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Health Supervision Flashcards

1
Q

Principles of Health Supervision

A
  • providing services proactively
  • optimizing child’s level of functioning
  • ensuring child is growing and developing appropriately
  • promoting best possible health
  • preventing injury and illness through child teaching
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2
Q

Medical Home

A

physician or nurse practitioner who has a long term and comprehensive relationship w/ the family, leading to comprehensive, continuous, coordinated, and cost effective care

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3
Q

What is considered vital for a child with a chronic illness?

A

effective partnership among the child’s medical home, family, and community

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4
Q

What will enhance the quality of life and health of a child with a chronic illness?

A

Coordination of specialty care, community agencies, and family support networks

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5
Q

Special Issues in Health Supervision

A
  • cultural influences
  • community influences
  • health supervision and the chronically ill child
  • health supervision and the internationally adopted child
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6
Q

What issues are covered in a psychosocial assessment?

A
  • health insurance coverage
  • transportation to health care facilities
  • financial stressors
  • family coping
  • school’s response to the chronic illness
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7
Q

Chronic Illnesses require what?

A
  • repeated assessments
  • need to determine health maintenance needs
  • frequency of visits
  • types of interventions
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8
Q

For international adoption the child will need a comprehensive screening for?

A
  • infectious diseases
  • disorders of G&D
  • vision/hearing
  • any testing bases on diseases prevalent in their country of origin
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9
Q

When does the screening need to be done?

A

within the first few weeks of arrival

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10
Q

Universal Screening

A
  • intestinal parasites
  • hepatitis A,B,C
  • varicella
  • HIV
  • syphilis
  • tuberculosis
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11
Q

The health supervision visit will include what?

A
  • history and physical assessment
  • developmental/behavioral assessment
  • sensory screening
  • appropriate at risk screening
  • immunizations
  • health promotion/anticipatory guidance
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12
Q

Health promotion/anticipatory guidance may include:

A

injury prevention
violence prevention
nutrition counseling

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13
Q

Appropriate At-Risk screening may include:

A 
lead
anemia 
TB test
HTN
cholesterol
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14
Q

What are the 3 components of Health Supervision?

A
  • developmental surveillance and screening
  • injury and disease prevention
  • health promotion
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15
Q

Health supervision should be viewed as what?

A

Viewed as part of a continuum of care and NOT as the accomplishment of isolated tasks

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16
Q

Components of Developmental Surveillance

A
  • noting and addressing parental concerns
  • obtaining a developmental history
  • making accurate observations
  • consulting w/ relevant professionals
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17
Q

What may indicate warning signs or identify risks for developmental delay?

A

Historical information obtained from the parent or primary caregiver about developmental milestones

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18
Q

Any child who “loses” a developmental milestone needs what?

A

An immediate full evaluation

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19
Q

Why does a child who “loses” a developmental milestone need an immediate full evaluation?

A

Because this indicates a significant neurological problem

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20
Q

To increase cooperation you can do what?

A

set up a reward system

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21
Q

Ways to increase cooperation are:

A
  • stamp/sticker on hand
  • decorating tongue blade for vision screening
  • copy a design and let them color
  • let them play with tools
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22
Q

Risk Assessment

A

includes objective and subjective data to determine likelihood child will develop a condition

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23
Q

Universal Screening

A

screening of an entire population regardless of child’s individual risk

24
Q

Selective Screening

A

done when a risk assessment indicates the child has one or more risk factors for a disorder

25
What are some specific types of screening performed?
- metabolic - hearing - vision - iron-deficiency anemia - lead - hypertension - hyperlipidemia
26
If a metabolic screening is not done before 48 hours of age when should it be done?
At first visit
27
What ages is universal hearing recommended?
4-8 and 10 years old
28
Criteria for Risk Assessment for Hearing Loss (3 mo- 5 yrs)
- auditory skill monitoring - developmental surveillance - assessment of parental concerns - older than 4 yrs - difficulty hearing on phone, in noisy background - frequently asking others to repeat themselves - turn tv up too loud
29
Using a vision screening chart
- place chart at eye level - place mark on floor 20 ft from chart - align child's heels w/ mark - have child read each line w/ one eye covered - have child read w/ both eyes
30
At what ages should you screen for iron-deficiency anemia?
4, 15, 18, and 30 months
31
The child's Hgb/Hct should be taken at how old?
12 months
32
What is an elevated blood lead level?
5 ug/dL
33
At what ages should you screen for elevated blood lead levels?
6,9,12,18,24 months and 3,4,5,6 years
34
When does the universal hypertension screening begin?
3 years
35
When do you screen for hyperlipidemia?
Once between 9-11 years and again between 18-21 years old
36
What happens when the immune system recognizes an antigen?
It responds by producing antibodies or directing special cells to destroy and remove the antigen
37
Immunity
ability to destroy and remove a specific antigen from the body
38
Passive Immunity
produced when the immunoglobulins of one person are transferred to another
39
Active Immunity
acquired when a person's own immune system generates the immune response
40
Intramuscular Vaccines
``` DTap, DT, Tdap Hepatitis A,B Hib Influenza Pneumococcal conjugate vaccine HPV MCV-4 IPV ```
41
Subcutaneous Vaccines
IPV MMR Varicella MPSV4
42
IM injection Birth-28 days and 1-12 months
anterolateral thigh
43
IM injection 1-2 years and 3-18 years
anterolateral thigh and deltoid muscle
44
SubQ injection 1-12 months
fatty tissue over anterolateral thigh
45
SubQ injection >12 months
fatty tissue over anterolateral thigh or triceps
46
Which vaccines are live virus vaccines?
MMR and Varicella
47
If the MMR and Varicella vaccine are not given on the same day how far apart should they be given?
28 days
48
What are no longer contraindications for MMR vaccine?
Egg allergies or pregnancy
49
LAIV should not be given to who?
Anyone who will be in contact w/ an immunosuppressed patient
50
The Influenza vaccine is contraindicated for who?
- child w/ large amounts of nasal drainage - child w/ underlying medical condition - child < 5 w/ recurrent wheezing in last 12 mo - immunocompromised children - taking aspirin - have been given other live vaccine in last 4 weeks
51
The Rotavirus Vaccine is contraindicated for who?
- children with SCID | - history of intussusception
52
HPV is how many doses?
2
53
What do we chart for immunizations?
- date the vaccine was administered - name of vaccine - lot number and expiration date of vaccine - manufacturers name - site and route - edition date of VIS given to parents - Name and address of the facility administering vaccine - Name of person administering immunization
54
What are significant causes of inadequate immunization?
- parental concerns about vaccine safety | - multiple physicians
55
Topics for Anticipatory Guidance
- promoting oral health care - healthy weight - healthy activity - personal hygiene - safe sun exposure
56
Contraindications
- anaphylactic or systemic allergic reaction to vaccine component - pertussis immunization, encephalopathy w/o an identified cause within 7 days of immunization

Pediatrics (24 decks)

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