6-week check Flashcards Preview

MD 3: Paeds > 6-week check > Flashcards

Flashcards in 6-week check Deck (9):
1

What areas in history are important at 6 weeks?

Parents
- Coping
- Concerns
- Delivery hx, complications
- Screen for baby blues/post-natal depression
- FHx significant diseases
- Sibling development

Child
- Delivery mode, complications
- Urine/faces outputs
- Sleeping
- Irritability
- Birth weight, weight gain
- Feeding
- Allergies

2

Important initial observations on 6-week examination

- Colour - cyanosis, jaundice
- Breathing - resp distress
- Dysmorphic features or deformities
- Eyes (leukocoria & eye movements)
- Development & social (spontaneous smiling, interaction, engagement)
- Limbs moving appropriately
- Rash

3

Growth assessment in 6-week examination

- Head circumference
- Weight
- Abdominal circumference
- Length

4

Abnormalities on growth centile charts

- Crossing centiles
- Any weight loss
- Height and weight are more than 2 centiles different
- Correct for prematurity until 2 yrs

5

Examination of head/face/neck at 6-weeks

Eyes
- Movements - normal is unable to cross midline
- Presence of red reflex (leukocoria)
- Absence = congenital cataracts or retinoblastoma
- Ask parents about responsiveness to visual cues ?visual ax

Ears
- Ask parents about response to auditory cues ?hearing ax

? Cleft palate

Neck muscle tone

Palpate for early closure of fontanelles

6

Examination of limbs at 6-weeks

- Leg length & proportion
- Asymmetry of creases (groin & bum) - DDH
- General symmetry
- Barlow and ortolani tests for DDH
- Femoral pulses - delay or unilateral absence = coarctation of aorta

7

Risk factors for Hip dysplasia (DDH)

- Female
- Breech
- FHx
- Intrauterine packaging disorders and volume reduction, eg/ first pregnancy, multiple pregnancies
- Wrapping the baby with straight legs

8

Neurological examination in a 6 week examination

- Developmental reflexes: moro, rooting, grasp, stepping, suck (should be gone by 3mo), upgoing Babinski
- Assess tone: should be able to hold head up, some head lag still
- Inspect spine

9

Health promotion in 6 week examination

- Immunisations
- Passive smoking
- Breastfeeding
- Car safety