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?

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 Signup and view all the answers

What age group is referred to as toddlers?

1 to 3 years old Signup and view all the answers

What age group is referred to as preschool children?

3 to 6 years old Signup and view all the answers

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

6 to 12 years old Signup and view all the answers

What age group is referred to as adolescents?

12 to 18 years old Signup and view all the answers

What age group is referred to as infants?

Birth to 12 months Signup and view all the answers

What is the cradle position?

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 Signup and view all the answers

What is the upright position for holding an infant?

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

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

Weight, height, and head circumference Signup and view all the answers

Why is a child's weight important?

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

How is an infant weighed?

In a recumbent position Signup and view all the answers

When is length measured instead of height?

When the child is younger than 24 months Signup and view all the answers

How is the length of a child measured?

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

Why is head circumference an important measurement?

Because infancy is a period of rapid brain growth Signup and view all the answers

What is the head circumference range of a newborn?

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

At what age should blood pressure be measured annually?

3 years and older Signup and view all the answers

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

Cuff size Signup and view all the answers

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

80% to 100% of the arm Signup and view all the answers

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

Midpoint between the acromion process (shoulder) and the olecranon process (elbow) Signup and view all the answers

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

The consistency of the medication and size of the child Signup and view all the answers

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

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

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

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

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

The dorsogluteal site Signup and view all the answers

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

Vastus lateralis muscle Signup and view all the answers

Where is the vastus lateralis muscle located?

Anterior surface of the midlateral thigh Signup and view all the answers

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

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

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

At least 18 months old Signup and view all the answers

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

The deltoid site is too small in an infant Signup and view all the answers

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

According to the amount of subcutaneous tissue over the injection site Signup and view all the answers

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

Anterior thigh Signup and view all the answers

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

Lateral part of the upper arm Signup and view all the answers

What is immunity?

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

What is active, artificial immunization?

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

What is a vaccine?

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

What is a toxoid?

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

What is the VIS (vaccine information sheet)?

Explains the benefits and risks of a vaccine Signup and view all the answers

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

Immunization-record card Signup and view all the answers

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

The VIS for each vaccine Signup and view all the answers

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

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

Why is a newborn screening test performed on an infant?

For the presence of certain metabolic and endocrine diseases Signup and view all the answers

What is tested for in a newborn screening test?

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

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

Phenylketonuria (PKU) Signup and view all the answers

What is PKU?

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

Where is the newborn screening test performed from?

Capillary blood Signup and view all the answers

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

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

How is the newborn screening testing done?

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

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

In a few days Signup and view all the answers

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

Further testing is performed 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

Studying That Suits You

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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!