Well Child Checks (WCC)

Question 1

True/False: A child should be undressed and in a gown for WCCs

Answer 1

True

Question 2

These are the areas surveyed during WCCs:

Answer 2

1. Growth 2. Nutrition, Elimination patterns, Sleep 3. Language 4. Gross/Fine motor skills 5. Personal/social behaviors 6. Safety 7. Anticipatory guidance

Question 3

What is the WCC schedule?

Answer 3

1-2 weeks, 2, 4, 6, 9, 12, 15, 18 Months, 2, 3, 4, 5 Years, Annually through 21yo

Question 4

These are the history components of a WCC:

Answer 4

• Growth Pattern
  
  • Weight, Length and HC (<2yo), BMI
• Developmental Milestones
• Nutrition
• Elimination Pattern
• Sleep Pattern
• Social Interaction/Language development

Question 5

These are the PE components of a WCC:

Answer 5

• Vitals (HR, Resp, BP 3yo+)
• Weight, Length/Height, HC, BMI (>2yo)
• Skin
• HEENT
  
  • Fontanelles
  • Vision exam 3yo+, Visual tracking, Red reflex, Corneal light reflex
  • Hearing test 4yo+
• Neck
• Respiratory
• Cardiac
• Abdomen (auscultation, percussion, palpation)
• Genitalia
• Femoral pulses
• Hips (<2yo check for congen. dislocation)
• Extremities/MSK
• Neuro (musc tone, hand grasp, DTRs, developmental milestones)

Question 6

At what age should a child be screened for lead?

Answer 6

1 year, 2 years, and 4 years

Question 7

At what age should a child be screened for Iron deficiency anemia?

Answer 7

1 year via CBC

Question 8

At what age should a child’s cholesterol be checked?

Answer 8

Between 9-11yo and again 17-21yo

Question 9

Define Newborn

Answer 9

First 28 days of life

Question 10

Define infancy

Answer 10

1 month - 1 year

Question 11

Define Toddler

Answer 11

13 months - 2 years

Question 12

Define Preschool years

Answer 12

3 - 5 years

Question 13

What occurs during puberty that leads to menarche in girls?

Answer 13

Ovaries begin to increase production of estrogen and progesterone

Question 14

What is the first sign of puberty in females?

In males?

Answer 14

Breast development = 1st female sign

(Normal sequence of puberty changes occur over 2 years: breasts, inc height, inc hip size, clear/whitish vaginal secretions, pubic/axillary/leg hair growth, menarche. Puberty usually complete by 17yo)

Enlargement of Testicles = 1st male sign

(Faster growth, esp height, hair growth in axilla/face/pubic, inc shoulder width, growth of penis, nighttime ejaculations, voice changes)

Question 15

Define Tanner Stage 1

Answer 15

Prepubertal with no pubic hair

Question 16

Define Tanner Stage 2

Answer 16

Sparse, straight hair along lateral vulva or base of penis

Question 17

Define Tanner Stage 3

Answer 17

Hair is darker, coarser, and curlier, extending over mid-pubis

Question 18

Define Tanner Stage 4

Answer 18

Hair is adult-like in appearance, but does not extend to the thighs

Question 19

Define Tanner Stage 5

Answer 19

Hair is adult-like in appearance, extending from thigh to thigh