Bright Futures Medical Screening Reference Table 2 to 5 Day (First Week) Visit

Transcription

1 Bright Futures Medicl Reference Tle 2 to 5 Dy (First Week) Visit Universl Action Metolic nd Verify documenttion of neworn metolic screening results, pproprite rescreening, nd needed follow-up. Document result of neworn screening. If not done previously (eg, neworn delivered Hemogloinopthy t home, neworn dischrged from neontl intensive cre unit [NICU]), conduct screening s required y the stte. Hering If not done t irth (eg, neworn delivered t home, neworn dischrged from NICU), screening should e completed within the first month of life. Regrdless of screening results, fmily history of hering loss or conditions ssocited with hering impirment should e otined, s well s identifiction of ny risk fctors for progressive hering loss, to inform ongoing surveillnce of hering nd communiction skill development. A history of premturity (<37 completed weeks), very low irth weight (<1,500 g), or other neontl compliction requiring intensive cre; congenitl hert disese (repired or not repired) A recurrent urinry trct infection, hemturi, or proteinuri Known renl disese or urologic mlformtions A fmily history of congenitl renl disese, solid-orgn trnsplnt, or mlignncy or one mrrow trnsplnt Tretment with drugs known to rise lood pressure Other systemic illnesses ssocited with hypertension (eg, neurofiromtosis, tuerous sclerosis) Evidence of incresed intrcrnil pressure Fmily history of congenitl ctrcts, retinolstom, nd metolic or genetic diseses Risk Assessment c Anorml funduscopic exmintion results or premturity with risk conditions If completed, review results of the stte neworn metolic screening test. Unville or pending results must e otined immeditely. If there re ny norml results, ensure tht pproprite retesting hs een performed or referrls re mde to pproprite suspecilists, if required. Stte neworn screening progrms re ville for ssistnce with referrls to pproprite resources. Any neworn tht does not pss the initil screen or ny susequent rescreen should e referred for dignostic udiologic ssessment, nd ny neworn with definitive dignosis should e referred to the stte erly intervention progrm. c See Rtionle nd Evidence (pges ) in Bright Futures: Guidelines for Helth Supervision of Infnts, Children, nd Adolescents, 3rd Edition, for the criteri on which risk ssessment questions re sed. The recommendtions in this puliction do not indicte n exclusive course of tretment or serve s stndrd of medicl cre. Vritions, tking into ccount individul circumstnces, my e pproprite. Originl document included s prt of Bright Futures Tool nd Resource Kit. Copyright 2010 Americn Acdemy of Peditrics. All Rights Reserved. The Americn Acdemy of Peditrics does not review or endorse ny modifictions mde to this document nd in no event shll the AAP e lile for ny such chnges. PAGE 1 OF 1

2 Bright Futures Medicl Reference Tle 1 Month Visit Universl Action Metolic nd Verify documenttion of neworn metolic screening results, pproprite rescreening, nd needed follow-up. If not done previously (eg, y delivered t home, y dischrged from neontl Hemogloinopthy intensive cre unit [NICU]), conduct screening s required y the stte. Hering If not done t irth (eg, y delivered t home, y dischrged from NICU), screening should e completed within the first month of life. Tuerculosis A history of premturity (<37 completed weeks), very low irth weight (<1,500 g), or other neontl compliction requiring intensive cre; congenitl hert disese (repired or not repired) A recurrent urinry trct infection, hemturi, or proteinuri Known renl disese or urologic mlformtions A fmily history of congenitl renl disese, solid-orgn trnsplnt, or mlignncy or one mrrow trnsplnt Tretment with drugs known to rise lood pressure Other systemic illnesses ssocited with hypertension (eg, neurofiromtosis, tuerous sclerosis) Evidence of incresed intrcrnil pressure Fmily history of congenitl ctrcts, retinolstom, nd metolic or genetic diseses Risk Assessment c Prentl concern, norml funduscopic exmintion results, or premturity with risk conditions Hs fmily memer or contct hd tuerculosis or positive tuerculin skin test? Ws your child orn in country t high risk for tuerculosis (countries other thn the United Sttes, Cnd, Austrli, New Zelnd, or Western Europe)? Hs your child trveled (hd contct with resident popultions) for longer thn 1 week to country t high risk for tuerculosis? Tuerculin skin test If completed, review results of the stte neworn metolic screening test. Unville or pending results must e otined immeditely. If there re ny norml results, ensure tht pproprite retesting hs een performed or referrls re mde to pproprite suspecilists, if required. Stte neworn screening progrms re ville for ssistnce with referrls to pproprite resources. Positive screenings should e followed up with dignostic udiologic ssessment, nd ny infnt with definitive dignosis should e referred to the stte erly intervention progrm. c See Rtionle nd Evidence (pges ) in Bright Futures: Guidelines for Helth Supervision of Infnts, Children, nd Adolescents, 3rd Edition, for the criteri on which risk ssessment questions re sed. The recommendtions in this puliction do not indicte n exclusive course of tretment or serve s stndrd of medicl cre. Vritions, tking into ccount individul circumstnces, my e pproprite. Originl document included s prt of Bright Futures Tool nd Resource Kit. Copyright 2010 Americn Acdemy of Peditrics. All Rights Reserved. The Americn Acdemy of Peditrics does not review or endorse ny modifictions mde to this document nd in no event shll the AAP e lile for ny such chnges. PAGE 1 OF 1

3 Bright Futures Medicl Reference Tle 2 Month Visit Universl Action Metolic nd Hemogloinopthy If not done previously, verify documenttion of neworn metolic screening results, pproprite rescreening, nd needed follow-up. Hering If not done previously, verify documenttion of neworn hering screening results nd pproprite rescreening. A history of premturity (<37 completed weeks), very low irth weight (<1,500 g), or other neontl compliction requiring intensive cre; congenitl hert disese (repired or not repired) A recurrent urinry trct infection, hemturi, or proteinuri Known renl disese or urologic mlformtions A fmily history of congenitl renl disese, solid-orgn trnsplnt, or mlignncy or one mrrow trnsplnt Tretment with drugs known to rise lood pressure Other systemic illnesses ssocited with hypertension (eg, neurofiromtosis, tuerous sclerosis) Evidence of incresed intrcrnil pressure Fmily history of congenitl ctrcts, retinolstom, nd metolic or genetic diseses Risk Assessment Prentl concern, norml funduscopic exmintion results, or premturity with risk conditions Positive screenings should e followed up with dignostic udiologic ssessment, nd ny infnt with definitive dignosis should e referred to the stte erly intervention progrm. See Rtionle nd Evidence (pges ) in Bright Futures: Guidelines for Helth Supervision of Infnts, Children, nd Adolescents, 3rd Edition, for the criteri on which risk ssessment questions re sed. The recommendtions in this puliction do not indicte n exclusive course of tretment or serve s stndrd of medicl cre. Vritions, tking into ccount individul circumstnces, my e pproprite. Originl document included s prt of Bright Futures Tool nd Resource Kit. Copyright 2010 Americn Acdemy of Peditrics. All Rights Reserved. The Americn Acdemy of Peditrics does not review or endorse ny modifictions mde to this document nd in no event shll the AAP e lile for ny such chnges. PAGE 1 OF 1

4 Bright Futures Medicl Reference Tle 4 Month Visit Universl None Hering Anemi Action A history of premturity (<37 completed weeks), very low irth weight (<1,500 g), or other neontl compliction requiring intensive cre; congenitl hert disese (repired or not repired) A recurrent urinry trct infection, hemturi, or proteinuri Known renl disese or urologic mlformtions A fmily history of congenitl renl disese, solid-orgn trnsplnt, or mlignncy or one mrrow trnsplnt Tretment with drugs known to rise lood pressure Other systemic illnesses ssocited with hypertension (eg, neurofiromtosis, tuerous sclerosis) Evidence of incresed intrcrnil pressure Fmily history of congenitl ctrcts, retinolstom, nd metolic or genetic diseses Risk indictors tht re mrked with n sterisk (*) re of greter concern for delyed-onset hering loss. Cregiver concern out hering, speech, lnguge, or developmentl dely* Fmily history of permnent childhood hering loss* Neontl intensive cre of more thn 5 dys In utero infections Crniofcil nomlies Physicl findings such s white forelock Syndromes ssocited with hering loss or progressive or lte-onset hering loss* Neurodegenertive disorders* Culture-positive postntl infections ssocited with sensorineurl hering loss* Hed trum, especilly sl skull or temporl one frcture* Chemotherpy* A history of premturity (<37 completed weeks) Very low irth weight (<1,500 g) Risk Assessment Prentl concern, norml funduscopic exmintion results, or norml lignment of eyes Do you hve concerns out how your child hers? Preterm nd low irth weight infnt nd those not on iron-fortified formul Is your child drinking nything other thn rest milk or iron-fortified formul? Action if Risk Assessment Referrl for dignostic udiologic ssessment Hemogloin or hemtocrit See Rtionle nd Evidence (pges ) in Bright Futures: Guidelines for Helth Supervision of Infnts, Children, nd Adolescents, 3rd Edition, for the criteri on which risk ssessment questions re sed. The recommendtions in this puliction do not indicte n exclusive course of tretment or serve s stndrd of medicl cre. Vritions, tking into ccount individul circumstnces, my e pproprite. Originl document included s prt of Bright Futures Tool nd Resource Kit. Copyright 2010 Americn Acdemy of Peditrics. All Rights Reserved. The Americn Acdemy of Peditrics does not review or endorse ny modifictions mde to this document nd in no event shll the AAP e lile for ny such chnges. PAGE 1 OF 1

5 Bright Futures Medicl Reference Tle 6 Month Visit Universl Orl Helth Hering Action Administer the orl helth risk ssessment. A history of premturity (<37 completed weeks), very low irth weight (<1,500 g), or other neontl compliction requiring intensive cre; congenitl hert disese (repired or not repired) A recurrent urinry trct infection, hemturi, or proteinuri Known renl disese or urologic mlformtions A fmily history of congenitl renl disese, solid-orgn trnsplnt, or mlignncy or one mrrow trnsplnt Tretment with drugs known to rise lood pressure Other systemic illnesses ssocited with hypertension (eg, neurofiromtosis, tuerous sclerosis) Evidence of incresed intrcrnil pressure Fmily history of congenitl ctrcts, retinolstom, nd metolic or genetic diseses Risk indictors tht re mrked with n sterisk (*) re of greter concern for delyed-onset hering loss. Cregiver concern out hering, speech, lnguge, or developmentl dely* Fmily history of permnent childhood hering loss* Neontl intensive cre of more thn 5 dys In utero infections Crniofcil nomlies Physicl findings such s white forelock Syndromes ssocited with hering loss or progressive or lte-onset hering loss* Neurodegenertive disorders* Culture-positive postntl infections ssocited with sensorineurl hering loss* Hed trum, especilly sl skull or temporl one frcture* Chemotherpy* Risk Assessment Prentl concern, norml funduscopic exmintion results, or norml lignment of eyes Do you hve concerns out how your child hers? Referrl for dignostic udiologic ssessment PAGE 1 OF 2

6 Bright Futures Medicl Reference Tle 6 Month Visit Led Tuerculosis Risk Assessment If no previous screen or chnge in risk Does your child hve siling or plymte who hs or hd led poisoning? Does your child live in or regulrly visit house or child cre fcility uilt efore 1978 tht is eing or hs recently een (within the lst 6 months) renovted or remodeled? Does your child live in or regulrly visit house or child cre fcility uilt efore 1950? Ws your child orn in country t high risk for tuerculosis (countries other thn the United Sttes, Cnd, Austrli, New Zelnd, or Western Europe)? Hs your child trveled (hd contct with resident popultions) for longer thn 1 week to country t high risk for tuerculosis? Hs fmily memer or contct hd tuerculosis or positive tuerculin skin test? Is your child infected with HIV? Led screen Tuerculin skin test See Rtionle nd Evidence (pges ) in Bright Futures: Guidelines for Helth Supervision of Infnts, Children, nd Adolescents, 3rd Edition, for the criteri on which risk ssessment questions re sed. Follow community nd stte recommendtions. The recommendtions in this puliction do not indicte n exclusive course of tretment or serve s stndrd of medicl cre. Vritions, tking into ccount individul circumstnces, my e pproprite. Originl document included s prt of Bright Futures Tool nd Resource Kit. Copyright 2010 Americn Acdemy of Peditrics. All Rights Reserved. The Americn Acdemy of Peditrics does not review or endorse ny modifictions mde to this document nd in no event shll the AAP e lile for ny such chnges. PAGE 2 OF 2

7 Bright Futures Medicl Reference Tle 9 Month Visit Universl Development Orl Helth Hering Action Structured developmentl screen Administer the orl helth risk ssessment. A history of premturity (<37 completed weeks), very low irth weight (<1,500 g), or other neontl compliction requiring intensive cre; congenitl hert disese (repired or not repired) A recurrent urinry trct infection, hemturi, or proteinuri Known renl disese or urologic mlformtions A fmily history of congenitl renl disese, solid-orgn trnsplnt, or mlignncy or one mrrow trnsplnt Tretment with drugs known to rise lood pressure Other systemic illnesses ssocited with hypertension (eg, neurofiromtosis, tuerous sclerosis) Evidence of incresed intrcrnil pressure Fmily history of congenitl ctrcts, retinolstom, nd metolic or genetic diseses Risk indictors tht re mrked with n sterisk (*) re of greter concern for delyed-onset hering loss. Cregiver concern out hering, speech, lnguge, or developmentl dely* Fmily history of permnent childhood hering loss* Neontl intensive cre of more thn 5 dys In utero infections Crniofcil nomlies Physicl findings such s white forelock Syndromes ssocited with hering loss or progressive or lte-onset hering loss* Neurodegenertive disorders* Culture-positive postntl infections ssocited with sensorineurl hering loss* Hed trum, especilly sl skull or temporl one frcture* Chemotherpy* Risk Assessment Prentl concern, norml funduscopic exmintion results, or norml cover/uncover test results Do your child s eyes pper unusul or seem to cross, drift, or e lzy? Do your child s eyelids droop or does one eyelid tend to close? Hve your child s eyes ever een injured? Do you hve concerns out how your child hers? Referrl for dignostic udiologic ssessment PAGE 1 OF 2

8 Bright Futures Medicl Reference Tle 9 Month Visit Led Risk Assessment If no previous screen or chnge in risk Does your child live in or regulrly visit house or child cre fcility uilt efore 1950? Does your child live in or regulrly visit house or child cre fcility uilt efore 1978 tht is eing or hs recently een (within the lst 6 months) renovted or remodeled? Does your child hve siling or plymte who hs or hd led poisoning? Led screen See Rtionle nd Evidence (pges ) in Bright Futures: Guidelines for Helth Supervision of Infnts, Children, nd Adolescents, 3rd Edition, for the criteri on which risk ssessment questions re sed. Follow community nd stte recommendtions. The recommendtions in this puliction do not indicte n exclusive course of tretment or serve s stndrd of medicl cre. Vritions, tking into ccount individul circumstnces, my e pproprite. Originl document included s prt of Bright Futures Tool nd Resource Kit. Copyright 2010 Americn Acdemy of Peditrics. All Rights Reserved. The Americn Acdemy of Peditrics does not review or endorse ny modifictions mde to this document nd in no event shll the AAP e lile for ny such chnges. PAGE 2 OF 2