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Flashcards in Well Child Exam Deck (88)
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1
Q

Beneficial Things About Well-Child Care

A

Form relationship with parents & child
Vaccinations
Pick up odd things in a child

2
Q

Approach to a Well Child Visit

A
Laid-back Attitude
Speak directly to child
Complement the child in some way
Smile
Be non-threatening
3
Q

What Should be Assessed in a Well-Child Visit?

A
Growth measurements
Interval History
PE abnormalities
Developmental assessment
Anticipatory Guidance
Immunizations
Answer questions
4
Q

What types of measurements should we measure?

A

Height
Weight
Head circumfrence

5
Q

Interval History Questions

A
How you feeling?
Baby/child doing?
How things going since last visit?
Appropriate follow-up questions
Devote entire time to situation
6
Q

Areas to be Assessed for a Developmental Assessment

A
Gross motor
Fine motor
Language
Personal-social
Vision
Hearing
7
Q

Developmental Delays

A

Motor delays- 1st year
Language delays- toddler-preschool years
Learning disabilities- school years

8
Q

Reasons for a Motor Delay

A

Neuromuscular
Genetic/Metabolic
Infectious

9
Q

Reasons for Language Delay

A

Hearing loss

Mental retardation

10
Q

Importance of Early Detection of Developmental Programs

A

Live independently
Graduate from HS
Contribute to society
Save society $30,000-$100,000 per child

11
Q

Types of Standardized Instruments for Developmental Assessment

A

Denver II
Ages & Stages Questionnaire (ASQ)
Brigance Screening
Parents’ Evaluation of Developmental Status (PEDS)

12
Q

Denver II Developmental Assessment Scale

A

Children 0-6 years

Four areas included: gross motor, fine motor, personal-social, and language

13
Q

Denver II Advanced

A

Child passes item that falls completely to the right of the age line

14
Q

Denver II Normal

A

Child passes, fails, or refuses item on which the age line falls between the 25th and 75th percentile

15
Q

Denver II Caution

A

Child fails or refuses item on which the age line falls between the 75th and 90th percentile

16
Q

Denver II Delayed

A

Child fails or refuses item that falls completely to the left of the age line

17
Q

Denver II Pass

A

No delays and a maximum of one caution

18
Q

Denver II Failure

A

Two or more delays noted

19
Q

Denver II Re-evaluate in 3 months

A

1 Delay and/or 2 or more cautions

20
Q

Denver II Untestable

A

Significant number of refusal or no opportunity test items

21
Q

Denver II Criticisms

A

Takes time
Norms established not representative of whole population
Some items difficult to test
Requires a number of items to administer test thoroughly
High over-referral rate

22
Q

Ages & Stages Questionaire (ASQ)

A
Info from parents
Developmental problems
10-15 minutes to complete
4 months-5 years
Separate form for each visit
Available in English, Spanish, Korean, & French
Standardized scoring
Photocopied
23
Q

Brigance Screening

A

Observation & elicitation of skills
Newborn- 8 years
Based on age
10-15 minutes

24
Q

Parents’ Evaluation of Developmental Status (PEDS)

A
Info from parents
Newborn- 8 years
10 questions
English, Spanish, & Vietnamese
2 minutes
Standardized scoring
25
Q

What is one advantage of the ASQ?

A

Gets parents involved in child’s care
More aware of child’s abilities/limitations
Saves time

26
Q

High Impact Anticipatory Guidance

A

No smoking

Reading to the child

27
Q

Newborn Anticipatory Guidance

A
Review feeding method
Sleep position & environment
Care of skin, cord, circumcision
Breast engorgement, vaginal discharge
Jaundice
Injury Prevention
When/why to call Dr.
Individuality of infant
28
Q

Newborn Injury Prevention

A
Microwave safety (bottles)
Car seat safety
Crib safety
Siblings
Pets
Smoke detectors
Hot water heater temp setting (120)
UV protection
Smoke free home
29
Q

Two-week Anticipatory Guidance

A

Answer questions about breast or formula feeding
Sleep patterns
Social Interaction with family
Injury prevention

30
Q

Two-week Injury Prevention

A
Car seat safety
Smoke detectors
Hot water temp
"Back to sleep"
Violence prevention
Education about colic
Educate on shaken baby syndrome
UV protection
Smoke free home
31
Q

Why shouldn’t we give a little child honey?

A

Clostridium botulinum

32
Q

Two-month Anticipatory Guidance

A
Nutrition (Vit. D, iron, fluoride, defer solids and honey)
Sleeping issues
Pay with, talk to, cuddle infant
Read to child
Educate about sibling time
Signs of maternal depression
Injury Prevention
33
Q

Two-month Injury Prevention

A

Smoke free home

Gun safety

34
Q

Four-month Anticipatory Guidance

A

6 URI’s/year
Elimination
Nutrition (solids, avoid honey)
Injury Prevention

35
Q

Four-month Injury Prevention

A

Smoke free home
Safe toys
Heating food in microwaves
UV protection

36
Q

Six-month Anticipatory Guidance

A
Nutrition (cup sips, solids)
Discuss sleep patterns
"Stranger danger"
Reading to infant
Injury Prevention
37
Q

Six-month Injury Prevention

A
No smoking
Childproof home
Poison control telephone number
NO infant walkers
Never leave infant alone in bathtub
38
Q

Nine-month Anticipatory Guidance

A

Nutrition (mealtimes, soft foods, cups, no milk)
Sleep patterns (regular bedtime routine)
Interaction with child
Injury prevention

39
Q

Nine-month Injury Prevention

A
No smoking
Childproof home
Avoid foods to be aspirated
Poison control number
No infant walkers
Car seat safety
Heating food in microwave
Never leave infant in bathtub
40
Q

12-month Anticipatory Guidance

A

Nutrition
Behavioral Development
Injury Prevention

41
Q

12-month Nutrition

A

Appetite may be decreased
Wean to cup
Baby food to table foods
Limiting cow’s milk

42
Q

12-month Behavioral Development

A

Seek increased autonomy

Interact with child

43
Q

12-month Injury Prevention

A
No smoking
Window & stair safety
Childproof home
Never leave child alone in bathtub
Appropriate car seat
Hot stoves, heaters, irons
UV protection
44
Q

15-month Anticipatory Guidance

A

Nutrition
Don’t expect potty training
Behavioral
Injury Prevention

45
Q

15-month Nutrition

A

Regular meals

Sits still to eat

46
Q

15-month Behavioral

A
Drive for autonomy
More "yes" than "no" messages
State "no" clearly
Lots of distraction
Participate in games
Temper tantrum management
Limit TV
47
Q

15-month Injury Prevention

A
No smoking
Appropriate car seat
Door, window, stairwell safety
Hot stoves, pots, pans, heaters, irons
Water safety
UV protection
48
Q

18-month Anticipatory Guidance

A

Nutrition
Toilet training techniques
Behavioral
Injury Prevention

49
Q

18-month Nutrition

A

Balanced diet
Encourage cup
Discourage bottle

50
Q

18-month Behavioral

A

Parallel play, not interactive
Self-conforting behaviors
Time-out
Allow decision making

51
Q

18-month Injury Prevention

A
Durable toys
No smoking
Appropriate car seat
Door, window, stairwell safety
Hot stoves, pots, pans, heaters, irons
Water safety
UV protection
52
Q

2-year Anticipatory Guidance

A

Nutrition
Note signs of toilet training readiness
Behavioral
Injury Prevention

53
Q

2-year Nutrition

A

Discontinue bottle-feeding

Balanced diet

54
Q

2-year Behavioral

A

Choices between acceptable alternatives
Read to child
Limit TV
Positive outcomes for desired behaviors

55
Q

2-year Injury Prevention

A
Durable toys
No smoking
Appropriate car seat
Door, window, stairwell safety
Hot stoves, pots, pans, heaters, irons
Water safety
UV protection
Gun safety
56
Q

3-year Anticipatory Guidance

A
Nutrition
Support toilet training
May discontinue naps
Interact appropriately with child
Injury Prevention
57
Q

3-year Nutrition

A

Encourage self-feeding (utensils)

Dental referral

58
Q

3-year Injury Prevention

A

Gun safety
Stranger danger
Water safety

59
Q

4-year Anticipatory Guidance

A
Regular dental care
Nocturnal enuresis
Opportunities to play with peers
Chores
Clear limits & consequences
Praise desired behavior
Injury Prevention
60
Q

4-year Injury Prevention

A

Bicycle helmets
Stranger danger
Animal danger
Water safety

61
Q

5-year Anticipatory Guidance

A

Regular physical activity
Increasing autonomy
Praise liberally
Injury prevention

62
Q

5-year Injury Prevention

A
Bicycle helmets
Pedestrian, bicycle safety
Dealing with strangers
Poisons, tools, guns
Water safety
63
Q

How to close the well-child visit?

A
Reschedule next appt.
Never appear hurried
Never check watch
Don't cut off parents sentences
Ask "Is there anything else I can do for you today?"
64
Q

Types of Pediatric Visits

A
Well-child
Acute care
Sports physical
Chronic disease
Counseling
65
Q

Five Critical Areas of Normal Development

A
Physical growth
Gross motor control
Fine motor control
Language
Personal-social
66
Q

First Year Normal Physical Development

A

Triples birth weight by one year of age

67
Q

First Year Normal Gross Motor Control

A
Lift head while prone
Rolls over
Sits independently
Crawl
Walk
68
Q

First Year Normal Fine Motor Control

A
Ulnar grasp
Thumb joins the party
Raking grasp, transfers objects
Pincer grasp, holds bottle, throws object
Fine pincer grasp
69
Q

First Year Normal Language Development

A
Smiles socially
Coos
Laughs, orients to voice
Babbles
Says "mama/dada" indiscriminately, waves bye-bye
2 words other than mama/dada, jargoning
70
Q

First year Personal-Social Development

A

Recognizes parent
Recognizes strangers
Starts exploring, plays gesture games
Imitates actions, comes when called

71
Q

Second Year Gross Motor Control

A

Creeps upstairs, walks backwards independently
Runs, throws objects from standing without falling
Walks up & down steps without help

72
Q

Second Year Fine Motor Control

A

Scribbles in imitation, builds tower of 2 blocks
Scribbles spontaneously, 3 block tower, turns 2-3 pages at a time
Imitates stroke with pencil, 7 block tower, turns 1 page at a time, removes shoes, pants

73
Q

Second Year Language Development

A

4-6 words, one-step command without gesture
Mature jargoning, 7-10 word vocabulary, knows 5 body parts
Uses pronouns inappropriately, follows 2 step commands, 50 word vocabulary, uses 2 word sentences

74
Q

Second Year Personal-Social Development

A

Uses spoon & cup
Copies parents in tasks, plays in company of other children
Parallel play

75
Q

Three Year Gross Motor Control

A

Alternate feet when going up steps

Pedals tricycle

76
Q

Three Year Fine Motor Control

A
Copies a circle
Undresses completely
Dresses partially
Dries hands if reminded
Unbuttons
77
Q

Three Year Language Development

A

250 word minimum
3-word sentences
Uses plurals
Knows all pronouns

78
Q

Three Year Personal-Social Development

A
Group play
Shares toys
Takes turns
Plays well with others
Knows full name
Age
Gender
79
Q

Four Year Gross Motor Control

A

Hops
Skips
Alternates feet going down steps

80
Q

Four Year Fine Motor Control

A

Copies a square
Buttons clothing
Dresses self completely
Catches ball

81
Q

Four Year Language Development

A

Knows colors
Says song or poem from memory
Asks questions

82
Q

Four Year Personal-Social Development

A

Tells “tall tales”

Plays cooperatively with a group of children

83
Q

Five Year Gross Motor Control

A

Skips alternating feet

Jumps over low obstacles

84
Q

Five Year Fine Motor Control

A

Copies triangle
Ties shoes
Spreads with knife

85
Q

Five Year Language Development

A

Prints first name

Asks what a word means

86
Q

Five Year Personal-Social

A

Plays competitive games
Abides by rules
Likes helping in household tasks

87
Q

Years 5-7

A

Move from dealing with one variable to dealing with multiple variables
Magical thinking diminishes
Reality of cause-effect relationships better understood

88
Q

Years 7-11

A

Devotion of energy to school & peers
Progressive interaction with opposite sex
Expectations for behavior and academics intensifies