IMCI 1.2 (AB) Flashcards by Shiela Micah Gascon

What immediate care is given to a newborn just delivered?

Provide emergency newborn care. Resuscitate using the Helping Babies Breathe approach. Keep baby warm. Assess and classify for possible serious bacterial infection. Support mother to initiate breastfeeding. Refer to maternity unit or hospital

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What is the first thing to ask the caregiver when the infant is not just delivered?

Ask why the caregiver has brought the child to the health facility today

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What steps are taken if the young infant is brought for an initial sick visit?

Urgently assess and classify for possible serious bacterial infection. Complete the young infant assessment. Provide treatment. Counsel caregiver on home care and when to return. Assess breastfeeding and support the mother

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What are the signs to assess for possible serious bacterial infection in young infants?

Convulsions. Apnea or abnormal breathing. Severe chest indrawing. Nasal flaring. Grunting. Bulging fontanelle. Temperature instability. Poor movement. Eye discharge or swelling. Umbilical redness or pus. Skin pustules

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What classifies a young infant as having no bacterial infection?

None of the danger signs are present

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What are the signs of local bacterial infection in young infants?

Sticky eye discharge. Red umbilicus. Skin pustules

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How is local bacterial infection in young infants managed?

Treat with cephalexin or flucloxacillin. Use chloramphenicol eye ointment for purulent eye discharge. Follow up after two days

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What signs indicate a possible serious bacterial infection in a young infant?

Convulsions. Apnea. Fast breathing over 60 per minute. Nasal flaring. Bulging fontanelle. Fever above 37.5 or below 35.5. Only moves when stimulated. Abundant eye pus or eyelid swelling. Umbilical redness extending to skin. Multiple skin pustules

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What pre-referral treatments are done for possible serious bacterial infection?

Give Diazepam for convulsions. Give oxygen if in distress. Give Ceftriaxone if CNS infection is suspected

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What are the classifications for jaundice in young infants?

No jaundice. Jaundice. Severe jaundice

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What indicates severe jaundice in a young infant?

Jaundice in the first 24 hours. Yellow palms and soles. Needs urgent referral

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What is the treatment for severe jaundice?

Test for low blood sugar. Keep the infant warm. Refer for evaluation. Use phototherapy if bilirubin is elevated

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How is diarrhea assessed in a young infant?

Ask duration and presence of blood. Look at condition. Check for sunken eyes. Pinch skin to see recoil speed

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What are the signs of severe dehydration in a young infant?

Lethargy. Sunken eyes. Skin pinch goes back very slowly. Infant less than 1 month old

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What classifies as severe persistent diarrhea in young infants?

Diarrhea lasting 14 days or more. Immediate referral

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How is a serious abdominal problem identified in a young infant?

Presence of blood in stool in 0 to 2 months age group

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What are priority congenital abnormalities to check at birth?

Cleft lip or palate. Imperforate anus. Nose not patent. Macrocephaly. Ambiguous genitalia. Abdominal distention. Very low birth weight

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How is possible congenital syphilis identified?

Mother RPR positive and untreated or partially treated. Signs like edema. Pallor. Jaundice. Petechiae. Large liver or spleen

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When is congenital TB suspected in a young infant?

Mother on TB treatment less than 2 months. Infant shows symptoms like poor feeding. Poor weight gain. Fever. Enlarged lymph nodes. Enlarged liver or spleen

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What are signs of good breastfeeding in a young infant?

Feeds 8 or more times in 24 hours. Exclusive breastfeeding. Gaining weight. Regained birth weight by 10 days. Good attachment and suckling

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What is the minimum weight gain expected for young infants?

Preterm: 10g per kg per day. Term: 20g per kg per day

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What should you do if a young infant is too sick to feed?

Give 3 ml/kg per hour of expressed breastmilk on the way to hospital. If severe lethargy and cannot swallow. give by nasogastric tube.

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What IV fluid is given if feeding is contraindicated in a young infant?

10 percent Neonatalyte by slow IV infusion at 3 ml/kg/hour.

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How do you prepare a 10 percent dextrose solution if Neonatalyte is not available?

Mix 1 part 50 percent dextrose with 4 parts water.

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When should low blood sugar be suspected in a young infant?

If infant is convulsing. unconscious. lethargic or has temperature below 35 degrees Celsius.

What is the treatment for blood sugar < 1.4 mmol/L in a young infant?

Give a bolus of 10 percent dextrose at 2 ml/kg. then continue at 3 ml/kg/hour. Repeat blood glucose in 15 minutes. Repeat bolus if still low.

Which young infants should be given oxygen?

Those with convulsions. apnoea or breathing < 30 breaths per minute. fast breathing. severe chest indrawing. nasal flaring or grunting.

What is the oxygen flow rate for nasal prongs in term babies?

1 litre per minute.

What size of nasal prongs should be used for small babies?

1mm prongs.

How much oxygen should be delivered via nasal cannula?

Half a litre per minute.

What method is used to keep a young infant warm if the mother is able?

Skin-to-skin or Kangaroo Mother Care.

How should an infant be dressed for skin-to-skin contact?

Cap. booties. nappy. placed skin to skin between mother’s breasts. covered and secured.

What antibiotic and dose is given for possible serious bacterial infection?

Intramuscular ceftriaxone 50 mg/kg.

What is the ceftriaxone dose for a 3 - 6 kg infant?

1 ml.

How long should cephalexin or flucloxacillin be given for skin pustules?

7 days.

What should you do if the infant has a penicillin allergy?

Refer.

What is the injection and dose used for possible congenital syphilis?

Benzathine Benzylpenicillin IM 50.000 units/kg.

What dose of Benzathine Benzylpenicillin is given to a 3.5 - <5 kg baby?

0.75 ml.

What ARV prophylaxis is given to low risk infants at birth?

Nevirapine for 6 weeks.

What ARV prophylaxis is given to high risk infants at birth?

Nevirapine for at least 12 weeks and Zidovudine for 6 weeks.

What ARV prophylaxis is given during breastfeeding for high risk infants?

Nevirapine for at least 12 weeks and Zidovudine for 6 weeks.

What ARV prophylaxis is given to high risk infants on exclusive formula feeding?

Nevirapine for 6 weeks and Zidovudine for 6 weeks.

What should you do if the infant’s HIV PCR test is positive?

Stop prophylaxis and initiate ART.

What is the Nevirapine dose for a 2.5 kg newborn?

1.5 ml daily.

What is the Zidovudine dose for a 2.5 kg newborn?

1.5 ml twice daily.

What should you do if a child has diarrhea with severe dehydration?

Start IV rehydration. give first dose of IM ceftriaxone and refer urgently.

How is oral thrush treated in infants?

Nystatin 1 ml after feeds for 7 days.

What should the caregiver do before and after wiping oral thrush plaques?

Wash hands with soap and water.

How is sticky eye discharge treated?

Clean with saline 4 times daily and apply chloramphenicol ointment 4 times daily for 7 days.

How are skin pustules or umbilical infections treated?

Clean with soap and water. apply povidone iodine 3 times daily. give cephalexin or flucloxacillin for 7 days.

What are the first steps if the infant has just been delivered?

What should you do if the infant is not newly delivered but is sick (initial visit)?

Urgently assess and classify for possible serious bacterial infection. Complete the young infant assessment. Provide treatment. Counsel the caregiver on home care and when to return. Assess breastfeeding and support the mother.

When is newborn screening performed and why not immediately after birth?

We wait 24-48 hours after birth when the child has been fed. This allows time for metabolites to be produced, which are not present immediately after birth.

What signs should be checked when assessing a young infant for possible serious bacterial infection?

Convulsions. Apnea. Current convulsions. Fast or slow breathing. Severe chest indrawing. Nasal flaring. Grunting. Bulging fontanelle. Fever or hypothermia. Reduced movement. Eye or umbilical discharge. Skin pustules.

What classifies as a local bacterial infection in a young infant?

Sticky eye discharge. Red umbilicus. Skin pustules. Treated with cephalexin or flucloxacillin and possibly chloramphenicol eye ointment. Follow up after two days.

What are the signs of possible serious bacterial infection?

Convulsions. Apnea or breathing <30. Fast breathing >60. Nasal flaring. Bulging fontanelles. Fever >37.5 or <35.5. Reduced movement. Abundant eye pus. Umbilical redness extending to skin. Several skin pustules.

What pre-referral treatments should be given for possible serious bacterial infection?

Give diazepam if convulsing. Give oxygen if in distress. Give ceftriaxone if CNS infection is suspected.

What indicates jaundice in a young infant requires urgent referral?

Jaundice within the first 24 hours. Yellow palms and soles. Signs of severe jaundice. Risk of neurotoxicity from high bilirubin.

What treatment is given for severe jaundice in infants?

Phototherapy. Evaluate bilirubin levels. Test for low blood sugar. Keep the infant warm. Refer urgently for evaluation.

What classifies severe dehydration in a young infant?

Lethargy. Unconsciousness. Sunken eyes. Skin pinch goes back very slowly. Infant less than 1 month old with sunken eyes.

When is diarrhea classified as severe persistent diarrhea?

When the infant has diarrhea for 14 days or more. Automatically classified as red and referred to the hospital.

When is blood in the stool considered a serious abdominal problem in young infants?

Blood in stool in infants 0-2 months is red category and needs immediate referral. More aggressive management than older children.

What congenital problems are considered major abnormalities needing urgent referral?

Cleft lip or palate. Imperforate anus. Nose not patent. Macrocephaly. Ambiguous genitalia. Abdominal distention. Very low birth weight.

How is congenital syphilis classified in a young infant?

If mother is RPR positive and untreated or partially treated. Signs include edema. Pallor. Jaundice. Petechiae. Blisters on hands and feet.

What are signs of congenital TB in a young infant?

Low birth weight. Poor feeding. Poor weight gain. Fever. Lethargy. Fast breathing. Enlarged lymph nodes. Hepatosplenomegaly.

What classifies possible congenital TB?

Mother on TB treatment for less than 2 months. Infant has signs of congenital TB. Refer to hospital and give BCG.

What are indicators of feeding problems in a breastfed infant?

Breastfeeding less than 8 times in 24 hours. Taking other foods or drinks. Low weight for age. Not gaining weight. Difficulty feeding.

What is considered normal weight loss and gain for newborns?

Up to 10 percent loss of birth weight in first few days. Regain birth weight by day 10. Preterm: gain at least 10g/kg/day. Term: 20g/kg/day.

IMCI 1.2 (AB) Flashcards

(68 cards)