Final: Concepts in Pediatric Assessment: H & P

Question 1

What is the purpose of a well-child visit? (4)

Answer 1

1. Prevention
   - immunization, nutrition, safety
2. Growth and Development (making sure its okay)
3. Opportunity for parents to express concerns and for physician to address them
4. Opportunity to establish medical home
   - so family and child gets used to physician

Question 2

If you are seeing a new baby and a new mom, what is a good practice to get into?

Answer 2

Ask how mom is doing

-post partum depression is real and talking about it can be very helpful

Question 3

What is probably the biggest difference in histories from neonates to adults?

Answer 3

You get the history from the parent!

Parents can usually tell when something is wrong.. Check your ego listen to them!

Question 4

If the patent is less than 5 years old with chronic illness, developmental delay, syndromic features, resp issues, etc. what is important to ask about? (3)

Answer 4

Prenatal History

• meds
• complications
• prenatal care

Perinatal History
-Apgar if known

Nursery History

• NICU?
• Did baby go home with you right after birth?
• Oxygen test results?

Question 5

What is one aspect of a pediatric history that you do NOT do in an adult history?

Answer 5

Discuss age-appropriate milestones (DDST-ii)

• always start with activities you know baby can do to build confidence in parents
• -different development is normal.. for a while

Question 6

How do you do a pediatic physical?

Answer 6

Head to toe exam
Look at VS
Longitudinal Assessment
-Height
-Weight
-Blood pressure
-Sexual Maturity

Question 7

What are some good physical exam Tips that Dr. Newman finds helpful? (3)

Answer 7

Open door slowly and be gentle with patient
-do not want to startle them

Ask parent how child will be comfortable and enlist their help
-Heart and lungs on parents lap is HUGE

Do not be too persistent

• some kids will just not want certain things looked at and that’s okay
• can injure them if overly pulling on them

Question 8

What is good standard of practice when doing a genital exam on a child?

Answer 8

Make sure parent can always see what you are doing and have parent join you

Have a chaperone!!

Question 9

What is important to remember about RR and HR in a pediatric patient less than 6 years old?

Answer 9

The younger the patent, the faster the rates
-Count for at least 30s and multiply by 2

If seems off, count for longer.