Community Pediatrics Committee - Part 2 Flashcards
What kind of approach do we advocate for when we teach parents about toilet learning?
The child-oriented approach
Most children in western countries achieve bladder and bowel control between which age?
24 months to 48 months
What are 4 of the 7 signs of a child’s toilet learning readiness?
- Able to walk to the potty chair
- Stable while sitting on the potty
- Able to remain dry for several hours
- Receptive language skills allow the child to follow simple 1-step or 2-step commands
- Expressive language allows the child to communicate the need to use the potty
- Desire to please based on positive relationship with caregivers
- Desire for independence and control of bowel or bladder function
What should be done if a child expresses toileting refusal?
A one to three-month break from training is suggested
What does the Canadian Dental Association recommend in regards to pacifier use (3 recommendations)?
- Pacifiers are preferred over thumb sucking
- Do not put sugar or sweetener on the pacifier
- Sucking habit should stop before the permanent teeth erupt
Most experts will agree that pacifiers are associated with which 3 negative outcomes? (not evidence proven)
- Early breast weaning
- AOM
- Dental problems
Early pacifier use signifies what to the HCP?
Possible breastfeeding difficulties
In which patients should pacifier use be restricted in?
Patients with chronic or recurrent AOM
At what age do children become aware of racial differences?
By 3 years of age
At what age do children understand race permanence?
By 7 years of age
In an infant or a school aged female child, what is the preferred position for a genital examination?
Girls can sit on the parent’s or caregiver’s lap in the supine frog-legged position
In an infant or a school aged male child, what is the preferred position for a genital examination?
Lateral decubitus position
What are the 4 identified causes of malnutrition in neurologically impaired children?
- Inadequate intake
- Increased losses
- Altered metabolism
- Oromotor dysfunction
What are two additional measures that can be done in order to evaluate the nutritional status of a neurologically impaired child that may be more accurate than weight-for-height to detect malnutrition?
- Triceps skinfold thickness
2. Mid-arm circumference
What bloodwork should you do if you suspect osteoporosis in a patient with malnutrition?
Phosphorus, Calcium, Vitamin D, ALP
It may be difficult to evaluate bone mineral density in neurologically impaired patients (due to skeletal deformities and inability to stay still). What may be an alternative option to BMD scans?
Bone quantitative U/S
What is the indication for GJ tube?
Patients with reflux who are poor candidates for the anti-reflux procedure
What should the weight for height percentile be for a neurologically impaired child who is wheelchair bound but able to accomplish transfers?
Weight-for-height should be in the 25th percentile
What are three barriers to health care for foster children and youth?
- Lack of or inadequate medical records
- Lack of consistent care or follow-up due to temporary placements
- Difficulty accessing services
What is foster care?
Foster care is the provision of care and supervision by a family other than a biological parent or guardian, and is approved and arranged by a child welfare authority
The AAP recommends an initial medical visit with a foster child after how many days of placement?
The initial medical visit should be within 24 hours of placement
Name at least four common medical issues in the CPS statement found in foster children?
- Poor hygiene
- Underimmunization
- Dental neglect
- Contraceptive needs for adolescents
Is routine ordering of tests recommended in the initial medical visit with a foster child?
No, but things to consider based on need include: complete blood count, ferritin, lead level, HIV, hepatitis B and C titres, b-hCG, cervical or urethral swabs for STIs, and Pap smear
What does “housing need” mean?
The term ‘housing need’ is used to describe substandard living conditions
What are the 4 populations at higher risk for housing need?
- First Nations
2. Recent immigrant households (
What does HOME mnemonic stand for in asking about housing need?
Harm - Is your home in need of major repairs
Occupancy - How many people live at home and how many rooms
Moves - How many times has your child moved
Enough/Income - Do you have enough money for housing, food, utilities?
