Pediatric Consultation Schedule & Objectives

• Pediatric consultations span from the early days of life up to 18 years of age

Schedule of Pediatric Consultations:

• 1st week of life
• 1st month
• 2nd month
• 4th month
• 6th month
• 9th month
• 12th month
• 15th month
• 18th month
• 2 years
• 3 years
• 4 years
• 5 years
• 6 or 7 years
• 8 years
• 10 years
• 12/13 years
• 15/18 years

Purpose of Child and Youth Health Monitoring

• Screening
• Assessment
• Intervention
• Guidance in problematic situations

Objectives of Health Exams:

• Evaluate the child's growth and development
• Encourage health-promoting behaviors like nutrition, physical exercise, and safety measures
• Promote oral health, breastfeeding, and the prevention of mistreatment
• Detect congenital malformations early and provide appropriate referrals
• Identify and support children with chronic diseases or disabilities
• Ensure genetic counseling is conducted
• Support and promote adequate parental responsibilities

Three Fundamental Consultations:

• At 5 years: Evaluate skills for starting school
• At 6/7 years: Identify previously undiagnosed issues like learning difficulties
• At 10 years: Mark the start of puberty and entry into the 5th grade

Consultation Start and End

• The consultation begins when the child enters the office and concludes upon their departure

Important Aspects of All Consultations:

• Inquire about the previous consultation with the parents at the beginning
• Prioritize the emotional state of the mother, watching for postpartum depression

Priority Groups:

• Adolescents are a priority, as trust is crucial to a successful consultation otherwise they may not return

Child Development

• Children are considered beings in motor, cognitive, emotional, and social development

Developmental Assessments:

• Motor, cognitive, emotional, and social assessments use scales and are not subjective

Observation

• Teachers and educators play a key role in observing potential psychomotor, social, and emotional problems due to their extended time with children

Child Evaluation Timing

• Evaluation can occur while the child is held by parents or while they are playing to ensure comfort
• This allows for a more accurate assessment.

Key Aspects of Development

• Professionals should use the information gathered about the child's development to educate parents

Important Considerations:

• Each child has a unique pace of development, and variations are normal
• Care should be taken when relaying information to parents in denial

Speech Therapy:

• Speech therapies are provided by health services, though not entirely free due to transportation and time constraints

Consultation Topics:

• Physical exams include weight, height, parental guidance, and record-keeping

Vaccination Process:

• Infants need to be held by a parent during vaccination

Child Oral Hygiene:

• Clean gums using a soft brush and adult toothpaste
• Begin brushing teeth twice a day as they emerge
• It's also important to watch for signs of mistreatment

Warning Signs for Nurses

• Nurses should be aware of key warning signs in children

Evaluation Scale

• These signs are assessed using the Sheridan scale

Signs Assessed:

• Posture and gross motor skills
• Vision and fine motor skills
• Hearing and language
• Behavior and social adaptation

Key Alert Signs for Nurses:

• It is important to note signs during the first consultation (4-6 weeks) and the second (1-2 months)

Third Consultation

• 4 months old
• Absence of head control, not looking head towards sound, poor hygiene, hypertonicity of feet, lack of alertness

Fourth Consultation

• 6 months old
• Lack of head control, can't grasp object, doesn't look at objects, constant straismus, doesn't babble, irritability

Fifth Consultation

• 9 months
• Doesn't move, can't grab at objects, doesn't react by voice, shows no emotion, odd emotional level (monotone or no emotion)

Sixth/Seventh Consultation

• 12-15 months
• Can't hold weight in their legs, doesn't respond when called, can't chew foods or swallow it, can't grab toys, can't make eye contact

Eighth Consultation

• 18 months
• Can't stand without help, always walking on toes, doesn't speak spontaneously/respond, doesn't have an interest in the outside world, throws things always

Ninth Consultation

• 2 years
• Can't speak, can't walk, can't follow instructions, can't imitate, doesn't make eye contact

Tenth Consultation

• 3 years
• Aggressive or violent, can't fall asleep, strange habits

Other general signs

• 4 years
• Easily hyperactive, distracted, speech issues

Consultation for Older Individuals

• 6-7 years
• Takes a long time to do daily chores, learning issues, instable psycologically

Individuals Over 10 years

• 10-18 years
• Unable to deal with everyday issues, excessive anxiety, insomnia, mood swings

In Teenage girls ages 12-18

• Anemia