| What is the definition of diarrhea in terms of stool frequency? | >3 loose or watery stools/ day | DIARRHEA IS • >3 loose or watery stools/ day • Acute Diarrhea <14 days • Persistent diarrhea >14 days • Dysentery – blood in stools SKIN PINCH TEST • Locate the area on the child’s abdomen halfway between the umbilicus and the side of the abdomen. • Use thumb and first finger to pinch and not finger tips. • The fold of the skin should be in a line up and down the child’s body. • Firmly pick up all layers of the skin and tissue under them. • Pinch the skin for one second and then release it. | 14 | definition | 1.000 | DIARRHEA IS • >3 loose or watery stools/ day • Acute Diarrhea <14 days • Persistent diarrhea >14 days • Dysentery – blood in stools SKIN PINCH TEST • Locate the area on the child’s abdomen halfway between the umbilicus and the side of the abdomen. | 1 | page=1,block=3 | 0.700 | valid |
| What is the definition of diarrhea based on stool frequency? | >3 loose or watery stools/ day | DIARRHEA IS • >3 loose or watery stools/ day • Acute Diarrhea <14 days • Persistent diarrhea >14 days • Dysentery – blood in stools SKIN PINCH TEST • Locate the area on the child’s abdomen halfway between the umbilicus and the side of the abdomen. • Use thumb and first finger to pinch and not finger tips. • The fold of the skin should be in a line up and down the child’s body. • Firmly pick up all layers of the skin and tissue under them. • Pinch the skin for one second and then release it. | 14 | definition | 1.000 | DIARRHEA IS • >3 loose or watery stools/ day • Acute Diarrhea <14 days • Persistent diarrhea >14 days • Dysentery – blood in stools SKIN PINCH TEST • Locate the area on the child’s abdomen halfway between the umbilicus and the side of the abdomen. | 1 | page=1,block=3 | 0.700 | valid |
| What is the definition of diarrhea based on the number of stools per day? | >3 loose or watery stools/ day | DIARRHEA IS • >3 loose or watery stools/ day • Acute Diarrhea <14 days • Persistent diarrhea >14 days • Dysentery – blood in stools SKIN PINCH TEST • Locate the area on the child’s abdomen halfway between the umbilicus and the side of the abdomen. • Use thumb and first finger to pinch and not finger tips. • The fold of the skin should be in a line up and down the child’s body. • Firmly pick up all layers of the skin and tissue under them. • Pinch the skin for one second and then release it. | 14 | definition | 1.000 | DIARRHEA IS • >3 loose or watery stools/ day • Acute Diarrhea <14 days • Persistent diarrhea >14 days • Dysentery – blood in stools SKIN PINCH TEST • Locate the area on the child’s abdomen halfway between the umbilicus and the side of the abdomen. | 1 | page=1,block=3 | 0.700 | valid |
| What should a mother do during transport to the hospital for a child with poor drinking? | continue rehydration by giving frequent sips of ORS during transport or use NG tube | Improvement: 3 days of treatment • No improvement → Cefixime 10 mg//kg/d, 2 div doses. Reassess after 2 days. If better complete 3 -5 days of treatment. • If stool routine positive for Ameobiasis : Metronidazole 10mg/kg/dose 8 hourly x 7 days (10 days in severe cases) • Refer to hospital (See box) • Urgent referral to hospital • Mother to continue rehydration by giving frequent sips of ORS during transport or use NG tube when possible in patients with poor drinking PATIENT EDUCATION • Danger signs* • Hygiene practices • Hand washing , proper disposal of excreta • Safe drinking water • Appropriate feeding practices • Vaccination as per IAP guidelines INVESTIGATIONS • Some dehydration: Preferable Tests- electrolytes • Severe dehydration: Essential tests- CBC, electrolytes Preferable Tests- Renal Function Tests, VBG • In suspected cholera cases: Preferable tests- stool for hanging drop and | 341 | relationship | 0.970 | • If stool routine positive for Ameobiasis : Metronidazole 10mg/kg/dose 8 hourly x 7 days (10 days in severe cases) • Refer to hospital (See box) • Urgent referral to hospital • Mother to continue rehydration by giving frequent sips of ORS during transport or use NG tube when possible in patients with poor drinking PATIENT EDUCATION • Danger signs* • Hygiene practices • Hand washing , proper disposal of excreta • Safe drinking water • Appropriate feeding practices • Vaccination as per IAP guidelines INVESTIGATIONS • Some dehydration: Preferable Tests- electrolytes • Severe dehydration: |
| What should mothers do during transport for urgent hospital referrals? | continue rehydration by giving frequent sips of ORS during transport or use NG tube when possible in patients with poor drinking | Improvement: 3 days of treatment • No improvement → Cefixime 10 mg//kg/d, 2 div doses. Reassess after 2 days. If better complete 3 -5 days of treatment. • If stool routine positive for Ameobiasis : Metronidazole 10mg/kg/dose 8 hourly x 7 days (10 days in severe cases) • Refer to hospital (See box) • Urgent referral to hospital • Mother to continue rehydration by giving frequent sips of ORS during transport or use NG tube when possible in patients with poor drinking PATIENT EDUCATION • Danger signs* • Hygiene practices • Hand washing , proper disposal of excreta • Safe drinking water • Appropriate feeding practices • Vaccination as per IAP guidelines INVESTIGATIONS • Some dehydration: Preferable Tests- electrolytes • Severe dehydration: Essential tests- CBC, electrolytes Preferable Tests- Renal Function Tests, VBG • In suspected cholera cases: Preferable tests- stool for hanging drop and | 341 | relationship | 0.970 | • If stool routine positive for Ameobiasis : Metronidazole 10mg/kg/dose 8 hourly x 7 days (10 days in severe cases) • Refer to hospital (See box) • Urgent referral to hospital • Mother to continue rehydration by giving frequent sips of ORS during transport or use NG tube when possible in patients with poor drinking PATIENT EDUCATION • Danger signs* • Hygiene practices • Hand washing , proper disposal of excreta • Safe drinking water • Appropriate feeding practices • Vaccination as per IAP guidelines INVESTIGATIONS • Some dehydration: Preferable Tests- electrolytes • Severe dehydration: |
| What dietary advice is given for children with persistent diarrhea? | give small, frequent meals (at least 6 times a day), and avoid very sweet foods or drinks | 2 of following: a) Lethargy / unconscious b) Sunken eyes c) Not able to drink/ drinking poorly d) Skin pinch - goes back slowly 2 of following: a) Restless , irritable b) Sunken eyes c) Drinks eagerly, thirsty d) Skin pinch - goes back very slowly Not enough signs to classify some or severe dehydration PERSISTENT DIARRHEA • Appropriate fluids to prevent or treat dehydration • Nutrition: • If breastfeeding, give more frequent, longer breastfeeds, day and night. • Other milk: replace with increased breastfeeding, or with fermented milk products, such as yogurt, or half the milk with nutrient-rich semi-solid food. • For other foods, follow feeding recommendations for the child’s age: give small, frequent meals (at least 6 times a day), and avoid very sweet foods or drinks. • Zinc for 14 days • Supplement vitamins / minerals • Antimicrobial to treat diagnosed infection A) Intestinal infection: • If blood in stool: Treat like dysentery • If stool routine suggestive of Amoebiasis: Treat for it • If stool suggestive of cyst/ Trophozoite of Giardia: Give Metronidazole 5mg/kg/dose x 8hrly x 5 -7 days B) Treat Non intestinal such as UTI / Otitis Media • Follow up in 5 days • Refer to hospital (See box) | 690 | summary |
| What should be done after 4 hours of ORS administration for some dehydration? | reassess the child, classify dehydration and select appropriate plan (A /B/C) | stool culture • Dysentery: (no response to antibiotic in 2 days) Preferable test- stool culture & stool routine for trophozoites of Ameoba • Persistent diarrhea: Preferable test- stool routine microscopy, urine routine microscopy, urine culture , sepsis screen SOME DEHYDRATION: PLAN B • Manage in clinic /daycare facility with recommended amount of ORS (75ml /kg) over 4hour period • If weight is not known • After 4 hours reassess the child, classify dehydration and select appropriate plan (A /B/C) • Give extra fluids, zinc supplement, feeding advise and counseling regarding danger signs* as in plan A • Follow up in 5 days if no improvement AGE < 4 months 4 -11 months 12 -23 months 2 – 4 years 5-14 years 15 years or older | 424 | summary | 0.970 | stool culture • Dysentery: (no response to antibiotic in 2 days) Preferable test- stool culture & stool routine for trophozoites of Ameoba • Persistent diarrhea: Preferable test- stool routine microscopy, urine routine microscopy, urine culture , sepsis screen SOME DEHYDRATION: PLAN B • Manage in clinic /daycare facility with recommended amount of ORS (75ml /kg) over 4hour period • If weight is not known • After 4 hours reassess the child, classify dehydration and select appropriate plan (A /B/C) • Give extra fluids, zinc supplement, feeding advise and counseling regarding danger signs* as in |
| What should a mother do during urgent referral to a hospital for a child with diarrhea? | continue rehydration by giving frequent sips of ORS during transport or use NG tube when possible in patients with poor drinking | Improvement: 3 days of treatment • No improvement → Cefixime 10 mg//kg/d, 2 div doses. Reassess after 2 days. If better complete 3 -5 days of treatment. • If stool routine positive for Ameobiasis : Metronidazole 10mg/kg/dose 8 hourly x 7 days (10 days in severe cases) • Refer to hospital (See box) • Urgent referral to hospital • Mother to continue rehydration by giving frequent sips of ORS during transport or use NG tube when possible in patients with poor drinking PATIENT EDUCATION • Danger signs* • Hygiene practices • Hand washing , proper disposal of excreta • Safe drinking water • Appropriate feeding practices • Vaccination as per IAP guidelines INVESTIGATIONS • Some dehydration: Preferable Tests- electrolytes • Severe dehydration: Essential tests- CBC, electrolytes Preferable Tests- Renal Function Tests, VBG • In suspected cholera cases: Preferable tests- stool for hanging drop and | 341 | summary | 0.970 | • If stool routine positive for Ameobiasis : Metronidazole 10mg/kg/dose 8 hourly x 7 days (10 days in severe cases) • Refer to hospital (See box) • Urgent referral to hospital • Mother to continue rehydration by giving frequent sips of ORS during transport or use NG tube when possible in patients with poor drinking PATIENT EDUCATION • Danger signs* • Hygiene practices • Hand washing , proper disposal of excreta • Safe drinking water • Appropriate feeding practices • Vaccination as per IAP guidelines INVESTIGATIONS • Some dehydration: Preferable Tests- electrolytes • Severe dehydration: |
| What should be done after 4 hours of administering ORS in Plan B for some dehydration? | reassess the child, classify dehydration and select appropriate plan (A /B/C) | stool culture • Dysentery: (no response to antibiotic in 2 days) Preferable test- stool culture & stool routine for trophozoites of Ameoba • Persistent diarrhea: Preferable test- stool routine microscopy, urine routine microscopy, urine culture , sepsis screen SOME DEHYDRATION: PLAN B • Manage in clinic /daycare facility with recommended amount of ORS (75ml /kg) over 4hour period • If weight is not known • After 4 hours reassess the child, classify dehydration and select appropriate plan (A /B/C) • Give extra fluids, zinc supplement, feeding advise and counseling regarding danger signs* as in plan A • Follow up in 5 days if no improvement AGE < 4 months 4 -11 months 12 -23 months 2 – 4 years 5-14 years 15 years or older | 424 | summary | 0.970 | stool culture • Dysentery: (no response to antibiotic in 2 days) Preferable test- stool culture & stool routine for trophozoites of Ameoba • Persistent diarrhea: Preferable test- stool routine microscopy, urine routine microscopy, urine culture , sepsis screen SOME DEHYDRATION: PLAN B • Manage in clinic /daycare facility with recommended amount of ORS (75ml /kg) over 4hour period • If weight is not known • After 4 hours reassess the child, classify dehydration and select appropriate plan (A /B/C) • Give extra fluids, zinc supplement, feeding advise and counseling regarding danger signs* as in |
| How is acute diarrhea classified based on its duration? | Acute Diarrhea <14 days | DIARRHEA IS • >3 loose or watery stools/ day • Acute Diarrhea <14 days • Persistent diarrhea >14 days • Dysentery – blood in stools SKIN PINCH TEST • Locate the area on the child’s abdomen halfway between the umbilicus and the side of the abdomen. • Use thumb and first finger to pinch and not finger tips. • The fold of the skin should be in a line up and down the child’s body. • Firmly pick up all layers of the skin and tissue under them. • Pinch the skin for one second and then release it. | 47 | definition | 0.940 | DIARRHEA IS • >3 loose or watery stools/ day • Acute Diarrhea <14 days • Persistent diarrhea >14 days • Dysentery – blood in stools SKIN PINCH TEST • Locate the area on the child’s abdomen halfway between the umbilicus and the side of the abdomen. | 1 | page=1,block=3 | 0.700 | valid |