3-year old well-child Flashcards
Vision and hearing screen
Before 3 years –> asking parents about problems with vision/hearing
- vision by 3
- hearing by 4
3-year old health maintenance visit
- Social - can detect delays
- Nutrition - ask about typical diet
- Exercise - both structured and imaginative play
- Toilet training - may not be completely independent but should be getting close
- Dental - should have first visit soon
- Safety - car seats/home
Early Childhood Assessment
Process of observing and taking history from parents
1. Surveillance - helps determine areas of concern (Bright Futures)
3-year old milestones
Social - brushes teeth, feeds self
Communication - 2-3 word sentences
Cognitive - knows name and uses words correctly
Physical - rides trike, copies circle, builds 6-8 blockss
4-year old milestones
Social - know gender and age, plays with kids
Communication - first and last name, sings song
Cognitive - knows colors, plays board games
Physical - hops on 1 foot, balances, cuts and mashes food
5-year old milestones
Social - listens and attends, shows sympathy
Communication - articulates, tells story, count to 10
Cognitive - draws person (stick), copies square and triangle
Physical - hops and skip, tie knot, pencil grasp, dress/undress
Interacting with toddler
at 3 years old, some are accomadating, some apprehensive, some need parental assurance
- be nice and smile, keep them entertained
Giving feedback to parents
important to praise parents for all the things they are doing right
- positive validation gives them security
Eczema (atopic dermatitis)
“the itch that rashes” - cycle of irritation and rashing
- more common with history of allergies and family history
DDx for atopic dermatitis
Psoriasis - rare in young kids but can happen
Seborrhea - cradle cap
Treatment of eczema
- lubricate intensively
- anti-inflammatories for short bursts
- treat associated skin infections aggressively
Toilet training
- consistency is important!
- avoid punishing, use positive reinforcement
Single parenting
More stress, inconsistent messages, lack of affordable care, more depression
*maternal depression can lead to child mood or behavior problems
Common dietary issues
- Inadequate nutrition - needs fruits/veggies, iron
- Milk/Juice intake - lack intake of 100% juice and milk, too much sugary juice/soda (extra calories)
- Dental caries - using a bottle increases risk of caries
- Control battles over food
Examining for strabismus
- Cover/uncover test
2. Hirschberg light reflex
