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PED Health Maintenan
PED Health Maintenance
| Question | Answer |
|---|---|
| Peds office visits | 2-4 days, 1 mo, 2mo, 4mo, 6mo, 9mo, 12mo, 15-18mo, 2 yr, Qyr |
| Babies released from the hospital usually | between 24-36 hours |
| Growth measurements | height, weight, head circumference (HC), (BMI at >/= 2 years) |
| Common problems | feeding problems, atopic dermatitis, allergic rhinitis, food allergies, ear infections |
| Common Concerns Neonates | head, skin, jaundice, feeding and stooling, umbilical hernia, circumcision, nasolacrimal duct stenosis, sleep |
| Umbilical stub should fall off by | first month |
| Common Concern Toddlers | Nutrition: picky eaters, transition to cup, whole milk, solid foods; temper tantrums, toilet training, speech |
| Common Concerns in young children | school issues: separation anxiety, ADHD; Bed wetting: enuresis, Encopresis (fecal incontinence), eating/feeding issues |
| At every visit the PE, at minimum, should include | Skin, HEENT, CV, Musculoskeletal |
| HC recorded until | 2 yo |
| Growth Delay | thyroid, renal, anemia, infection, malabsorption, growth hormone, collagen vascular disease, leukemia |
| Big Milestones | Sit unsupported (6mo), Walks (1yr), Dress self (4yrs ), Put together 2 or 3 words (18mo) |
| Visual acuity is measured first at age | 3 |
| Tumbling E's and picture tests are | formal vision tests |
| Age at which infant should be able to fixate on face | 1mo old |
| Ambylopia | loss of vision due to disuse (lazy eye, if they don't use it, they will lose acuity and it may not be recoverable). |
| Hearing tests (universal newborn hearing screening program: UNHSP). Done before baby is sent home | ABR (auditory brainstem response), and EOAE (evoked otoacoustic emissions - in ear canal) |
| Pure tone audiometry in | 3 yo. But Peggy uses watch ticks and starts audiometry at 5 |
| Lead and Hct need to be done at least | once between 12 & 24 months. |
| Labs | Newborn screen for metabolic and genetic dz (all include PKU, hypothyroidism), Anemia, Lead, Cholesterol, TB, Pap, HIV, other STDs |
| Newborn Screening Disorders and Conditions (this is for NC) | Amino acid disorders (including PKU), Fatty acid disorders, organic acid disorders, Biotinidase deficiency, Hypothyroidism, Congenital adrenal hyperplasia, Sickle cell disease |
| Most common cause of Anemia in Peds | iron deficiency; risk: LBW, cow's milk, anemic mother. Sx: Developmental & behavior deficits. Prevention: Fe fotified cereal/formula, limit cow's milk to less than 24 oz/d after 1yo |
| Minimum screen for anemia | screen @ 12-24 months, 4-6 y/o, and menstruating females |
| Rx for anemia | Fe 4mg/kg/dSE: taste, constipation |
| Lead Screening | sources: lead based paint and gas. Medidcal emergency>70ug/dL. Lead>55ug/dL: colic, nausea, myalgia, seizures, HA, anemia. Lead>10ug/dL: decreased IQ, academic difficulties. Screening between 12 and 24 months |
| TB Screening | Mantoux is only recommended test and can be done as early as 3 monthsBCG vaccination is not a contraindication to TB skin testing |
| Cholesterol Screening | as early as 2 yrs for those at risk. Risk: parent/grandparent with CAD or MI<55 yo, Parents chol>240, Overweight, evidence of insulin resistance. Measure total chol. <110 LDL acceptable. TX if LDL>190 after diet Rx |
| #1 cause of death >1 yo | preventable injury. Address safety measures |
| <20# | rear facing seat |
| 20-40lbs | front facing seat |
| 40-60lbs | booster seat |
| >60lbs | lap belt |
| 4' | regular shoulder/lap belt |
Created by:
ltm12