Well Child Flashcards
Examine an older infant/young child v. school age child?
Infant - on parent’s lap
Older child - on exam table
How much of upper arm should the BP cuff cover?
2/3 of upper arm
too large = falsely low BP
too small = falsely high BP
What four things are documented on growth chart?
Height, weight, Head Circumference (if under two years), BMI
Less than 2 years old v. older than 2 years old - how to do you measure growth for growth curve?
0-2 = length (lay down) 2-18 = height (takes into account lumbar lordosis)
Chest deformity when chest caves inward.
Pectus Excavatum.
Chest deformity when chest is convex outward.
Pectus Carinatum
Four listening posts
Aortic, Pulmonic, Tricuspid, Mitral (MV/LV by apex)
First Heart Sound
normal splitting S1 may be appreciated.
Should you hear splitting of second heart sound (S2) in a child upon inspiration or exhalation?
Inspiration, because of increased filling of right heart, causing PV to close later than AV.
Why are there cardiac murmurs in kids?
Consequence of turbulent flow - not all indicate structural or pathologic cardiac problems.
What grade murmur (and above) is never normal? What does this level sound like?
Grade 4 - associated with a thrill.
Grade 5 thrill with steth barely touching chest wall.
Grade 6 thrill with steth NOT touching chest wall.
Anticipatory Guidance
see powerpoint
Components of a well-child exam
see powerpoint
How to approach different aged children in physical exam
see card 1
