Self-Assessment Questions (SAQs) for Study Session 9

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering these questions. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.

Read Case Study 9.1 and answer the questions below.

Case Study 9.1 for SAQ 9.1

Gizaw is 18 months old. He weighs 7 kg. His temperature is 37°C. His mother brought him today because the child has had diarrhoea for three days. There is no blood in the stool. You checked for general danger signs and there was no general danger sign detected.

He does not have a cough or difficulty breathing. You assessed him for diarrhoea and classified him as diarrhoea, no dehydration. He has no fever. He does not have ear problems.

You next checked him for malnutrition or anaemia. Gizaw does not have visible severe wasting. There is no palmar pallor. He does not have oedema of both feet. You measured MUAC and it is 11.7 cm.

Then you assessed Gizaw for symptomatic HIV infection. He has oral thrush. His parotid glands are enlarged. He has no enlarged lymph nodes. He tested HIV-positive using the antibody test.

SAQ 9.1 (tests Learning Outcomes 9.1, 9.2 and 9.3)

  • a.What are Gizaw’s signs?
  • b.How would you classify Gizaw for HIV infection and why?
  • c.What treatment would you propose for Gizaw?

Answer

  • a.Gizaw has moderate acute malnutrition with diarrhoea; he has oral thrush and enlarged parotid glands.
  • b.The classification is confirmed symptomatic HIV infection.
  • c.He should be treated with cotrimoxazole propylaxis, and a multivitamin and be referred for antiretroviral therapy.

Read Case Study 9.2 and then answer the questions below.

Case Study 9.2 for SAQ 9.2

Rediet is six months old. She weighs 7 kg. Her temperature is 36.8°C. Her mother brought her today because the child has been coughing for four days.

You checked for general danger signs and she does not have any of the general danger signs.

You assessed her for cough or difficult breathing. You counted 54 breaths per minute. Rediet has no chest wall in-drawing or stridor when calm. You classified Rediet as having pneumonia.

She does not have diarrhoea, fever or ear problems.

You next checked her for malnutrition or anaemia. Rediet does not have visible severe wasting. There is no palmar pallor. She does not have oedema of both feet. You measured MUAC and it is 11.5 cm.

Rediet’s mother had a positive HIV test done during her pregnancy. Rediet has oral thrush. She has no enlarged lymph nodes. Her parotid glands are not enlarged.

SAQ 9.2 (tests Learning Outcomes 9.1 and .2)

  • a.How would you record Rediet’s signs?
  • b.How would you classify Rediet for HIV infection?
  • c.How would you counsel Rediet’s mother?

Answer

  • a.Rediet has pneumonia and oral thrush. Her mother has a positive HIV test.
  • b.The classification is suspected symptomatic HIV infection.
  • c.The mother needs to be advised that the treatment will help her to look after Rediet.

SAQ 9.3 (test Learning Outcomes 9.3 and 9.4)

Why are good communication and counselling skills particularly important when you are advising the mother of a child with possible HIV infection?

Answer

HIV is a sensitive subject and there can be secrecy about it in a community. So the mother might be reluctant to tell you her own HIV status if she knows it and also be very concerned about confidentiality. But you need the help of the mother in different ways: testing for herself, looking after the child and also preventing the rest of the family being infected. So you need to work hard to gain her trust.

Summary of Study Session 9