Chapter 24 Pediatric Examination

what are the components of a well child visit?

Patient history, Physical exam, anticipatory guidance, evaluation of growth and development of the child

What topics are commonly included in anticipatory guidance?

Providing parents with info to prepare them for anticipated developmental events and assist them in promoting their children's well-being( safety, nutrition, sleep, pay, exercise, development, and discipline)

what is the usual schedule for well-child visits?

after birth: 3-5 days, 1 month, 2, months, 18 months, 24 months, 30 months, 3 years, 4 years, and 1 year therefore

what is the purpose of the sick child visit?

If the child is exhibiting signs and symptoms of disease, and the physician evaluates the patient's condition to arrive at a diagnosis and to prescribe treatment

what procedures are often performed by the medical assistant during pediatric office visits?

Measurement of temp, pulse, respirations, bp, height and weight, visual and hearing acuity, assisting with the physician

why is it important for the medical assistant to develop a rapport with the pediatric patient?

To gain the child's trust and confidence, the child is likely to cooperate during an exam or procedure

List the two positions that can be used to safely carry an infant

cradle position and upright position

why is it important to measure the growth (weight and height or length) of the child during each office visit?

to determine nutritional needs ad proper dosage of a medication to administer to the child

what is the difference between height and length?

height is measured for older children, length is measured for children younger than 24 months

what is the purpose of measuring head circumference?

important for brain growth and screening for microencephaly and macroencephaly

what is the primary use of growth chart?

to look at child's growth patterns

what is the primary cause of childhood obesity?

overeating and inadequate exercise

what problems are associated with childhood obesity?

High blood pressure, type 2 diabetes, orthopedic problems cause by increase stress on weight bearing joints, skin disorders such as dermatitis, sleep apnea, low self esteem, social isolation, and dealing of rejection and depression

list five guidelines for preventing childhood obesity?

encourage active play, limit television, video, and computer time, limit junk food in the house, do not offer desert as a reward for finishing a meal, do not frequently eat fast food.

according to the American academy of pediatrics, at what age and how often should blood pressure be measured in children?

Children 3 years and older have their bp measured annually

what is the importance of measuring bp in children?

To identify children at risk for developing hypertension as adults

what criteria must be followed to determine the correct cuff size for a child

bladder of the cuff should encircle 80% to 100% of the arm, circumference should be assessed at the mid point of the acromion process and the olecranon process.

what occurs if the blood pressure cuff is too small or too large

to small - causes falsely high reading

to large- causes falsely low readings

what three factors must be taken into consideration when determining if a child has hypertension

child's age, heigh and gender

list three reasons for collection a urine specimen from a child

screen for presence of disease, assist in diagnosing pathologic conditions, and to evaluate the effectiveness of therapy

why should the child's genitalia be pleased before applying a pediatric urine collector

prevent contaminants from entering the urine specimen, which can effect the results of urine specimen

what gauge length of the needle are recommended for giving an intramuscular injection to a child?

5/8 inch- 1 inch

why is the dorogluteal site not recommenced for an intramuscular injection to an infant or young child?

it can come dangerously close to the sciatic nerve. Danger s increased if the child is squirming for fighting

why is the vests lateralis muscle recommend as a good site for giving intramuscular injections to an infant or young child? How is this located?

Located on the anterior surface of the mid lateral thigh, away from major nerves and blood vessels, and large enough to accommodate the injection medication

at what age can the site be used to administer an IM injection to a child? Explain the reason for this?

Until a child is at least 18 months old because the deltoid site is so small in an infant

what is the recommended subcutaneous injection site for an infant younger than 12 months of age

anterior thigh

what is the recommended subcutaneous injection site for a child that is 12 months of age or older?

lateral part of the upper arm

what is the difference between a vaccine and a toxoid?

Vaccine is suspension of attenuated or kill MO's by stimulating the production of antibodies; toxoid is a poisonous substance that has been treated by heat or chemicals to destroy its harmful properties

what immunizations are included in DTaP

Diphtheria, tetanus, acellular pertussis

what immunizations are included in MMR

measles, mumps, rubella

what info must be provided to parents as required by the NCVIA

info about benefits and risks of childhood immunizations

what info is included in a VIS

info about reporting an adverse reaction, the NVIC program, and how to get more info abut childhood diseases and vaccines. Is given to parents or guardians each time before child receives vaccine