anticipatory guidance Right Ans - Patient/family counseling which includes
information, advice, and suggestions about expected health-related life
occurrences, health maintenance, and preventive plans.
where should pediatric history information be obtained from? Right Ans -
both patient and parent; obtain as much as possible from patient to give child
a degree of control over a potentially threatening situation
order of pediatric physical examination Right Ans - 1. inspection first, from
afar; examine skin color and work of breathing before beginning exam;
establish trust; allow child to sit in parents lap; defer otoscopic exam until last
when should eyes and ears be examined? Right Ans - during every health
visit
3 components of vision assessment Right Ans - - visual inspection of
eyes/eyelids
- alignment of eyes
- visual acuity
birth to age 3 ophthalmic exam includes: Right Ans - - eye history
- vision assessment
- inspection of eyelids and eyes
- pupil examination
- ocular mobility
- red reflex check
age 3 and up ophthalmic exam includes: Right Ans - - eye history
- vision assessment
- inspection of eyelids and eyes
- pupil examination
- ocular mobility
- red reflex check
visual acuity test with eye chart; classes should be worn if prescribed and
record data as "corrected"
, assessing newborn visual acuity Right Ans - should be able to briefly track
mother's face or brightly colored object within an hour after birth (fixation
reflex not developed for several weeks); dont talk while assessing vision, baby
may look toward sound rather than visual stimulus
when patient presents with eye condition (infection, injury, etc), what do you
check first? Right Ans - visual acuity; UNLESS there is chemical injury to
eye, then you should irrigate first and refer to ophthalmologist; when there is
decreased acuity, also refer to ophthalmologist
what is the visual acuity of a newborn? Right Ans - 20/200-20/400; acuity
reaches adult level of 20/20 by age 5
when to refer child to ophthalmologist Right Ans - - 3-5yr: if acuity is less
than 20/40 in either eye, or if theres a difference in two lines in acuity
between eyes
- 6yr and older: if acuity is less than 20/30 or if theres a difference in two lines
in acuity between eyes
when to assess red reflex Right Ans - birth until the child can read eye
chart
when should you start to assess fixation and following? Right Ans - 2
months; refer out if fixation and following are poor by 3 months
when to test corneal light reflex (hirschsbergs test)? Right Ans - 3 months-
5 years; refer out for asymmetry in light reflex
when to start cover testing for strabismus Right Ans - 6 months- 5 years
when to start a fundoscopic exam Right Ans - 3 years
when to start preliterate eye chart testing Right Ans - 3-4 years
minimal visual acuity at age 3-5 Right Ans - 20/40
minimal visual acuity greater than 6 years old Right Ans - 20/30
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