IMCI-ORS-MUAC COMMUNITY HEALTH NURSING PDF

COMMUNITY HEALTH NURSING IMCI

1. IMCI Overview
Prepared by: Norhanie A. Lininding,RN,RM,MN,MANc

2. Integrated Management of Childhood
Illness(IMCI)
Action-oriented classification used by healthcare professionals who see sick infants
and children.
The World Health Organization's (WHO)Integrated Management of Childhood
Illness (IMCI)strategy focuses on the management of the leading causes of
childhood mortality, particularly in low-resource settings.
Integrated Management of Childhood Illness (IMCI) strategy targets childrenunder
five years of age(from birth to their fifth birthday).
IMCI specifically addresses illnesses such as:
1.Malnutrition
2.Pneumonia
3.Diarrhea
4.Measles
5.Malaria

3. Assess & Classify the Sick Child aged 2
months up to 5 y/o.
Check for General Danger Signs
• Vomits everything
• Convulsion/seizure
• Difficulty drinking/breastfeeding
• Drowsiness/lethargy/difficult to awaken
Assess COUGH/DIFFICULTY BREATHING
• Cough/ difficulty breathing: HOW LONG?
• Fast breathing
• Chest Indrawing
• Stridor in calm child

4. COLOR SYSTEM
PINK ROW: severe classification; needs
immediate attention and referral
• Any general
danger signs
• Chest indrawing
• Stridor in calm
child
SEVERE
PNEUMONIA or
VERY SEVERE
DISEASE
• Give first dose of
appropriate antibiotics
• Give Vit. A
• Treat the child to prevent
low blood sugar
• Refer URGENTLY to
hospital

5. COLOR SYSTEM
YELLOW ROW: needs appropriate antibiotic/
other treatment
• FAST
BREATHING
0-2 months: >60bpm
2 months 1 y/o:
>50bpm
1 –5 years old: >
40bpm
PNEUMONIA• Give an appropriate antibiotic for
5 days
• Soothe the throat & relieve the
cough with safe remedy
• Advise mother when to return
immediately
• Follow-up in two days

6. COLOR SYSTEM
GREEN ROW: no need for specific
medical treatment such as antibiotics
• NO signs of
pneumonia or
very severe
disease
NO PNEUMONIA
COUGH/ COLD
• If coughing more than 30
days, refer for assessment
• Soothe the throat &
relieve the cough with safe
remedy
• Advise mother when to
return immediately
• Follow-up in 5 days if not
improving

7. AGE LESS THAN 2 MONTHS
VERY SEVERE DISEASE
SEVERE PNEUMONIA
NO PNEUMONIA/ COUGH/COLD
LESS THAN 2 MOS: NO PNEUMONIA MANAGEMENT
*Keep WARM
*Breastfeed frequently (Clear nose if it interferes with feeding)
*Return quickly if:
-Breathing becomes FAST & DIFFICULT
-Feeding becomes a problem
-Becomes SICKER

8. 2 MOS-5 YEARS: PNEUMONIA MANAGEMENT
Antibiotics for FIVE DAYS
Mothers told to bring back the child after 2 days for
reassessment/ earlier if condition worsens
Home care
COTRIMOXAZOLE: BID for FIVE DAYS
PROCAINE PENICILLIN: OD for FIVE DAYS (IM)
Less than 2 mos(less than 5kg): 200,000 units
2-12 mos(6-9kg): 400,000 units
12 mos-5 yrs(10-19kg): 800,000 units

9. IMCI Chart Example for Sick Child:

11. C.D.D.: CONTROL OF DIARRHEAL DISEASES
❖TYPES OF DIARRHEA
ACUTE: < 14DAYS
PERSISTENT: 14 DAYS or more
DYSENTERY: Blood in the stool; with or
without mucus

12. CLASSIFY DEHYDRATION
❖SEVERE DEHYDRATION
❖Two of the ff:
✓Abnormally sleepy
✓Sunken eyes
✓Drinks poorly
✓Skin pinch goes very slowly
❖Tx PLAN C: Referral to hospital for IVF!!!

13. SOME DEHYDRATION
Two of the ff:
✓Restless, irritable
✓Sunken eyes
✓THIRSTY: drinks eagerly
✓Skin pinch goes back
❖Tx PLAN B
O.R.S: first 4hours after assessment
200-400ml 0-4mos
400-700ml 4-12mos
700-900ml 1-2 yrs
900ml-1L 2-5yrs

14. NO DEHYDRATION
Not enough signs to classify some or severe
Tx PLAN A
Give extra fluids
50-100ml after each watery stool (0-2y/o)
100-200ml (2 y/o & above) as tolerated
(10y/o & above)
Continue feeding
Return if with danger sign/s

16. Oral Rehydration
Solution(ORS)

17. ORS
Oral rehydration solutions
(ORS) are usedto treat
dehydration caused by
diarrhea.
Ithelps prevent complications
like muscle cramps, fatigue,
and even severe dehydration.

18. Important Considerations
•Use Clean Water:Always start with boiled or filtered water to ensure
safety.
•Measure Accurately:Use household measuring spoons, not silverware,
to get the correct proportions.
•Taste Test:A slightly salty taste is ideal;too little salt won't be effective,
and too much can be dangerous.
•Keep Covered:Store the mixed solution in a clean, covered container.
•Discard After 24 Hours:Make a fresh batch of ORS as needed, as the
mixed solution is only safe for up to 24 hours.
•Seek Medical Help:While helpful, this homemade version is a last
resort.If diarrhea increases, vomiting persists, or symptoms worsen, it's
crucial to consult a doctor or seek medical care.
•Do not drink ORS on an empty stomach;having food beforehand can help
improve absorption and potentially reduce nausea or vomiting.

19. Steps in making ORS
1.Boil water and let it cool completely.
2.Add the sugar and salt to the cooled water.
3.Stir well until all ingredients are completely dissolved.
4.Ensure the solution has a slightly salty taste, but not
an excessively strong one.

20. How and when should an oral rehydration
solution be used?
Children under 2 years
50–100 mL (¼ to ½ cup) after each
episode of diarrhea
Children 2 to 9 years
100–200 mL (½ to 1 cup) after each
episode of diarrhea
Persons 10 years or older
As much as wanted, up to approximately
2L (8½ cups) a day

21. MUAC(Mid-Upper Arm Circumference)

22. MUAC(Mid-Upper Arm
Circumference)measurement isa simple, fast
method used by health workers to screen for
malnutrition in adults and children by
measuring the circumference of the mid-point
of the upper arm using a special, often color-
coded, tape.
is a quick and simple way to determine whether or
not a child is malnourished