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IDENTIFY TREATMENT, TREAT and COUNSEL

Activity 6

Name:_ Sumbad, Mark Bhen E.__________ Section: _NBA_ Date:_15/05/2020___ Score:_________________

Situation # 1 Case study 1 : Henri (14 pts)

Henri is 3 weeks old. His weight is 3.6 kgs. He is breastfed. Henri is brought to the clinic because he is

having difficulty breathing. Henri has fast breathing. His mother says Henri does not have difficulty

breathing. He is classified as having very severe disease and no jaundice.

1. Should you refer this infant urgently to hospital? ______________Yes______________

1. What urgent pre-referral treatments are needed for Henri’s very severe disease? Place check (/) mark

which is/are INCLUDED and X mark which is/are NOT included.

___x__ Give first dose of oral antibiotics

___/_ Give first dose of intramuscular antibiotics

___/__Treat to prevent low blood sugar

___/__Advise mother how to keep the infant warm on the way to the hospital

2. Henri needs ampilicin (250 mg vial) and gentamicin ( 2 ml vial containing 20 mg) for very severe disease.

What dose of ampicillin is needed? ________________1.3ml_________________

What dose of gentamicin is needed? _____________1ml___________________

3. What would you do to prevent low blood sugar? Place check (/) mark which is/are INCLUDED and X

mark which is/are NOT included.

___/__ ask the mother to breastfeed the young infant

___/__Give expressed breast milk

__x___ Give sugar water

4. When ask about immunizations. Henri’s mother says that Henri was born at home and had no

immunizations.

Is Henri’s immunization up to date? ________________no________________________

What immunization does Henri need today? ____________BCG HepaB-0______________________

Henri needs BCG vaccine. Would you give him the vaccine today? _______Yes________

In how many weeks should Henri return for the next immunization ____at 6 weeks of age 6/3/2020 __________
Situation # 2: Case study 2 : Jenna (29 pts)

Jenna is 7 weeks old, her weight is 3 kgs, Her mother brings Jenna to the clinic because she has

diarrhea. The health worker assesses Jenna and classified her as Severe Disease or Local bacterial

infection unlikely, no jaundice some dehydration and HIV unlikely.

When asked about feeding, Jenna’s mother says that Jenna usually feeds well. She breastfeeds 3 x a

day. She takes a bottle of breastmilk substitute 3x a day. The health worker checks Jenna’s weight for

age. Jenna has low weight for age. Then the health worker looks in her mouth. He sees no ulcers or

white patches in her mouth.

Then the health worker assesses breastfeeding. Jenna has not fed in the previous hour. Her mother

agrees to try to breastfeed now. The health worker observes that Jenna’s chin is not touching the

breast. Her mouth is not very wide open, her lips are pushed forward. The same amount of areola is

visible above and below the mouth. Her sucks are quick and are not deep.

The health worker classifies Jenna as having Feeding problem or low weight.

1. Should you refer this infant urgently to hospital? ______Yes_______________

2.Which plan would you use to treat Jenna’s dehydration? (tick your answer)

Plan A __Plan B _/_Plan C___

3. Which treatment/s does Jenna need for feeding problem or low weight? Place check(/) mark which is/are

INCLUDED and X mark which is/are NOT included.

___/__Teach correct positioning and attachment

___/__ Teach mother to express breast milk and feed using a cup

___x_ Advise to increase frequency of feeding

___/__ Advise the mother to breastfeed as often as long as the infant wants, day and night

___/__ Counsel the mother about breastfeeding more, reducing other foods or drinks, and using a cup

___/__ Refer for breastfeeding counselling

___/__ Advise about correctly preparing breast-milk substitutes and using a cup

___x__ Advise the mother how to feed and keep the low weight infant warm at home

___x___ Advise mother to give home care for the young infant

___x__ Follow -up any feeding problem in 2 days

___/__ Follow-up low weight for age in 14 days


4. Jenna needs treatment for some dehydration according to Plan B.

Find out how much ORS Jenna should be given for the 1st 4 hours of treatment. Write down the lower

limit of the range. _______________________225ml________________________________________

5. Should Jenna receive any other fluids in addition to ORS during the 4 hour period? Place check(/) mark

which is/are INCLUDED and X mark which is/are NOT included.

__/__ Water

__x___ Tea

__x___ Fruit Juice

__/___ Breast milk

__x__ soft drink

6. After 4 hours of treatment, Jenna is reassessed. She is calm and her eyes are not sunken. Her skin pinch

goes back immediately. The health worker classified her as having NO DEHYGRATION. Which plan would you

use to treat Jenna now. Tick your answer.

___/__Plan A ____Plan B _____Plan C

7. How many days should Jenna return for a follow-up visit (earliest time)? _____________2 days______________

8. What should the health worker tell Jenna’s mother about when to return immediately?

8.1 return if Jenna is not breastfeeding _______

8.2. has Reduced activity ___________________

8.3. Becomes sicker_____________________

8.4. has Difficulty breathing_______________

8.5. Feels unusually cold __________________

8.6. Jenna has a fever____________________

8.7. When child`s Palms and soles appear yellow ___

8.8. Fast breathing __________________________