CHC Flashcards
What screening blood tests should be done in adolescents?
Lipid levels once during adolescence
CBC in menstruating females
When should screening for autism be done?
MCHAT should be done between 18-24 mos
Siblings keep an eye on from young age b/c increased risk of developing autism
When on average does the anterior fontanel close?
Avg=10-14 months
May stay open up to 18 months
How often should a newborn be fed?
Every 2-3 hours or 8-12 times in 24 hours
How long should a newborn nurse for?
10-20 minutes on each breast
How much should newborns who are bottle fed be taking?
1/2 to 2 ounces at each feed
How many wet diapers and stools a day should an new infant have (birth- 4 months)?
5-8 wet diapers
3-4 stools
What is the max amount of formula you should feed a term newborn?
24-32 ounces in 24 hours
How much weight is it acceptable for a baby to lose after birth? When should they be back to birth weight by?
Acceptable loss=5-7% although some say up to 10%
Should be back to birth weight by 2 weeks
What is the goal weight gain the first 6 months? From 6 months-1year?
First 6 months= 5-7 ounces per week
Birth weight should double by 5 months
6 months-1year= 3-5 ounces per week
What are the criteria for starting solids?
Baby should be able to:
- sit with support
- hold head up
- be double birth weight/at least 13 pounds
When can babies start drinking juice?
After 6 months of age
- only in a sippy cup
- no more than 4-6 ounces per day
What foods should ALWAYS be avoided in infants?
No honey or karo syrup until 1year old (botulism)
Avoid for choking risk until 2-3 years
- nuts
- peanuts
- popcorn
- hot dogs
- whole grapes
- hard candy
- raw vegetables
- raisins
- gum
When can you feed baby finger foods?
When able to sit up and bring objects to mouth or usually by 9 months of age
When is it ok to put cereal in baby’s bottle?
When the baby has GERD/reflux
When should a baby be weaned from a bottle?
Between 12-15 months
What foods can you introduce after the first year of life?
Whole cows milk Citrus fruits and juices Eggs Tomatoes Small pieces of berries Honey
Still avoid choking hazard foods
How much should a toddler be eating?
3 meals and 2-3 snacks per day
What are the things to assess for at first office visit for newborn (2-3 days post leaving the office)?
Feeding Weight gain (% down from birth weight or back up) Bilirubin/other labs Umbilical cord stump care Bathing Soothing
When does the anterior fontanel close?
Average= 10-14 months
May remain open until 18 months
When do primary teeth erupt?
Central incisors appear between 5-7 months
Then 1 tooth/month until 23-30 months
When do permanent teeth erupt?
Central incisors 5-7 years, third molars in place between 17-22 years
32 adult teeth
When should a pacifier be discontinued?
By 18 months of age, can cause oral and dental distortions
When does handedness usually develop?
Usually by 18-24 months
If hand preference before age 12 months, suspect a problem with non preferred hand (hemiparesis, brachial plexus injury)
By what age should premature infants be caught up in growth and development?
2-3 years
Age range for holding head steady when placed in supported position?
1-4 months
Age range for sits without support for more than 30 seconds
5-8 months
Age range for cruising or walking holding onto things
7-13 months
Age range for standing alone
9-16 months
Age range for walking alone
9-17 months
Age range for walks up stairs with help
12-23 months
Age range for grasping objects
2-4 months
Age range for reaching for objects
3-5 months
Age range for transferring objects from hand to hand
5-7 months
Age range for developing fine pincer grasp with index finger and thumb apposition
9-14 months
Age range for spontaneous scribbling
12-24 months
What are the best measures of cognitive development?
Receptive lanugage
By what age should a child have imitative play? (helping with dishes, doll play)
24 months
By what age should a child engage in make believe play?
36 months
By what age should s child be able to play simple rule based playground games or board games?
48 months
By what age should a child be able to: Copy a cross Copy a circle Copy a square Copy a triangle
Circle-3 years
Cross-3 years
Square- 4 years
Triangle- 5 years
Describe the language a child should have by 3 months
Expressive-coos
Receptive-alerts to voice
Describe the language Milestones by 4-6 months
Expressive: monosyllabic babbling, laugh, raspberry
Receptive: turns to voice and sounds
What is the minimum number of wet diapers an infant should be making a day.?
=at least 4 (most babies more frequent than that)
True or false: a breast fed baby at 3-6 weeks of age who has only 1-2 bowel movements a week is normal
True
- total frequency can vary a lot
- formula fed a baby should have at least 1 BM a day
What is the average weight at:
- birth
- 1yr
- 5yrs
- 10 yrs
Birth: 3.5 kg
1yr: 10 kg
5 yrs: 20kg
10 yrs: 30 kg
How is colic diagnosed?
Rule of 3s: crying more than 3 hours per day, more than 3 days per week, for more than 3 weeks
- crying began before 3 weeks of age
- crying worse afternoon and evening
- infant otherwise thriving
- no organic cause on eval
- facial grimacing, drawing up of legs, passing gas
Where should you check for hair tourniquets
Check fingers and toes carefully as hair can get wrapped around and cut off blood supply
What is a positive Galeazzi sign?
Screen for developmental hip dislocation.
Have infant lying supine on firm surface with hips and knees flexes at 90 degrees.
If one knee looks higher than the other= +sign (the lower side is the side with the dislocated hip)
