Pediatric visit and the newborn Flashcards
what are the first 28 days of life considered
newborn/neonates
what ages are considered mild childhood
5-10 years old
also known as elementary
what is the age group of 1-4 year olds called
early childhood
what is the age group of 10-20 year olds
adolescence
what is another name for Well Child Check (WCC)
Pediatric Health Supervision Visits
what are the goals of pediatric visits?
disease detection
disease prevention
health promotion
anticipatory guidance
what is anticipatory guidance
age specific advice
-more parental than child
When is developmental surveillance done?
it is an ongoing process
done at every visit
parental history
skilled, experienced observation
when is developmental screening done
it is a formal process that uses a standardized tool
universal screenings at specified ages
selective screening when risk assessment raises a concern
what are the main differences between adult and pediatric evaluations
getting history from parent
need to get both child’s and parents’ perspectives especially as child gets older
note parent-child interaction
parental emotions and behaviors
What is the difference with past medial history for pediatric patients
prenatal history of the mother
birth history
newborn history (included for all children three and under)
what is the important components of prenatal history
mothers age at delivery
previous pregnancy history
maternal illnesses during pregnancy
medication exposure during pregnancy
complications of pregnancies
what are the important factors of the birth history (perinatal)
duration of pregnancy
kind and duration of labor
type of delivery
use of medications during delivery
condition of child at birth
need for resuscitation at birth
apgar scores
complications of delivery
what are components of pediatric health maintenance
feeding/nutrition
growth and development
immunizations
sleep patterns
elimination patters
dental care
safety
what is HEADSS
social history in teens
Home
Education and Employment
activities
drug use
sexual activity/sexuality
suicide
what is the Apgar score
scoring system to assess the need for resuscitation and the response to resuscitation (if needed)
- done at 1 minute and 5 minutes in ALL newborns
what is assessed with the Apgar score
Heart rate (pulse)
Respirations
Muscle tone (activity)
Reflex irritability (grimace)
Color (appearaance)
1 minute Apgar score of 0-4 is indicative of
severe depression, requiring immediate resuscitation
1 minute Apgar score of 5-7 is indicative of
some nervous system depression
1 minute Apgar score of 8-10 is indicative of
normal
5 minute Apgar score of 7-10 is indicative of
reassuring
5 minute Apgar score of 4-6 is indicative of
moderately abnormal - need close attention
5 minute Apgar score of 0-3 is indicative of
low
what is lanugo
fine downy growth of hair over the entire body
more prominent in preemies
shed in the first few weeks of life
what is vernix caseosa
present at birth - white paste
what should be evaluated if there is central cyanosis/mucous membranes
evaluate for congenital heart disease
what type of cyanosis is normal after birth
Acrocyanosis (first 24-48 hours) blue hands and feet
what is Milia
“newborn acne”
pinhead white raised areas due to retention of sebum in the openings of sebaceous glands
can be present at birth
appear within first few weeks of life
gradually disappear
what is Pustular Melanosis
more common in African Americans
small, vesiculopustular lesions with a brown macular base
last for several months
what is erythema toxicum
appear on day 2-3
erythematous macules with central pinpoint vesicles
over whole body
unkown etiology
disappear in a week or so
what is nevus simplex
aka salmon patch or stork bite
what is congenital dermal melanocytosis
aka mongolian spot
most common in asian populations
blue-grey patch, usually in sacral-gluteal region or shoulders
fade during first 1-2 years of life, most disappear completely by age 10 years
what is a port wine stain
aka nevus flammeus
capillary malformations in the skin
usually, an isolated patch
growing in proportion to the childs growth
look for underlying disease
what is sturge-weber syndrome
rare congenital capillary-venous malformations in the brain and eye
what are the primitive reflexes
Moro reflex
Grasp reflex
Stepping reflex
Rooting reflex
babinski
Asymmetrical tonic neck reflex
what is the Moro reflex
aka startle reflex
sudden, slight dropping of head from slightly raised supine position: opening of hands, extensions and abduction of arms, then flexion of arms and crying
disappears by 5-6 months
when does the palmar grasp reflex disappear
by 5-6 months
when does the plantar grasp reflex disappear
by 9-10 months
when does the stepping reflex disappear
by 1-2 months
when does the rooting reflex disappear
by 2-3 months
when does the babinksi sign disappear
between 9-24 months
what are the universal newborn screenings
hearing (otoacoustic emissions, automatic auditory brainstem response)
metabolic and genetic disorders (inborn errors of metabolism)
Endocrine disorders (cong. hypothyroidism, or adrenal hyperplasia)
Hemoglobinopathies
