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Pediatrics > Health Supervision > Flashcards

Health Supervision Flashcards

1
Q

Principles of Health Supervision

A
  • providing services proactively
  • optimizing child’s level of functioning
  • ensuring child is growing and developing appropriately
  • promoting best possible health
  • preventing injury and illness through child teaching
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2
Q

Medical Home

A

physician or nurse practitioner who has a long term and comprehensive relationship w/ the family, leading to comprehensive, continuous, coordinated, and cost effective care

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3
Q

What is considered vital for a child with a chronic illness?

A

effective partnership among the child’s medical home, family, and community

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4
Q

What will enhance the quality of life and health of a child with a chronic illness?

A

Coordination of specialty care, community agencies, and family support networks

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5
Q

Special Issues in Health Supervision

A
  • cultural influences
  • community influences
  • health supervision and the chronically ill child
  • health supervision and the internationally adopted child
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6
Q

What issues are covered in a psychosocial assessment?

A
  • health insurance coverage
  • transportation to health care facilities
  • financial stressors
  • family coping
  • school’s response to the chronic illness
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7
Q

Chronic Illnesses require what?

A
  • repeated assessments
  • need to determine health maintenance needs
  • frequency of visits
  • types of interventions
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8
Q

For international adoption the child will need a comprehensive screening for?

A
  • infectious diseases
  • disorders of G&D
  • vision/hearing
  • any testing bases on diseases prevalent in their country of origin
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9
Q

When does the screening need to be done?

A

within the first few weeks of arrival

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10
Q

Universal Screening

A
  • intestinal parasites
  • hepatitis A,B,C
  • varicella
  • HIV
  • syphilis
  • tuberculosis
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11
Q

The health supervision visit will include what?

A
  • history and physical assessment
  • developmental/behavioral assessment
  • sensory screening
  • appropriate at risk screening
  • immunizations
  • health promotion/anticipatory guidance
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12
Q

Health promotion/anticipatory guidance may include:

A

injury prevention
violence prevention
nutrition counseling

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13
Q

Appropriate At-Risk screening may include:

A 
lead
anemia 
TB test
HTN
cholesterol
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14
Q

What are the 3 components of Health Supervision?

A
  • developmental surveillance and screening
  • injury and disease prevention
  • health promotion
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15
Q

Health supervision should be viewed as what?

A

Viewed as part of a continuum of care and NOT as the accomplishment of isolated tasks

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16
Q

Components of Developmental Surveillance

A
  • noting and addressing parental concerns
  • obtaining a developmental history
  • making accurate observations
  • consulting w/ relevant professionals
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17
Q

What may indicate warning signs or identify risks for developmental delay?

A

Historical information obtained from the parent or primary caregiver about developmental milestones

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18
Q

Any child who “loses” a developmental milestone needs what?

A

An immediate full evaluation

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19
Q

Why does a child who “loses” a developmental milestone need an immediate full evaluation?

A

Because this indicates a significant neurological problem

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20
Q

To increase cooperation you can do what?

A

set up a reward system

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21
Q

Ways to increase cooperation are:

A
  • stamp/sticker on hand
  • decorating tongue blade for vision screening
  • copy a design and let them color
  • let them play with tools
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22
Q

Risk Assessment

A

includes objective and subjective data to determine likelihood child will develop a condition

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23
Q

Universal Screening

A

screening of an entire population regardless of child’s individual risk

24
Q

Selective Screening

A

done when a risk assessment indicates the child has one or more risk factors for a disorder

25
Q

What are some specific types of screening performed?

A
  • metabolic
  • hearing
  • vision
  • iron-deficiency anemia
  • lead
  • hypertension
  • hyperlipidemia
26
Q

If a metabolic screening is not done before 48 hours of age when should it be done?

A

At first visit

27
Q

What ages is universal hearing recommended?

A

4-8 and 10 years old

28
Q

Criteria for Risk Assessment for Hearing Loss (3 mo- 5 yrs)

A
  • auditory skill monitoring
  • developmental surveillance
  • assessment of parental concerns
  • older than 4 yrs
  • difficulty hearing on phone, in noisy background
  • frequently asking others to repeat themselves
  • turn tv up too loud
29
Q

Using a vision screening chart

A
  • place chart at eye level
  • place mark on floor 20 ft from chart
  • align child’s heels w/ mark
  • have child read each line w/ one eye covered
  • have child read w/ both eyes
30
Q

At what ages should you screen for iron-deficiency anemia?

A

4, 15, 18, and 30 months

31
Q

The child’s Hgb/Hct should be taken at how old?

A

12 months

32
Q

What is an elevated blood lead level?

A

5 ug/dL

33
Q

At what ages should you screen for elevated blood lead levels?

A

6,9,12,18,24 months and 3,4,5,6 years

34
Q

When does the universal hypertension screening begin?

A

3 years

35
Q

When do you screen for hyperlipidemia?

A

Once between 9-11 years and again between 18-21 years old

36
Q

What happens when the immune system recognizes an antigen?

A

It responds by producing antibodies or directing special cells to destroy and remove the antigen

37
Q

Immunity

A

ability to destroy and remove a specific antigen from the body

38
Q

Passive Immunity

A

produced when the immunoglobulins of one person are transferred to another

39
Q

Active Immunity

A

acquired when a person’s own immune system generates the immune response

40
Q

Intramuscular Vaccines

A 
DTap, DT, Tdap
Hepatitis A,B
Hib
Influenza 
Pneumococcal conjugate vaccine 
HPV
MCV-4 
IPV
41
Q

Subcutaneous Vaccines

A

IPV
MMR
Varicella
MPSV4

42
Q

IM injection Birth-28 days and 1-12 months

A

anterolateral thigh

43
Q

IM injection 1-2 years and 3-18 years

A

anterolateral thigh and deltoid muscle

44
Q

SubQ injection 1-12 months

A

fatty tissue over anterolateral thigh

45
Q

SubQ injection >12 months

A

fatty tissue over anterolateral thigh or triceps

46
Q

Which vaccines are live virus vaccines?

A

MMR and Varicella

47
Q

If the MMR and Varicella vaccine are not given on the same day how far apart should they be given?

A

28 days

48
Q

What are no longer contraindications for MMR vaccine?

A

Egg allergies or pregnancy

49
Q

LAIV should not be given to who?

A

Anyone who will be in contact w/ an immunosuppressed patient

50
Q

The Influenza vaccine is contraindicated for who?

A
  • child w/ large amounts of nasal drainage
  • child w/ underlying medical condition
  • child < 5 w/ recurrent wheezing in last 12 mo
  • immunocompromised children
  • taking aspirin
  • have been given other live vaccine in last 4 weeks
51
Q

The Rotavirus Vaccine is contraindicated for who?

A
  • children with SCID

- history of intussusception

52
Q

HPV is how many doses?

A

2

53
Q

What do we chart for immunizations?

A
  • date the vaccine was administered
  • name of vaccine
  • lot number and expiration date of vaccine
  • manufacturers name
  • site and route
  • edition date of VIS given to parents
  • Name and address of the facility administering vaccine
  • Name of person administering immunization
54
Q

What are significant causes of inadequate immunization?

A
  • parental concerns about vaccine safety

- multiple physicians

55
Q

Topics for Anticipatory Guidance

A
  • promoting oral health care
  • healthy weight
  • healthy activity
  • personal hygiene
  • safe sun exposure
56
Q

Contraindications

A
  • anaphylactic or systemic allergic reaction to vaccine component
  • pertussis immunization, encephalopathy w/o an identified cause within 7 days of immunization

Pediatrics (24 decks)

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