The 6 week check

Question 1

What are the 4 components of the check

Answer 1

1 - a physical examination
2 - a review of development
3 - an opportunity to give health promotion advice
4 - an opportunity for the parent to express concerns

Question 2

What are the first 4 steps of the physical examination

Answer 2

weight check
measure head circumference
general assessment of appearance - colour, behavior, breathing, activity
Assessment of tone, movements and posture

Question 3

Describe the head to toe physical assessment - 8

Answer 3

Assessment of head: fontanelles, face, nose, palate, symmetry.

Assessment of the eyes for the presence of the red reflex and visual fixing.

Assessment of the heart: position, murmurs, rate, femoral pulses

Assessment of the lungs: added sounds and rate.

Assessment of the abdomen: shape, organomegaly, herniae.

Assessment of the genitalia: normality, testicular descent

Examination of the hips (by Barlow and Ortolani tests, and by looking for symmetrical skin creases in the thighs).

Assessment of the spine.

Question 4

What does no femoral pulse indicate

Answer 4

Coarctation of the aorta

Question 5

How does a PDA present

Answer 5

a continuous murmer at the upper left sternal border.

Question 6

How does developmental dysplasia of the hip (DDH) present - 3

What should you do if suspicious

Answer 6

Leg-length discrepancy
Asymmetry of leg creases
Positive Barlow and Ortolani tests

Refer promptly for USS - must detect this early for chance of successful treatment

Question 7

What is the red reflex test looking for

Answer 7

Cataracts or corneal abnormalities

Question 8

What serious condition of the eye should parents be asked about family history wise

Answer 8

Retinoblastoma

Question 9

What is the course of action if testes are undescended in the scrotum

Answer 9

If undescended, they can be monitored until 1 year

At a year, if still not descended then surgical treatment must take place

Question 10

What does the review of development entail - 4

Answer 10

• review feeding a weight gain
• check growth chart in red book
• review vision and hearing, majority of neonates are screened before they leave hospital
• check if baby is smiling and making sounds

Question 11

What health promotion advice can be given - 6

Answer 11

• vaccinations
• breastfeeding and weaning
• dangers of passive smoking
• safe sleeping
• car safety
• dental health