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Chapter 1 Index
A. General Information
about the well child examination
--Prenatal Visit
--Well Child Check-up
--Neonatal Jaundice
--Breast
Milk Jaundice
--Circumcision
--Diapers
--Pacifiers
--Birth Defects
--Newborn Metabolic Screen |
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Body Language and the Office Visit
1. Greeting of the parent
- Attire - wear white coat - not scrubs; try and look relaxed.
- Demeanor - do not chew gum.
- Greeting parent/child: do not say “Mom” when referring to the mother
of your patient. Try to call both mother and child by name: Mrs. ----- or
Ms. -----.
- Door - always close the door when having a patient interaction.
Ensures privacy.
- Sit - even if only for a few minutes, sit down to discuss issues.
2. Taking the History: sit down!
- Eye contact - important that they know you are taking them seriously.
- Ask “ How can I help you today?” Use open-ended questions whenever
possible.
- Do not interrupt - let the parent talk uninterruptedly for several
minutes about problems.
- Focus history - after a few minutes have passed, then gently focus the
history by directing questions to involve the chief complaint.
- Give cues that listening: nod, smile, and give facial interactions.
- Interact visually with child - see if history fits the story you are
being told.
3. Physical Exam: Child Totally Undressed Even for an Earache. Girls
over 5-6 years of age should be given a drape to wear, boys can have their
shirts off. Teenagers can have a sheet to cover their legs if they so
desire.
- Demeanor
- smile and talk to child - even if the child an infant; call baby by
name.
- Act relaxed - even when you are rushed.
- Actual PE:
- Note age/weight/development as examine: fit with history (visual
exam)?
- Be focused but do complete PE.
4. Assessment
- If in continuity clinic, come to own assessment first.
- Mention that will return, and then present to faculty member:
- - 2 minute summary: hx, pe, assessment; plan: meds, when return
5. Instructions to Parents
- Summarize findings and plan of treatment: be specific how often the
medication should be taken, and when it should be finished.
- Inform parents of what specific problems to watch for, and when to
call back: for example, “call back if fever persists for 48 hours.”
- Give time to return (2 weeks, next check-up, etc.).
- If well visit, and immunizations are anticipated, describe the shots,
their possible side effects and when parents need to call back.
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