Pediatric Assessment and Vaccine Teaching Plan Assessment

Well-Child Visits Importance

Well-child visits are essential because, during the examination, the pediatrician can assess the physical and emotional needs of the child and intervene if even slight deviations are found. Therefore, well-child visits are fundamental for disease prevention and early intervention. During these visits, the child also receives the vaccinations required to attend school or kindergarten and play sports. During the visit, the parent may ask questions about health and development, and the pediatrician should be prepared to provide an expert answer.

The pediatrician should ask the child about their mental health, academic performance, communication problems, or significant events that affected the child. The pediatrician must provide immunization and talk about the related diseases. The pediatrician should discuss diet, sleep patterns, nutrition, social interactions, behavior, and stress levels with the child and parent. For well-child visits of children 11-14 and 14-18 years old, the doctor should discuss physical and emotional maturation topics. For example, children between 11-14 years old need to be consulted about hormonal changes. The doctor can advise the parent on what new skills the child should have at this stage.

Developmental milestones for 11-14-year-olds are indicative of normal development. They include showing greater interest in looks and dress, mood swings, more concern about the opinions of friends and classmates, improved problem-solving skills, a clearer understanding of right and wrong, and a desire for greater independence, challenge to the rules, and resistance to parenting advice. At this age, children may show signs of depression or eating disorders. At the age of 11-14, the child is examined in private, without the parent’s presence, and the doctor can ask questions and give advice to the child in person. The child can later call the doctor on their own to make an appointment and help fill out medical forms. Finally, the doctor can advise the parent on talking to the child about sex, tobacco, alcohol, drugs, safe Internet use, or bullying.

Vaccination

At age 12, your child should receive several essential vaccinations. These are the annual vaccinations against Influenza (IIV) or Influenza (LAIV4), Tetanus, diphtheria, & acellular pertussis (Tdap) immunization, and Human papillomavirus (HPV) immunization, and the first dose of Meningococcal immunization (“Recommended Child and Adolescent Immunization,” 2021 ). Influenza (IIV) or Influenza (LAIV4) helps prevent influenza, a viral infection that affects the respiratory system. The flu does not cause complications for most people, but it can be dangerous for young children, older people, pregnant women, and people with weakened immune systems. Chronic diseases such as asthma, heart disease, kidney disease, liver disease, diabetes, and a BMI of 40 or higher are also risk factors for fatal complications.

Tetanus, diphtheria, and whooping cough (acellular pertussis) are dangerous diseases caused by bacteria. People with tetanus have painful muscle tension, sometimes a blockage of the jaw, and the condition is fatal in 1 in 10 cases. Diphtheria leads to plaque build-up in the nose, throat, and airways; the illness can cause breathing problems, paralysis, heart failure, or death. A person with whooping cough experiences severe coughing bouts that interfere with eating, drinking, and breathing. Attacks can last for weeks; the main dangerous consequences of this disease are pneumonia, seizures, brain damage, and death. Diphtheria and whooping cough are spread from person to person, and tetanus can enter the body through a cut or wound.

Human papillomavirus is sexually transmitted and usually clears up on its own, but genital warts and cancer can cause complications. This disease is one of the most common sexually transmitted infections in the United States. Meningococcal disease causes illnesses that can be fatal, such as infections of the lining of the brain and spinal cord (meningitis) and infections of the bloodstream. Meningococcal bacteria are spread through saliva; immediate medical intervention is crucial in case of illness. It can save a patient from death, but vaccines are the most reliable way of protection.

Abnormal Assessment Findings

Abnormal assessment findings include some yellow stains on teeth and hair having some graying. The most common causes of teeth yellowing include contamination from beverages such as coffee, tea, dark sodas and red wine, and tobacco contamination. Improper oral care, such as improper brushing with a toothbrush, can be another important cause. Graying hair in children can have some more serious reasons, such as illness, vitamin B12 deficiency, genetics, anemia, and thyroid disease. Based on the examination results, the most likely cause is vitamin B12 deficiency.

Teaching Points and Post-Immunization Guidance

Risks associated with immunization include possible mild influenza symptoms with Influenza (IIV) immunization; other vaccinations have no side effects. Also, the doctor must strictly adhere to the deadlines and not exceed the dosage of vaccines. If the patient does not have certain vaccines, the doctor must complete the vaccination schedule under the CDC guidelines. Recommendations for abnormal findings include the need to review diet to correct graying hair problems. A healthy diet can reduce the severity of the problem; the child should be getting enough vitamin A, vitamin B, minerals, and proteins. Influenza (IIV) and Influenza (LAIV4) vaccines are safe for children and adults; Influenza (IIV) can cause side effects in the form of mild fever symptoms. Contraindications include severe allergy to the previous dose of vaccine and allergy to eggs. Contraindications for Tetanus, diphtheria, & acellular pertussis (Tdap) immunization and Meningococcal immunization include a severe allergic reaction to a previous dose. HPV immunization is contraindicated in cases of allergy to a vaccine or yeast allergy.

Patient Teaching Handout for Parents

Influenza (IIV) and Influenza (LAIV4) vaccination	Influence vaccines recommended for children to prevent viral respiratory diseases include Influenza (IIV) and Influenza (LAIV4). According to CDC research, the inactivated influenza (IIV) vaccine is safe for children and adults (CDC). The Influenza (IIV) vaccine is given by injection; after the injection, the patient may experience pain in the injection area and observe redness and swelling. More serious side effects include fever, malaise, and myalgia, which are mild and do not require treatment. This vaccine contains an inactivated virus that does not cause influenza. Contraindications include people who are severely allergic to a previous dose of IIV or LAIV vaccine. Also, people with egg allergies should not take this vaccine, which should be replaced with the RIV vaccine. The live attenuated influenza vaccine (LAIV) is given intranasal and protects against four influenza viruses. This vaccine cannot cause influenza because it contains weakened types of the virus. The vaccine is contraindicated in people who have experienced an allergic reaction to a previous dose of any influenza vaccine, allergic to eggs, children, or adolescents who receive aspirin or other salicylates. This vaccine is also contraindicated in patients with immunodeficiency diseases or in caring for people with severe immunodeficiency. In addition, the vaccine should not be given to patients who have taken antiviral drugs for influenza within the previous 48 hours.
Tetanus, diphtheria, & acellular pertussis (Tdap) immunization	Tetanus, diphtheria, & acellular pertussis (Tdap) immunization can be done using several types of vaccines, such as the DTaP vaccine (diphtheria, tetanus, and acellular pertussis) and the DT (diphtheria and tetanus) vaccine given to younger children, Tdap (combined tetanus, diphtheria, and acellular pertussis) vaccine, for adolescents and adults, and Td (tetanus and diphtheria) vaccines for adolescents and adults. Typically, teens receive a single dose of Tdap between the ages of 11 and 12. Contraindications for these vaccines include a severe allergic reaction after a previous dose, such as anaphylaxis; or allergy to vaccine components.
Human papillomavirus (HPV) immunization	Human papillomavirus (HPV) immunization is recommended for adolescents of both sexes aged 11–12 years. HPV immunization protects a person from HPV infections throughout life, which is very important as these infections can cause cancer later in life. According to CDC guidelines, teens 11-12 years old receive two doses of HPV vaccine 6 to 12 months apart. Contraindications include allergic reactions to the previous dose of the vaccine or its component, yeast allergy (Gardasil and Gardasil 9), and pregnancy. This vaccine is safe and can be given during mild forms of a cold, runny nose, or cough with a temperature below 101 degrees. If the disease is moderate or severe, vaccination should be postponed.
Meningococcal immunization	According to the CDC guidelines, Meningococcal immunization is given to adolescents aged 11-12, followed by booster vaccinations at 16 years of age. The CDC also recommends routine serogroup B meningococcal vaccination for patients over 10 years of age with an increased risk of meningococcal infection. A contraindication is a severe allergic reaction to a previous dose or any component of the vaccine.

Reference

Recommended child and adolescent immunization schedule for ages 18 years or younger, United States. (2021). CDC. Web.