Screenings Flashcards
what is the importance of anticipatory guidance?
answering commonly asked questions
anticipate parent concerns
opportunity for education
sharing resources that are available
what are common topics of preventative care?
illness/injury update growth developmental milestones socialization and emotional concerns nutrition sleep home environment risk/safety immunizations screening needs
what are common problems brought to you by parents?
crying infant
temper tantrums, aggressive behavior
sleep and eating problems
fever
self settling should begin around what age?
2 months
risks are ___ specific
age
what are recommendations for screenings?
standardized and performed at ket dev. ages performed
when should STI and HIV screenings be performed?
STI: high risk
HIV: age 17
visual acuity tests should begin at age __
3
when should an ophthalmoscope exam be performed?
6-12 mo
likely not sufficient until 3 y.o
at age 0-3 months what eye exams will you perform?
red reflex
inspection
pupil exam
at age 3-6 what eye exams will you perform?
red reflex
inspection
pupil exam
FIXATION
at age 6-12 months what eye exam wil you perform?
red reflex inspection pupil exam fixation cover/uncover
at age 3 y.o. what eye exam will you perform?
red reflex inspection pupil exam fixation cover/uncover VISUAL ACUITY
___ problems are one of the most common conditions present at birth
hearing
children should be able to hear as low as ___ dB and hear pitch from___-___ Hz
20
250-8000
when is the 1st hearing screening performed?
new born with the auditory brainstem response (ABR) test or the evoked otoacoustic emissions (EOAE) test
when should you Screen infants who require neonatal intensive care w/ ABR technology ?
before they are d/c
when shoudl you screen Screen infants who were born outside a hospital or birthing center or who were d/c before receiving hearing screening?
by 1 month of age
when shoudl you Refer for a formal audiologic evaluation?
Intervention services should start by no later than____
no later than 3 mo of age or w/in 3 mo of d/c from NICU
6 mo old
Screening w/ standard hearing test are performed at what key developmental ages:
Infancy
Early Childhood: 4 y/o
Middle Childhood: 5, 6, 8, 10 y/o
What are RF for hearing problems?
- FHX of permanent hearing loss
- NICU care of >5 days
- Infxns assoc. w/ hearing loss
- Craniofacial abnormalities
- Chemotherapy
- Chronic or recurrent OME for at least 3 mo
- PE findings assoc. w/ sensorineural or conductive hearing loss
- Head trauma
When should you Use validated developmental screening tools
Infancy - 9 months
Early Childhood – 18 and 30 months
Any time when the parent or provider has a concern
what si the screening tool used for Autism Screening
MCHAT
according to the AAP and Bright Futures autism screenings are recommend when?
when does the CDC recommend screening?
At 18 and 24 months & any time parent raises concern
18, 24, and 30 months
when should BP screenings begin?
age 3
what are the recommendations for assessing BP?
SBP and DBP < 90th: normal BP
SBP and/or DBP > 90th: Repeat measurements x2, average readings
BP > 90th: See National Heart, Lung, and Blood Classification of HTN in Children and Adolescents chart
what are the tx for Normal or prehypertensive?
Hypertensive?
Healthy diet, Physical activity
If overweight→ counseling and referral if needed
Consider meds, change diet/physical activity level
when are laboratory screenings collected?
at least 24 hrs after birth but <7 days of age
__% children in US live in housing w/ deteriorating lead paint
25
Blood lead levels as low as __ mcg/dL have been assoc. w/ adverse effects on cognitive development, growth, and behavior in children 5 y/o and younger
10
__% of American children enrolled in Medicaidw/ blood levels >__ mcg/dL
83
20
how often are Medicaid enrollees screened for lead?
by 12 months age
24 months
36-72 months if not tested earlier
when are Refugees and Internationally adopted children screened for lead?
Upon arrival in US
Repeat in children < 6 y/o in 3-6 mos after permanent placement
When does the AAP/Bright Futures for non-Medicaid children recommend Screening for lead?
According to local or state HD recs,
otherwise at 12 and 24 mo unless lead exposure can be confidently excluded
Know risk factors
who is at risk for Lead poisoning?
Housing built before 1950 = prime source of lead contamination
when should a child be screened for Iron Deficiency Anemia
Performed @ 12 mo.
what are some consequences of iron deficiency anemia?
developmental delays
behavioral disturbances that may persist past school age unless the deficiency is treated
Population at Risk for iron deficiency anemia
Infants on WIC
Infants and children of migrants or recent refugees
Preterm or low birth weight infants
Breastfed infants >6 mo not getting adequate iron from supplementary foods
Infants who do not receive sufficient iron after 4-6 months of age
Infants fed cow’s milk <12 mo, children >12 mo who drink >24 oz milk/day
Infants and children at risk because of special health care needs
Children who follow strict vegetarian diet without iron supplementation
Adolescent females who have begun menstruating
Children/teens with other risk factors
what are the Recommendations for iron def. anemia?
4, 18, and 24 months
Annually between 3 and 21 years
when does the AAP and Bright Futures recommend iron def. anemia screening:
All infants at 12 months
All non-pregnant females (11-21) every 5-10 years
Anyone at risk
when are TB Screening Recommended?
All HIV-infected children/teens annually
All incarcerated teens annually
when are Risk Assessment Recommendations for TB?
Infancy: by 1 month; at 6 months
Early Childhood: 12, 18, and 24 months; 3 and 4 y/o
Middle Childhood and Adolescent: Annually
when should a child be screened for dyslipidemia?
children and teens at high risk
when should dyslipidemia screenings be perform?
24 months and 4 y/o
6, 8, and 10 years
Annually 11-21 y/o
All teens once between 18 and 21 y/o
Screen children and teens at high risk
