Child Health and Family Health Nursing
The integrated approach
Child health items follow the IMCI pattern: assess, classify by colour (red = urgent referral, yellow = treat and review, green = home care), then treat and counsel. Master the general danger signs - inability to drink or breastfeed, persistent vomiting, convulsions, lethargy or unconsciousness - which override any other classification.
Growth, nutrition and prevention
Know the Ghana immunization schedule: BCG and OPV0 at birth; OPV1, pentavalent 1, PCV1 and rotavirus 1 at 6 weeks; the same series at 10 and 14 weeks; measles–rubella at 9 and 18 months. Vitamin A and deworming follow national campaign schedules. Severe acute malnutrition is identified by MUAC below 11.5 cm, bilateral pitting oedema or weight-for-height Z-score below −3, and is managed with F-75 stabilisation, then F-100 or ready-to-use therapeutic food.
Diarrhoea and dehydration
Low-osmolarity ORS plus zinc for 10–14 days (10 mg daily under 6 months, 20 mg daily from 6 months) is standard; antibiotics are reserved for cholera, dysentery and confirmed cases. Breastfeeding is continued throughout. Newborn care: warmth, early initiation of breastfeeding within one hour, exclusive breastfeeding for six months, cord care and kangaroo mother care for small babies.
Traps
Giving antibiotics for simple acute watery diarrhoea; using APGAR or weight alone to decide referral; stopping breastfeeding during illness; and forgetting that a child with stridor at rest or chest indrawing is a red classification.
Worked example
A 14-month-old with watery stool, sunken eyes, slow skin pinch and lethargy: classify as severe dehydration (red), start Plan C intravenous Ringer's lactate, and refer - not Plan A at home.