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Adv Prac Child Adolescent 6036 Test 1 COMPLETE ☑️ > Module 1 (a) > Flashcards

Module 1 (a) Flashcards

1
Q

Components of the WCV

-All Components

A
  1. Vision screening
  2. Hearing Screening
  3. Developmental/Behavioral Screening
  4. Laboratory
  5. Immunizations

At each visit you will assess the need for a formal screening ** “Ask the parent”
-If Parent has a concern, you will perform a formal screening

Additionally, follow the periodicity chart to conduct recommended screenings at the identified ages**

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2
Q

Components of the WCV

-Vision Screening

A
  1. Age 0-3 years subjective findings (Observation) — Trouble with Eye contact and following gaze, squinting, sitting close to books or TV? Eye hand coordination, sensitivity to light, difficulty coloring w/in lines All RED FLAGS
  2. Age 4 and up OBJECTIVE finding — Snellen chart, Allen cards
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3
Q

Components of the WCV

-Hearing Screen

A
  1. Completed at birth then routinely starting at age 4, UNLESS there is a concern
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4
Q

Components of the WCV

-Developmental Surveillance Vs Screening **TEST

A
  1. Surveillance is (DEVELOPMENTAL HX; reviewing risk factors)
    - Flexible and continuous, observation, parental concerns and history
  2. Screening is
    - Standardized test, used when surveillance detects abnormality, identifies risks, NOT DIAGNOSTIC
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5
Q

5 Components of Developmental Surveillance

A
  1. Eliciting and attending to parents concerns about child’s development
  2. Documenting and maintaining developmental history
  3. Making accurate observations of the child
  4. Identifying risks and protective factors
  5. Maintaining accurate records and documenting the process & findings

Environmental, genetic, biological, social & demographic factors can all increase a child’s risk for delays and development

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6
Q

Components of the WCV

-Labs **TEST

A
  1. Newborn screens done at birth — Ex: Cystic Fibrosis, Congenital adrenal hyperplasia, hemoglobinopathies, congenital hypothyroidism, etc.
  2. Lead Level - 12 m and 24 m
  3. Hct or hgb at 12 months
  4. Dyslipidemia panel 9-11 yrs
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7
Q

Components of the WCV

-Anemia Risk Assessment

A
  1. Check anemia risk starting at 4 months**
  2. Risk factors include
    - Prematurity and low birth weight — 80% of iron is transferred from mother to infant in last trimester
    - Human milk has low iron - Exclusively Breast fed babies need iron supplementation starting at 4 months
    - Exposure to Lead is a risk for anemia
  3. Healthy, term, breast fed only and partially breastfed babies get
    - 1mg/kg/day of iron starting at 4 months until iron containing foods are introduced (including iron fortified cereal)
  4. Full-term formula fed infants do not need iron supplementation
  5. Pre-term Breastfed infants require 2mg/kg/day starting in the first month of life until sufficient intake from food
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8
Q

Vitamin D Supplementation

A
  1. Recommendation for 400 IU per day starting “soon after birth”
    - Continue until weaned to 1L of whole mild per day (12 months) — MILK not recommended under 12 months
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9
Q

Components of the WCV

-Risk Assessments

A
  1. Lead risk assessment at 6, 9, 18 months and 3-6 years
  2. Dyslipidemia risk assessments beginning at age 2
  3. TB risk assessment beginning at age 12 months
  4. Anemia risk assessment at 4, 18, and 24 months
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10
Q

Components of the WCV

-Vital Signs

A
  1. Growth measurements correlate directly to a child’s nutritional status (Objective)
  2. Linear growth — (Line straight across instead of an up curve)**
    —Can be: Malnutrition, chronic illness, psychosocial deprivation, hormonal disorders, or dwarfism
  3. Head circumference and length should correlate. Should be in the same percentile
    - Measure head circumference < age 2
    - Start BP > age 3
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11
Q

Components of the WCV

-Growth Charts

A
  1. Normal weight is anywhere from 5th - 85th percentile
  2. Overweight is 85th -94th percentile
  3. Obese is 95th percentile

Measurements correlate w/ child’s nutritional status

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12
Q

Components of the WCV

-Health Education and Anticipatory Guidance

A
  1. Injury and injury prevention
  2. Nutrition Counseling
  3. Emotional well-being
  4. Developmental milestones
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13
Q

Periodicity Schedule

A
  1. Published by the American academy of pediatrics
  2. Recommendations for preventative pediatric healthcare
  3. For a circle, you would screen every child
  4. For a star, you would only screen those who are AT RISK
  5. Autism screening is done at 18 months and 24 months
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14
Q

Examples of Screening Tools

A
  1. Developmental & Behavioral Screening tools
    - Parents evaluation of Developmental status (PEDS)
    - PEDS: Developmental Milestones (PEDS:DM)
  2. Developmental-ONLY screening tools
    - Ages and stages questionnaire
  3. Behavioral screening tools
    - Connors Rating Scale
    - Pediatric Symptom checklist
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15
Q

National Childhood Vaccine Injury Act (NCVIA)

-Requirements

A
  1. Date of administration
  2. VIS provided
  3. Date on VIS
  4. Manufacturer and lot #
  5. Name, address and title of person administering vaccine
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16
Q

Vaccine information **

-True and False ?’s

A
  1. All vaccines are held for minor illness?? FALSE
  2. You do not have to restart a documented vaccine series because the time between doses was too long? TRUE
  3. Patients on low dose steroids should hold vaccines until steroids are complete? FALSE - only hold for high dose steroids >1mg/kg
  4. A temperature should be routinely checked before administering vaccines? FALSE
17
Q

Puberty Definition

A
  1. Biologic process that leads to fertility
18
Q

Hypothalamic-Pituitary Gonadal Axis

A
  1. Responsible for release of Estradiol and Testosterone from ovaries and testes
  2. Leads to growth spurt, Adult body configuration, and adult hair distribution and voice changes
19
Q

Hypothalamic-pituitary Adrenal Axis (HPA)

A
  1. Responsible for the androgens DHEA and DHES

2. Leads to small role in growth spurt, adult body configuration, and adult hair distribution and voice changes

20
Q

Growth Hormone Axis

A
  1. Responsible for long bone formation leading to adolescent growth spurt
21
Q

Tanner Stages (Sexual maturity rating scales)

A
  1. 5 stages that categorizes secondary sexual characteristics
  2. Females — measurement of pubic hair and breast changes
  3. Males — Measurement of public hair and genitalia changes
22
Q

First sign of puberty in Females & Males?

A
  1. Females — Development of breast buds

2. Males — Enlargement of the testes

23
Q

Puberty Fun facts?

A
  1. Average timeframe is 4 years — can range from 1.5 yrs to 8 years
  2. Menarche typically occurs 2 years after breast budding
  3. Estrogen — biphasic effect on bone
    —Causes growth and also closes growth plate — early puberty can lead to early closure of plates — Refer to endocrinology
    —Early puberty is <8 years old.
24
Q

Brain Development

A
  1. Pre-frontal cortex — Planning and problem solving (Myelination and synaptic pruning)
  2. Executive Suite — Risk and reward, emotional regulation, problem solving, self-evaluation, long term planning (Mid 20’s)
  3. Cerebellum — Emotional processing (girls age 11, boys age 13.
25
Q

Leading Causes of Disease Worldwide

-Adolescents

A
  1. Developing Countries — HIV/AIDS and road injuries

2. Developed Countries — Mental disorders, especially depression

26
Q

Leading Cause of Adolescent Death in the US?

-Ages 15-19

A
  1. Accidents
  2. Suicide
  3. Homicide
27
Q

Systems to Monitor Adolescent Health

A
  1. National Survey of Children’s Health — Funded by maternal and child health bureau HHS
  2. Youth Risk Behavior Surveillance System — Measures risky behaviors among adolescents in the US - CDC managed
    -YRBSS monitored
    —Sexual behavior, high-risk substance use, Violence victimization, mental health and suicide
28
Q

Trends

-Ages 10-24

A
  1. 17.8% live in poverty
  2. High school enrollment increased, dropout rates have decreased
  3. College enrollment increased 12% in the last 30 years
29
Q

MVA’s

-Ages 10-24

A
  1. Mortality rate 18.8

2. Alcohol involved in 23% of drivers ages 16-20 and 41% of drivers ages 21-24.

30
Q

Mental Health

-Ages 10-24

A
  1. Suicide is second leading cause of death
  2. Rates are higher for males
  3. Attempts are higher for females
31
Q

Violence

-Ages 10-24

A
  1. Homicide is third leading cause of death ages 10-24
  2. Disproportionally affects males
  3. 81.6% are from firearms
32
Q

Exercise, Diet and Obesity

-Ages 10-24

A
  1. Exercise levels have remained stable since 1993
  2. Sedentary activity (Measured by 3 or more hrs of TV per day) has decreased — 35.4%
  3. Fruit and veggie consumption is 21.4%
  4. Obesity rates have TRIPLED over past 30 years — 1/3 of adolescents were overweight or obese 31%
33
Q

Worrisome Trends

A
  1. Hearing impairment
  2. Excessive UV exposure/tanning beds
  3. Illicit drugs “club drugs”
  4. E-cigarettes
34
Q

30% of Adolescents have a chronic condition

A
  1. Asthma
  2. Diabetes
  3. Allergies
  4. Seizure disorder
  5. Cystic fibrosis
  6. CHD
  7. Inflammatory bowel disease
  8. Obesity, HTN, Psych

Adv Prac Child Adolescent 6036 Test 1 COMPLETE ☑️ (5 decks)

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