1. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Chapter 42 Pediatric Examinations

2. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Pediatrics Specialty practice dealing with children from birth through ages 16-18

3. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Pediatrics Pediatric patients are examined more frequently than adults – Recommended screening schedule from American Academy of Pediatrics (AAP) – Medicaid’s EPSDT program

4. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Pediatric Growth and Development Growth – Refers to changes in height and weight Development – Refers to the ability to control the body and use verbal and mental skills – See Table 42-1

5. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Pediatric Measurements Measurements are essential for monitoring growth and development – Recumbent length of patient – Height – Weight – Head circumference – Chest circumference

6. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Pediatric Measurements Growth charts are used to record measurements – Available from the CDC: www.cdc.gov/growthcharts www.cdc.gov/growthcharts – Able to compare measurements with percentiles of children the same age – Failure to thrive

7. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Growth Charts

8. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Pediatric Office Environment The office will have protocols to deal with well and sick children – Follow standard precautions – Maintain the play area and common areas Establishing rapport with children is important to gain the child’s trust and cooperation

9. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. MA Role in Pediatrics Assist the patient and parents – Provider patient education Assist the provider – Assist in gathering data – Document – Perform screening tests within your scope of practice

10. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Child Neglect and Abuse Threats or acts that may cause physical or mental harm to a child must be reported Neglect versus Abuse – Neglect: the lack of or withholding care – Abuse: inflicting emotional, physical, or sexual injury

11. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Assisting with the Exam Establish rapport with the patient and caregiver – Treat children as individuals – Give the same kindness and respect as any other patient Assist the provider – Exam is similar to adult comprehensive physical exam, reviewing from head to toe

12. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Immunizations You may assist the provider in administrative immunizations, or administer them yourself (per office policy and state law) Immunization schedules are provided from the CDC – 0-6 years – 7-13 years

13. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Recording Immunizations Prior to administration, patients (or caregivers) are given vaccine information sheets Documentation is required – Vaccine Administration Record in chart – Parent’s Booklet

14. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Vision and Hearing Screening Vision screening – Snellen big E chart (shown right) – Kindergarten chart with shapes and symbols

15. Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Vision and Hearing Screening Hearing screening – Infants and small children: based on observation – Older children: testing with audiometer