# Situation: During the twice-yearly Garantisadong Pambata week, a nurse at a Barangay Health Station (BHS) screens children under 5 years of age and counsels their mothers on nutrition. A 13-month-old boy received vitamin A 100,000 IU at 7 months of age and has had no dose since. He is well, and his mother keeps his record card. What should the nurse give today?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=627061  
> language: ko  
> subject: Nursing Practice I — Community Health Nursing

## 문제

Situation: During the twice-yearly Garantisadong Pambata week, a nurse at a Barangay Health Station (BHS) screens children under 5 years of age and counsels their mothers on nutrition.

A 13-month-old boy received vitamin A 100,000 IU at 7 months of age and has had no dose since. He is well, and his mother keeps his record card. What should the nurse give today?

## 보기

1. Vitamin A 200,000 IU, the dose from 12 to 59 months **✔ 정답**
2. Vitamin A 100,000 IU, the same dose as his last dose
3. No vitamin A until he turns 18 months old
4. Vitamin A 50,000 IU, to avoid a toxic overdose

**정답: 1**

## 해설

Infants 6 to 11 months receive vitamin A 100,000 IU once; children 12 to 59 months receive 200,000 IU every 6 months. The boy is now 13 months old and his last dose was 6 months ago, so he is due for 200,000 IU today. The dose is recorded to avoid duplication.

## 심화 해설

During the twice-yearly Garantisadong Pambata week, the nurse reviews the child’s age and previous vitamin A dose. The boy is now 13 months old, which places him in the 12 to 59 months age group. His last dose was 100,000 IU at 7 months of age, and he has had no dose since. Because supplementation is given every 6 months and the dose changes when the child reaches 12 months, he is due for the higher dose today.

The age-based schedule reflects the body’s increasing vitamin A requirement as the child grows. From 6 to 11 months, infants receive 100,000 IU once. From 12 to 59 months, the dose increases to 200,000 IU every 6 months. The larger dose is safe and appropriate for this age group because vitamin A stores are still being built, and periodic high-dose supplementation is a proven strategy to reduce deficiency and child mortality in areas where dietary intake is inadequate [4].

Key point! The dose is determined by the child’s current age, not by repeating the previous dose. Once a child turns 12 months, the standard dose becomes 200,000 IU.

Watch out! Do not give 50,000 IU to “avoid toxicity.” The 200,000 IU dose is a safe, high-potency supplement given at 6-month intervals, and the risk of deficiency far outweighs the risk of a single age-appropriate dose [4]. Toxicity is a concern with frequent, repeated high doses over a short period, not with the standard twice-yearly schedule.

The nurse should also record the dose on the child’s record card. This prevents duplication if the child is seen at another health station or during a subsequent outreach activity. In community-based programs, mothers’ awareness and correct use of the record card support timely follow-up and reduce missed or repeated doses .

| Age group | Vitamin A dose | Frequency |
| --- | --- | --- |
| 6 to 11 months | 100,000 IU | Once |
| 12 to 59 months | 200,000 IU | Every 6 months |

Because the child is 13 months old and his last dose was 6 months ago, the correct action is to give 200,000 IU today. This aligns with the standard schedule and ensures the child maintains adequate vitamin A status during a critical period of growth and immune development [4].References (research sources)

- [4]Childhood mortality after a high dose of vitamin A in a high risk population.Research articleDaulaire NM, Starbuck ES, Houston RM, Church MS, Stukel TA, Pandey MR (1992) · DOI: 10.1136/bmj.304.6821.207

## 임상 시나리오

Vitamin A Dosing by AgeGarantisadong Pambata supplementation schedule
For a child 13 months old, the correct dose is 200,000 IU of vitamin A. The dose is determined by the child's current age, not the previous dose. Children 12 to 59 months receive 200,000 IU every 6 months.

Infants 6 to 11 months receive 100,000 IU once. Once the child reaches 12 months, the dose increases to 200,000 IU every 6 months. The larger dose is safe and appropriate for this age group.

CautionDo not give 50,000 IU to avoid toxicity. The 200,000 IU dose is a safe, high-potency supplement at 6-month intervals. Toxicity is a concern with frequent, repeated high doses over a short period, not with the standard twice-yearly schedule. Always record the dose on the child's record card to prevent duplication.

## 핵심 개념

- **Garantisadong Pambata** — A twice-yearly Philippine Department of Health program providing vitamin A supplementation, deworming, and growth monitoring for children under 5 years.
- **Vitamin A supplementation schedule** — Infants 6-11 months receive 100,000 IU once; children 12-59 months receive 200,000 IU every 6 months.
- **High-dose vitamin A** — Periodic large doses of vitamin A given to prevent deficiency and reduce child mortality in areas with inadequate dietary intake.
- **Record card** — A document used to track a child's immunizations and vitamin A supplementation to prevent duplication of doses.

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