Integrated Management of Childhood Illnesses

GROUP 2

CASE: NIMWELL
Day 1: February 27, 2013 Nimwell is 3 weeks old. He weighs 2.6 kg. His axillarys temperature is 36.8C. The student nurses assessed for any general danger signs. No dangers were observed. Nimwells breathing rate is 57 per minute. He has mild chest indrawing. He is awake and not abnormally sleepy. He does not have diarrhea. In term of Nimwell feeding, his mother says there is no difficulty in feeding him. He breastfreeds about 8 times in 24 hours. The student nurses determines Nimwells weight (2.6kg) for age and it is low for his age (3 weeks). The mother says Nimwell receives water (4 times a day) along with breastmilk. The student nurses assess for breastfeeding. The infant has not fed in the previous hour. The students asked the mother to put her infant on her breast. After assessing the breastfeeding for 4 minutes, the student nurses evaluated there were signs of poor attachment and the infant is sucking ineffectively. Nimwells mother has an immunization card. It shows that he received BCG at birth and is scheduled to receive his dose of Hep B1 on March 17 2013. The student nurses asks the mother is Nimwell has any other problems, she says no.

Day 2 : March 10, 2013 Nimwell is 5 weeks old. He weighs 3.1 kg. His axillarys temperature is 36.9C. The student nurses assessed for any general danger signs. No dangers were observed. Nimwells breathing rate is 59 per minute. He has mild chest indrawing. He is awake and not abnormally sleepy. He does not have diarrhea. In term of Nimwell feeding, his mother says there is no difficulty in feeding him. He breastfreeds about 8 times in 24 hours. The student nurses determines Nimwells weight (3.1kg) for age and it is low for his age (3 weeks). The mother says she stopped giving the infant water and is exclusively breastfreeding. The student nurses assess for breastfeeding. The infant has not fed in the previous hour. The students asked the mother to put her infant on her breast. After assessing the breastfeeding for 4 minutes, the student nurses evaluated there were signs of good attachment and the infant is sucking effectively. Nimwells mother has an immunization card. It shows that he received BCG at birth and is scheduled to receive his dose of Hep B1 on March 17 2013. The student nurses asks the mother is Nimwell has any other problems, she says no.