🩺 Health Supervision Cram
Chapter 31 · highest-yield points
1Health supervision basics
Proactive care · identify concerns early
Medical home: continuous, coordinated, family-centered
Components: surveillance + screening · injury/disease prevention · health promotion · immunizations · anticipatory guidance (teaching before the next change).
2Surveillance vs screening
Surveillance = ongoing observation
Screening = standardized tool
Positive screen ≠ diagnosis — means further testing/referral. Universal = everyone · selective = risk factors. Act on: parent concern, missed milestones, regression = prompt eval.
3Screenings to know
Newborn: metabolic · CF · CCHD · hearing
Iron deficiency: affects cognition + school
Lead: NO safe level — older housing/paint = assess. Pediatric BP: correct cuff, interpret by age/sex/height, never diagnose on one reading.
4Injury prevention by stage
Infant: sleep · choking · car seat
Toddler: poison · drowning · burns
School age: bike · sports
Teen: driving · substances · suicide risk
Teach to anticipate current AND next abilities.
5Active vs passive immunity
Active: own immune system · lasting · memory
Passive: borrowed antibodies · temporary
Active = infection or vaccine. Passive = maternal antibodies, breast milk, immune globulin — and RSV monoclonal antibody (NOT a vaccine).
6Vaccine types
Live: MMR · varicella · rotavirus
Inactivated: IPV
Toxoid: tetanus · diphtheria
Conjugate: Hib · recombinant: HepB · mRNA / viral vector: genetic instructions. Live vaccines + immunosuppression = avoid.
7Routine schedule
Early: HepB · RV · DTaP · Hib · PCV · IPV
Later: MMR · varicella · HepA · flu
Teen: Tdap · HPV · MenACWY · MenB
HPV: best before exposure, prevents cancers. Tdap: booster as DTaP wanes. Meningococcal: meningitis + meningococcemia.
8Rotavirus — the trap
LIVE oral vaccine, given in infancy
Never with SCID or intussusception history
SCID = almost no immune defense. Intussusception = bowel telescoping into itself. Flu repeats yearly — strains change.
9Reactions + contraindications
Expected: sore arm · low fever · fussiness
Anaphylaxis: can't breathe · swelling · hives
Contraindication = do NOT give. Precaution = assess first. Never vaccinate after severe allergy to a prior dose.
10Health promotion hits
Never bed with sugary bottle
Water = primary drink · never food as reward
Weight: health, not the scale — no teasing/comparing. Sunscreen: broad-spectrum, reapply. Cut excessive screen time.