THE PEDIATRIC DIAGNOSTIC EXAMINATION - PART 1 docx

[...]... questions first to him or her Early in the visit, thank the parent or parents for accompanying their teen, and ask them to share their concerns with the patient in the room Explain that this is the policy of the clinic to listen to their concerns and gather the data, but then excuse them from the room Inform them that you will call them back before the end of the visit so that they can hear your opinions and... How does the father participate in care? Is he actively involved? How do mother and father act together in the context of the 14 Chapter 1: Taking a History in Infants, Children, and Adolescents child? What impact has the baby had on the marriage? How do they share responsibilities and decision making? If the father is not present, does he provide financial support? Are there siblings? How are they doing... egocentric, and they feel that they are the cause of every outcome As they get older, around ages 3 to 6, they begin to see causes and effects based on outside events and observations, and then they draw conclusions from that But because of their limited experience, the conclusions may be flawed For example, a 3- or 4-year-old may see a ball of clay rolled into a snakeshaped object He may conclude that the snake... more than the ball because it is longer A 7-year-old with more experience may come to the conclusion that the clay weighs the same in both instances because the snake may be longer, but it is also thinner An older child may reason that the weight is the same because reshaping the ball of clay neither adds nor takes away anything History of Present Illness 15 Children about age 5 develop the ability... of an overarching nature that define the unique features of pediatrics as a specialty and set this text apart from other textbooks on the diagnostic examination The editors and authors are experienced pediatricians who are widely regarded as among the best in their respective subspecialty areas As a physician who has spent the past 40 years honing my skills as a diagnostician, I see this book as a welcome... problems The reader also will learn to seek additional information about appropriate related problems that will lead to a correct diagnosis History of Present Illness 11 TABLE 1 6 The PQRST System for Clarification P Q R S T Provocative or palliative measures Quality of the problem Region involved Severity of the problem Temporal pattern of the problem Always enter the chief complaint into the chart in the. .. gives the best possible view of the patient’s perception of his or her problem The PQRST mnemonic is most helpful in analyzing a problem (TABLE 1 6) Always let the patient supply the answers to these questions Just listen and record Do not ask any other questions at this time Using this schema for a given problem, such as pain, we may ascertain the following: • What makes the pain worse or better? The. .. adolescents in FIGURE 1 2 It should be posted in every exam room • Is there any particular time of the day that the pain changes? Does it affect work or sleep? If it comes and goes, how long do the episodes last? How much time is free of pain? Let the patient answer the question • What are the patient’s (parents’) goals for and means of pain relief? • Are there any personal or cultural barriers to the ability... financially, and temperamentally? How will this child fit into the parents’ priorities? Do both parents work outside the home? How much do their jobs keep them away from home? Do they have any other priorities that may conflict with parenting? How are the parents’ support systems? Are there grandparents? Once the baby is born, it is important to assess the mother’s psychological state Giving birth is an overwhelming... of new mothers will report feeling “overwhelmed,” “scared,” “tearful,” or “depressed” in the first few weeks after delivery These are considered typical “baby blues” and should dissipate by 1 month postpartum However, they may not, and therefore, the mother may be experiencing a postpartum depression It is well known that maternal depression has a significantly negative impact on child well-being It . without the prior written permission of the publisher. 0-0 7 -1 5935 4-3 The material in this eBook also appears in the print version of this title: 0-0 7 -1 4 717 6-6 . All trademarks are trademarks of their. to the overall efficiency and quality of the care of the patient. This is particularly true in the case of the newborn, child, and adolescent. The Pediatric Diagnostic Examination provides the. click here 11 . THE MUSCULOSKELETAL SYSTEM 3 01 Dilip R. Patel 12 . THE NEUROLOGY SYSTEM 349 Arthur N. Feinberg 13 . THE ENDOCRINE SYSTEM 403 Martin B. Draznin and Manmohan K. Kamboj 14 . THE RENAL