Case Study: Preparing for a Well-child Visit

Case Study: Preparing for a Well-child Visit Discuss the history that you would take on this child in preparation for the well-child visit.

A well-child visit is beneficial in child care since it gives the pediatrician an opportunity to conduct a critical evaluation of the child to determine irregularities in physical, behavioral, emotional and developmental aspects of the child (Gullotta & Blau, 2016). Various issues need to be considered in preparation for a well-child visit. For instance, it is important to ask the mother concerning the type of delivery, health challenges related to pregnancy and delivery, history of drug and alcoholism during pregnancy, as well as the immunization and nutrition status of the child. It is also important to ask to ask the mother concerning the communication methods used by the child as well as the signs of language development such as gurgling sounds made by the baby.

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Questions regarding the safety of the patient should also be considered (Gullotta & Blau, 2016). For instance, the mother can be asked whether Asia rides in a car seat and the measures put in place to ensure her safety. She can also be asked whether any member of the family smokes cigarettes which may expose the child to second-hand smoke. Furthermore, the mother should be asked whether she has noticed any developmental abnormalities and limited learning capabilities in the child.

The developmental tool to be used for Asia; its reliability and validity and how Asia scored developmentally on this tool. Is she developmentally appropriate for her age?

The Ages and Stages Questionnaire 3rd edition (ASQ-3) is the most practical developmental assessment tool to use for Asia. This tool is designed strategically to facilitate the collection of data concerning the five key areas of child development which include the fine motor, the gross motor, personal-social, communication and problems solving (Gullotta & Blau, 2016). Parents can complete this screening and assessment tool. It is a reliable and family friendly as well as an accurate way of screening the developmental progress of a child (Gullotta & Blau, 2016). It helps in identifying potential development delays in children between one month and five and a half years. The ASQ-3 was selected since it addresses more developmental issues than other editions thereby making it reliable in screening different aspects of development in a child. This tool is designed for screening children between 1 and 66 months old (Fischer et al., 2014).

Moreover as pointed out by Gullotta and Blau, (2016), the screening can be carried out through online platforms such as the ASQ family access. The findings of various studies vary slightly regarding the sensitivity and specificity of the ASQ. Some studies have shown that ASQ3 has a specificity of approximately 86% with a sensitivity of 85% (Gullotta & Blau, 2016). The

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ASQ-3 revealed that the developmental milestones including language, fine and gross motor as well as language for the child had been accomplished.

The immunizations to give Asia at this visit; what is the patient education and follow-up?

During well-child visits, the pediatrician should assess the immunization status to ensure it is up to date. Some of the immunizations that should be given to Asia include the first dose of DTaP, PCV, Rotavirus, the second dose of Hep B, Hib, and IPV AT 2 months ((Thomas & Margulis, 2016) A 6 months the child should be given the second dose DTaP, IPV, Hep B, PCV, and Rotavirus. She should also be vaccinated against Influenza if it is the right season (Thomas & Margulis, 2016). At nine months the child should be vaccinated against measles, influenza, and given any other catch up immunizations (Thomas & Margulis, 2016).

Patient education at this point includes teaching the parent concerning the reactions of some vaccinations which include elevated temperature, and irritation at injection sites (Burns, Dunn, Brady, Starr, Blosser, 2012). Importantly, the parent should be discouraged from giving the child Tylenol in cases of fever as this medication tends to lower the immune response to vaccines. The parent should be advised to follow-up in 12 months for the next well-child visit or earlier if the need arises.

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Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G. (2012). Pediatric primary care. New York, NY: Elsevier Science Health.

Fischer, V. J., Morris, J., & Martines, J. (2014). Developmental screening tools: Feasibility of use at primary healthcare level in low- and middle-income settings. Journal of Health Population and Nutrition, 32(2), 314–326.

Gullotta, T. P., & Blau, G. M. (2016). Handbook of childhood behavioral issues: evidence-based approaches to prevention and treatment. New York, NY: Taylor & Francis.

Thomas, P., & Margulis, J. (2016). The vaccine-friendly plan. New York, NY: Random House Publishing Group, 2016