Pediatric Examination Chapter 24
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Questions and Answers

What are the two broad categories of pediatric patient office visits?

  • Well-child visit (correct)
  • Sick-child visit (correct)
  • Emergency visits
  • Regular check-up

    • What are the components of a well-child visit?

    Growth and development, anticipatory guidance, physical examination

    What topics are commonly included in anticipatory guidance?

    Safety, nutrition, sleep, play, exercise, development, and discipline

    What is the typical schedule for well-child visits?

    <p>3-5 days, 1 month, 2 months, 4 months, 6 months, 9 months, 15 months, 18 months, 24 months, 30 months, 3 years, and yearly thereafter</p> Signup and view all the answers

    What age group is referred to as toddlers?

    <p>1 to 3 years old</p> Signup and view all the answers

    What age group is referred to as preschool children?

    <p>3 to 6 years old</p> Signup and view all the answers

    What age group is referred to as school-age children?

    <p>6 to 12 years old</p> Signup and view all the answers

    What age group is referred to as adolescents?

    <p>12 to 18 years old</p> Signup and view all the answers

    What age group is referred to as infants?

    <p>Birth to 12 months</p> Signup and view all the answers

    What is the cradle position?

    <p>Holding an infant with one hand and forearm under the infant's back and grasps the infant's arm from behind with thumb and fingers encircling the infant's forearm while the other hand and forearm are under the infant's buttocks</p> Signup and view all the answers

    What is the upright position for holding an infant?

    <p>Holding an infant with one hand under the head and shoulders while the other hand supports the buttocks.</p> Signup and view all the answers

    What should be measured during each visit and plotted on a growth chart from birth to age 3?

    <p>Weight, height, and head circumference</p> Signup and view all the answers

    Why is a child's weight important?

    <p>It is used to determine nutritional needs and proper dosage of medication.</p> Signup and view all the answers

    How is an infant weighed?

    <p>In a recumbent position</p> Signup and view all the answers

    When is length measured instead of height?

    <p>When the child is younger than 24 months</p> Signup and view all the answers

    How is the length of a child measured?

    <p>From the vertex (top) of the head to the heel of the infant in a supine position</p> Signup and view all the answers

    Why is head circumference an important measurement?

    <p>Because infancy is a period of rapid brain growth</p> Signup and view all the answers

    What is the head circumference range of a newborn?

    <p>32 to 38 cm or 12 1/2 to 15 inches</p> Signup and view all the answers

    At what age should blood pressure be measured annually?

    <p>3 years and older</p> Signup and view all the answers

    What is the most important criterion in obtaining an accurate pediatric blood pressure measurement?

    <p>Cuff size</p> Signup and view all the answers

    What percentage of the arm should the bladder of the cuff encircle for an accurate blood pressure measurement?

    <p>80% to 100% of the arm</p> Signup and view all the answers

    Where should the child's arm circumference be assessed for a blood pressure?

    <p>Midpoint between the acromion process (shoulder) and the olecranon process (elbow)</p> Signup and view all the answers

    What two factors are considered when giving a child intramuscular injections?

    <p>The consistency of the medication and size of the child</p> Signup and view all the answers

    What is the typical length and gauge of a needle used to administer intramuscular injections to a child?

    <p>5/8 to 1 inch in length and 22 to 25 gauge range</p> Signup and view all the answers

    What is the typical length and gauge of a needle used to administer subcutaneous injections to a child?

    <p>1/2 to 5/8 inch in length and 23 to 25 gauge range</p> Signup and view all the answers

    What site should never be used as an injection site for infants or young children?

    <p>The dorsogluteal site</p> Signup and view all the answers

    What site is recommended for injections of infants and young children?

    <p>Vastus lateralis muscle</p> Signup and view all the answers

    Where is the vastus lateralis muscle located?

    <p>Anterior surface of the midlateral thigh</p> Signup and view all the answers

    How do you locate the vastus lateralis site of an infant and young child?

    <p>Divide the mid anterior thigh into thirds, administer the injection into the middle third of the thigh</p> Signup and view all the answers

    At what age should the deltoid site begin to be used for injections?

    <p>At least 18 months old</p> Signup and view all the answers

    Why should the deltoid site not be used in infants and children younger than 18 months?

    <p>The deltoid site is too small in an infant</p> Signup and view all the answers

    How should the length of the needle be adjusted when giving an injection in the deltoid site?

    <p>According to the amount of subcutaneous tissue over the injection site</p> Signup and view all the answers

    Where is the recommended subcutaneous site for an infant younger than 12 months?

    <p>Anterior thigh</p> Signup and view all the answers

    Where is the recommended subcutaneous site for a child 12 months or older?

    <p>Lateral part of the upper arm</p> Signup and view all the answers

    What is immunity?

    <p>The resistance of the body to harmful agents, such as pathogenic microorganisms and their toxins</p> Signup and view all the answers

    What is active, artificial immunization?

    <p>The process of becoming immune through the use of a vaccine or toxoid</p> Signup and view all the answers

    What is a vaccine?

    <p>A suspension of attenuated (weakened) or killed microorganisms administered to prevent infectious disease</p> Signup and view all the answers

    What is a toxoid?

    <p>A toxin that has been treated to destroy its harmful properties, administered to prevent infectious disease</p> Signup and view all the answers

    What is the VIS (vaccine information sheet)?

    <p>Explains the benefits and risks of a vaccine</p> Signup and view all the answers

    What should a parent be supplied with at their child's first well visit?

    <p>Immunization-record card</p> Signup and view all the answers

    What must the medical assistant give the parent before their child's immunizations?

    <p>The VIS for each vaccine</p> Signup and view all the answers

    What information must be charted in the patient's chart at each immunization?

    <p>The name and publication date of each VIS provided and the vaccination details</p> Signup and view all the answers

    Why is a newborn screening test performed on an infant?

    <p>For the presence of certain metabolic and endocrine diseases</p> Signup and view all the answers

    What is tested for in a newborn screening test?

    <p>Phenylketonuria (PKU), biotinidase deficiency, congenital adrenal hyperplasia, and others</p> Signup and view all the answers

    What is the most important test performed for a newborn screening test?

    <p>Phenylketonuria (PKU)</p> Signup and view all the answers

    What is PKU?

    <p>A congenital hereditary disease caused by a lack of the enzyme phenylalanine hydroxylase</p> Signup and view all the answers

    Where is the newborn screening test performed from?

    <p>Capillary blood</p> Signup and view all the answers

    Where is the capillary blood obtained from for a newborn screening test?

    <p>The fleshy part of the lateral or medial posterior curve of the infant's heel</p> Signup and view all the answers

    How is the newborn screening testing done?

    <p>The blood specimen is placed on special filter paper for analysis.</p> Signup and view all the answers

    Once the newborn screening test is performed, how long does it take to get results?

    <p>In a few days</p> Signup and view all the answers

    What happens if one of the screening test results is positive?

    <p>Further testing is performed</p> Signup and view all the answers

    Study Notes

    Pediatric Patient Office Visits

    • Two main types: well-child visits and sick-child visits

    Well-Child Visit Components

    • Focuses on growth and development, anticipatory guidance, and physical examination

    Anticipatory Guidance Topics

    • Covers safety, nutrition, sleep, play, exercise, development, and discipline

    Well-Child Visit Schedule

    • Recommended at: 3-5 days, 1 month, 2, 4, 6, 9, 15, 18, 24, 30 months, then yearly after 3 years

    Age Groups

    • Infant: birth to 12 months
    • Toddler: 1 to 3 years
    • Preschool: 3 to 6 years
    • School-age: 6 to 12 years
    • Adolescent: 12 to 18 years

    Infant Holding Positions

    • Cradle position: one hand supports the back, other grasps the arm
    • Upright position: one hand supports head and shoulders, other under buttocks

    Growth Measurements

    • Requires regular recording of weight, height, and head circumference from birth to age 3
    • Weight determines nutrition and medication dosages
    • Infants weighed in a recumbent position
    • Length measured instead of height for children under 24 months, from head to heel

    Head Circumference

    • Critical for assessing brain growth during infancy
    • Normal range: 32 to 38 cm or 12.5 to 15 inches for newborns

    Blood Pressure Measurement

    • Recommended annually starting at 3 years old
    • Cuff size is the most crucial factor for accurate readings

    Injection Techniques

    • Intramuscular injections consider medication consistency and child's size
    • Typical needle size for IM: 5/8 to 1 inch length, 22 to 25 gauge
    • Subcutaneous injections: 1/2 to 5/8 inch length, 23 to 25 gauge
    • Avoid dorsogluteal site; use vastus lateralis for infants
    • Deltoid site suitable for children 18 months and older

    Immunity and Vaccination

    • Immunity: body’s resistance to harmful agents
    • Active, artificial immunization: inducing immunity via vaccines
    • Vaccine: weakened or killed microorganisms that stimulate antibody production
    • Toxoid: treated toxins from bacteria used to prevent disease

    Vaccine Information and Administration

    • VIS (Vaccine Information Sheet) outlines benefits and risks
    • Provide immunization record card during first well-visit
    • Chart details at immunization: VIS info, vaccine admin date, manufacturer, and healthcare provider's signature

    Newborn Screening Tests

    • Tests for metabolic and endocrine diseases in infants
    • Common tests: phenylketonuria (PKU), biotinidase deficiency, congenital adrenal hyperplasia, and more
    • PKU is the most critical test; results typically available within a few days
    • Blood sample taken from the heel, placed on filter paper for lab analysis

    Positive Screening Results

    • A positive result necessitates further testing for confirmation

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    Description

    Test your knowledge on pediatric office visits with this quiz based on Chapter 24 of the pediatric examination. Learn about the crucial components such as well-child and sick-child visits, as well as anticipatory guidance topics. Perfect for future pediatricians and healthcare professionals!

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