Communicable & Infectious Diseases in Children (IMCI) - Concept Map
Communicable & Infectious Diseases in Children (IMCI)
Related concepts
Common Childhood Communicable Diseases
Sub concepts
Measles (Rubeola)
Hallmark
Koplik spots before rash, 3 C's, cephalocaudal rash
Management
Supportive care, Vitamin A supplementation, airborne precautions
Complication
Pneumonia (most common cause of death)
Transmission
Airborne
Mumps (Parotitis)
Hallmark
Painful parotid gland swelling
Management
Analgesics, soft bland diet, droplet precautions
Complication
Orchitis, meningitis, deafness
Transmission
Droplet
Varicella (Chickenpox)
Hallmark
Pruritic vesicular rash in crops, dewdrops on rose petal appearance
Management
Calamine lotion, antihistamines, NO aspirin (Reye's syndrome risk), acyclovir for high-risk
Complication
Secondary infection from scratching
Transmission
Airborne and contact
Rubella (German Measles)
Hallmark
Pink maculopapular rash, postauricular/occipital lymphadenopathy
Management
Supportive care, prevent with MMR, isolate from pregnant women
Complication
Congenital rubella syndrome in pregnancy
Transmission
Droplet
Pertussis (Whooping Cough)
Hallmark
Paroxysmal cough with inspiratory whoop, post-tussive vomiting
Management
Macrolide antibiotics (erythromycin, azithromycin), gentle suctioning, droplet precautions
Complication
Apnea in infants, pneumonia, seizures
Transmission
Droplet
Diphtheria
Hallmark
Greyish-white pseudomembrane on tonsils/pharynx, bull neck
Management
Diphtheria antitoxin, antibiotics, do NOT remove membrane, droplet precautions
Complication
Airway obstruction, myocarditis, neuritis
Transmission
Droplet
Dengue
Hallmark
High fever, retro-orbital pain, positive tourniquet test
Management
Supportive fluids (priority), monitor platelets/hematocrit, NO aspirin/NSAIDs, paracetamol for fever
Complication
Dengue shock syndrome, plasma leakage, bleeding
Transmission
Vector (Aedes aegypti mosquito - day-biter)
Diarrhoeal Disease
Hallmark
Loose stools, dehydration risk
Management
ORS + Zinc (cornerstone), fluid management by Plan A/B/C, continue feeding/breastfeeding
Complication
Severe dehydration, under-5 mortality
Transmission
Fecal-oral (viral, bacterial, parasitic)
Relationship to central
Core diseases managed under IMCI framework
Infection Control & Isolation Precautions
Sub concepts
- Airborne precautions (measles, varicella, pertussis initial)
- Droplet precautions (mumps, rubella, diphtheria, pertussis)
- Contact precautions (varicella)
- Standard precautions (all diseases)
Relationship to central
Essential nursing intervention to prevent transmission
Integrated Management of Childhood Illness (IMCI)
Sub concepts
IMCI Assessment
Components
Danger signs, main symptoms (cough/difficult breathing, diarrhoea, fever, ear problem), nutritional status, immunisation status
IMCI Classification
Components
PINK (urgent referral), YELLOW (treat at facility), GREEN (home management)
IMCI Age-Based Charts
Components
Young infant (1 week - 2 months), Child (2 months - 5 years)
General Danger Signs
Components
Unable to drink/breastfeed, vomits everything, convulsions, lethargic/unconscious
Relationship to central
WHO/UNICEF/DOH strategy organizing frontline assessment and care
Fast-Breathing Assessment (Pneumonia Criteria)
Sub concepts
- < 2 months: ≥ 60 breaths/min (fast breathing)
- 2-12 months: ≥ 50 breaths/min (fast breathing)
- 12 months - 5 years: ≥ 40 breaths/min (fast breathing)
- Chest indrawing indicates severe pneumonia (urgent referral)
Relationship to central
Key IMCI respiratory assessment to identify pneumonia
Dehydration Assessment & Management (Diarrhoea)
Sub concepts
Plan A: No Dehydration
Indicators
Normal thirst, normal drinking, skin pinch goes back quickly
Management
Home care - extra fluids, ORS after each loose stool, Zinc, continue feeding/breastfeeding
Plan B: Some Dehydration
Indicators
Slightly increased thirst, drinks eagerly, skin pinch goes back slowly
Management
Supervised ORS 75 mL/kg over 4 hours at facility, reassess, then home care
Plan C: Severe Dehydration
Indicators
Drinks poorly or unable to drink, skin pinch goes back very slowly (>2 seconds), weak/absent radial pulse
Management
IV fluids immediately (Ringer's lactate), then ORS when able, monitor carefully
Relationship to central
Critical intervention in diarrhoeal disease management
Zinc Supplementation in Diarrhoea
Sub concepts
- Infants < 6 months: 10 mg/day for 10-14 days
- Children ≥ 6 months: 20 mg/day for 10-14 days
- Prevents future episodes
- Cornerstone of ORS + Zinc strategy
Relationship to central
Evidence-based intervention reducing duration and severity
Vaccination & Prevention (EPI / Garantisadong Pambata)
Sub concepts
Expanded Program on Immunization (EPI)
Prevents
Measles, pertussis, TB, diphtheria, tetanus, polio, Hepatitis B, Hib, pneumococcus, rotavirus
Schedule
BCG and Hep B at birth; pentavalent/OPV/PCV at 6-10-14 weeks; measles-containing vaccine at 9 and 12 months
Garantisadong Pambata (GP) Biannual Program
Frequency
Twice-yearly child-health package
Components
Vitamin A supplementation, deworming, immunisation catch-up, health education
Vitamin A Supplementation
Special
Also given in measles cases to reduce severity/mortality
Infants 6 11 months
100,000 IU once
Children 12 59 months
200,000 IU every 6 months
Relationship to central
Primary prevention strategy for communicable diseases
Nursing Diagnoses & NANDA Framework
Sub concepts
Risk for Infection Transmission
Related to
Communicability of childhood diseases, inadequate isolation precautions
Interventions
Implement appropriate isolation precautions, teach hand hygiene, screen visitors
Risk for Dehydration
Related to
Diarrhoea, vomiting, fever
Interventions
Monitor fluid intake/output, administer ORS, assess skin turgor and mucous membranes
Acute Pain
Related to
Mumps parotitis, measles photophobia, varicella pruritus
Interventions
Analgesics, cool/warm compresses, dim lighting, soft bland diet
Ineffective Airway Clearance
Related to
Diphtheria pseudomembrane, pertussis coughing, airway edema
Interventions
Monitor for stridor/respiratory distress, suctioning, emergency airway equipment ready
Hyperthermia
Related to
Fever in measles, mumps, dengue, diphtheria
Interventions
Antipyretics (paracetamol), tepid sponging, light clothing, fluid intake
Deficient Knowledge (Caregiver)
Related to
Transmission, home care, feeding during illness, warning signs
Interventions
Health education on ORS preparation, hygiene, when to return immediately, immunisation importance
Relationship to central
Clinical nursing judgment applying NANDA taxonomy
DOH Prevention Strategy for Dengue (4-S)
Sub concepts
- Search and destroy - identify and destroy Aedes aegypti breeding sites
- Self-protection - use repellent, wear long sleeves, use screens/bed nets
- Seek early consultation - report fever and warning signs promptly
- Support fogging - community-level insecticide spraying during outbreaks
Relationship to central
Community-level dengue prevention aligned with DOH guidelines
Young Infant (1 week - 2 months) Specific Assessment
Sub concepts
- Danger signs specific to young infants: not feeding well, convulsions, fast breathing (≥60/min), severe chest indrawing
- Temperature assessment: fever ≥37.5°C or low <35.5°C (both concerning)
- Responsiveness: movement only when stimulated or no movement indicates urgent referral
- Assess breastfeeding attachment and correct feeding problems
- Check for jaundice, weight, and keep infant warm during referral
Relationship to central
Specialized IMCI approach for highest-risk age group
Maslow's Hierarchy & Prioritization in IMCI
Sub concepts
- Level 1 - Physiological needs (airway, breathing, circulation, fluid balance) - assess respiratory rate, hydration, fever
- Level 2 - Safety needs (infection control, referral for danger signs, protection from complications)
- Level 3 - Love/belonging needs (breastfeeding support, mother-child bonding)
- Level 4 - Esteem needs (empower caregivers with knowledge)
- Level 5 - Self-actualization (long-term prevention through immunisation and health education)
Relationship to central
Nursing priority framework guiding IMCI assessment order
Concept connections
- Common Childhood Communicable DiseasesIMCI Assessment FrameworkIMCI provides systematic approach to recognize and classify each disease
- MeaslesVitamin A SupplementationVitamin A is mandatory intervention in measles that reduces severity and mortality
- Diarrhoeal DiseaseDehydration ManagementDehydration is the primary life-threatening complication managed by Plans A/B/C and ORS/Zinc
- Fast-Breathing AssessmentPneumonia ClassificationRespiratory rate and chest indrawing determine pneumonia severity and need for referral
- DengueWarning Signs MonitoringSpecific warning signs indicate progression to dengue shock syndrome requiring urgent escalation
- Infection Control & Isolation PrecautionsCommon Childhood Communicable DiseasesEach disease requires specific precautions (airborne, droplet, contact) based on transmission route
- EPI ImmunisationCommon Childhood Communicable DiseasesVaccination prevents most childhood communicable diseases listed
- Garantisadong PambataVitamin A SupplementationGP program delivers Vitamin A biannually as part of integrated child health package
- Young Infant AssessmentIMCI Assessment FrameworkSpecialized IMCI protocol for 1-2 months age group with different danger signs and approach
- Nursing Diagnoses NANDAIMCI ClassificationNANDA diagnoses guide prioritization aligned with IMCI color-coded triage system
- Maslow's HierarchyIMCI Assessment OrderIMCI follows Maslow framework prioritizing physiological (airway, breathing, hydration) then safety then learning needs
- PertussisFast-Breathing AssessmentPertussis causes fast breathing and apnea, requiring careful respiratory assessment, especially in infants
- Zinc SupplementationDiarrhoeal DiseaseZinc is cornerstone intervention in diarrhoea reducing duration severity and preventing future episodes
- ORS AdministrationPlan A Plan B Plan CORS is used in Plan A and B with volume and duration determined by dehydration degree
- DiphtheriaAntitoxin AdministrationAntitoxin is specific life-saving treatment for diphtheria myocarditis prevention
- VaricellaAspirin AvoidanceAspirin in varicella carries risk of Reye's syndrome, therefore contraindicated
- RubellaCongenital Rubella SyndromeRubella in pregnancy causes CRS, therefore isolation from pregnant women and prevention through MMR critical
- DOH 4-S Prevention StrategyDengue4-S framework provides comprehensive dengue prevention approach aligned with DOH guidelines
- Caregiver CounsellingIMCI Follow-upEffective counselling on home care and danger signs ensures treatment adherence and safe follow-up
- RA 9173 Nursing PracticeIMCI ImplementationRN scope of practice under RA 9173 includes IMCI assessment classification treatment and counselling at primary care level
Diagrams
Communicable & Infectious Diseases in Children (IMCI) - Full Concept Hierarchy
Comprehensive mind map showing the full hierarchy of communicable and infectious diseases in children, IMCI assessment framework, dehydration management plans, infection control precautions, prevention strategies, and nursing care components. This is the central organizing structure for the entire chapter.
IMCI Assessment & Classification Decision Tree (2 months - 5 years)
Decision tree showing the step-by-step IMCI assessment and classification process for children aged 2 months to 5 years. Starts with danger signs check, progresses through main symptoms (cough, diarrhoea, fever, ear), and guides classification into PINK (urgent referral), YELLOW (treat at facility), or GREEN (home management) categories.
Dehydration Assessment & ORS/Zinc Management Plan
Detailed management algorithm for diarrhoeal disease showing dehydration assessment criteria and corresponding treatment plans (A, B, C). Includes ORS administration volumes, Zinc dosing by age, monitoring parameters, and reassessment points. Emphasizes that feeding continues throughout and highlights prevention education.
Respiratory Assessment for Pneumonia (Fast-Breathing & Chest Indrawing)
Step-by-step respiratory assessment guide for identifying pneumonia in children using IMCI age-specific fast-breathing thresholds and chest indrawing assessment. Shows classification (PINK for severe, YELLOW for non-severe), referral criteria, and antibiotic treatment protocols for non-severe pneumonia.
Measles: Clinical Recognition & Management Protocol
Clinical assessment and management pathway for measles, highlighting early recognition (Koplik spots), progression through prodromal and exanthem phases, classification, mandatory Vitamin A supplementation (cornerstone of care), supportive management, complication monitoring, isolation precautions, and vaccination follow-up.
IMCI Nursing Care Sequence: From Assessment to Follow-up
Sequence diagram showing the complete IMCI nursing care journey from initial child-caregiver arrival through danger sign assessment, symptom evaluation, classification, treatment delivery, caregiver counselling, home care implementation, and follow-up reassessment. Emphasizes the iterative nature of IMCI and continuous caregiver engagement.
Young Infant (1 week - 2 months) IMCI Assessment Protocol
Specialized IMCI assessment protocol for young infants (1 week to 2 months), the highest-risk age group. Includes age-specific danger signs (respiratory rate ≥60/min, temperature extremes, poor feeding, movement changes), targeted assessment for jaundice and feeding problems, dehydration management, and close follow-up. Emphasizes maintaining warmth during any referral.
Distribution of Communicable Diseases Impact in Philippine Child Health Context
Proportional representation of major communicable disease causes of childhood under-5 mortality in the Philippines. Highlights that respiratory infections and diarrhoeal disease together account for over half of communicable disease-related deaths, underscoring the critical importance of IMCI respiratory and fluid assessment and management.
Dengue Management: Warning Signs & Escalation Protocol
Comprehensive dengue management protocol emphasizing warning signs that indicate progression to dengue shock syndrome. Highlights the critical importance of fluid management, daily monitoring through the critical phase (days 4-6), and immediate escalation criteria. Integrates DOH 4-S prevention strategy.