Module 15: Pediatric Flashcards
1
Q
Components of Pediatric Wellness Exam
A
- Vision and hearing screening
- Developmental/behavioral screen
- Autism screen
- Laboratory and immunizations
2
Q
Developmental Surveillance
A
- Flexible and continuous process
- Skilled observations performed during the provision of healthcare
Includes:
-Eliciting and attending to parental concerns
-Obtaining relevant developmental hx
-Making accurate and informative observations
-Sharing opinions and concerns w/ family and other relevant professionals
3
Q
Developmental Screening
A
- Uses a standardized test ( SCREENING is NOT Diagnostic)**TEST
- Used when surveillance detects an abnormality or periodically at 9, 18, or 30 month visit
- Autism screening at 18 and 24 month visit
- Identifies risks
- NOT Diagnostic
4
Q
Vital Signs and Measurements
A
- Growth charts — Birth to 36 months AND 24 months to 19 years
- BP starting at age 2
- Measure head circumference — birth to age 3
- Use appropriate BMI for age.
- >/=95 is obesity
- >/=85th <95th percentile is overweight
5
Q
Growth in children
A
- Growth velocity or growth rate in a child one of the MOST IMPORTANT Vital signs
- Children should grow about 2 inches (5 cm) per year
6
Q
Neonatal Period?
A
- 0 to 29 days is the neonatal period
7
Q
Infants
-0-6 months
A
- Competencies — Adaptation to extra uterine life and building a relationship w/in the family
- Morrow or startle reflex
8
Q
Infants
-Hints for a successful Exam
A
- Observation alone may be the MOST essential aspect of PE
- Observe general level of activityTEST
- Mood
- Parent-child interaction
- Turning to sound - hearing check
- Smiling at toy - vision check
- Rolling, crawling
9
Q
0-6 months Exam
A
- Approach gradually, use a toy for distraction
- Examine in parents lap
- Speak softly or mimic the infant’s sounds to attract attention
- Assess visual tracking, response to sound and tone before touching the infant
10
Q
6-12 months
-Exploring and clinging
A
- Average weight gain is 1 ounce per day
- Stranger danger — Avoid eye contact w/ infant
- Increasing mobility brings increased risk for injury
- Develop will and intention
- Advances in cognition and language
- Discovery of hands and body parts
11
Q
Infant Reflexes
A
- A complete PE, preferably w/ the child UNCLOTHED
- Check primitive Reflexes
- Rooting (Newborn - 3-4 months)
- Sucking (N - 3-4 months)
- Moro (startle) (N - 3-4 months)
- Grasp palmar, plantar (N - 3-6months)
- Pacing/stepping (N - 1-2 months) — Leg crossing is abnormal
- Tonic neck (N - 3 months)
- Babinski (N-12 months or when walking)
12
Q
Fontanelles
A
- Anterior fontanelle closes between 4-26 months of age
- If it closes early, keep an eye on head circumference
13
Q
Weight gain and Height for 1st Year?
A
- By 1 year, the birth weight TRIPLES and height increases by 50%
- Double birth weight at 6 months
14
Q
Tips for Examining the Young Child
A
- Using reassuring voice throughout the exam
- Let the child see and touch the exam tools you will be using
- Avoid asking permission to examine a body part — Ask, which body part you would like to start w/
- Examine child on parent’s lap — Allow parent to undress child
- If unable to console the child, allow a short break
- Make a game out of the exam
15
Q
Pre-school (3-5 yrs)
A
- Imagination, creativity, curiosity, and enthusiasm
- “Kids say the earnest things”
- Advanced gross motor skills — roller skating, dancing, riding a two wheeler
- Make the exam a game “Let’s see how far you can stick out your tongue”
- Allow child to see and touch the tools you will be using
