. Teach the mother to give Oresol more slowly.

#10. Lautaru Caceres a 5-month old infant was brought by his mother to the health center because of diarrhea for 4 to 5 times a day. Her skin goes back slowly after a skin pinch and her eyes are sunken. Using the IMCI guidelines, you will classify this infant in which category?

The data is insufficient.

Severe dehydration

Some dehydration

No signs of dehydration

Using the assessment guidelines of IMCI, a child (2 months to 5 years old) with diarrhea is classified as having SOME DEHYDRATION if he shows 2 or more of the following signs: restless or irritable, sunken eyes, the skin goes back slowly after a skin pinch.

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