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One month NUTRITION
encourage exclusive breast feeding. correct formula preparations. Vit D adequacy. no solids or water.
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One month DEVELOPMENTAL SURVEILLANCE
calms when upset. follows parent with eyes. recognizes caregiver voice. starts to smile. lifts head when prone.
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One month KEY ITEMS ON PE
growth trajectory and percentiles. rashes, bruising. fontanells. eye mobility, red reflexes. murmurs pulses. hip stability. tone and strength
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One month ANTICIPATORY GUIDANCE
back to sleep, tummy time when awake. rear facing car seat in back. scald prevention. water heater at `120 F, no hot beverage while holding baby. fall prevention. passive smoking. dealing with crying baby
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One month UNIVERSAL SCREENING
postpartum depression. review newborn screening results
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Two months NUTRITION
encourage exclusive breast feeding. correct formula preparation. vit D adequacy. no water or solids
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Two months DEVELOPMENTAL SURVEILLANCE
social smile. self comforts. holds head up. symmetric movements. begins push up when prone.
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Two months KEY ITEMS ON PE
growth trajectory and percentiles, rashes, bruising. fontanelles. eye mobility red reflexes. murmurs pulses. hip stability. tone strength
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Two months ANTICIPATORY GUIDANCE
back to sleep, tummy time when awake. encourage self comforting to sleep. rear facing car seat in back. scald prevention. fall prevention. passive smoking. dealing with crying baby.
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Two months UNIVERSAL SCREENING
postpartum depression. review newborn screening results if not done already.
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Four months NUTRITION
encourage exclusive breast feeding. correct formula preparation. vit d adequacy. cereal 4-6 months on with spoon. no honey under 12 months.
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Four months DEVELOPMENTAL SURVEILLANCE
expressive babbling. pushes chest to elbows. begins to roll and reach
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Four months KEY ITEMS ON PE
growth trajectory and percentiles. rashes, bruising. fontanelles. skull shape. eye mombility, red reflexes. corneal light reflexes. murmurs pules. hip symmetry. tone strength
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Four months ANTICIPATORY GUIDANCE
encourage self comforting to sleep. stop night feedings. rear facing car seat in back. scald prevention. fall prevention. passive smoking. keep small objects, plastic bags, poisons from baby.
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6 months NUTRITION
encourage exclusive breast feeding. correct formula preparation. vitamin d adequacy. intro of cereal, vegetables, fruits. solids only with spoon. start water, limit juice. introduce cup. no honey under 12 months. fluoride supplementation
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6 months DEVELOPMENTAL SURVEILLANCE
recognizes faces. babbles, vocal turn taking, responds to name. visual and oral exploration. hand to mouth. rolls over, sits with support, stands supported and bounces
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6 months KEY ITEMS ON PE
growth trajectory and percentiles. rashes bruising. fontanelles. skull shape. eye mobility, red reflexes, corneal light reflexes. hip symmetry. tone and strength.
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6 months ANTICIPATORY GUIDLINES
assess flouirde source, cleen teeth, avoid bottle propping and grazing. read picture books to baby. rear facing car seat in back. scald prevention. fall prevention. passive smoking. keep small objects, plastic bags, poisons from baby. home safety check. gates barriers, storage of dangerous items. no infant walkers. poison control 1800-222-1222. parent at arms reach while child is in water.
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6 months UNIVERSAL SCREENING
oral health, development
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9 months NUTRITION
encourage self feeding. regular mealtime routines. vit d adequacy. table food introduction. cup drinking; plan to d/c bottle by 12 months. continue nursing if desiriable. no honey under 12 months
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9 months DEVELOPMENTAL SURVEILLANCE
stranger anxiety. points to objects. plays peek a boo. sits with no support. says dada/mama nonspecifically
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9 months KEY ITEMS ON PE
growth trajectory and percentiles. rashes and bruising. fontanelles, skull shape. eye mobility, red reflexes. murmurs pulses. hip symmetry. tone and strength. parachute reflex
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9 months ANTICIPATORY GUIDANCE
keep consistent daily routines. read picture books; avoid tv, other screens. rear facing car seat in back. scald prevention. fall prevention. passive smoking. keep small objects plastic bags, poison from baby. home safety check; gates. storage of dangerous material, no infant walkers. set water temp <120F. within arm reach while in water. poison control 1800-222-1222
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9 month UNIVERSAL SCREENING
oral health development
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30 months NUTRITION
three meals, two snacks. low fat milk 16-24 oz, limit juice. iron rich foods. fruits and veges. avoid choking hazards.
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30 month DEVELOPMENTAL SRUVEILLANCE
three to four word phrases, half of speech understandable. is your child speaking in sentences? points to six body parts. dresses with help. copies vertical line.
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30 month KEY ITEMS ON PE
growth trajectory and percentiles, including BMI. eye cover/uncover, red reflexes. observer coordination, language clarity, socialization
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30 month ANTICIPATORY GUIDANCE
read picture books, limit tv and other screens to 1-2 hours and assess quality. encourage family physical activity. tell me what you do as a family. encourage independence by offering choices. discuss toilet training, personal hygiene. apply fluoride varnish; dental referral. car seat placed in back. dental referral. bike helmet. supervise child outside. window guards above ground level. smoke detector; fireplan. water safety, "touch" supervision. store guns unloaded and locked away, with ammo separate
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30 month UNIVERSAL SCREENING
development
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3 years NUTRITION
three meals two snacks. low fat milk 16-24 oz limit juice. iron rich foods, fruits/veges
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3 years DEVELOPMENTAL SURVEILLANCE
feeds, dresses self. two to three sentences. speech 75% understandable. gender identity. tower of six to eight blocks. alternate feet up stairs. copies circle
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3 years KEY ITEMS ON PE
bp, growth trajectory and percentiles, including BMI. fundoscopic exam. dental caries, plaque, gingivitis. speech clarity. adult child interaction
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3 years ANTICIPATORY GUIDANCE
read books, limit tv and other screesn. encourage interactive games, taking turns. family time and exercise. dental referral. car seat placed in back. bike helmet. supervise child outside. window guards above ground level. smoke detector, fireplan. store guns unloaded and locked with ammo separate and locked.
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3 years UNIVERSAL SCREENING
development visual acuity
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language is the best indicator of future _____ ____.
intellectual potential
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language delay is the most commonly diagnosed form of _____ delay in preschool children.
developmental delay
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true dysfluency is _____
stuttering- and speech therapy is often effective
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shots at one month
Heb B (can be at month 2)
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shots at 2 months
- Hep B, RV, DTaP, Hib, PCV, IPV
- RV-rotavirus, DTAP-diptheria and tetanus toxoids and acellular pertussis, IPV- polio, PCV-pneumococcal
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4 months shots
RV, DTaP, Hib, PCV, IPV
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6 months shots
Hep B (6-18 mo), RV, DTaP, Hib, PCV, IPV (6-18 mo), and influenza can be started yearly
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12-15 month shots
MMRV, Hib, PCV
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Lower central incisor develop around __ to __ months followed by upper incisor __ to __ months
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The full set of 20 primary teeth will erupt by ____
25 to 33 (two years 1 month)
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At first tooth eruption , parents should be advised to clean teeth with a ___, ___daily
soft brush or cloth twice daily
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Fluoride in ___ ppm is effective in aid of protecting teeth.
.7 to 1.2 ppm
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The leading cause of death through 4 months of age is....
SIDS
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After four months of age the leading cause of death in child is...
trauma
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Drowning is ___, fire is ___
2nd and 3rd in leading causes of death in child hood.
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Scald burns can be prevented by turning the water heater temp down to <____
120F
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risk of choking and poisoning is highest between ages _ months and _ years
9 months and 3 months
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fall are the leading cause of ___ in children
nonfatal injuries
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The leading chronic illness in kids is...
dental caries
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M-Chat is used for .... and should be done ...
autism and 18-24 months
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Too much fluoride can cause ____ and stain teeth permanently.
fluorisis
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Vit K injection to a newborn prevents the development of ____.
hemorrhagic disease
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What three measurements are taken and recorded of a newborn to determine norm for gestational age.
head circumference, ht, wt
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appropriate for gestational age means...
the infants wt.
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small for gestational age means the wts is less than ____ for gestational age.
<10th percentile
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babies with SGA (small for gestational age should have ___ monitored?
blood glucose, due to decrease glycogen stores and risk for hypoglycemia
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The three factors that contribute to intrauterine growth retardation?
Fetal factors, maternal factors, placental factors
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IUGR, intrauterine growth retardation is divided into two categories based on gestation age at onset. ____IUGR and _____IUGR
- early onset/symmetrical prior to 28 weeks
- and
- late onset/asymmetrical (big head compared to body, placenta was not sufficient enough to meet demands of body)
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LGA large for gestational age
newborns in the 90th percentile for gestational age
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superficial nonblanching hemangiotic lesion most commonly located on the eyelids and posterior neck at the hairline is...(newborn)
- stork bite/ salmon patch
- more prominent with bathing but fade with time.
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flat dark blue-black pigmented macules the lower back and buttocks...(newborn)
mongolion spots common in AA, Asian, and Indian ethnic groups
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pearly white pale or pale yellow epidermal cysts found on the nose, chin, and forehead. lesions will exfoliate and disappear withing the first few weeks of life needing no treatment.
milia
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extremely common rash in newborns is _____. and consists of evanescent papules, vesicles, and pustules, each on an erythematous base, that usually occur initially on the trunk and spread outward tot he extremities. it typically appears to 24 to 72 hours after birth. and typically resolves around day 3-5. it is of no clinical significance.
erythema toxicum
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______ is due to the same reasons that neonatal breast budding and vaginal bleeding occur and will go away as these hormones are resolved. no treatment is needed
neonatal acne
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unexplained hoarseness warrants...(neonate)
further investigation
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umbilical hernias are common and if they persist beyond __ years they are surgically repaired.
3-4 years
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male neonate genitalia, hypospadias is
the ventral surface of the penis urethral opening
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cryptorchidism is fixed at __ if the testicle has still not gone into sac
1 year`
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Caput successdaneum is
edema of the scalp tissues. the swelling often crosses the midline and or suture lines and is firm but pits to pressure
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neonates are obligate ___ breathers
nose
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choanal atresia is...
a congenital condition that is the blockage of the posterior nasal airway by a membranous or bony obstruction
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torticollis is...
restriction of head turning to either side . a unilateral congenital fibrotic shortening of the sternocleidomasoid muscles. girls with Turner syndrome.
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Clavicle fractures are present in __% of neonates post deliveries.
2%
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Erb palsy
infant holds the affected arm close to the body. extended at the elbow, internally rotated, with forearm fixed in pronation but hand movement is preserved.
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Klumpke paralysis
the upper arm is unaffected, but the hand muscles are weak and the grasp reflex is not present
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___ ___ may be a cause of anterior and posterior medial thigh creases and gluteal folds that are asymmetric.
hip dysplasia
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metatarsus adductus is
medial curving of the forefoot
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talipes equinovarus is
clubfoot
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