MN 580 Unit 2 Discussion Topic 1: Pediatric Health Maintenance Exam and PPE

MN 580 Unit 2 Discussion Topic 1: Pediatric Health Maintenance Exam and PPE

MN 580 Unit 2 Discussion Topic 1: Pediatric Health Maintenance Exam and PPE

The foundation of pediatric healthcare visits, both sick and well, starts with a thorough health history; from the data collected, an accurate physical examination and diagnosis can be made. Primary care healthcare visits are an integral part of ensuring the health and well-being of the child. In children that participate in sports, a preparticipation physical examination (PPE) is required and may be the only contact the healthy child has with their healthcare provider. This week’s Discussion will focus on these key topics.

Your professor will assign a topic to present and, in return, you will reply to your classmates in the other topics in order to promote a robust discussion.

Please complete each post in APA format following the Discussion Board grading rubric.

Topic 1: What are the different types of pediatric health histories? When would you use each specific type?

Topic 2: What is the review of systems (ROS)? In a SOAP note, where does the ROS belong? What is the relationship between the ROS and the physical exam?

Topic 3: Shelby is a 5-year-old female, brought to the clinic by her parents and will be starting kindergarten in the fall. The parents state that she needs her physical and shot record to register her for school. The parents state that she has been healthy and voice no concerns although Shelby is “scared” about the exam and vaccines. How would you address Shelby’s fear of the exam and vaccines? What age-appropriate screenings and lab tests are recommended for Shelby? What immunizations will Shelby require, if any?

Topic 4: Peyton is a 2-month-old female brought to the clinic by her 18-year-old mother for her health maintenance exam. What should the physical examination focus on for this child? What immunizations are due, if any? What age-appropriate anticipatory guidance topics should be discussed with mom?

Topic 5: George is a 12-year-old male brought to the clinic by his father and wants to start playing football and needs a preparticipation physical examination (PPE). He is an established patient in your practice and his last health maintenance exam was at 11 years of age. In reviewing his health history, you note that he has sickle cell trait but otherwise healthy. During his exam, you auscultate a Grade I murmur, and the remaining exam is normal. Dad asks if you will clear George to start football practice tomorrow. Would you clear George? Why or why not? Are there any specialists George needs to see before clearance? What are some of the preventive measures you would discuss with George and his father related to playing sports, specifically football?

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Part Three


One of the appropriate developmental milestones for the child at this time is social and emotional development. Social and emotional development regulates one’s behavior. The nurse assesses social and emotional development by playing with the child or observing her interacting with the mother. The other milestone is language development as seen from calling parents by names such as mama or papa. The nurse observes and points to her mother to elicit her to call by names such as mama. Language development is important for expression. The other developmental milestone is cognitive development. Cognitive development is important for processes such as decision-making. The nurse assesses cognitive development from behaviors such as putting something in a cup or container. The last one is movement or physical development. Physical development milestones are important to rule out developmental delays. The nurse assesses this milestone by determining if the child is able to stand or hold onto the furniture (CDC, 2023).

Plan of Care

The child wellness visit did not reveal any condition in the child. There are no indications for pharmacological treatments, interprofessional collaboration, or referrals. However, the mother was educated in several areas. They include the following:

Educate the mother on promoting balanced nutrition for the child

Educate the mother on safety precautions at home

Educate the mother on the risks of over-the-counter medications

Educate the mother on the importance of ensuring adequate play

Educate the mother on danger signs that should be reported

Educate the mother on the child’s developmental milestones

Educate the mother on the normal side effects of vaccines

Educate the mother on the management of the child’s reactions to vaccines

Educate the mother on the importance of hygiene for disease prevention

Follow-up care after a month

Health Maintenance Item

Balanced nutrition: Balanced nutrition is important for the child’s health and well-being. Balanced nutrition improves the child’s immunity, hence, protection against infections. It also promotes normal development, which prevents delayed developmental milestones (Marshall et al., 2022).

Social Determinants of Health

Educational level is a potential social determinant of health in the case study. Educational level influences other health-related aspects such as awareness about health promotion interventions and access to high-quality care for the infant. Low education affects the utilization of health promotion services such as immunizations among the population (Johnson, 2020). I will address the obstacle by educating the mother about health promotion and disease prevention strategies.

Differential Diagnoses

Influenza: Influenza is the child’s first differential diagnosis. The mother reports that the child occasionally has some nasal drainage. Influenza is a respiratory condition with similar symptoms such as nasal drainage (Duris, 2022). However, the child does not have other symptoms such as a sore throat or irritability.

Allergic rhinitis: Allergic rhinitis is the other differential that should be considered based on the history of runny or stuffy nose (Duris, 2022). Additional information such as the presence or absence of fever, irritability, or poor feeding should be obtained to rule out allergic rhinitis.

Anatomic rhinitis: Anatomic rhinitis is the other differential to be considered because of a history of nasal drainage (Duris, 2022). Anatomic rhinitis develops due to structural problems such as the deviation of the nasal septum.

Bacterial rhinitis: Bacterial rhinitis is the last differential diagnosis that should be considered for the child. However, it is the least likely diagnosis because of the lack of fever.




CDC. (2023, December 7). What developmental milestones is your 1-year-old reaching? Centers for Disease Control and Prevention.

Duris, A. (2022). Textbook of 2023 Medical-Surgical Nursing. Amazon Digital Services LLC – Kdp.

Johnson, T. J. (2020). Intersection of Bias, Structural Racism, and Social Determinants With Health Care Inequities. Pediatrics, 146(2), e2020003657.

Marshall, N. E., Abrams, B., Barbour, L. A., Catalano, P., Christian, P., Friedman, J. E., Hay, W. W., Hernandez, T. L., Krebs, N. F., Oken, E., Purnell, J. Q., Roberts, J. M., Soltani, H., Wallace, J., & Thornburg, K. L. (2022). The importance of nutrition in pregnancy and lactation: Lifelong consequences. American Journal of Obstetrics and Gynecology, 226(5), 607–632.


Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.

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Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.

One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.

I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.

In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.

Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).

Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).

Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.

I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.

As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.

It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.


Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.