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Block 11; Week 1 > Pediatric Well Visits > Flashcards

Pediatric Well Visits Flashcards

1
Q

Describe ROWS. What do you measure?

A 
Length/Height and Weight
Head Circumference
Weight for Length
Body Mass Index
Blood Pressure
BMI starts at 2 yo
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2
Q

Sensory screening or developmental/behavioral assessment with ROWS?

A 
Sensory Screening:
Vision
Hearing
Developmental/Behavioral Assessment:
Developmental Screening
Autism Screening
Developmental Surveillance
Psychosocial/Behavioral Assessment
Alcohol and Drug Use Assessment
Depression Screening
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3
Q

When are newborns screened for the 1st & 2nd time?

A

1st time in the hospital

2nd time at 2 weeks.

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4
Q

Procedures in ROWs?

A 
Newborn Blood Screening
Critical Congenital Heart Defect Screening
Immunization
Hematocrit or Hemoglobin
Lead Screening
Tuberculosis Testing
Dyslipidemia Screening
STI/HIV Screening
Cervical Dysplasia Screening
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5
Q

WHen should you have your first oral health exam?

A

by 1 year of age.

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6
Q

What is the screening test for ADHD?

A

Vanderbilt/Conners

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7
Q

What is considered overweight or obese for children?

A

overweight>85%

obese>95%

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8
Q

What is considered hypertensive?

A

Normal 95%

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9
Q

50% of kids are Vit D deficient. When?

A

breastfed

400 IU Vit D/day recommend.

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10
Q

Is there fluoride in the Reno water?

A

No

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11
Q

First vaccine a baby receives in the hospital?

A

Hep B

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12
Q

What are some good nutrition recommendations?

A 
low fat or non fat dairy
more fish
5 fruits & vegetables
whole grains
no sugary beverages
reduce salt intake
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13
Q

When can kids start taking solid food?

A

after 6 months

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14
Q

When can kids eat meats & finger foods? Table foods?

A

9 months–meats, finger food

12 months–table foods

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15
Q

How much physical activity should kids get per day?

A

1 hour of vigorous activity

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16
Q

How much screen time is recommended per day?

A

1-2 hours limit

17
Q

How much should kids sleep per night?

A

ideally 11 hours/night

18
Q

What is some important safety counseling for kids?

A

firearm safety
sports safety
traffic safety
water safety

19
Q

What are we worried about the physical exam of a newborn?

A
  1. weight
  2. skin–look for jaundice
  3. cardiac exam
  4. hips
  5. umbilicus
  6. take care of mom & counsel about stuff
  7. cord care
20
Q

What should you think about at 2 weeks old?

A

should have regained birth weight by this time
GERD
6 wo hip ultrasound if born breech.

21
Q

What do we talk about at 2 months?

A 
tummy time
no solid foods
no propping bottles
look for strabismus: refer by 6 mo if hasn't corrected
check hips
other safety talks
look for smiles
immunizations
vitamin D
22
Q

4 mo check up?

A 
Smiles spontaneously, self-consolation, babbles, rolling over, lifts head/chest, reaches for toys & brings to mouth, no head lag when pulled to sitting, laughs
Quiet and active playtime
Hip time/check folds
Injury prevention
Teething
23
Q

6 mo check up?

A

Socially interactive with parent, recognizes familiar faces, knows name, visual/oral exploration, sits with support/stands and bounces, may crawl, transfers objects hand to hand, pincer grasp (fine motor)
Start use of high chair/upright seat. DO NOT use a walker.
Reciprocal play
May introduce solids at 6 months
Start cereal, baby foods stage 1. Spoon ONLY (not in a bottle)
One new food per week. Finger foods should be soft. No citric acid products, no whole milk, avoid nuts
Review choking hazards
Solids do not replace breast milk/formula needs.
Begin cup use. Limit juice. May now have water.
Assess for fluoride, clean teeth with wet washcloth or finger brush

24
Q

9 mo check up?

A

Stranger Danger, separation anxiety, responds to name, waves bye-bye, mama/dada babble, points to objects, interactive games (peek-a-boo, pat-a-cake), exploring environment: crawling/cruising, pulls self up
Use consistent, positive discipline (limit use of the word “no”)
Strangulation/fall risks (stairs, gates, cords from drapes/blinds)
Play with cause-and-effect toys
3 meals, 2 -3 snacks daily, decrease BM/formula
Encourage use of cup
*Put Poison Control number at each telephone

25
Q

What happens at 12 mo?

A

Interactive games, imitates activities, waves “bye-bye,” speaks 1-2 words, follows simple directions, stands alone, may walk
Discipline with time-outs and positive distractions
Continue 1 nap per day
Establish teeth brushing routine
Encourage self-feeding
Whole milk! (16-24oz/daily) And mostly table foods. Juice less than 8 oz/day
Baby decides quantity of food/parents choose types of food
Visit dentist by 12 months or after first tooth
Offer only water if still using a bottle/discontinue bottle use
Remove guns from home
Rear-facing car seat until 2 years per AAP recommendations/1 year AND 20 lbs by law (and even longer if possible!)
Check CBC or H/H 9-12 months old (AAP), check lead if at risk

26
Q

15 months old?

A

Listens to a story, may help in house, brings objects to show, says 2-3 works, scribbles, can walk backwards, climbs stairs, 3 block tower, drinks from cup
Check for any speech delay
Allow child to choose between 2 acceptable options
Consistent bedtime routine
Do not give bottle in bed
Praise good behavior
Injury prevention

27
Q

18 months old?

A

Laughs in response to others, explores alone, speaks 6-10 words, 4 cube tower, points to 1 body part, walks up steps/runs, stacks 2-3 blocks, uses spoon/cup without spilling
MCHAT (18-24 months) autism screen
Support emerging independence but reinforce limits
Encourage language development by reading and singing
Toilet training: wait until child is ready (dry for periods of about 2 hours, knows wet and dry, can pull pants up/down, can indicate bowel movement)

28
Q

2 years?

A

Imitates adults, refers to self as “I” or “me,” has at least 50 words, uses 2 word phrases, follows 2 step commands, stacks 5-6 blocks, imitates horizontal and circular strokes with crayon, jumps, runs well, throws/catches, 7 cubes
Read together daily
Encourage interactive play with other children
Encourage self-expression
Plan for frequent toilet breaks (up to 10 times/daily)
Change to 2% milk
Check cholesterol screen if + Fam hx/risk factoss
Check for obesity with BMI! PLOT it!!
Temper tantrums

29
Q

3 years?

A 
Feeds self, sentences, jumps in place, balances on one foot, counts 3 objects.
Start yearly vision/hearing screen
Check growth/nutrition
75% speech comprehended
Start BP checks annually
30
Q

4 years?

A

100% speech comprehension, sings, talks about experiences, hops, pedals tricycle
Counting/ABCs/Coloring
Check vision/hearing
Inappropriate touch counseling

31
Q

5 years?

A

Skips, balances well, copies figures, dresses self, defines words, sense of “right and wrong”
Increased strength and coordination

32
Q

Adolescents?

A 
CRAFFT screen/HEADSS
Menarche/family planning/STD (esp chlamydia)
No pap needed
Tanner staging
Confidentiality issues
33
Q

What does HEADSS stand for?

A 
Home & Environment
Education & Employment
Activities
Drugs
Sexuality
Suicide/Depression
34
Q

Which are the first teeth to peek out?

A

lower incisors

35
Q

What are the most effective ways to talk to parents about vaccines who are hesitant?

A

Talk about Side Effects & be honest, but emphasize that autism isn’t one of them.
talk about benefits directly to the child, rather than society
use anecdotes, rather than numbers.

36
Q

Thimerosal is a preservative in very few vaccines, none of which are used in children under 6…what are parents worried about?

A

mercury
but prob not dangerous
not even used anymore

37
Q

Is it a problem to use multiple vaccines in a child?

A

NO

Block 11; Week 1 (15 decks)

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