Pediatrics Module 3: Well-Child Checks

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Questions and Answers

Which of the following is NOT a typical offering of early childhood programs?

School meals

Home visitations

Parent classes

Job placement services (correct)

What is the primary focus of well-child checks (WCC) concerning a child's development?

Addressing sleeping and eating habits exclusively.

Tracking milestones, social behaviors, and learning, while also being aware of parental concerns. (correct)

Primarily focusing on physical health issues, such as immunizations and nutrition.

Administering standardized developmental screening tools only at specific ages

At what age should standardized developmental screening tools be administered during well-child checks, according to the provided information?

At 6-month, 12-month, and 18-month visits

At 3-month, 12-month, and 24-month visits

At 9-month, 18-month, and 24- or 30-month visits (correct)

Only at 24- or 30-month visits

According to the information provided, what is typically the first gross motor milestone achieved in infancy?

Chin up when prone (C) Signup and view all the answers

What is the role of a team approach in well-child checks?

To create trustworthy relationships and meet needs of infants, children, and adolescents (B) Signup and view all the answers

Which of the following is NOT considered one of the four main domains of childhood development?

Nutritional skills (D) Signup and view all the answers

What is the primary goal of well-child checks?

To identify children with developmental delays or at risk for delays early. (C) Signup and view all the answers

Which of the following is NOT an established principle of child development?

Development is random. (B) Signup and view all the answers

Which of these is NOT a direct determinant of growth parameters?

Social interactions (B) Signup and view all the answers

Which of the following is NOT a typical parameter used to track growth in children?

Number of teeth (B) Signup and view all the answers

Which of these is considered a Social Determinant of Health (SDoH) that can negatively affect growth and development?

Family stability (A) Signup and view all the answers

Which of the following is a negative effect of early life stressors and adverse childhood events (ACEs)?

Reduced social functioning (B) Signup and view all the answers

What is a characteristic of normal growth patterns?

Pulsatile (C) Signup and view all the answers

At what age do infants typically develop the ability to sit unassisted?

6 months (A) Signup and view all the answers

Which developmental milestone is typically achieved around 8 months of age?

Pincer grasp (B) Signup and view all the answers

What is the typical feeding amount for a 4-month old infant?

Up to 8 oz every 3-4 hours (D) Signup and view all the answers

Approximately how much sleep per day is typical for a newborn?

Up to 18 hours (D) Signup and view all the answers

Which of these is NOT typically included in the pediatric history for school-aged children (4-11 years)?

Stooling and urination (B) Signup and view all the answers

Which of the following developmental screening tools is appropriate for use with children 1 month to 5.5 years?

ASQ-3 (C) Signup and view all the answers

When are solid foods typically introduced to an infant?

6 months (C) Signup and view all the answers

If a two-year old needs to be plotted on a growth chart, which growth chart should be used?

CDC growth chart (D) Signup and view all the answers

Which of the following is least likely to be a direct benefit of high-quality early childhood programs?

Reduced incidence of chronic diseases in adulthood. (B) Signup and view all the answers

During a well-child check, the identification of a child not reaching specific milestones is primarily used to:

Flag potential developmental delays that may need further evaluation. (B) Signup and view all the answers

What is the primary focus of tracking growth parameters and developmental milestones during well child checks?

Monitor the child's overall well-being and detect potential health or developmental issues early. (D) Signup and view all the answers

If a parent expresses concern about their child's development during a well-child check, what is the most appropriate next step?

Administer standardized developmental screening tools if not already done. (A) Signup and view all the answers

Which scenario most appropriately aligns with the recommended use of standardized developmental screening tools during a well-child check?

Using the standardized tool at 9 months, 18 months and either 24 or 30 months checks, or when concerns are raised. (D) Signup and view all the answers

Which of the following best describes the relationship between growth and development?

Growth focuses on quantitative changes, while development encompasses both physical and socio-emotional changes. (A) Signup and view all the answers

Which factor has the least direct impact on a child’s developmental trajectory, according to the provided content?

Individual rate of development. (C) Signup and view all the answers

What is the primary purpose of the American Academy of Pediatrics Bright Futures initiative, in the context of pediatric health?

To establish standardized guidelines for monitoring development. (D) Signup and view all the answers

What is meant by the statement 'development is predictable'?

While the exact timing may vary, the sequence of developmental milestones usually follows a specific pattern. (A) Signup and view all the answers

Which of the following statements most closely describes the relationship between Social Determinants of Health (SDoH) and child development?

SDoH can affect multiple areas of development, and can lead to chronic diseases. (A) Signup and view all the answers

Why is it important to understand 'normal' growth patterns when evaluating a child's development?

To identify children with potential developmental delays. (C) Signup and view all the answers

What does the 'pulsatile' nature of growth refer to?

Growth occurs in distinct periods of rapid increase followed by periods of slower growth. (C) Signup and view all the answers

Which of the following factors is least likely to influence the accuracy of a child’s growth parameter measurements?

The environment where the measurement is taken. (D) Signup and view all the answers

At what age does an infant typically begin to crawl?

9 months (B) Signup and view all the answers

What is the typical amount of formula a 4-6 month old infant consumes per feeding?

6-8 oz (C) Signup and view all the answers

Which developmental skill is typically identified around 11 months of age?

Standing and cruising (C) Signup and view all the answers

What frequency of sleeping hours is typical for a toddler?

10-11 hours/day (B) Signup and view all the answers

What is a significant aspect of the CDC checklist in pediatric assessments?

Tracking of developmental milestones (B) Signup and view all the answers

What is the characteristic feeding pattern for an infant aged 2 months?

4-5 oz formula every 3-4 hours (B) Signup and view all the answers

Which pediatric growth chart is recommended for children aged 2-20 years?

CDC growth chart (B) Signup and view all the answers

What is the appropriate number of wet diapers an infant should have daily?

4-6 wet diapers (C) Signup and view all the answers

Study Notes

Pediatrics and Adolescent Medicine - Module 3: H&P; Well-Child Checks

This module covers well-child checks for infants, toddlers, and school-aged children (0-11 years).
Development is a broad term including four domains; physical/motor skills, cognitive skills, language skills, and behavioral, social-emotional, and mental health domains.
The goal of well-child checks is to identify children with developmental delays or at risk, early.
Development is predictable, and pathways are measurable.
The range of norms for development is wide, depending on age, sex, and individual rate.
H&P examinations are variable based on developmental level, and understanding the norms.
Determinants of growth include maternal nutrition, intrauterine environment, genetics, the environment and diet, and chronic illness.
Parameters of growth include weight, length/height, BMI, head circumference and Tanner stages.
Social Determinants of Health (SDoH) affect growth and development, including factors such as adversity (maltreatment, poverty, family instability, unsafe neighbourhoods, lead exposure, racism).
Negative effects of SDOH include: inadequate coping skills, difficulty regulating emotions, reduced social function, Cognitive delays, poor academic achievement, chronic diseases, and tobacco, alcohol and drug use.
High-quality developmental and educational programs, like Head Start, improve health outcomes, learning and social skills, school readiness, and academic achievement.
Well-child checks aim to prevent illness (immunizations, safety and nutrition), track growth and development (milestones, social behaviors, learning), discuss parental concerns (sleeping, eating, development, relations with others), and build strong relationships with families.
Standardised developmental screening tools should be administered at 9-month, 18-month, and 24- or 30-month well-child checks, and whenever concerns arise.
Examples of gross motor milestones in infancy include chin up when prone (1 month), visual tracking of an object (2 months), reaching for objects (4 months), sitting unassisted (6 months), pincer grasp (8 months), crawling (9 months), and standing and cruising (11 months) .
Examples of developmental screening tools include the ASQ-3 (Ages and Stages Questionnaire, 3rd edition), for ages 1 month to 5.5 years. This covers communication, gross motor, fine motor, problem-solving, and personal/social skills.
Pediatric history for 0-3 years includes birth history, medical history, family history, social history, developmental milestones, feeding, sleeping, stooling, urination and vaccinations.
Pediatric history for 4-11 years includes birth history (if applicable), medical history, family history, social history, developmental milestones, feeding, sleeping, vaccinations, and school performance.
Examples of infant and toddler norms include feeding (e.g., 2-month-old infant: 4-5 oz formula every 3-4 hours), sleeping (0-6 months: 15-16 hours/day; 6 months-toddler: 10-11 hours/day), stooling and urination (infants may defecate once a day, several times per day, or go several days; infants: 4-6 wet diapers per day or more).
Important factors for lead screening: all enrolled NM Medicaid children MUST be tested for lead at 12 months old; 24 months old. AAP recommends universal lead screening at each age. Levels should be less than 5mcg/dL; If 5mcg/dL+ follow up and retesting is needed.
A typical 6-month-old well-child visit would include questions concerning growth, immunizations, age-appropriate milestones, introduction of solids, anticipatory guidance, and universal screening.

Childhood Vaccines

The recommended childhood vaccination schedule should be referenced and reviewed.
Specific examples of vaccines due for infants include those at 1 day old, 6 months old, 15 months old, 5 years old, and 10 years old. (Note: this is not an exhaustive list, and scheduling must be tailored to individual needs).

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Description

This quiz focuses on well-child checks for infants, toddlers, and school-aged children aged 0-11 years. It covers developmental domains, growth determinants, and health assessments to identify potential developmental delays early. Understanding each element is key to ensuring children's health and development.