I.

INTRODUCTION
IMCI focuses on illnesses that cause the majority of deaths in children

under-5 years, many of which are preventable or readily treatable using simple
interventions:

These

are

pneumonia,

diarrhea,

meningitis,

malaria,

malnutrition, and anemia. Other important aspects of child health are also
addressed such as ear infections, the sick young infant (under 2 months),
breast-feeding and feeding assessment. In IMCI, there are several things we
need to assess. First, we have to check for general danger signs which include
convulsions during the illness, lethargy or unconsciousness, inability to drink
or breastfeed, and vomiting. These signs present themselves whenever a child
has a serious problem. Most children with general danger signs need urgent
referral to the hospital. They may need life-saving treatment with injectable
antibiotics, oxygen or other treatments which may not be available in the
health center. When there are general danger signs present, finish the
assessment immediately.

When there are no general danger signs present,

proceed to assessing the main symptoms.

Pneumonia is an infection of the lungs often due to bacteria the most
common are streptococcus pneumoniae and hemophilus influenza. Children
with pneumonia may die from hypoxia or sepsis. When children develop

pneumonia, their lungs become stiff one of the bodys responses to become stiff
lungs and hypoxia is fast breathing. When pneumonia becomes more severe
the lungs become even stiffer chest indrawing may develop. RISK FACTORS
S/S
Cough and difficult breathing are common problems in young children.
The causes range from a mild, self-limited illness to severe, life-threatening
disease. There are classifications for a child with cough or difficulty of
breathing: A child with cough or difficult breathing , chest indrawing or stridor
would be assigned to the severe, red classification, called Severe Pneumonia or
Very Severe Disease. If the child has none of these signs, but has fast
breathing, then the classification is Pneumonia. A child with none of the severe
signs and a normal breathing rate is classified as Cough or Cold.

OBJECTIVES:
For Students:

To be able to apply Integrated Management of Childhood Illness (IMCI)

to some of the children of Barangay Tanqui San Fernando La Union

To gain new knowledge about Integrated Management of Childhood
Illness (IMCI) now that we are here in the community

To acquire experience regarding Integrated Management of Childhood

Illness

For the community:

To be able to impart knowledge and identify target of intervention

Involvement and awareness of the community and identify priority

needs
To impart some home interventions or treatment for childhood
illnesses

II. NURSING HEALTH HISTORY

S.C is a 27 months old. She weighs 10 kg. her temperature is 36
c. S.C is a resident of District 6 Barangay Tanqui Lipit City of San
Fernando, La Union. She was born on August 19, 2011 at Ilocos Training
Regional Medical Center. Her nationality is Filipino. Thus her Religious
Affiliation is Roman Catholic. She is the youngest daughter of Mr. R.A.C
and Mrs. J. C. She has an older sister named R.J.C.
Past Medical History:
Patient S.C has a past history of asthma. She goes for a check-up
because of cough with an interval of at least 1 month. She is having her
check- up at City Health Office in City of San Fernando, La Union.

Present Health History:

During the assessment last December 5, 2013 we have assessed
that she is having Pneumonia because based on our assessment she is
having coughs and colds for almost 7 days and she is having fast
breathing.
During our initial visit, her vital signs were taken. Her temperature
is 36oC. Her respiratory rate is 44 breaths per minute, then we reassessed, the second count is 42 breaths per minute. And her pulse rate
were also taken, it is 86 beats per minute.
Family Health History:
Her mother and father are aged between 30-40. Her family has no
serious illnesses. But sometimes they do have respiratory problems
because of their environment. And her older sister sometimes experience
common coughs and colds.
Lifestyle And Practices:
Patient S.C. most of the time plays with her older sister. She is
eating solid foods thrice a day. She eats fish and meat but most of the
time she is eating vegetables.

At night before she sleeps, her mother

breastfeeds her. At afternoon she takes a nap for 1-2 hours. She is living
with her immediate family together with her aunties, uncles and
grandparents. Sometimes they visit Aringay because they have relatives
there. And their house is Bungalow Type.

IV.

EVALUATION

Integrated Management of Childhood Illness is the strategy that deals

with the management of the common childhood illness done in an incorporated
manner to reduce the mortality and morbidity associated with the major
causes of childhood illnesses.

During in our two weeks of stay on barangay Tanqui, San Fernando La

Union we are able to accomplish our objectives. We are able to apply our
learning skills on IMCI. On our first day in the barangay, we immediately look
for a case to work for. We found SC patient residing at District 6 of Barangay
Tanqui, that according to our assessment, who is having a cough for 7 days
and was having a fast breathing of 44 breaths per minute then we reassess it
and we ended up founding 42 breaths per minute. We found out that patient
SC is having Pneumonia.
When we asked the mother if she already sent her child for a checkup,
she replied yes and it was at the City Health Office and the doctor prescribed
Cotrimoxizole but the mother did not buy it yet so we gave her an initial dose of
antibiotic, Amoxicillin syrup 100 mg per 5 ml, 3.5 ml given two times daily for 3
days. And before we leave we advised the mother to do home interventions for
her childs cough and cold, we suggested that she can make a calamansi juice
instead of a cough syrup.
We gave the follow up checkup last December 7, 2013 and we assessed
her again. When we checked for her respiratory rate, we counted it, its 38
breaths per minute which is already normal. But she still has her cough and
cold, so we decide to give them the 1 bottle of Ammoxicillin syrup 100 mg per 5
ml, 3.5 ml. We told the mother to give it twice a day for 3 days. And it will

expire after 5 days. We also counsel the mother on care for development
recommendations that children, as they grow older, develop more complex
skills necessary for them to learn. Since SC is 27 months of age, the mother
should:

Play:
In this section, the mother may ask what is that? Where is your
father? What shape is this? Which is the blue ball? She can ask these
questions because at this point, children are more aware of the different
colours around them. They also learn to compare and identify shapes
and sizes. The mother could:
o Help your child count, name, and compare things.
o Make simple toys for your child.

Communicate
At 2 years of age, children learn to listen and understand. Simple
questions by the mother would help facilitate and encourage the children
to talk. And in turn, a mother should also try to answer her childs
questions because this would help the child understand things that are
unclear to him/her.

During this time, a mother would have a chance to teach her child how
to act and behave towards other people through stories, songs, and games. A
mother could also teach the child what is right or wrong. At this point, a child
may mimic the words and actions made by his/her mother because he/she
thinks that what his/her mother is doing is right. When a child does
something wrong, they should be corrected gently so they wont feel ashamed.
o Encourage your child to talk and answer your childs questions.
Teach your child stories, songs, and games.
We encourage the mother to try activities recommended for the age of her
child, like playing with simple homemade toys, helping the child count by
asking how many, counting things together and letting the child play with
other children and to learn from them.
We also advised the mother to increase fluid intake of the child during
his/her illness because the child loses fluid during his/her illness. To prevent
dehydration and for the child to feel stronger and better, he/she needs to drink
extra fluid. We also advised the mother to return immediately or send her child
to the hospital if the child is not able to drink or breastfeed, becomes sicker,
develops fever, and is having difficulty of breathing.

Our goals and objectives for us students were achieved because of our
experiences in the community. Same with our objectives for the community,
they were also achieved because we imparted some our knowledge to them by
means of teaching them on how to manage the treatment