RLE FORM 020

Cebu Normal University

College of Nursing
Cebu City
MANAGEMENT OF THE SICK CHILD AGE 2 MONTHS UP TO 5 YEARS
Date: _____________________________
Child’s name: __________________________________________________ Age: ____________ Sex: ________ Weight: ____________kg. Temperature: __________ oC
ASK: What are the child’s problems? _____________________________________________________________________________ Initial visit: _______ Follow-up visit: _______
ASSESS (Circle all signs present) CLASSIFY
CHECK FOR GENERAL DANGER SIGNS GENERAL DANGER SIGNS
PRESENT?
NOT ABLE TO DRINK OR BREASTFEED ABNORMALLY SLEEPY OR DIFFICULT TO AWAKEN
VOMITS EVERYTHING YES_____ NO_____
CONVULSIONS
DOES THE CHILD HAVE COUGH OR DIFFICULT BREATHING? YES_____ NO_____
 For how long? _____days  Count the breaths in one minute.
_____breaths per minute. Fast breathing?
 Look for chest indrawing.
 Look and listen for stridor.
DOES THE CHILD HAVE DIARRHEA? YES_____ NO_____
· For how long? _____ days · Look at the child’s general condition. Is the child:
· Is there blood in the stool? Abnormally sleepy or difficult to awaken?
Restless or irritable?
· Offer the child fluid.
Is the child unable to drink or breastfeed?
Is the child drinking eagerly, thirsty?
· Look for sunken eyes.
· 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 o C or above) YES_____ NO_____
Decide malaria risk
· Does the child live in malaria area? LOOK AND FEEL:
· Has the child visited or  Look or feel for stiff neck
stayed overnight in a malaria area in the · Look for runny nose
past 4 weeks?
If malaria risk, obtain a blood smear.
(+) (Pf) (Pv) (-) (not done)
THEN ASK: Look for signs of MEASLES
· For how long has the child has fever? _____ days · Generalized rash and
· If more than 7 days, has the fever been present every day? · One of these: cough, runny nose, or
· Has the child had measles within the last 3 months? eyes red

If the child has measles now or within the last 3 months:

· Look for mouth ulcers.
If yes, are they deep and extensive?
· Look for pus draining from the eye.
· Look for clouding of the cornea.
ASSESS DENGUE HEMORRHAGIC FEVER
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 or 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 child is 6 months or older AND has no other
signs AND has fever for more than 3 days.
DOES THE CHILD HAVE AN EAR PROBLEM? YES _____ NO _____
· Is there ear pain? · Look for pus draining from the ear.
· Is there ear discharge? · Feel for tender swelling behind the ear.
If Yes, for how long? _______ days
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 (Tick the immunization already given; circle immunization needed today.) Return for next immunization
_____ ______ on
BCG HEP B1
_____ _____ ______
DPT1 OPV1 HEP B2
_____ _____ ________ (Date)
DPT2 OPV2 MEASLES
_____ _____ ______
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 ___
Has the child received Vitamin A in the past 6 months? Yes ___ No ___ Yes_____ No _____

CHECK FOR DEWORMING STATUS for children 12 months and older Abendazole/Mebendazole
Has the child received Abendazole and Mebendazole for the past 6 months? Yes___ No ___ needed today?
Yes___No___

ASSESS THE CHILD’S FEEDING if child has ANEMIA OR VERY LOW WEIGHT or is less than 2 years old
Feeding Problems:
· 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 his/her own serving? _____ Who feeds the child and how? _________________________________________________________
· During the illness, has the child’s feeding changed? Yes ___ No ___
If yes, how? ________________________________________________________________________________________________________________

ASSESS CARE FOR DEVELOPMENT: Care and Development

Ask questions about how the mother cares for her child. Compare the mother’s answers to the Recommendations for Care and Development for the child’s Problems:
age.
· How do you play with your child?
· How do you communicate with your child?

ASSESS OTHER PROBLEMS

__________________________________
Student Nurse

__________________________________ __________________________________
Health Center Staff Clinical Instructor