Cebu Normal University

College of Nursing
Cebu City

MANAGEMENT OF THE SICK CHILD AGE 2 MOTHS UP TO 5 YEARS

Date: __________________
Child’s name:__________________________________________________________Age: ______Sex:______Weight:______ kg Temperature:
C
ASK: What are the child’s problems? ________________________________________________________ Initial visit: _______ Follow-up visit:
_________
ASSESS (Circle all signs present) C
LASSIFY
CHECK FOR GENERAL DANGER SIGNS
NOT ABLE TO DRINK ABNORMALLY SLEEPY OR DIFFICULT TO General Danger signs present?
AWAKEN YES ___ NO___
VOMITS EVERYTHING
CONVULSIONS
DOES THE CHILD HAVE COUGH OR DIFFICULTY BREATHING YES___ NO___
For how long? _____ days Count breaths in one minute
______ Breaths per minute. Fast
breathing?
Look for chest indrawing.
Look and listen for stridor.
Look and listen for wheezing.
DOES THE YOUNG INFANT HAVE DIARRHEA? YES___ NO___
For how long? _______ days Look at the young infant’s general condition. Is the
infant:
· Is there blood in the stool? 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?
Drink 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
Does the child live in a malaria risk area? LOOK AND FEEL:
Has the child visited/traveled or Look or feel for stiff neck.
stayed overnight in a malaria area in Look for runny nose.
the past 4 weeks
If malaria risk, obtain a blood smear Look for signs of MEASLES:
+ Pf Pv -Not done Generalized rash and
THEN ASK: One of these: cough, runny nose,
or red eyes.
For how long? _____ Days
If more than 7 days, has fever been present every day?
Has child had measles within the last three months
If the child has measles now or within the last 3 months:
• Look for mouth ulcers. I f Yes, are they deep and
extensive?
• Look for pus draining from the eye.
• Look for clouding of the cornea.
ASSESS DENGUE HEMORRHAGIC FEVER
THEN ASK:
Has the child had any bleeding from the nose or LOOK AND FEEL:
gums or in the vomitus or stool? Look for bleeding from nose and gums
Has the child had black vomitus or black stool? Look for skin petechiae
Has the child had persistent abdominal pain? Feel for cold and clammy extremities
Has the child had persistent vomiting? Check capillary refill. _____ seconds
Perform tourniquet test if the
child is 6 months or
Older and has no other signs
AND has fever for
For more than 3 days
DOES THE CHILD HAVE AN EAR PROBLEM?
• Is there ear pain? • Look for pus draining from the ear.
• Is there ear discharge? • Feel for tender swelling behind the ear.

THEN CHECK FOR MALNUTRITION AND ANEMIA

Look for visible severe wasting
Look for edema of both feet.
Look for palmar pallor.
Severe palmar pallor? Some palmar pallor?
Determine weight for age
Very low?
CHECK THE CHILD'S IMMUNIZATION STATUS Circle immunizations needed today
BCG DPT1 OPV1 HEP B1 Return for next immunization
_____ _____ _______ __________ on:
DPT2 OPV2 HEP B2 MEASLES ___________
_____ _____ _______ (Date)
DPT3 OPV3 HEP B3
CHECK THE VITAMIN A SUPPLEMENTATION STATUS for children 6 months or older Vitamin A needed today?
Is the child six months of age or older? YES___ NO___ YES ___ NO___
Has the child received Vitamin A in the past six months? YES NO
CHECK THE DEWORMING STATUS for children 12 months or older Albendazole/mebendazole
Has the child received Albendazole/Mebendazole for the past 6 months? YES___ NO___ needed today?
YES NO
ASSESS CHILD'S FEEDING if child has ANEMIA OR VERY LOW WEIGHT or is less than 2 years Feeding problems:
old
Do you breastfeed your child? Yes ___No ___
If Yes, how many times in 24 hours? ___ times. Do you breastfeed during the night? Yes ___ No ___
Does the child take any other food or fluids? Yes ___ No ___
If Yes, what food or fluids? ____________________________________________________________
How many times per day? ___ times. What do you use to feed the child?
If very low weight for age: How large are the servings? ____________________________________
Does the child receive how own serving? ____ Who feeds the child and how?
During the illness, has the child's feeding changed? Yes ___ No ___
If Yes, how?
ASSESS FOR CARE DEVELOPMENT Care and development
Ask questions about how the mother cares for her child. Compare the mother’s answers to the Problems
recommendations for Care and development for the child’s stage:
How do you play with your child?
How do you communicate with your child?
ASSESS OTHER PROBLEMS
_________________________ _______________________
Student Nurse Clinical Instructor

_________________________
Health Center Staff