PED Health Maintenance
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| Peds office visits | 2-4 days, 1 mo, 2mo, 4mo, 6mo, 9mo, 12mo, 15-18mo, 2 yr, Qyr
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| Babies released from the hospital usually | between 24-36 hours
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| Growth measurements | height, weight, head circumference (HC), (BMI at >/= 2 years)
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| Common problems | feeding problems, atopic dermatitis, allergic rhinitis, food allergies, ear infections
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| Common Concerns Neonates | head, skin, jaundice, feeding and stooling, umbilical hernia, circumcision, nasolacrimal duct stenosis, sleep
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| Umbilical stub should fall off by | first month
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| Common Concern Toddlers | Nutrition: picky eaters, transition to cup, whole milk, solid foods; temper tantrums, toilet training, speech
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| Common Concerns in young children | school issues: separation anxiety, ADHD; Bed wetting: enuresis, Encopresis (fecal incontinence), eating/feeding issues
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| At every visit the PE, at minimum, should include | Skin, HEENT, CV, Musculoskeletal
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| HC recorded until | 2 yo
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| Growth Delay | thyroid, renal, anemia, infection, malabsorption, growth hormone, collagen vascular disease, leukemia
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| Big Milestones | Sit unsupported (6mo), Walks (1yr), Dress self (4yrs ), Put together 2 or 3 words (18mo)
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| Visual acuity is measured first at age | 3
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| Tumbling E's and picture tests are | formal vision tests
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| Age at which infant should be able to fixate on face | 1mo old
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| 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).
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| 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)
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| Pure tone audiometry in | 3 yo. But Peggy uses watch ticks and starts audiometry at 5
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| Lead and Hct need to be done at least | once between 12 & 24 months.
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| Labs | Newborn screen for metabolic and genetic dz (all include PKU, hypothyroidism), Anemia, Lead, Cholesterol, TB, Pap, HIV, other STDs
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| 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
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| 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
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| Minimum screen for anemia | screen @ 12-24 months, 4-6 y/o, and menstruating females
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| Rx for anemia | Fe 4mg/kg/dSE: taste, constipation
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| 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
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| 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
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| 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
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| #1 cause of death >1 yo | preventable injury. Address safety measures
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| <20# | rear facing seat
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| 20-40lbs | front facing seat
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| 40-60lbs | booster seat
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| >60lbs | lap belt
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| 4' | regular shoulder/lap belt
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