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Clin Med 1 Final > Routine Medical Care for the Well-Child > Flashcards

Routine Medical Care for the Well-Child Flashcards

1
Q

routine well-child visit schedule

A

1 week, 1,2,4,6,9,12,15,18,24,30 months, 3 years, 4 years, 5 years and annually thereafter

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2
Q

school physicals

A

K,6,9

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3
Q

sports physicals

A

annual

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4
Q

newborns lose…. in the first week of life

A

up to 10% of birth wt

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5
Q

weight gain in the first 6 months

A

1 oz/day

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6
Q

weight and height at one year

A

wt - 3X birth weight, height - 1.5X birth length

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7
Q

weight and height at 2+ years

A

gain 2-3 kg/ year, grow 5-7 cm/ year

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8
Q

30 month old

A

weights 30 lbs and is 30 in tall

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9
Q

4 year old

A

weighs 40 lbs and is 40 in tall

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10
Q

milestones from 1-12 months

A 
1 month - smiles
2 months - vocalizes
3 months - lifts head           
4 months - reaches
5 months - rolls over
6 months - sits alone
7 months - crawls
8 months - pincer grasp
9 months - pulls to stand
10 months - “cruises”
11 months - stands alone
12 months - walks alone
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11
Q

1 week visit

A

hx - feeding/I&O, sleeping
PE - W/L/HC, red reflex, hips, testes, jaundice in skin
screening - newborn blood and hearing if not done, bilirubin if jaundiced, immunization - Hep b #1 if not done
anticipatory guidance - sleep on back, car seats, illness s&s - fever, feeding, lethargic, etc.

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12
Q

1 month

A

hx - diet, I/O, sleep, concerns
milestones - turns head to side, follows to midline, smiles
PE- W/W/HC, full exam
no screening
Hep B #2
anticipory guidance - crying peaks at 4-6 weeks, illness, sibling rivalry, support/relief for parents

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13
Q

2 months

A

Hx
Milestones - smiles, vocalizes, follows past midline
PE- W/L/HC, full exam
no screening
immunization - DTap, Hib, IPV, PCV, Rota #1
anticipatory guidance - always watch, thumb-sucking, sleeping in crib now

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14
Q

4 months

A

hx
milestones - lifts head, eyes follow 180 degrees, squeals, rolls front-to-back
PE- W/L/HC, full exam,
no screening,
immunization - DTaP #2, Hib #2, IPV #2, PCV #2, Rota #2
anticipatory guidance - feeding & solids, falls, choking, teething

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15
Q

6 months

A

hx
milestones - sits alone, head lag gone, reaches for objects
PE- W/L/HC, full exam
no screening
immunization - DTaP #3, Hib #3, Hep B #3, PCV #3, Rota #3 if needed
anticipatory guidance - poisoning and OTC med doses, no walkers, gates, no unattended baths

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16
Q

9 months

A

hx
milestones - teeth, crawls, pincer grasp, looks for dropped objects
PE- W/L/HC, full exam
developmental screening
immunization - IPV #3
anticipatory guidance - table foods, chocking hazards, stop night bottle, try spoon and cup

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17
Q

12 months

A

hx
milestone - cruises, stands alone, walks?, says 1-2 words
PE - Wt and ht?, HC, Full exam
H/H screening
immunization - MMR, Varicella, Hep A
anticipatory guidance - whole/2% milk, time-out, allow to feed self when possible

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18
Q

15 months

A

hx
milestone - two block towers, 3-6 words, hugs, takes lids off containers
PE - W/H/HC, full exam
no screening
immunization - PCV #4, Hib #4, DTaP #4, anticipatory guidance - appetite fall-off, childproof home, temper tantrums, masturbation

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19
Q

18 months

A

hx
milestones - walks well/ runs, climbs, scribbles, points/asks for wants
PE - W/H/HC, full exam
screen- development, autism
no immunizations
anticipatory guidance - 3 meals with healthy snacks, injury prevention, toilet training?

20
Q

24 months

A

hx
milestones - vocab of 50 words, 2-word phrases, 5-6 block towers, throws ball overhand, kicks ball
PE - H/W, BMI
screening - autism if didn’t pass 1st time
immunization - hep A #2
anticipatory guidance - decreasing appetite, low-fat milk, needs peers, safety incl. guns, sharing difficult, toilet training

21
Q

30 months

A

hx
milestones - short sentences, 50% understandable by non-parents, jumps, points to 6 body parts
PE - H/W/BMI, practice BP
screening - development
anticipatory guidance - peer play opportunity, read books and talk to child, offer 2 choices, safety incl. swimming

22
Q

3-4 years

A

milestones - all teeth, helps with dressing, 200-500 words, first/last name
PE - W/H/BP/BMI
screening - vision, hearing, oral health, no immunization
anticipatory guidance - 3 meals with limited snacks, appropriate TV, movies and internet, 911, sharing with peers, normal sexual curioisity

23
Q

4-6 years

A

hx
milestones - skips, dresses/undresses, knows age and phone number,
full PE
screening - U/A, H/H, vision, hearing, oral health, immunization - DTaP #5, IPV #4, MMR #2, Varicella #2,
anticipatory guidance - school preparedness

24
Q

7-10 years

A

hx, PE, screening - lipids at around 10, no immunizations

25
Q

11-12 years

A

hx, physical,

vision screening at 12, depression annually, immunization Tdap x 1, HPV (3 dose series), MCV4 Dose #1

26
Q

13-18 years

A

hx, physical
screening - annual depression, STI/HIV 16-18 years, vision at 15 and 18,
immunization - MCV4 dose #2 at 16

27
Q

U/A

A

kindergarten, HS

28
Q

H/H

A

12 months, kindergarten, HS

29
Q

lead screening

A

preschool or with risk factors

30
Q

Tb

A

preschool, kindergarten, 5th grade

31
Q

lipids

A

10, 18+, or obesity, HTN, +FH

32
Q

teething

A

eruption of primary teeth at 6 months (4-12), complete by age 3, may cause fussiness, drooling, decreased appetite, low-grade fever, tx with tylenol, teething rings, caution with topical anesthetics

33
Q

thumb-sucking

A

nonnutritive sucking on fingers or pacifier, normal at first - reflex, self-soothing habit, most kids stop by 2-3, dental problem if 4+, gentle reminders work better than fancy, expensive things

34
Q

toilet training

A

kids start around 18-24 months when they have adequate biological and neurological development, takes weeks - months to master, don’t force issue, kids will win every time, if failing - stress, constipation, spina bifida occulta, genital anomalies evaluation

35
Q

bedwetting

A

nocturnal enuresis, 5+ for girls, 6+ for boys, r/o diabetes, may be due to small bladder or deep sleeper, often +FH, tx: avoid late fluids, trial of alarms and meds, do not punish

36
Q

discipline

A

age appropriate - redirection for infants, ifnore for toddlers, tim-out - 1 min/1 year of life, reward desired behavior, reason as they get older, make consequences predictable/immediate, discourage shame, scolding, spanking

37
Q

safe bedding for infants

A

place baby on back on firm fitting mattress in a crib with current safety standards met, remove other things from crib and use a sleeper or sleeping clothing as alternative to blankets, make sure babies head is uncovered during sleep, no waterbed, sofa, soft mattress, pillow, etc to sleep

38
Q

car seats -infant only

A

backwards until age 2 or 2+ until wt/ht too much for st

39
Q

convertible car seats

A

forward facing, back seat until highest wt/ht for seat

40
Q

booster seats

A

forward facing, backseat until tall enough for belt

41
Q

seat belts only

A

4’9” and 8-12 years old, backseat only until 13

42
Q

choking hazards

A

foods, small toy parts, balloons, coins, marbles, beads, necklaces, plastic bags, blinds cords

43
Q

walkers

A

34 death since 1973, send 14,000 children to hospital annually, DO NOT help infants walk sooner

44
Q

siblings

A

baby jealousy, toddler safety, less fighting with parental identification and talk about feelings, focus on unwanted behavior but most of all catch them being good!

45
Q

accidental ingestions

A

meds, cleaning agents, plants, perfume, lead, insect baits, antifreeze, baby oil - call US National Poison Hotline

Clin Med 1 Final (6 decks)

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