NORCET 9 Mains - 2025: According to the IMNCI program, if a child comes with fever, which of the following should the nurse assess f…

NORCET 9 Mains - 2025

Child Health Nursing (Pediatrics)

Easy

Appeared in: NORCET 9 Mains - 2025

Explanation

The IMNCI protocol for a child with fever begins with assessing for general danger signs, followed by addressing the main complaint.
For fever, the very first step is to decide the local malaria risk (high or low).
This initial stratification for malaria is critical because it dictates the subsequent steps, including whether to perform a diagnostic test and what treatment to initiate.
Prioritizing malaria assessment is a key public health strategy to reduce child mortality from a common and treatable, yet potentially fatal, disease.

Option A: Typhoid fever is not a primary assessment in the initial IMNCI fever algorithm. It is typically considered later, especially if the fever is prolonged (present for more than 7 days).
Option C: Assessment for measles is part of the IMNCI fever algorithm but occurs after the initial determination of malaria risk.
Option D: Dehydration is a primary assessment for the main symptom of diarrhea, not fever. While a child with fever can become dehydrated, it is not the first condition to assess for under the fever-specific IMNCI protocol.

Clinical Relevance

Nursing practice connection: Use the key finding related to IMNCI guidelines for fever management in children to guide bedside assessment, documentation, and the next nursing action.
Using structured protocols like IMNCI is essential in primary healthcare settings, especially in resource-limited areas, to ensure that life-threatening conditions are identified and managed promptly, reducing child mortality.
A nurse's ability to correctly follow the IMNCI flowchart can be the difference between life and death for a child with a severe febrile illness.
What if? If the child was in an area with no malaria risk, the nurse would still follow the fever chart but would focus on identifying other causes of fever, such as pneumonia or other severe bacterial infections, without initially testing for malaria.

How to Approach the Question

First, identify the key elements of the question: 'IMNCI program', 'child with fever', and 'assess first'.
The term 'IMNCI' signals that the answer must be based on this specific, structured protocol, not just general clinical knowledge.
Recall the IMNCI algorithm for the management of a sick child. Remember that it is a flowchart with specific pathways for major symptoms like cough, diarrhea, and fever.
Focus on the 'fever' pathway. The first step after checking general danger signs is to stratify by the most urgent and common life-threatening cause, which in many regions is malaria.
Evaluate the options based on this protocol. Eliminate options that are assessed later (Measles) or are part of a different symptom pathway (Dehydration for Diarrhea).

Concept Tested & Keywords

Concept Tested: IMNCI guidelines for fever management in children.
Stem keywords: IMNCI program, child, fever, nurse assess
Lead-in keywords: assess first
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) pp. 817-819, 798-800

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