The Pediatric Examination

What is the difference between height and length?

Height is the measurement of a child in the standing position. Length is the measurement of a infant in the supine position.

What is the importance of measuring blood pressure in children?

Help to identify children at risk for developing hypertension as adults. High blood pressure can cause kidney disease.

What topics are commonly included in anticipatory guidance?

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

Why is it important to measure the growth (weight and height or length) of the child during each office visit?

To determine nutritional needs and the proper dosage of a medication to administer to the child.

Why is it important for the medical assistant to develop a rapport with the pediatric patient?

To gain the child's trust and confidence, so the child will be more cooperative during an examination or procedure.

What is the primary use of growth charts?

To look at the child's growth pattern and to determine if the growth is normal. Also to identify growth and nutritional abnormalities.

What is the purpose of measuring head circumference?

To measure rapid brain growth in infants.

Why should the child's genitalia be cleaned before applying a pediatric urine collector?

To prevent contaminations, such as baby powder, fecal material, and microorganisms, from entering the urine specimen, which could affect the test results.

What occurs if the blood pressure cuff is too small or too large?

Too small, the reading may be falsely high. Too large, the reading may be falsely low.

What is the difference between a vaccine and a toxoid?

Vaccine is a suspension of weakened or killed microorganisms. Toxoid is a poisonous substance.

What gauge and length (range) of needle are recommended for giving an intramuscular injection to a child?

A needle length from 5/8 inch to 1 inch. Gauge of the needle ranges from 22 to 25, depending on the viscosity (thickness) of the medication.

At what age can the deltoid site be used to administer IM injection to a child? Explain the reason for this.

At the age of at least 18 months old. Because the deltoid site is so small in an infant.

According to the NCVIA, what information must be recorded in the patient's medical record after a pediatric immunization has been administered?

The name and publication date of each VIS provieded to the parent, the date the VIS was given to the patient.

List five guidelines for preventing childhood obesity.

1. Encourage active play. 2. Do not use food for reward, comfort, or bribes. 3.Limit television, video, and computer time. 4. Limit the amount of "junk" food kept in the home. 5. Do not make the child eat when he or she is not hungry.

List three reasons for collecting a urine specimen from a child.

1. To screen for the presence of disease. 2. To assist in the diagnosis of a pathological condition. 3. To evaluate the effectiveness of therapy.

What is the usual schedule for the well-child visits?

3 to 5 days, 1 month, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 24 months, 30 months, 4 years and once a year thereafter.

What three factors must be taken into consideration when determining if a child has hypertension?

Age, height, and gender.

Why is the dorsogluteal site recommended for use as an intramuscular injection site in infants and young children?

An injection in the dorsogluteal site may come dangerously close to the sciatic nerve.

Why can the PKU screening test be performed earlier on infants on formula compared with breast-fed babies?

Because formula contains phenylalanine, whereas the

Why can the PKU screening test be performed earlier on infants on formula compared with breast-fed babies?

Because formula contains phenylalanine, whereas the "first breast milk" or colostrum, does not and usually the test are invalid until the mother begins producing milk.

According to the American Academy of Pediatrics, at what age and how often should blood pressure be measured in children?

Children 3 years old and older have their blood pressure measure annually.

List the two positions that can be used to safely carry an infant.

Cradle position, upright position

What problems are associated with childhood obesity?

High blood pressure, type 2 diabetes, orthopedic problems caused by increase stress on weight-bearing joints, skin disorders, sleep apnea, low self-esteem, social isolation and feelings of rejection and depression.

What information must be provided to parents as required by the NCVIA?

Information about the benefits and risks of childhood immunizations.

Why is the vastus lateralis muscle recommended as a good site for giving an intramuscular injection to an infant or young child? How is the site located?

It is located on the anterior surface of the midlateral thigh, away from major nerves and blood vessels, and it is large enough to accommodate the injected medication. To locate, divide the mid-anterior thigh into thirds. The injection is administered into the middle third of the thigh.

What procedures are often performed by the medical assistant during pediatric office visits?

Measurements of: vital signs (temperature, pulse, respiration, blood pressure), weight, height, visual acuity, hearing acuity, assisting with the physical examination.

What are the symptoms of PKU if left untreated?

Mental retardation and other abnormalities, such as tremors and poor muscle coordination.

What is the primary cause of childhood obesity?

Overeating and inadequate exercise.

The newborn screening test screens for which metabolic diseases?

Phenylketonuria (PKU), biotinidase deficiency, congential adrenal hyperplasia, maple sugar urine disease, congential hypothyroidism, galactosemia, homocystinuria and sickle cell anemia

What are the components of the well-child visit?

Physical exam, necessary immunizations, providing parents with information to prepare them for development status of the child.

What is the purpose of the sick-child visit?

So the physician can evaluate the patient's condition to arrive at a diagnosis and to prescribe treatment when a child is exhibiting the signs and symptoms of disease.

What information is included in a VIS?

The benefits and risks of a vaccine. Information about reporting an adverse reaction and how to get more information about childhood disease and vaccines.

What criteria must be followed to determine the correct cuff size for a child?

The bladder of the cuff should encircle 80% to 100% of the arm. The child's arm circumference should be assessed at the mid-point of the shoulder to elbow.

What is the recommended subcutaneous injection site for each of the following? a. An infant younger than 12 months of age. b. A child that is 12 months of age or older.

a. The anterior thigh b. The lateral part of the upper arm

What immunizations are included in the following? a. DTaP: b. MMR:

a. diphtheria and tetanus toxoids and acellular pertussis b. measles, mumps and rubella