AGE

PHYSICAL EXAM

FACTS and COMMENTS

Birth to one (1) month of age

·  Check rate of growth; height, weight and head size

·   Mental and social learning skills are assessed

Tests for certain conditions may be done just after birth:

§     Genetic Condition Testing (for example, thyroid disease, PKU)

§     Blood Count (or Hemoglobin level for anemia)

1-2 months

Yes

Hepatitis, a very important immunization; helps prevent cirrhosis of the liver

2 months

Yes

DPT--These diseases are rare but the risk for them still exists

HIB and Pneumococcus can cause pneumonia and ear infection

4 months

Yes

 

Growth and Development

6 months

Yes

Growth and Development

12 months

Yes

Hemoglobin (1 year)

15 months

Yes

Counseling on safety issues, injury prevention, dental health, diet (nutrition) and behavior

18 months

Yes

Same as above

< 23 months

--

--

2-6 years

·         Height and Weight; Blood Pressure (over 4 years old)

·         Vision screen (3-4 years of age)

·         Psychological and Social Development

Repeat boosters are necessary (See the immunizations given at 15 and 18 months of age)

Pneumococcus--For all high-risk children[1]

7-12 years

·      Height and weight

·      Growth and Development (Sexual Maturation)

·      Blood pressure

Counseling Documented:

·      Injury prevention

·      Dental health; Diet

·      Substance abuse

13-19 years

·   Growth & Development (height, weight, sexual maturation, and blood pressure

·   Rubella or MMR vaccination

·   Pap smear

·      Prevention: injury, tobacco, alcohol/substance abuse, sexuality, dental health and nutrition (watch for "Anorexia"and "Bulemia" conditions)

·      Nutrition/Exercise

 

AGE

PHYSICAL

IMMUNIZATIONS

OTHER

20-24 yrs.

Examination to include:

·      Height and Weight

·      Blood pressure

·      Pap smear (if sexually active)

·      Rubella vaccination history and/or serologic testing

·      Assess for problem drinking

Hep B (if not given in infancy, give 1st dose)

Dose at current visit, # 2 dose as early as one month later and # 3 dose in 6 months

 

Rubella (MMR) if not previously immunized.

Counseling Documented:

·      Injury Prevention

·      Tobacco use/cessation counseling

·      Alcohol/substance abuse

·      Sexual behavior inc. STD’s, HIV and Pregnancy Prevention

·      Dental Health

·      Nutrition, diet and exercise

·      Chemo-prophylaxis--multivits if female planning pregnancy

25-64 yrs.

Examination to include:

·      Height and Weight

·      Blood pressure

·      Total Serum Cholesterol

Þ      Men 35-64 yrs

Þ      Women 45-64 yrs

·      Pap smear (< or = every 3 yrs.)

·      Fecal occult blood and/or colonoscopy annually (>50 yrs. of age)

·      Mammography +/- clinical breast exam, women (ev. 1-2 yrs, ages 40-60); yearly if >50 yrs of age)

·      Rubella vaccination history and/or serologic testing

·      Assess for problem drinking

Tetanus Booster

 

Rubella (MMR) if not previously immunized

 

Influenza vaccination for high-risk persons (e.g., COPD, immunocompromised, etc.)

 

23PS Pneumococcal vaccine

Counseling Documented:

·      Injury Prevention

·      Tobacco use/cessation counseling

·      Alcohol/substance abuse

·         Sexual behavior inc. STD’s, HIV and Pregnancy Prevention

·      Dental Health

·      Nutrition, diet and exercise

·      Chemo-prophylaxis e.g., multivitamins for females planning pregnancy

·      Hormone therapy discussion especially for females, pre and post menopausal

65 yrs. and older

Examination to include:

·      Height and Weight

·      Blood pressure

·      Hearing and visual impairment tests

·      Pap smear (may consider D/C after age 65 yrs., if previous screening was regularly done and consistently nl.)

·      Fecal occult blood and/or colonoscopy, annually (> 50 yrs)

·      Assess for problem drinking

·      Yearly Mammography/clinical breast exam

·      Evaluate social support system, depression and end of life decisions.

Influenza vaccination for high-risk persons (e.g., COPD, immunocompromised, etc.)

 

23PS Pneumococcal vaccine

Counseling Documented:

·      Injury Prevention

·      Tobacco use/cessation counseling

·      Alcohol/substance abuse

·         Sexual behavior inc. STD’s, HIV and Pregnancy Prevention

·      Dental Health

·      Nutrition, diet and exercise

·      Chemo-prophylaxis

·      Hormone therapy discussion especially for females, pre and post menopausal

 

[1]  For children who have an underlying illness or medical condition.  See www.pneumo.com/home. html