Preventive Pediatrics Flashcards
EINC
Essential Intrapartum and Newborn Care
“Unang Yakap”
EINC Steps
- immediate and thorough drying
- early skin-to-skin contact
- properly-timed cord clamping
- non-separation, early breastfeeding
EINC Step 1
immediate and thorough drying
EINC Step 2
early skin-to-skin contact
EINC Step 3
properly-timed cord clamping
EINC Step 4
non-separation, early breastfeeding
Exclusive breastfeeding up to _____.
6 months
Continued breastfeeding up to _____.
2 years
Pregnant women should be informed about the deleterious effects of _____, _____ and _____ during pregnancy.
smoking, alcohol, teratogens
_____ immunization should be started or continued during pregnancy.
Tetanus Toxoid
Discharging newborns before 48 hours:
_____ antepartum, intrapartum and postpartum courses for both mother and newborn.
Uncomplicated
Discharging newborns before 48 hours:
Outcome
SVD, singleton, ≥ 37 weeks, AGA
Discharging newborns before 48 hours:
Vital Signs during the preceding 12 hours
RR < 60
HR 100-160
axillary T 36.5-37.4 (clothed, open crib)
Discharging newborns before 48 hours:
Output
with UO
at least 1 BM
Discharging newborns before 48 hours:
Breastfeeding
proper latch milk transfer swallowing infant satiety (-) nipple discomfort
Discharging newborns before 48 hours:
PE
normal
Discharging newborns before 48 hours:
Jaundice
(-) jaundice for the first 24 hours
Discharging newborns before 48 hours:
_____ and ability of the parents to _____.
Educability, care for the child
Discharging newborns before 48 hours:
Follow-Up
within 48 hours
How often should adolescents undergo health screening?
annually
HEEADSSS: H
Home
HEEADSSS: E
Education/Employment
Eating
HEEADSSS: A
Activities
HEEADSSS: D
Drugs
HEEADSSS: S
Sexuality
Suicidal Ideations/Depression
Safety
Adolescent Health Care: PE
Tanner Staging/SMR
Breast Examination
Spine and Shoulders (scoliosis, kyphosis)
Genitals and Anus
Adolescent Health Care: CBC
every stage of adolescence
Adolescent Health Care: urinalysis
first encounter
Adolescent Health Care: vaginal wet mount/Pap smear
sexually active females
Adolescent Health Care: serologic syphilis test
sexually active males
Adolescent Health Care: test for gonorrhea and chlamydia
sexually active males and females
Adolescent Health Care: Anticipatory Guidance and Counseling
self breast examination
healthy lifestyle
sexual behavior (STDs, HIV)
injury and accident prevention
Developmental surveillance should be done _____.
at every well child visit
Developmental Surveillance Components
parent's concerns developmental history observation of the child risk and protective factors document the process and findings
Developmental Surveillance: specified ages
9, 18 and 30 months
every year thereafter
Social-Emotional Red Flags:
lack of smiles or other joyful expressions
6 months
Social-Emotional Red Flags:
lack of reciprocal (back-and-forth sharing of) vocalizations, smiles, or other facial expressions
9 months
Social-Emotional Red Flags:
failure to respond to name when called
absence of babbling
lack of reciprocal gestures (showing, reaching, waving)
12 months
Social-Emotional Red Flags:
lack of proto-declarative pointing or other showing gestures
lack of single words
15 months
Social-Emotional Red Flags:
lack of simple pretend play
lack of spoken language/gesture combinations
18 months
Social-Emotional Red Flags:
lack of two-word meaningful phrases (without imitating or repeating)
24 months
Social-Emotional Red Flags:
loss of previously acquired babbling, speech or social skills
any age
Social-Emotional Red Flags:
6 months
lack of smiles or other joyful expressions
Social-Emotional Red Flags:
9 months
lack of reciprocal (back-and-forth sharing of) vocalizations, smiles, or other facial expressions
Social-Emotional Red Flags:
12 months
failure to respond to name when called
absence of babbling
lack of reciprocal gestures (showing, reaching, waving)
Social-Emotional Red Flags:
15 months
lack of proto-declarative pointing or other showing gestures, lack of single words
Social-Emotional Red Flags:
18 months
lack of simple pretend play
lack of spoken language/gesture combinations
Social-Emotional Red Flags:
24 months
lack of two-word meaningful phrases (without imitating or repeating)
Social-Emotional Red Flags:
any age
loss of previously acquired babbling, speech or social skills
Motor Red Flags:
lack of steady head control when sitting
4 months
Motor Red Flags:
inability to sit
9 months
Motor Red Flags:
inability to walk independently
18 months
Motor Red Flags:
4 months
lack of steady head control when sitting
Motor Red Flags:
9 months
inability to sit
Motor Red Flags:
18 months
inability to walk independently
Receptive Language Red Flags:
does not alert or quiet to sound
2 months
Receptive Language Red Flags:
does not turn to source of sound
6 months
Receptive Language Red Flags:
does not respond to own name
10 months
Receptive Language Red Flags:
does not follow verbal routines/games
12 months
Receptive Language Red Flags:
does not understand simple questions
does not stop when told “NO”
does not understand at least 3 different words
15 months
Receptive Language Red Flags:
does not point to 3 body parts
does not follow simple commands
18 months
Receptive Language Red Flags:
does not follow 2 part commands
30 months
Receptive Language Red Flags:
does not answer simple questions
36 months
Receptive Language Red Flags:
2 months
does not alert or quiet to sound
Receptive Language Red Flags:
6 months
does not turn to source of sound
Receptive Language Red Flags:
10 months
does not respond to own name
Receptive Language Red Flags:
12 months
does not follow verbal routines/games
Receptive Language Red Flags:
15 months
does not understand simple questions
does not stop when told “NO”
does not understand at least 3 different words
Receptive Language Red Flags:
18 months
does not point to 3 body parts
does not follow simple commands
Receptive Language Red Flags:
30 months
does not follow 2 part commands
Receptive Language Red Flags:
36 months
does not answer simple questions
Expressive Language Red Flags:
does not coo
6 months
Expressive Language Red Flags:
does not babble
10 months
Expressive Language Red Flags:
6 months
does not coo
Expressive Language Red Flags:
absence of pointing
14 months
Expressive Language Red Flags:
does not say 3 different spontaneous words
16 months
Expressive Language Red Flags:
vocabulary of not more than 35-50 words
does not produce 2-word phrases
24 months
Expressive Language Red Flags:
no simple sentences
36 months
Expressive Language Red Flags:
intelligibility to unfamiliar adult at 50%
42 months
Expressive Language Red Flags:
not able to tell or retell a familiar story
54 months
Expressive Language Red Flags:
not fully intelligible to an unfamiliar adult
60 months
Expressive Language Red Flags:
not fully mature speech sounds
> 72 months
Expressive Language Red Flags:
6 months
does not coo
Expressive Language Red Flags:
10 months
does not babble
Expressive Language Red Flags:
12 months
absence of non-verbal purposeful messages (show objects)
Expressive Language Red Flags:
14 months
absence of pointing
Expressive Language Red Flags:
16 months
does not say 3 different spontaneous words
Expressive Language Red Flags:
24 months
vocabulary of not more than 35-50 words
does not produce 2-word phrases
Expressive Language Red Flags:
36 months
no simple sentences
Expressive Language Red Flags:
42 months
intelligibility to unfamiliar adult at 50%
Expressive Language Red Flags:
54 months
not able to tell or retell a familiar story
Expressive Language Red Flags:
60 months
not fully intelligible to an unfamiliar adult
Expressive Language Red Flags:
> 72 months
not fully mature speech sounds
Eye and Vision Screening:
Premature infants who are _____, _____ and _____ should undergo screening.
≤ 32 weeks
≤ 1500 g
stormy medical course
Eye and Vision Screening:
Infants and children with _____ and/or _____ should undergo screening.
metabolic disorders
medical conditions with associated eye problems
Eye and Vision Screening:
Infants and children with a history of _____, _____ and/or _____ should undergo screening.
squinting
head tilt
head turn
Eye and Vision Screening:
Children with _____ and/or _____ should undergo screening.
visual difficulties
learning problems
Eye and Vision Screening:
Family History
strabismus amblyopia congenital cataract congenital glaucoma retinoblastoma ocular and systemic genetic diseases
Visual Acuity Assessment Tests
Fixes and Follows Test
Subjective/Formal Visual Acuity Testing
Visual Acuity Assessment:
test for preschoolers or children who are not familiar with letters
LEA Pictures Chart
Visual Acuity Assessment:
test for literate children
Sloan Letters
HOTV Chart
Visual Acuity: 3 years old
20/50 (10/25)
Visual Acuity: 4 years old
20/40 (10/20)
Visual Acuity: 5 years old
20/30 (10/15)
Ocular Motility Assessment
Corneal Light Reflex
Versions and Ductions
Cross Cover Test
Red Orange Reflex Examination:
Light reflects back from the _____.
choroidal blood vessels
LEA Chart:
Age
3 years old
LEA Chart:
Distance
6 meters (20 ft) or 3 meters (10 ft) 34-40 cm (14-16 in) - reading distance
LEA Chart:
Test Result
at least 4/5 symbols read correctly
Use of Fluoride Toothpaste
twice daily
Use of Fluoride Toothpaste:
6 mos. to < 2 y.o.
Fluoride Concentration (ppm)
1000ppm
Use of Fluoride Toothpaste:
6 mos. to < 2 y.o.
Minimum Daily Use
twice daily
Use of Fluoride Toothpaste:
6 mos. to < 2 y.o.
Amount of Toothpaste
smear
2.5mm / 0.125g
Use of Fluoride Toothpaste:
6 mos. to < 2 y.o.
Amount of Fluoride (mg)
0.25mg
Use of Fluoride Toothpaste:
2-6 y.o.
Fluoride Concentration (ppm)
1000ppm
Use of Fluoride Toothpaste:
2-6 y.o.
Minimum Daily Use
twice daily
Use of Fluoride Toothpaste:
2-6 y.o.
Amount of Toothpaste
pea size
5mm / 0.25g
Use of Fluoride Toothpaste:
2-6 y.o.
Amount of Fluoride (mg)
0.5mg
Use of Fluoride Toothpaste:
> 6 y.o.
Fluoride Concentration (ppm)
1500ppm
Use of Fluoride Toothpaste:
> 6 y.o.
Minimum Daily Use
twice daily
Use of Fluoride Toothpaste:
> 6 y.o.
Amount of Toothpaste
full length of bristle
10-20mm / 0.5-1g
Use of Fluoride Toothpaste:
> 6 y.o.
Amount of Fluoride (mg)
1mg
Topical Fluoride Treatment
every 6 mos.
Benefits of Breastmilk
- safe, sterile, always available
- perfect nutrients up to 6 mos.
- easily digested
- contains antibodies
- contains fats (DHA)
Advantages of Breastfeeding
- emotional bonding
- protects mother’s health
- return to pre-pregnancy weight
- financial savings
Correct Breastfeeding Techniques:
_____ the baby’s head and the entire body.
Support
Correct Breastfeeding Techniques:
Head, back and hips should be facing the _____ and aligned in a _____ manner.
breast, straight
Correct Breastfeeding Techniques:
Maintain the position of the baby in such a way that he is _____.
face to face
chest to chest
tummy to tummy
Correct Breastfeeding Techniques:
Support the breast with the hand of the _____ arm in a _____ position.
opposite, C-hold
Correct Breastfeeding Techniques:
Stimulate the infant to open the mouth wide by _____.
stroking the corner of the baaby’s lips
Correct Breastfeeding Techniques:
Check that the chin touches the _____ and the lower lip is turned _____.
breast, outward
Correct Breastfeeding Techniques:
Ensure that the baby grasps the _____.
entire nipple plus one inch of the surrounding areola
Correct Breastfeeding Techniques:
Allow the baby to suck _____ per breast to extract both _____.
15-30 mins., foremilk and hindmilk
Correct Breastfeeding Techniques:
Empty the breast around _____ a day.
8-10 times
Breastmilk Storage:
Store in _____ containers labeled with _____ of breastmilk collection.
sterile polypropylene (cloudy hard plastic), date and time
Breastmilk Storage: room temperature (<25°C)
4 hours
Breastmilk Storage: room temperature (>25°C)
1 hour
Breastmilk Storage:
refrigerator (4°C)
8 days
Breastmilk Storage:
freezer of a 1-door refrigerator
2 weeks
Breastmilk Storage:
freezer of a 2-door refrigerator
3 months
Breastmilk Storage: deep freezer (-20°C)
6 months
Diet of a Lactating Mother:
rice
6 cups
Diet of a Lactating Mother:
fruits
vitamin C-rich
different varieties
4 pieces
Diet of a Lactating Mother:
vegetables
green leafy
yellow
1 1/2 cups
Diet of a Lactating Mother:
meat, fish, poultry, seafood
5 matchbox-size pieces
2 cups cut into small pieces
Diet of a Lactating Mother:
eggs
4 pieces a week
Diet of a Lactating Mother:
beans
1 1/2 cups 3x/week
Diet of a Lactating Mother:
milk
2 glasses
Diet of a Lactating Mother:
fats
7 teaspoons
Diet of a Lactating Mother:
fluids
7 glasses of water
1 glass of fresh fruit juice
Complementary food must be:
- timely
- adequate
- safe
- properly fed
Introducing Complementary Food:
Begin with _____ to be given for _____.
one new food at a time, 3 days
Introducing Complementary Food:
Start with _____, giving _____ a day.
porridge, cereal, fruits, vegetables
1-2 teaspoons
Introducing Complementary Food:
pureed food
6 months
Introducing Complementary Food:
finger food
8 months
Introducing Complementary Food:
lumpy or chopped food
10 months
Introducing Complementary Food:
table food
12 months
Introducing Complementary Food:
6-8 mos., frequency
2-3x/day
Introducing Complementary Food:
9-24 mos., frequency
3-4x/day
Introducing Complementary Food:
snacks
1-2x/day
Introducing Complementary Food:
Do not add SALT before _____.
1 y.o.
Introducing Complementary Food:
Give _____ if diet is primarily plant based.
iron, zinc, calcium, vitamin B12
Child Maltreatment:
Recognize and report ongoing child maltreatment.
R.A. 7610
Child Maltreatment:
R.A. 7610
Recognize and report ongoing child maltreatment.
Child Maltreatment:
Establish Women and child protection in all government hospitals.
DOH Administrative Order 2013-0011
Child Maltreatment:
DOH Administrative Order 2013-0011
Establish Women and child protection in all government hospitals.
Anticipatory Guidance for Prevention of Violence Against Children (VAC):
Infancy
domestic violence
infant crying
dangers of shaking
Anticipatory Guidance for Prevention of Violence Against Children (VAC):
Toddler
domestic violence
positive discipline
safety in others’ homes or with other people
Anticipatory Guidance for Prevention of Violence Against Children (VAC):
Pre-School
domestic violence positive discipline safety in others' homes or with other people normal sexual behavior good vs. bad touch
Anticipatory Guidance for Prevention of Violence Against Children (VAC):
School Age
domestic violence positive discipline safety in others' homes or with other people normal sexual behavior good vs. bad touch bullying peer relationships mobile phone and internet safety