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(BQ) Part 2 book Manual of ambulatory pediatrics presents the following contents: Management of common pediatric problems (allergic response to hymenoptera, allergic rhinitis and conjunctivitis, anorexia nervosa, aphthous stomatitis,...), drug index (altabax ointment, amoxicillin and clavulanate potassium, budesonide inhalation suspension,...).
11304-04_Part II.qxd >>>>> 11/26/08 10:03 AM Page 201 PART II Management of Common Pediatric Problems Elizabeth S Dunn and Sherri B St Pierre P art II covers common pediatric health problems within the scope of practice for nurse practitioners and others responsible for the delivery of primary health care The most common management problems are included and are developed according to the SOAP format, an outline form that includes subjective data, objective data, assessment, and plan The subjective data include the information with which the child or parent presents or the provider expects to elicit in a history of the presenting illness The objective data include the information that would be obtained from the physical examination of the child and from laboratory tests In the assessment, the differential diagnoses for each management problem are listed and include relevant information to assist the provider in making an accurate diagnosis The plan consists of various treatment modalities used in managing the case, as well as specific pharmaceutical and symptomatic treatment Additionally, for each protocol, there is an extensive education section that includes pertinent information for parents as well as helpful suggestions for the health care provider It incorporates physical care, psychosocial issues, medication information, and general information about the presenting problem The etiology, incidence, communicability, and incubation period have been included for each protocol when applicable Similarly, complications and indications for follow-up, consultation or referral are a part of every protocol Where applicable, resources for both the health care provider and patient/family have been included at the end of the protocol Before initiating a treatment plan for any management problem, several factors must be recognized and assessed First, a high anxiety level may interfere with the parent’s or child’s ability to hear and remember the recommended plan; the provider should recognize this anxiety and deal with it Second, the ability to follow through with recommendations should be assessed; for example, a parent already stressed by the daily care of several small children may find the additional tasks involved in coping with a sick 201 11304-04_Part II.qxd 202 11/26/08 10:03 AM Page 202 PART II Management of Common Pediatric Problems child overwhelming Third, given that compliance is enhanced by knowledge, it is essential to evaluate the parent’s or child’s understanding of the disease and the treatment The provider must be aware of potential barriers to compliance, such as ethnic or religious customs or restrictions, and address them as necessary Fourth, regarding pharmaceuticals, it is necessary to ascertain whether the family can afford the prescribed medication, how they intend to measure the dosage, whether they understand the route of administration, whether they can give it at proper intervals, and whether they know the importance of continuing the medication for the duration prescribed Protocols are included for some of the most common childhood problems Changes and additions may need to be noted, because specific practices and geographic locations may necessitate minor revisions For most effective use, each protocol should be carefully reviewed by the health care team and amended, if necessary, for their particular health center Once reviewed and amended by the nurse practitioner and collaborating physician, they can be used as guidelines for practice as required for nurses practicing in an expanded role Indications for use and dosages for drugs are from current literature However, because medicine is a constantly changing science, recommendations for management and standards for use of drugs are subject to frequent change For this reason, current recommendations should be reviewed on a regular basis Health care providers must be cautious and vigilant in their diagnosis and in their prescribing of antimicrobials in this era of ever-increasing antibiotic resistance It is incumbent on us to use antibiotics carefully and judiciously to avoid perpetuating or contributing to the current trend It is also our responsibility to be aware of the resistant strains in our communities before prescribing for children Anorexia and bulimia have been included in this section Although these are not necessarily problems that should be managed solely in the primary health care setting, the health care provider is responsible for the diagnosis, referral, and coordination of care for these contemporary issues Such cases are presented with pertinent background information, presenting signs and symptoms, indicators for diagnosis, broad guidelines for management, and referral sources The health care provider may choose to keep a list of local resources pertaining to each of these protocols E.S.D ACNE An inflammatory eruption involving the pilosebaceous follicles characterized by comedones (open and closed), pustules, or cysts It is a chronic disorder, has a varied presentation, and is often resistant to treatment I Etiology A Pilosebaceous follicle activity is stimulated by increased androgen levels during puberty Desquamation of the follicular wall occurs, creating a number of cells that, combined with sebum, result in a plug, obstructing the lumen of the follicle Corynebacterium acne enzymes hydrolyze these trapped sebaceous lipids, causing distention and rupture of the sebaceous ducts 11304-04_Part II.qxd 11/26/08 10:03 AM Page 203 Acne 203 B An inflammatory reaction occurs in the dermis with the release of the keratin, bacteria, and sebum II Incidence A Affects approximately 80% of adolescents in varying degrees B Generally disappears by the early 20s in males, somewhat later in females C Severe disease affects males 10 times more frequently than females III Subjective data A Vary according to the degree of severity; complaints include: “Bumps,” blackheads, whiteheads, pimples, cysts, scarring Pain on application of pressure Premenstrual flare B Location: Face, chest, back, buttocks C Pertinent subjective data to obtain Does patient see acne as a problem and want treatment for it? Does acne flare with stress or emotional upheaval? Does acne flare premenstrually? Do seasonal changes affect acne (e.g., improve in summer or worsen with high humidity)? Does acne worsen in response to certain foods? What are these types of food? What treatment has been used in the past? What was the response to previous treatment? Has female patient been on birth control pills? Are there any associated endocrine factors? a Does patient have regular menstrual periods? b Does patient complain of hirsutism? 10 Does patient use cosmetics or creams on skin? Determine type— oil-based or water-based 11 Is patient exposed to heavy grease and oil? D Note: Often the patient will not complain of any symptoms because of embarrassment It is the responsibility of the nurse practitioner to raise the issue IV Objective data A Inspect the entire body Lesions may be found on the face, earlobes, scalp, chest, back, buttocks; they generally recur in the same areas B Lesions Mild acne a Closed comedones (whiteheads) b Open comedones (blackheads) c Occasional pustules Moderate acne a Comedones—open and closed b Papules c Pustules 11304-04_Part II.qxd 204 11/26/08 10:03 AM Page 204 PART II Management of Common Pediatric Problems Severe, inflammatory acne a Comedones—open and closed b Erythematous papules c Pustules d Cysts C Scarring may be present in any stage D Hair is often very oily V Assessment A Diagnosis is easily made by the appearance of the different lesions present on the skin B Assess degree of involvement—both physical and emotional—to determine the best therapeutic plan VI Plan A Mild acne Topical bacteriostatic: Benzoyl peroxide products are potent antimicrobial agents as well as exfoliant, sebostatic, and comedolytic agent a Use one of the following: (1) Desquam-X (clear aqueous gel) (2) Benzagel (clear alcohol gel) (3) PanOxyl (clear alcohol gel) (4) Benzac W (2.5% aqueous base gel) b Begin with 5% used once daily (With fair or sensitive skin, use every other day and increase frequency accordingly.) c Follow-up telephone call in weeks If no sensitivity, gradually increase application to twice daily or add Topical antibiotic a T-Stat pads, bid b Cleocin T lotion, gel, or solution, bid or Retinoid a Retin-A: Use 0.025% cream or 0.01% gel or b Differin 0.1% gel or cream (1) Initially, use on a small area every other day, and increase use to once daily if no irritation develops c Combined retinoid-bacteriostatic therapy (1) Apply retinoid cream or gel at bedtime (2) Apply benzoyl peroxide preparation in AM (3) With Retin-A, not apply simultaneously; will inactivate both chemicals (4) Differin gel or cream has a lower incidence of irritation than Retin-A gel and is compatible with concurrent application of benzoyl peroxide 11304-04_Part II.qxd 11/26/08 10:03 AM Page 205 Acne 205 Recheck in the office in month Continue regimen if condition responds to treatment If there is no response to treatment and no sensitivity to the medication: a Increase strength of benzoyl peroxide preparations to 10% used once daily Increase frequency to twice daily after weeks if no sensitivity b Increase strength of Retin-A to 0.05% cream or 0.025% gel used once daily Increase frequency to twice daily after weeks if no sensitivity Use cream base for dry skin, gel base for oily skin c During early treatment, an increase in inflammatory lesions is common Improvement may take as long as months Further follow-up should be individualized according to the patient’s needs and the degree of response to therapy B Moderate acne Benzoyl peroxide gel (types and dosages as above) or Retin-A Cream 0.05% or Differin gel 0.1% or BenzaClin Topical gel, twice a day Hot soaks to pustules to times a day Tetracycline 250 mg qid or 500 mg bid, over age 12 or alternately Erythromycin gm/d Recheck in weeks a With no improvement and no local irritation: (1) Increase tetracycline to 1.5 g/d for weeks, then g/d for weeks (2) Increase strength of keratolytic gel to 10% or increase Retin-A to 0.1% cream or change to 0.025% gel b With marked improvement, decrease tetracycline to 250 mg bid Recheck again in weeks a With no improvement: (1) Continue tetracycline at g/d (2) Use keratolytic gel at bedtime and Retin-A in the morning b With improvement: (1) Decrease tetracycline to 250 mg qid or discontinue if already decreased to bid (2) Continue with topical medication Continue individualized follow-up: a Every to weeks while on tetracycline b Every to months while on topical medication 11304-04_Part II.qxd 206 11/26/08 10:03 AM Page 206 PART II Management of Common Pediatric Problems 10 Note: If patient is an adolescent female on the birth control pill or seeking oral contraception order, Ortho Tri-Cyclen #28 a It has minimal intrinsic androgenicity b Studies have shown clinically significant improvement in total acne lesions and inflammatory lesions C Severe or inflammatory acne Topical medication as above Hot soaks to inflamed lesions to times a day Tetracycline 250 mg qid Recheck in weeks With no improvement, increase tetracycline as above Refer to dermatologist if no improvement on this regimen D Note: Limit refills on tetracycline to ensure follow-up visits Tetracycline is generally drug of choice It is inexpensive, has few side effects, and is well-tolerated for long-term administration The usual precautions for young children or possibility of pregnancy should be followed Antibiotic therapy may take to weeks for any noticeable improvement to occur Sulfur can be comedogenic Keratolytic gels penetrate better than creams or solutions When discussing acne, not hesitate to touch the area so child does not feel he or she is “dirty.” Tell child that blackheads are not dirt but oxidized melanin Psychological scarring may occur Appropriate therapy should be instituted if patient perceives acne as a problem “Prom Pills”—Emergency clearing of inflammatory acne for a prom, wedding, or other major event: Prednisone, 20 mg every morning for days 10 Do not use BenzaClin gel in conjunction with erythromycin VII Education A Acne is chronic It cannot be cured, but it can be controlled Acne flare ups occur in cycles, both hormonal and seasonal B Explain etiology (for psychological support) C When local treatment is instituted, acne may appear worse before it improves Expect 6–8 weeks before treatment is effective D For mild and moderate acne, the aim is to dry and desquamate the skin Expect some dryness, peeling, and faint erythema of the skin E Topical medication If marked erythema and pruritus develop in response to topical medication, discontinue use temporarily and then resume with less frequent application Apply 20 to 30 minutes after gentle washing Apply lightly to affected area Do not rub in vigorously Expect a feeling of warmth and slight stinging with application 11304-04_Part II.qxd 11/26/08 10:03 AM Page 207 Acne 207 F Hygiene Avoid abrasive agents (e.g., over-the-counter scrubs) Shampoo frequently; no special shampoo is necessary Change pillowcase daily Do not pick or squeeze lesions; this will retard healing and cause scarring Use face cloth and hot water for soaks Try to soak for 10 to 20 minutes to times a day Wash face gently three times daily with mild soap; excess scrubbing can exacerbate acne Facials may exacerbate acne Use only water-based cosmetics a Oil-free is not necessarily water-based b Use loose powder and blush Acne medications can be applied under cosmetics and sunscreens 10 Avoid oily sunscreens Sundown and PreSun are generally acceptable G Avoid foods that seem to make acne worse H Overexposure to sunlight can exacerbate acne, alone or in combination with topical medications Topical medications can be used under sunscreens It may, however, be necessary to discontinue these medications in the summer I Mild sun exposure often dramatically improves acne J High humidity and heavy sweating exacerbate acne, as does exposure to heavy oils and grease K Tetracycline While on medication, restrict exposure to sunlight Do not take if there is any question of pregnancy Take hour before or hours after a meal If unable to take four times a day because of schedule, take 500 mg every 12 hours Nurse practitioner should acknowledge that it may be a problem for an adolescent to have an empty stomach times a day Patient must take the full dose for at least month for effective treatment Moniliasis may occur in females L Discuss preparations available over the counter Explain to adolescent (and parent, if applicable) that it is more cost-effective to follow the treatment regimen than to try all the latest acne products for the dramatic cures that advertisements promise M.Birth control pill may need to be changed to one that does not contain norgestrel, norethindrone, or norethindrone acetate N T-Stat should be applied with the disposable applicator pads Drying and peeling can be controlled by reducing the frequency of application O BenzaClin gel may bleach hair or fabric P Inflammatory acne can result in scarring and/or pigment changes Treatment will prevent or minimize these changes 11304-04_Part II.qxd 208 11/26/08 10:03 AM Page 208 PART II Management of Common Pediatric Problems VIII Follow-up A Acne is chronic Treatment should be continued until the process subsides spontaneously but may be interrupted or discontinued during summer months when temporary remission may occur because of sun exposure B Return visits need to be individualized according to the severity of the acne and the emotional needs of the adolescent Once control has been achieved, however, the frequency of follow-up can be decreased The patient may need to remain on a 250- to 500-mg daily maintenance dose of tetracycline for several months, in which case 6- to 12-week return visits should continue If patient is on topical medications alone, after acne is controlled, the frequency of application can be adjusted by the patient, and telephone follow-up may be sufficient IX Complications A Psychological problems B Secondary bacterial infection C Scarring X Consultation/referral A Moderate acne: Consult for treatment if no improvement noted after treatment with tetracycline for months before continuing treatment plan B Severe or inflammatory acne: Consult for treatment Refer if no improvement noted after treatment with tetracycline for month It may require more aggressive therapy, such as treatment with Accutane C Severe or resistant acne in a woman if accompanied by hirsutism, irregular menses, or other signs of virilism A DHD A neurodevelopment disorder, attention deficit hyperactivity disorder (ADHD) presents as a persistent pattern of inattention, hyperactivity, and impulsivity that is more frequent and severe than is typically observed in people at a comparable level of development (Diagnostic and Statistical Manual of Mental Disorders [DSMIV]) There is strong evidence of a genetic component Inattention, hyperactivity, and impulsivity—the core symptoms—must be observed before the age of years and have been present for at least months Impairment of social, academic or occupational functioning must be evident in more than one setting ADHD is diagnosed clinically since no objective tests exist to confirm the diagnosis I Etiology Underlying causes unknown but appear to be heterogeneous Various environmental factors have been associated with the diagnosis Multiple possible etiologies are: Neuroanatomical/neurochemical Genetic Environmental CNS Insults 11304-04_Part II.qxd 11/26/08 10:03 AM Page 209 ADHD 209 II Incidence A 4%–12% of school children in US according to DSM-IV Males are at an increased risk B It frequently co-exists with other conditions For example, Oppositional Defiant Disorder is present in 35%, conduct disorder in 26%, anxiety disorder in 26%, and depressive disorder in 18% C Up to 80% continue symptomatic into adolescence and up to 60% into adulthood D Siblings of children with ADHD are at greater risk III Types A Inattentive B Hyperactive/impulsive C Combined inattentive/Hyperactive/Impulsive IV Subjective findings A Inattention: Difficulty paying attention Daydreams Easily distracted Forgetful Careless Disorganized Does not want to things requiring sustained attention or effort B Hyperactivity In constant motion—squirms, fidgets, cannot sit still Talks too much Cannot play quietly Continually “flits” from one activity to another C Impulsivity Interrupts conversations and games Cannot wait for turn Answers before question completed Acts without thinking—e.g., runs into street D Parents have difficulty with discipline or managing behaviors E Poor time management F Room, desk, belongings in a state of chaos IV Objective A DSM-IV Criteria for ADHD Inattention: Six or more of the following symptoms of inattention have been present for at least months to a point that is disruptive and inappropriate for developmental level: a Does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities b Often has trouble keeping attention on tasks or play activities c Often does not seem to listen when spoken to directly d Often does not follow instructions and fails to finish schoolwork, chores or duties in the workplace (not due to oppositional behavior or failure to understand instructions) 11304-04_Part II.qxd 210 11/26/08 10:03 AM Page 210 PART II Management of Common Pediatric Problems e Often has trouble organizing activities f Often avoids, dislikes, or doesn’t want to things that take a lot of mental effort for a long period of time (such as schoolwork or homework) g Often loses things needed for tasks and activities (e.g., toys, school assignments, pencils, books, or tools) h Is often easily distracted i Is often forgetful in daily activities Hyperactivity-impulsivity: Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least months to an extent that is disruptive and inappropriate for developmental level: Hyperactivity a Often fidgets with hands or feet or squirms in seat b Often gets up from seat when remaining in seat is expected c Often runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless) d Often has trouble playing or enjoying leisure activities quietly e Is often “on the go” or often acts as if “driven by a motor.” f Often talks excessively Impulsivity a Often blurts out answers before questions have been finished b Often has trouble waiting one’s turn c Often interrupts or intrudes on others (e.g., butts into conversations or games) d Some symptoms that cause impairment were present prior to years of age e Some impairment from the symptoms is present in two or more settings (e.g., at school/work and at home) f There must be clear evidence of significant impairment in social, school, or work functioning g The symptoms not happen only during the course of a pervasive developmental disorder, schizophrenia, or other psychotic disorder The symptoms are not better accounted for by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, or a personality disorder) V Assessment A Diagnosis: Assessment is based on the above criteria which is obtained by observation and evaluation of Connors questionnaires from parents and teachers or by the Vanderbilt rating scale (see Appendix O, p 572) There is no single diagnostic test The diagnosis involves information from several sources and should be made following DSM-IV criteria 11304-22_Index.qxd 596 11/26/08 2:34 PM Page 596 INDEX Hydrocortisone probutate 0.1%, 536 Hydrocortisone valerate 0.2%, 535 Hydroxyzine hydrochloride, 476 interactions with CNS depressants, 476 Hygiene, assessment/anticipatory guidance about, at 9- to 11-year well child visit, 145 Hymenoptera, allergic response to, 215–218 Hyperactivity See also Attention-deficit/ hyperactivity disorder characteristics of, 209–210 Hyperhidrosis, differential diagnosis of, 399 Hyperpyrexia See Fever Hypersensitivity reaction See Poison ivy; Poison oak Hyperthermia, management of, 301 Hypopigmentation, 401–402 Hypoxia in bronchiolitis, 248–249 and serum theophylline levels, 563 Hytone, 475, 535 I Ibuprofen, 476–478 for acute cervical adenitis, 259–260 for cat-scratch disease, 256 for herpangina, 307 for herpetic gingivostomatitis, 319 for infectious mononucleosis, 327 Ideal body weight (IBW), anorexia nervosa and, 225–226 Identity vs role confusion, 6, 151, 157 Idoxuridine ointment, for herpes simplex type 1, 310 Illness(es) chronic, differential diagnosis of, 334 frequent, abuse and, 23 reaction to, assessment/anticipatory guidance for, at 9-month well child visit, 77 Ilosone See Erythromycin Ilotycin ophthalmic ointment, for marginal blepharitis, 341 Imipenem + cilastatin, formulation, 546t Imipramine, for enuresis, 287–289 Imiquod, for common warts, 434 Immune system, assessment/anticipatory guidance about at 2-week well child visit, 33 at 2-month well child visit, 41 at 6-month well child visit, 60 at 9-month well child visit, 71 at 3-year well child visit, 117 Immunization(s) See also Plan at 12- to 17-year well child visit, 160 childhood and adolescent, recommendations for, 521t–531t Immunization history, 12–13 Immunization schedule(s) catch-up, for children months to 18 years, 518t–519t for children from birth to years, 516t for children to 18 years, 517t Immunomodulator(s) See also Pimecrolimus topical, for atopic dermatitis, 244–245 Imodium See Loperamide Impetigo, 322–325 differential diagnosis of, 310, 323, 378, 411 treatment of, 447, 457, 484 Impulsivity See also Attention-deficit/ hyperactivity disorder characteristics of, 209–210 Inattention See also Attention-deficit/ hyperactivity disorder characteristics of, 209 Incontinence See also Encopresis; Enuresis urinary treatment of, 463 in urinary tract infection, 405–407 Indirect fluorescent antibody assay, for Lyme disease diagnosis, 338 Industry vs inferiority, 5, 137 Infant(s) growth and development in, 18 nutrition, assessment at 2-month well child visit, 40–41, 45–46 at 4-month well child visit, 50 poor feeding practices, differential diagnosis of, 262 Infection(s) See also specific organism bacterial See Bacterial infection chronic, differential diagnosis of, 334 ENT, treatment of, 495 fungal See Fungal infection intestinal, treatment of, 466–467 nasal, treatment of, 466–467 respiratory tract See also Lower respiratory tract infection; Upper respiratory tract infection treatment of, 450–451 secondary in atopic dermatitis, 244–246 urinary tract See Urinary tract infection(s) (UTI) viral See Viral infection Infectious mononucleosis, 325–328 differential diagnosis of, 259, 389 Infectious rhinitis, 220 Inflammation, in atopic dermatitis, 241–242 Influenza, 328–330 croup caused by, 414–421 differential diagnosis of, 329 Influenza A virus, 328 Influenza B virus, 328 Influenza vaccine, 526t–527t Initiative vs guilt, 4, 122–123, 131 Injury(ies) prevention of assessment/anticipatory guidance about in newborn period, 38 at 2-month well child visit, 39, 47–48 at 4-month well child visit, 49, 56–57 at 6-month well child visit, 57–58, 68 at 9-month well child visit, 69–70, 80 at 12- to 15-month well child visit, 81, 90 at 18-month well child visit, 91, 100–101 at 24-month well child visit, 102, 113 at 3-year well child visit, 114, 128 11304-22_Index.qxd 11/26/08 2:34 PM Page 597 Index at 6-year well child visit, 129, 142 at 9- to 11-year well child visit, 144, 153 at 12- to 17-year well child visit, 154–156, 163 guidelines for, 20–21 previous, history-taking about, 13 risk factors for, 21 Insect bites allergic response to, 215–218 differential diagnosis of, 316, 411 treatment of, 465–466 Insect stings, allergic response to, 215–218 Insomnia, treatment of, 489 Intal See Cromolyn sodium Intellectual development, assessment/anticipatory guidance about at 2-week well child visit, 33 at 2-month well child visit, 39, 42, 44, 46–47 at 4-month well child visit, 48, 51, 53, 55 at 6-month well child visit, 57, 60, 62, 66 at 9-month well child visit, 69, 72, 74, 78 at 12- to 15-month well child visit, 81, 83, 85, 88–90 at 18-month well child visit, 91, 93, 95, 98–100 at 24-month well child visit, 101, 104–105, 110–112 at 3-year well child visit, 114, 118, 120, 123–124, 126–127 at 6-year well child visit, 129, 131–132, 134, 137–139, 141 at 9- to 11-year well child visit, 143, 146, 149–153 at 12- to 17-year well child visit, 154, 158, 164–165 Intertrigo, 330–332 differential diagnosis of, 397 Intracranial pressure, increased, 300 Intussusception, 427 Ipratropium HFA MDI, usual dosages in children, 569 nebulized for acute severe asthma attack, 235 usual dosages in children, 570 Iritis, differential diagnosis of, 267 Iron deficiency, treatment of, 468–470 dietary sources of, 335 elemental See also Ferrous sulfate therapy with adverse effects and side effects of, 335 for iron deficiency anemia, 335–336 serum levels, in iron deficiency anemia, 334 supplement, nonprescription, 468–469 Iron deficiency anemia, 332–336 Itch-scratch cycle, in atopic dermatitis, 241–242, 245 Itraconazole, for tinea cruris, 398 Ixodes dammini, 337, 340 J Jaundice, in infectious mononucleosis, 326 Jock itch, 396–399 Johnson’s Baby Shampoo, for eyelid/eyelash cleansing, 321, 341 597 Joint pain, in Lyme disease, 338 Joy, development of, assessment/anticipatory guidance about, at 24-month well child visit, 110 Juvenile arthritis, treatment of, 477–478, 485 K Kapok, 291 Kawasaki syndrome, differential diagnosis of, 382 Keflex See also Cephalexin for athlete’s foot, with concurrent infection or cellulitis, 400 for impetigo, 324 for secondary infection in atopic dermatitis, 245 Kenalog, 535–536 for aphthous stomatitis, 229–230 Keratolytic agent(s), for acne, 205 Kerion, 393 Ketek See Telithromycin Ketoconazole See also Nizoral interactions, with fexofenadine hydrochloride, 470 for tinea capitis, 393 for tinea versicolor, 402 Koplik’s spots, 326, 382 Kwell (Lindane) for pediculosis capitis, 360–361 for pediculosis corporis, 361 for pediculosis pubis, 362 for scabies, 379 L LABAs See Beta2-agonists, long-acting Laboratory test(s) See Plan; specific test Lactation See also Breastfeeding initiation of, 24–25 Lactulose, for constipation, 271 LAIV See Influenza vaccine, live attenuated Language See also Speech assessment/anticipatory guidance about at 2-month well child visit, 47 at 4-month well child visit, 55 at 6-month well child visit, 66 at 9-month well child visit, 72, 78 at 12- to 15-month well child visit, 88–90 at 18-month well child visit, 98 at 24-month well child visit, 103–104, 110, 113 at 3-year well child visit, 121, 124 at 6-year well child visit, 132, 138, 141 at 9- to 11-year well child visit, 149–151, 153 development, history-taking about, 11 Laryngotracheobronchitis, 414–421 differential diagnosis of, 234, 416t–420t Laxative(s) abuse, 225, 227 See also Bulimia for constipation, 271 Lead poisoning differential diagnosis of, 334 screening for, at 9-month well child visit, 73 Learning See also Intellectual development assessment/anticipatory guidance about, at 6-year well child visit, 131–132 11304-22_Index.qxd 598 11/26/08 2:34 PM Page 598 INDEX Learning (contd.) preoperative/intuitive, 93, 110, 123–124 sensorimotor, 42, 93 Learning disorder, and ADHD, 211 Legionnaires’ disease, treatment of, 466–467, 492 Legs, examination of, 18 Leukemia(s), differential diagnosis of, 259, 326 Leukotriene receptor antagonists, for long-term asthma control, 236–237 usual dosages, 562 Levalbuterol, 478–479 Levaquin See Levofloxacin Levofloxacin, formulations, 545t Lice, 358–364 Lice Arrest, for pediculosis capitis, 361 Lichen simplex psoriasis, chronic, treatment of, 475 Lidex, 536 Lidex-E, 536 Lidocaine, topical, for herpes simplex type 2, 313 Limit setting, 180–183 Lindane See also Kwell for pediculosis capitis, 361 for pediculosis corporis, 361 for pediculosis pubis, 362 Linezolid, formulations, 546t Lips, examination of, 16 Liquiprin See Acetaminophen Lisdexamfetamine dimesylate, 543 Listening skills, assessment/anticipatory guidance about, at 6-year well child visit, 141 Locoid, 535 Locoid Lipocream, 535 Long-acting beta2-agonists See Beta2-agonists, long-acting Loperamide, 479 Loprox, topical, for tinea cruris, 397 Loratadine, 480 Loss and grief, 187–195 Lotrimin See also Clotrimazole for athlete’s foot, 400 for tinea corporis, 396 Lower respiratory tract infection treatment of, 447–448, 456, 466–467, 488, 495 viral, and asthma, 231 Lungs See also Respiratory system examination, at 12- to 17-year well child visit, 159 Luride See Fluoride Luxiq, 535 Lyme disease, 336–341 Lyme titer, 338 Lymphadenopathy in cat scratch disease, 255 in roseola infantum, 375 in tinea capitis, 393–394 Lymph nodes, examination of, 16 Lymph tissue, examination of, at 12- to 17-year well child visit, 159 Lytren for acute vomiting, 427–428 for viral gastroenteritis, 423–424 M Macrobid See Nitrofurantoin Macrodantin See Nitrofurantoin Macrolides See also Azithromycin formulations, 544t Malassezia furfur, 401 Malathion lotion 0.5%, for pediculosis capitis, 360–361 Malnutrition, in anorexia nervosa, 225–227 Marginal blepharitis, 341–342 Mastoiditis, otitis media and, 354 Masturbation assessment/anticipatory guidance about at 24-month well child visit, 111–112 at 12- to 17-year well child visit, 157 and vulvovaginitis in prepubertal child, 429–432 Maxipime See Cefepime MDI See Metered dose inhaler Measles cervical adenitis in, 258 differential diagnosis of, 326 Measles, mumps, rubella vaccine See MMR vaccine Mebendazole, 480–481 Melena, pertussis and, 368 Memory See also Object permanence development of, assessment/anticipatory guidance about at 9-month well child visit, 78 at 18-month well child visit, 93 at 24-month well child visit, 110 at 3-year well child visit, 124 impairment, in Lyme disease, 338, 341 Meningitis aseptic, in infectious mononucleosis, 328 in Lyme disease, 338–339 otitis media and, 354 and pulse rate, 300 vomiting in, 427 Meningococcal conjugate (MCV4) vaccine, 531t Meningococcemia, differential diagnosis of, 376 Menstrual history, 281–282 Menstrual pain See Dysmenorrhea Menstruation, assessment/anticipatory guidance about, at 12- to 17-year well child visit, 157 Meperidine, drug interactions with, 476 Meropenem, formulation, 546t Merrem See Meropenem Metadate CD, for attention-deficit/hyperactivity disorder, 211, 540 ER, for attention-deficit/hyperactivity disorder, 541 Metaproterenol, for asthma, dosage and administration of, 237 Metered dose inhaler, education about, 239 Methicillin-resistant Staphylococcus aureus, treatment of, 259 Methylin, 541–542 Methylphenidate, 539 See also Daytrana patch, for attention-deficit/hyperactivity disorder, 212 11304-22_Index.qxd 11/26/08 2:34 PM Page 599 Index Methylphenidate hydrochloride, 538, 540–542 See also Concerta; Metadate; Methylin; Ritalin Metronidazole formulations, 544t Miconazole for candidiasis/diaper rash, 254 vaginal suppository, 481–482 Microsporum, 395 Milaria rubra, 342–344 Mimyx Cream, for atopic dermatitis, 243–244 Mineral oil for constipation, 271 for cradle cap, 384 Minocin See Minocycline Minocycline, formulation, 545t Miralax O.C., 482 for constipation, 271 Mites, 377–381 Mixed dextroamphetamine/amphetamine salts, 538 See also Adderall MMR vaccine, 525t–526t Moisturizers, for atopic dermatitis, 243, 245–246 Mold(s), in home, 291 Molluscum contagiosum, 344–346 differential diagnosis of, 433 Mometasone DPI, estimated comparative daily dosages in children, 566 furoate 0.1%, 482–483, 535 Moniliasis, differential diagnosis of, 430 Monistat Derm See Miconazole Monistat Vaginal Suppository See Miconazole, vaginal suppository Monodox See Doxycycline Monospot test, 258–259, 326, 328, 389 Montelukast, 483–484 Monurol See Fosfomycin Moraxella catarrhalis infection conjunctivitis caused by, 265 otitis media caused by, 349 sinusitis caused by, 385–388 treatment of, 450 Mother See also Parent(s) assessment/anticipatory guidance for at 2-week well child visit, 30, 32 at 4-month well child visit, 49–50 at 9-month well child visit, 75 return to work, 38 working, assessment/anticipatory guidance for at 9-month well child visit, 75 at 12- to 15-month well child visit, 86 at 18-month well child visit, 96 at 24-month well child visit, 107 Motion sickness, treatment of, 489 Motor development See also Fine motor skills; Gross motor skills assessment/anticipatory guidance about at 9-month well child visit, 77 at 12- to 15-month well child visit, 82–83 history-taking about, 11 Motrin See Ibuprofen Mouth examination, 16 at 2-week well child visit, 34 599 at 2-month well child visit, 43 pain, in herpetic gingivostomatitis, 318–319 Moxifloxacin, formulations, 545t MRSA See Methicillin-resistant Staphylococcus aureus Mumps, differential diagnosis of, 259 Mupirocin ointment, 484–485 for herpes simplex type 2, 314 Musculoskeletal system, examination, 18 at 9-month well child visit, 72 at 12- to 15-month well child visit, 84 at 18-month well child visit, 93 at 24-month well child visit, 104 at 3-year well child visit, 116, 119 at 6-year well child visit, 133 at 9- to 11-year well child visit, 148 at 12- to 17-year well child visit, 159 Myalgias, in influenza, 329 Mycelex See Clotrimazole Mycoplasma pneumoniae, 346–349 conjunctivitis, treatment of, 490 Mycostatin See also Nystatin for thrush, 392 Mylicon, for colic, 263 Myositis, acute, in influenza, 330 Myringotomy with tube insertion, 355, 357–358 N Naproxen, 485–486 See also Anaprox Naps, assessment/anticipatory guidance about at 12- to 15-month well child visit, 87 at 18-month well child visit, 92, 97 at 24-month well child visit, 103 at 3-year well child visit, 122 Nasacort See also Triamcinolone acetonide, inhaled AQ, for seasonal rhinitis, 221 Nasal discharge, in sinusitis, 386–387 Nasal infections, treatment of, 466–467 Nasopharyngeal infection, treatment of, 456 National Pediculosis Association, 364 Nausea and vomiting See also Vomiting in infectious mononucleosis, 326 in influenza, 329 treatment of, 489 Neck, examination, 16 at 3-year well child visit, 118 Nedocromil, for asthma, 236 Negativism, 88 anticipatory guidance about, at 12- to 15-month well child visit, 89 Neglect, 198–199 Neisseria gonorrhoeae See Gonorrhea Neonatal health, history-taking about, 10 Neosporin ointment in herpes simplex type 1, 310 in herpes zoster (shingles), 316 in scabies, 379 for varicella with infected lesions, 412 Neurologic system examination of at 2-month well child visit, 43 at 6-year well child visit, 133 in review of systems, 14 11304-22_Index.qxd 600 11/26/08 2:34 PM Page 600 INDEX Newborn examination of, at 2-week well child visit, 30–31 growth and development in, 18 nutrition, assessment, at 2-week well child visit, 32 risk factors for, assessment, at 2-week well child visit, 33 Nicotine, and cold exposure, 304 Nipple(s), sore, in breastfeeding mother, 27 Nitrofurantoin, formulations, 546t Nitroimidazoles, formulations, 544t Nix Creme Rinse, for pediculosis capitis, 360 Nizoral See also Ketoconazole for athlete’s foot, 400 shampoo, for tinea versicolor, 402 for tinea versicolor, 402 Nocturnal emission, in 12- to 17-year old, 157 Non-gonococcal urethritis (NGU), treatment of, 450–451 Nonsteroidal anti-inflammatory drugs (NSAIDs) See also Naproxen for dysmenorrhea, 282–284 for herpes simplex type 2, 314 Norfloxacin, formulation, 545t Noroxin See Norfloxacin Nose See also HEENT examination of, 16 Nosebleeds, allergic rhinitis and, 223 Nutrition See also Feeding assessment/anticipatory guidance about at 2-week well child visit, 32, 36 at 2-month well child visit, 40–41, 45–46 at 4-month well child visit, 50, 54 at 6-month well child visit, 59, 63 at 9-month well child visit, 70–71, 76 at 12- to 15-month well child visit, 82, 86–87 at 18-month well child visit, 92, 97 at 24-month well child visit, 103, 107 at 3-year well child visit, 115, 121 at 6-year well child visit, 130, 135 at 9- to 11-year well child visit, 145, 150 at 12- to 17-year well child visit, 156, 162 history-taking about, 10–11 Nystatin See also Mycostatin for candidiasis/diaper rash, 254, 331 O Object permanence, development of, 55, 60 Occlusal for common warts, 433 for plantar warts, 434 for warts, 434–435 Occlusal-HP, for molluscum contagiosum, 345 Occlusive therapy, for warts, 433–435 Ofloxacin for external otitis, 297 formulation, 545t Ointment(s), for atopic dermatitis, 243, 245–246 Olux-E, 536 OME See Otitis media, with effusion Omnicef See Cefdinir Ophthalmia neonatorum, differential diagnosis of, 267 Ophthalmics, topical, for allergic conjunctivitis, 221–223 Oppositional defiant disorder, and ADHD, 209, 211 Optimism, development of, 104 Optivar ophthalmic, for allergic conjunctivitis, 222, 268 Orabase, for aphthous stomatitis, 229–230 Ora-Jel, for aphthous stomatitis, 230 Oral contraceptives for acne, 206–207 amoxicillin and, 448 for dysmenorrhea, 283–284 Oral rehydration solution (ORS) for acute vomiting, 427–428 in diarrhea, 278–280 for viral gastroenteritis, 423–424 Orapred, for acute severe asthma attack, 235 Ortho Tri-Cyclen #28, for acne, 206 Orudis, for dysmenorrhea, 283 Osteoarthritis, treatment of, 477–478, 485 Otalgia See Ear pain Otitis externa, 295–299 Otitis media acute, 349–355 differential diagnosis of, 351 middle ear effusion after, 355 treatment of, 351–353, 455 chemoprophylaxis, 354 differential diagnosis of, 297 with effusion, 355–358 differential diagnosis of, 351 serous, 357 allergic rhinitis and, 222–223 differential diagnosis of, 351 and hearing loss, 222 streptococcal pharyngitis and, 391 treatment of, 448–450, 456–457, 461, 488 vomiting in, 427 Otoscopy, 16 pneumatic, in otitis media with effusion, 356 Ovide, for pediculosis capitis, 360–361 Oxistat Cream for athlete’s foot, 400 for tinea corporis, 396 for tinea cruris, 397 Oxygen therapy, for acute severe asthma attack, 235 P Pad and bell technique, for enuresis, 288–290 Pain abdominal See Abdominal pain back, in urinary tract infection, 405–407 ear in mycoplasmal pneumonia, 347 in otitis media, 350 flank, in urinary tract infection, 405–407 joint, in Lyme disease, 338 menstrual See Dysmenorrhea reaction to, assessment/anticipatory guidance for, at 9-month well child visit, 77 suprapubic, in urinary tract infection, 405–407 Palate See also Petechiae, palatal 11304-22_Index.qxd 11/26/08 2:34 PM Page 601 Index examination of, 16 Palivizumab, for bronchiolitis, 248 Pandel, 536 PanOxyl, for acne, 204 Papule(s) of molluscum contagiosum, 344–346 of ringworm, 395 of scabies, 378 Parachute reflex, 72, 84 Parainfluenza infection bronchiolitis in, 247 croup caused by, 414–421 differential diagnosis of, 329 Parasite(s), diarrhea caused by, 276, 278 Parent(s) See also Family status; Mother; Parent (caregiver)-child interaction abusive, characteristics of, 22–23, 199–200 assessment/anticipatory guidance for at 2-week well child visit, 30, 35–36 at 2-month well child visit, 38, 42, 44–45 at 4-month well child visit, 51–53 at 6-month well child visit, 59, 61, 66 at 9-month well child visit, 72–75, 78 at 12- to 15-month well child visit, 83, 86, 88 at 18-month well child visit, 93, 96 at 24-month well child visit, 105–107 at 3-year well child visit, 115, 119, 121 at 6-year well child visit, 133, 135 at 9- to 11-year well child visit, 150, 152 at 12- to 17-year well child visit, 155, 160–161 developmental process for at 2-week well child visit, 31, 33 at 2-month well child visit, 40 at 4-month well child visit, 48 at 6-month well child visit, 57–58, 62 at 9-month well child visit, 68, 70, 74 at 12- to 15-month well child visit, 80–81, 85–86 at 18-month well child visit, 91–92, 95–96 at 24-month well child visit, 101–102 at 3-year well child visit, 113 at 6-year well child visit, 128, 130 at 9- to 11-year well child visit, 143–145 at 12- to 17-year well child visit, 153, 155 injury prevention counseling for, 21 single assessment/anticipatory guidance for at 6-month well child visit, 59 at 9-month well child visit, 75 at 12- to 15-month well child visit, 86 at 18-month well child visit, 96 at 24-month well child visit, 107 injury prevention counseling for, 21 Parent (caregiver)-child interaction assessment/anticipatory guidance about at 2-week well child visit, 34 at 2-month well child visit, 43 at 4-month well child visit, 52, 55 at 6-month well child visit, 60–61, 63 at 9-month well child visit, 73 at 12- to 15-month well child visit, 84 at 24-month well child visit, 104 at 3-year well child visit, 119 601 at 9- to 11-year well child visit, 148 at 12- to 17-year well child visit, 160 colic and, 264 Parinaud oculoglandular syndrome, in cat-scratch disease, 256 Passivity, assessment/anticipatory guidance about, at 3-year well child visit, 123 Pastia’s lines, 382 Patanol ophthalmic, 486 for allergic conjunctivitis, 221, 268 PCE See Erythromycin PCV See Pneumo vaccine, conjugate Peak expiratory flow rate, in asthma, 234 education about, 239–240 Peak flow meter, education about, 239–240 Pedialyte, 487 for acute vomiting, 427–428 for diarrhea, 278 for viral gastroenteritis, 423–424 Pediapred, for asthma, dosage and administration of, 238 Pedia Profen for fever, 301 for hand-foot-and-mouth disease, 306 Pediatric Symptom Checklist, 579–580 Pediazole See Erythromycin + sulfisoxazole Pediculosis (capitis, corporis, pubis), 358–364 Pediculus humanus capitis (head louse), 358–359 Pediculus humanus corporis (body louse), 358–359 Peer group(s), assessment/anticipatory guidance about at 6-year well child visit, 140 at 9- to 11-year well child visit, 152 PEFR See Peak expiratory flow rate Pelvic exam, for dysmenorrhea, 282–283 Penciclovir, for herpes simplex type 1, 310 Penicillin(s) adverse effects and side effects of, 383 allergy to, 324, 447–448, 450, 455–457, 495 antipseudomonals, formulations, 545t broad spectrum See also Trimox formulations, 545t formulations, 545t penicillinase-sensitive, formulations, 545t for streptococcal pharyngitis, 327 for vulvovaginitis in prepubertal child, 431 Penicillin G for scabies, with secondary infection, 379 for scarlet fever, 383 Penicillin V for scarlet fever, 382 for streptococcal pharyngitis, 390 Penicillin VK, 487–488, 545t Penicillin V potassium See Penicillin VK Pen-Vee-K See Penicillin VK Pepcid See Famotidine Pepcid AC See Famotidine Pepcid Complete See Famotidine Perfloxacin, interactions with theophylline, 564 Perineal hygiene, 431 Periorbital edema, in infectious mononucleosis, 326 Peripheral neuropathy, in Lyme disease, 338 11304-22_Index.qxd 602 11/26/08 2:34 PM Page 602 INDEX Permethrin, 340 for pediculosis capitis, 360 for scabies, 379 Personality trait(s) See also Temperament parents’ view of, history-taking about, 12 Pertussis, 364–368 differential diagnosis of, 234 treatment of, 366–367, 466–467 Pessimism, development of, 104 Pet(s) allergenic, 291–292 ticks on, 340 Petechiae in infectious mononucleosis, 326 in scarlet fever, 381 in streptococcal pharyngitis, 389 Petroleum jelly See also Vaseline for cradle cap, 384 for herpes simplex type 1, 310 perianal application, in diarrhea, 280 PFT See Pulmonary function testing Pharyngitis in infectious mononucleosis, 326–327 streptococcal, 388–391 cervical adenitis in, 257 differential diagnosis of, 326 in infectious mononucleosis, 326–327 treatment of, 327 treatment of, 450–451, 455–457, 466–467 viral, differential diagnosis of, 389 vomiting in, 427 Phenergan See Promethazine hydrochloride Phenobarbital, interactions with theophylline, 564 Phenothiazine(s) See Promethazine hydrochloride Phenytoin for bulimia, 252 interactions with theophylline, 564 Phthirius pubis (pubic louse), 358–359 Physical abuse, 197–198 Physical development assessment/anticipatory guidance about at 2-week well child visit, 32–33 at 2-month well child visit, 39, 41, 44, 46 at 4-month well child visit, 48, 50–52, 54–55 at 6-month well child visit, 57, 59–60, 62, 65–66 at 9-month well child visit, 69, 71, 73 at 12- to 15-month well child visit, 80, 82–83, 85, 87 at 18-month well child visit, 91, 93, 95, 98 at 24-month well child visit, 101, 103, 105, 108–109 at 3-year well child visit, 114, 119–122, 126 at 6-year well child visit, 129, 131, 133–134, 136, 140 at 9- to 11-year well child visit, 143, 145, 149–151 at 12- to 17-year well child visit, 154, 157, 164 history-taking about, 11 Physical examination at 2-week well child visit, 34 at 2-month well child visit, 43 at 4-month well child visit, 51–52 at 6-month well child visit, 61 at 9-month well child visit, 72–73 at 12- to 15-month well child visit, 84 at 18-month well child visit, 93 at 24-month well child visit, 104 at 3-year well child visit, 118–119 at 6-year well child visit, 132–133 at 9- to 11-year well child visit, 147–148 at 12- to 17-year well child visit, 159–160 at well child visit, 14–18 Physical neglect, 198 Piaget, Jean, developmental theory of, 2, 33, 42, 51, 55, 60, 72, 78, 83, 88, 93, 98, 104, 110, 131–132, 137, 146, 151, 158, 164–165 Pimecrolimus, 466 topical, for atopic dermatitis, 244–245 Pinworm, 368–370 differential diagnosis of, 430 treatment of, 480–481 Piperacillin + tazobactam, formulations, 545t Pirbuterol CFC autohaler, usual dosages in children, 568 Pityriasis rosea, 371–372 differential diagnosis of, 395, 402 Plant(s), allergenic, 291 Plantar wart(s), 432–435 Pneumatic otoscopy, in otitis media with effusion, 356 Pneumococcal infection external otitis caused by, 295 and vulvovaginitis in prepubertal child, 431 Pneumocystis carinii pneumonitis, treatment of, 461 Pneumonia differential diagnosis of, 248, 416t–420t mycoplasmal (walking), 346–349 treatment of, 419t–420t, 457, 466–467 Pneumothorax, pertussis and, 368 Pneumo vaccine, 529t–530t Podofilox, for plantar warts, 434 Poison(s), safety guidelines for, 21 Poisoning prevention of, assessment/anticipatory guidance about, at 9-month well child visit, 69 vomiting in, 427 Poison ivy/poison oak, 372–375 differential diagnosis of, 378 Polio vaccine, 523t Polyp(s), nasal, 220, 493 Polyradiculitis, in Lyme disease, 341 Polysporin, for diaper rash, 274 Polytrim ophthalmic solution, 490 for bacterial conjunctivitis, 268 Ponstel, for dysmenorrhea, 283 Postherpetic neuralgia, 317 Postpartum depression, identification of, 30 Postural drainage, 238 Poxvirus infection, molluscum contagiosum in, 344–346 PPV See Pneumo vaccine, polysacch 11304-22_Index.qxd 11/26/08 2:34 PM Page 603 Index Preadolescent(s) anticipatory guidance for, at 9- to 11-year well child visit, 149–150 individualized guidelines for, 143 Precipitated sulfur, for scabies, 379 Prednicarbate 0.1%, 535 Prednisolone, systemic, for asthma for long-term control, usual dosages in children, 559 for quick relief, usual dosages in children, 571 Prednisone for acne, 206 for asthma, 235, 238 for Hymenoptera allergy, 216 for infectious mononucleosis, 327 for pityriasis rosea, 372 for poison ivy/poison oak, 374 Pregnancy, erythema infectiosum in, 293, 295 Pregnancy history, Premedication, 476 Preschool-age child, growth and development in, 19 Previous illnesses, history-taking about, 13 Prickly heat, 342–344 Primaxin See Imipenem + cilastatin Principen See Ampicillin Projectile vomiting, 426 Promethazine hydrochloride, 488–490 Prom Pills, 206 ProQuin XR See Ciprofloxacin Proteus infection treatment of, 458 of urinary tract, 405 treatment of, 461 Protopic See Tacrolimus Proventil See Albuterol (sulfate) Pruritus anal, pinworm and, 368–370 in athlete’s foot, 399 of atopic dermatitis, 241, 244 histamine-mediated, treatment of, 476 with lice, 359, 362 in pityriasis rosea, 371–372 of ringworm, 395 of scabies, 377–380 in seborrhea of scalp, 384–385 in tinea capitis, 393–394 of tinea cruris, 397 treatment of, 462–463, 475–476 of varicella, 411–413 in vulvovaginitis in prepubertal child, 429–432 Pseudoephedrine, for seasonal rhinitis, 221 Pseudomonas infection conjunctivitis caused by, treatment of, 490 external otitis caused by, 295 of urinary tract, 405 Psorcon E, 536 Psoriasis differential diagnosis of, 243, 274, 372–373, 384, 395, 397 guttate, differential diagnosis of, 372 Puberty See also Secondary sex characteristics assessment/anticipatory guidance about 603 at 9- to 11-year well child visit, 145 at 12- to 17-year well child visit, 164 Pubic lice, 358–364 Pulmicort Respules See Budesonide, inhalation suspension for nebulization Pulmonary disease, and respiratory rate, 300 Pulmonary function testing, in asthma, 233 Pulse rate bacterial infection and, 300 fever and, 300 increased intracranial pressure, 300 Punishment, 182–183 assessment/anticipatory guidance about, at 3-year well child visit, 128 Purging, 249–251 Pustule(s) of impetigo, 323 of scabies, 378 Pyelonephritis, 409 differential diagnosis of, 286 Pyloric stenosis, 427 Pyoderma in scarlet fever, 383 streptococcal pharyngitis and, 391 Pyrethrin, for pediculosis capitis, 361 Q Quinolones, 545t Quinupristin/dalfopristin, formulation, 546t R Radioallergosorbent test (RAST), in atopic dermatitis, 243, 246 Raniclor See Cefaclor Rapid Direct Antigen Test, 389 Rash See also Diaper rash; Exanthem(s) of atopic dermatitis, 242 of erythema infectiosum, 293–295 of hand-foot-and-mouth disease, 305 of intertrigo, 330–332 of Lyme disease, 337–340 of milaria rubra, 342–344 of pityriasis rosea, 371–372 of poison ivy/poison oak, 373–374 of ringworm, 395 of roseola infantum, 375–377 of scabies, 377–380 of scarlet fever, 381–383 of tinea cruris, 397–399 of tinea versicolor, 401–402 of varicella (chickenpox), 409–414 Rectal prolapse, pertussis and, 368 Rectum, examination of, 18 in constipated patient, 270 Reflexes, evaluation of at 2-month well child visit, 43 at 4-month well child visit, 52 at 6-month well child visit, 61 at 9-month well child visit, 72 at 12- to 15-month well child visit, 84 Rehydralate, for diarrhea, 278 Remarriage See also Step-parents; Step-siblings anticipatory guidance about, at 12- to 17-year well child visit, 162 11304-22_Index.qxd 604 11/26/08 2:34 PM Page 604 INDEX Renal scintigraphy, 408 Repetabs, 445 Respiratory syncytial virus (RSV) bronchiolitis caused by, 247 croup caused by, 414–421 differential diagnosis of, 329 Respiratory system See also Lower respiratory tract infection; Upper respiratory tract infection compromise, in infectious mononucleosis, 327–328 examination at 2-week well child visit, 33 at 3-year well child visit, 117 in atopic dermatitis, 243 infections, treatment of, 450–451, 457 in review of systems, 14 Retapamulin 1% Ointment See Altabax ointment Reticulocyte count, in iron deficiency anemia, 334, 336 Retin-A for acne, 204–205 for common warts, 434 for molluscum contagiosum, 345 for tinea versicolor, 402 Retinoid, for acne, 204 Review of systems at 3-year well child visit, 115–117 in initial history, 13–14 Rewarming, for frostbite, 303–304 Reye’s syndrome, in varicella, 413 Rheumatic fever, 390–391 prevention of, 383 scarlet fever and, 383 streptococcal pharyngitis and, 391 treatment of, 488 Rheumatoid arthritis (RA), treatment of, 477–478, 485 Rhinitis See also Allergic rhinitis in influenza, 329 nonallergic, treatment of, 472 and sinusitis, 385–388 Rhinitis medicamentosa, 220 Rhinocort Aerosol, for seasonal rhinitis, 221 Aqua See Budesonide, intranasal spray Rhinorrhea in allergic rhinitis, 219 in bronchiolitis, 247 in otitis media, 350 Rhus toxins, 372 Ricelyte for acute vomiting, 427–428 for diarrhea, 278 for viral gastroenteritis, 423–424 RID, for pediculosis corporis, 362 Rid, for pediculosis capitis, 361 Rifadin See Rifampin Rifampin, 546t Ringworm, See Tinea Rinne test, in otitis media with effusion, 356 Risk factors, assessment/anticipatory guidance about at 2-week well child visit, 30–31, 33 at 2-month well child visit, 39–40, 42–44, 47 at 4-month well child visit, 49, 51, 53, 55 at 6-month well child visit, 57, 60, 62, 66–67 at 9-month well child visit, 69, 72, 74, 78 at 12- to 15-month well child visit, 81, 83–85, 88–89 at 18-month well child visit, 91, 93–96, 99 at 24-month well child visit, 101, 104, 106, 111–112 at 3-year well child visit, 114, 118, 120, 126 at 6-year well child visit, 132, 134, 139–140 at 9- to 11-year well child visit, 144, 147, 152–153 at 12- to 17-year well child visit, 154, 158–159 Ritalin for attention-deficit/hyperactivity disorder, 542 LA, for attention-deficit/hyperactivity disorder, 211, 542 SR, for attention-deficit/hyperactivity disorder, 542 Rocephin See Ceftriaxone Rocky Mountain spotted fever, treatment of, 492 Rondec, for seasonal rhinitis, 221 Roseola, 375–377 differential diagnosis of, 382 Rotahaler, 446 Rotavirus diarrhea caused by, 276 gastroenteritis caused by, 421–425 Rotavirus (Rota) vaccine, 527t Roundworm, treatment of, 480–481 Rubella cervical adenitis in, 258 differential diagnosis of, 376, 382 Rubeola, differential diagnosis of, 376, 382 S Safety assessment/anticipatory guidance about at 2-month well child visit, 47–48 at 4-month well child visit, 49, 56–57 at 6-month well child visit, 67–68 at 9-month well child visit, 69–70, 80 at 12- to 15-month well child visit, 81, 90 at 18-month well child visit, 91, 100–101 at 24-month well child visit, 102, 108, 113 at 3-year well child visit, 114, 128 at 6-year well child visit, 129, 134, 136, 142 at 9- to 11-year well child visit, 144, 149–150, 153 at 12- to 17-year well child visit, 154–155, 163 for newborn, 38 Safety strategy(ies), 20 Salicylate poisoning, and vomiting, 427 Salicylic acid, 433–434 Salmeterol, for asthma for exercise-induced asthma, 236 for long-term control in children, usual dosages, 560 Salmonella infection (salmonellosis) diarrhea caused by, 276, 278 treatment of, 279 gastroenteritis caused by, 423 and pulse rate, 300 11304-22_Index.qxd 11/26/08 2:34 PM Page 605 Index Sarcoptes scabiei, 377 Scabicides, 379–380 Scabies, 377–381 differential diagnosis of, 243, 313, 373, 378, 411 treatment of, 462 Scalp See also Pediculosis (capitis, corporis, pubis); Tinea capitis seborrhea of, 341, 384–385 Scarlet fever, 381–383 School assessment/anticipatory guidance about, at 12to 17-year well child visit, 165 environmental control in, for atopic child, 293 School-age child, growth and development in, 19 School history, 11–12 School progress ADHD and, 210, 212–214 otitis media and, 357–358 School readiness at 3-year well child visit, 124 Screening test(s) at 9-month well child visit, 73 at 12- to 15-month well child visit, 84 at 3-year well child visit, 119 at 6-year well child visit, 133 at 9- to 11-year well child visit, 148 at 12- to 17-year well child visit, 160 history-taking about, 12–13 Seborrhea, 384–385 differential diagnosis of, 323, 384 Seborrheic dermatitis differential diagnosis of, 243, 371, 397 and external otitis, 295 and marginal blepharitis, 341 Secondary sex characteristics, development of, at 6-year well child visit, 136 at 9- to 11-year well child visit, 145–146 Sedation, 476 Seizure(s) See also Febrile convulsions herpangina and, 307 pertussis and, 368 Selective serotonin reuptake inhibitors (SSRIs) for anorexia nervosa, 227 for bulimia, 252 Selenium sulfide shampoo, for tinea capitis, 393 for tinea versicolor, 402 Self-concept, development of at 6-year well child visit, 137 Self-control, development of, assessment/ anticipatory guidance about at 9-month well child visit, 78 at 12- to 15-month well child visit, 88–89 at 18-month well child visit, 99 Self-esteem, development of, assessment/ anticipatory guidance about at 12- to 15-month well child visit, 88–89 at 18-month well child visit, 93, 98 at 6-year well child visit, 137 Self-identity, development of, assessment/ anticipatory guidance about, at 6-year well child visit, 137 Selsun Lotion, for tinea versicolor, 402 Separation anxiety, 53 Septra See also Sulfamethoxazole + trimethoprim for urinary tract infection, 407 605 Sexual abuse, 23, 199 assessment for at 9-month well child visit, 76 at 12- to 15-month well child visit, 86 at 18-month well child visit, 96 at 9- to 11-year well child visit, 144, 150 at 12- to 17-year well child visit, 155 differential diagnosis of, 430 and pubic lice, 360 Sexual activity assessment/anticipatory guidance about, at 12- to 17-year well child visit, 156 and screening tests, at 12- to 17-year well child visit, 160 and urinary tract infection, 405 Sexual development, and anorexia nervosa, 225 Sexual experimentation, assessment/anticipatory guidance about, at 9- to 11-year well child visit, 146 Sexual identity at 24-month well child visit, 106, 111 at 3-year well child visit, 118, 120 at 6-year well child visit, 137, 139 at 9- to 11-year well child visit, 152 at 12- to 17-year well child visit, 157 Sexually transmitted disease (STD) with pediculosis pubis, 364 urethritis in, differential diagnosis of, 407 Sexual maturity, assessment/anticipatory guidance about at 9- to 11-year well child visit, 146 at 12- to 17-year well child visit, 157 Shaken baby syndrome, 23 Shampoo(s) antifungal, for tinea capitis, 393 for seborrhea of scalp, 384–385 Shigella, diarrhea caused by, 276, 278 treatment of, 279 Shingles See Herpes zoster (shingles) Shyness, assessment/anticipatory guidance about, at 3-year well child visit, 123 Sibling(s), assessment/anticipatory guidance for at 9-month well child visit, 76 at 12- to 15-month well child visit, 86 at 18-month well child visit, 96 at 24-month well child visit, 107 at 3-year well child visit, 121 at 12- to 17-year well child visit, 162 Sibling rivalry, 183–187 Sight, stimulation of, assessment/anticipatory guidance about at 4-month well child visit, 56 at 6-month well child visit, 67 at 9-month well child visit, 79 at 12- to 15-month well child visit, 90 at 18-month well child visit, 100 Singulair See Montelukast Sinusitis acute, 220 treatment of, 455–456 bacterial, 385–388 chronic, 220 in influenza, 330 treatment of, 448, 457 11304-22_Index.qxd 606 11/26/08 2:34 PM Page 606 INDEX Skeletal system assessment, at 3-year well child visit, 116 in review of systems, 14 Skin (and skin structures) examination, 15 at 2-week well child visit, 34 at 2-month well child visit, 43 at 4-month well child visit, 52 at 6-month well child visit, 61 at 9-month well child visit, 72 at 12- to 15-month well child visit, 84 at 18-month well child visit, 93 at 24-month well child visit, 104 at 3-year well child visit, 116, 118 at 6-year well child visit, 133 at 9- to 11-year well child visit, 147 at 12- to 17-year well child visit, 159 in atopic dermatitis, 242–243 in frostbite, 302–305 infections, treatment of, 448, 450, 455–457, 466–467, 495 in review of systems, 13 tinea versicolor and, 401–402 Slapped-cheek appearance, 293–294, 382 Sleep, assessment/anticipatory guidance about at 2-week well child visit, 32 at 2-month well child visit, 41, 46 at 4-month well child visit, 50, 54 at 6-month well child visit, 59, 65 at 9-month well child visit, 71, 76–77 at 12- to 15-month well child visit, 82, 87 at 18-month well child visit, 92, 97 at 24-month well child visit, 103, 108 at 3-year well child visit, 115, 120, 122 at 6-year well child visit, 130, 135 at 9- to 11-year well child visit, 145 at 12- to 17-year well child visit, 157 Smallpox, 411 Smoking, and serum theophylline levels, 239, 564 Social development, assessment/anticipatory guidance about at 18-month well child visit, 95, 99–100 at 24-month well child visit, 105–106, 110–113 at 3-year well child visit, 114, 118, 120, 125–128 at 6-year well child visit, 129, 132, 134, 138–140, 142 at 9- to 11-year well child visit, 144, 146–147, 151–153 at 12- to 17-year well child visit, 154, 158, 165 Social history, Sodium Sulamyd Ophthalmic ointment, 342 for hordeolum, 321 Sodium sulfacetamide 2, 321 Soft tissue infections, treatment of, 450, 458 Sore throat See also Pharyngitis in hand-foot-and-mouth disease, 305 herpangina and, 307 in herpetic gingivostomatitis, 318–319 in infectious mononucleosis, 325 in influenza, 329 in mycoplasmal pneumonia, 347 in scarlet fever, 381 Spectazole, topical, 396–397 Spectracef See Cefditoren Speech assessment/anticipatory guidance about at 4-month well child visit, 51, 55 at 6-month well child visit, 60, 66 at 12- to 15-month well child visit, 83 at 18-month well child visit, 93 at 24-month well child visit, 109 at 3-year well child visit, 115, 122 at 6-year well child visit, 131, 136 at 12- to 17-year well child visit, 157 development of, otitis media and, 357–358 Spirometry, in asthma, 233 Splenic rupture, in infectious mononucleosis, 328 Splenomegaly, in infectious mononucleosis, 326–327 Sporanox, for tinea cruris, 398 Sports assessment/anticipatory guidance about at 6-year well child visit, 135–136, 140 at 9- to 11-year well child visit, 150 Squamous cell carcinoma, atopic dermatitis and, 246 Staphylococci (Staphylococcus spp.) infection cervical adenitis in, 258–259 food poisoning caused by, 423 otitis media caused by, treatment of, 457 Staphylococcus aureus See also Methicillinresistant Staphylococcus aureus and blepharitis, 341 and conjunctivitis, 265 treatment of, 490 and hordeolum, 320–322 and impetigo, 322–325 treatment of, 447, 484 otitis media caused by, 349 sinusitis caused by, 385–388 urinary tract infection, 405 Staphylococcus epidermidis infection, conjunctivitis caused by, treatment of, 490 Staphylococcus saprophyticus, urinary tract infection, 405 Starvation diarrhea, 278, 424 Step-parents, assessment/anticipatory guidance for, at 12- to 17-year well child visit, 161 Step-siblings, assessment/anticipatory guidance for, at 12- to 17-year well child visit, 162 Steroid(s) for allergic rhinitis, 221 systemic, for viral croup, 415 topical, 535t–536t Stimulants, 211–213 Stimulation, assessment/anticipatory guidance about in neonatal period, 37 at 2-month well child visit, 47 at 4-month well child visit, 56 at 6-month well child visit, 67–68 at 9-month well child visit, 79–80 at 12- to 15-month well child visit, 90 at 18-month well child visit, 100 at 24-month well child visit, 113 Stool assessment at 2-month well child visit, 46 at 4-month well child visit, 50 11304-22_Index.qxd 11/26/08 2:34 PM Page 607 Index of breastfed baby, 32 in constipation, 269 of formula-fed baby, 32 starvation, 424 Stool culture, 422–423 Stool softener See Docusate Stranger anxiety, assessment/anticipatory guidance about, at 6-month well child visit, 62–63 Strattera, for attention-deficit/hyperactivity disorder, 543 Strawberry tongue, in scarlet fever, 381–382 Streptococci (Streptococcus spp.) infection external otitis caused by, 295 group A beta-hemolytic, 391 cervical adenitis in, 258–259 differential diagnosis of, 387 otitis media caused by, 349 pharyngitis caused by, 388–391 scarlet fever caused by, 381–383 treatment of, 457 and vulvovaginitis in prepubertal child, 429, 431 impetigo caused by, 322–325 nephritogenic, 324–325 otitis media caused by, treatment of, 457 pharyngitis caused by, cervical adenitis in, 257 rapid test for, 389 scarlet fever caused by, 381–383 Streptococcus pneumoniae infection conjunctivitis caused by, 265 otitis media caused by, 349 treatment of, 457 sinusitis caused by, 385–388 treatment of, 450 Streptococcus pyogenes infection impetigo caused by, treatment of, 447, 484 pharyngitis caused by, 388–391 sinusitis caused by, 385–388 treatment of, 450 Stridor congenital laryngeal, differential diagnosis of, 415 inspiratory, in croup, 414 Stuttering, assessment/anticipatory guidance about, at 3-year well child visit, 122 Sty, 320–322 recurrent, 322 Subdural hematoma, pertussis and, 368 Substance abuse, assessment/anticipatory guidance about, at 12- to 17-year well child visit, 154, 158–159 Sudafed for acute otitis media, 353 for seasonal rhinitis, 221 Sudden infant death syndrome (SIDS), 23 Suffocation, prevention of, 21 Suicide in anorexia nervosa, 224, 227 risk of, assessment/anticipatory guidance about, at 12- to 17-year well child visit, 154, 158–159 607 Sulfamethoxazole + trimethoprim, 461–462 See also Bactrim; Septra for acute otitis media, 352 for E coli diarrhea, 279 for pertussis, 366 for shigellosis, 279 Sulfisoxazole, 545t for chemoprophylaxis of otitis media, 354 Sulfonamides, formulations, 545t Sultrin cream, for vulvovaginitis in prepubertal child, 432 Sumycin See Tetracycline(s) Sun protection atopic dermatitis and, 246 herpes simplex and, 311 Support system(s), assessment, at 2-week well child visit, 32 Suprapubic pain, in urinary tract infection, 405–407 Suprax See Cefixime Suture infection, treatment of, 455 Swimmer’s ear, 295–299 Symbicort inhalant, 491 Synalar, 535 for diaper rash, 275 Synercid See Quinupristin/dalfopristin Syphilis, secondary, differential diagnosis of, 372 T Tacrolimus, topical, for atopic dermatitis, 244–245 Tagamet See also Cimetidine for molluscum contagiosum, 345 Tantrums, 175–178 Tavist syrup, for seasonal rhinitis, 221 Tdap vaccine, 523t Td vaccine, 523t Teeth, assessment/anticipatory guidance about, 16 at 6-month well child visit, 61 at 9-month well child visit, 72 at 12- to 15-month well child visit, 84 at 18-month well child visit, 93 at 24-month well child visit, 104 at 3-year well child visit, 116 at 6-year well child visit, 131, 133, 136 at 9- to 11-year well child visit, 147, 151 at 12- to 17-year well child visit, 159 Teeth grinding, assessment/anticipatory guidance about, at 3-year well child visit, 122 Teething, assessment/anticipatory guidance about at 6-month well child visit, 59, 62, 65 at 9-month well child visit, 71 Television watching and anorexia nervosa, 227 assessment/anticipatory guidance about, at 3year well child visit, 125 Telithromycin, formulation, 546t Temovate, 536 Temovate-E, 536 Temp-a-Dot, 301 Temperament, at 24-month well child visit, 109 at 3-year well child visit, 123 at 6-year well child visit, 137 11304-22_Index.qxd 608 11/26/08 2:34 PM Page 608 INDEX Temperature body See Body temperature; Fever environmental, rapid changes in, and asthma, 231 Fahrenheit/Centigrade conversions, 512t Temper tantrums, 175–178 anticipatory guidance about, at 12- to 15-month well child visit, 89 Tempra See Acetaminophen Tendinitis, acute, treatment of, 485 Testicular torsion, differential diagnosis of, 262 Tetanus, diphtheria, acellular pertussis vaccine, 523t Tetracaine cream, for herpes simplex type 1, 310 Tetracap See Tetracycline(s) Tetracycline(s), 491–492 for acne, 205–208, 491 compresses, for aphthous stomatitis, 230 formulations, 491, 545t mouth rinse, for herpetic gingivostomatitis, 319 for mycoplasmal pneumonia, 348 Thalassemia trait, differential diagnosis of, 334 Theophylline for asthma, 236–239 drug interactions with, 238, 564 Thermometer(s), 301 Throat See also HEENT examination, 16 at 3-year well child visit, 118 at 6-year well child visit, 133 Throat culture after streptococcal pharyngitis, 391 in infectious mononucleosis, 326 in scarlet fever, 382 in streptococcal pharyngitis, 389 Throat swab(s), 389 Thrush, 34, 253, 391–393 Thyroglossal duct cyst, differential diagnosis of, 259 Tick(s) See also Ixodes dammini removal of, 340 Tick-borne disease See also Lyme disease prevention of, 339–340 Tick repellent, 340 Ticlopidine, interactions with theophylline, 564 Tigecycline, formulation, 546t Tinactin cream for athlete’s foot, 400 for tinea cruris, 397 Tinea capitis, 393–395 differential diagnosis of, 384 Tinea corporis, 395–396 differential diagnosis of, 371, 384 Tinea cruris, 396–399 prevention of, 398 Tinea pedis, 395, 397, 399–401 complications of, 400–401 prevention of, 400 treatment of, 400 Tinea versicolor, 401–403 TIV See Influenza vaccine, trivalent inactivated TM See Tympanic membrane Tobramycin, ocular, 492–493 See also Tobrex Tobrex See also Tobramycin, ocular for bacterial conjunctivitis, 267 Toddler, growth and development in, 19 Tofranil See Imipramine Toilet training, 178–180 assessment/anticipatory guidance about at 9-month well child visit, 71, 77 at 12- to 15-month well child visit, 82, 87 at 18-month well child visit, 97 at 24-month well child visit, 103, 108 and constipation, 271–272 history-taking about, 11 Tongue, examination of, 16 Tonsil(s), examination, 16 at 3-year well child visit, 118 at 6-year well child visit, 133 Tonsillitis cervical adenitis in, 257 in infectious mononucleosis, 326–327 treatment of, 450–451, 455–457 Toothpaste swish, for aphthous stomatitis, 230 Topicort, 536 Topicort-LP, 535 Total iron-binding capacity, in iron deficiency anemia, 334 Touch and smell, stimulation of, assessment/anticipatory guidance about at 4-month well child visit, 56 at 6-month well child visit, 67 at 9-month well child visit, 79 at 12- to 15-month well child visit, 90 Tracheomalacia, differential diagnosis of, 248 Trachoma, differential diagnosis of, 267 Trachomatis, treatment of, 466–467 Trans-Plantar patch, for plantar warts, 434–435 Trans-Ver-Sal patch, for common warts, 433–435 Traumatic grief, 188 Triamcinolone acetonide inhalation aerosol, 494–495 inhaled, 493–494 nasal spray, 493–494 topical, 535–536 Trichloroacetic acid 25%, for molluscum contagiosum, 345 Trichomonas vaginitis, differential diagnosis of, 430 Trichophyton, 395–396 Trichophyton mentagrophytes, 399 Trichophyton rubrum, 399 Trichophyton tonsurans, 393–394 Trichuriasis, treatment of, 480–481 Trimethoprim-sulfamethoxazole See Sulfamethoxazole + trimethoprim Trimox, 495–496 See also Amoxicillin Troleandomycin, interactions with theophylline, 564 Trust vs mistrust, 2–3, 33 T-Stat, for acne, 204, 207 Tuberculosis, differential diagnosis of, 259 Tygacil See Tigecycline Tylenol, 496–497 for acute cervical adenitis, 259–260 for cat-scratch disease, 256 for herpes simplex type 2, 314 11304-22_Index.qxd 11/26/08 2:34 PM Page 609 Index Tympanic membrane hyperemia of, differential diagnosis of, 351 inflamed in mycoplasmal pneumonia, 347 in otitis media, 351 involvement in external otitis, 297 in otitis media with effusion, 356 perforation, otitis media and, 354, 358 Tympanometry, in otitis media with effusion, 356 Tympanosclerosis, otitis media and, 358 U U-cort, 535 Ulcer(s), oral, of herpetic gingivostomatitis, 318–320 Ultram, for herpes simplex type 2, 314 Ultravate, 536 Umbilical cord care, 403–404 Umbilical granuloma, 404 Unasyn See Ampicillin + sulbactam Upper respiratory allergy(ies), treatment of, 464 Upper respiratory tract infection cervical adenitis in, 257 and sinusitis, 385–388 treatment of, 447, 466–467, 488 viral and asthma, 231 treatment of, 235 differential diagnosis of, 387 Urethral meatus, ulceration, 274 Urethritis differential diagnosis of, 286, 407 in sexually transmitted infection, differential diagnosis of, 407 treatment of, 450–451 URI See Upper respiratory tract infection Urinalysis, 13 indications for, 286 screening, recommendations for, 148 in urinary tract infection, 406 Urinary retention, with herpes simplex type 2, 313, 315 Urinary tract infection(s) (UTI), 404–409 chlamydial, treatment of, 466–467 differential diagnosis of, 286, 376, 407 etiology of, 405 gonococcal, treatment of, 466–467 treatment of, 448, 457, 461 vomiting in, 427 Urine assessment at 2-week well child visit, 32 at 2-month well child visit, 46 at 4-month well child visit, 50, 54 at 6-month well child visit, 59, 65 at 24-month well child visit, 103 culture, in urinary tract infection, 406–407, 409 sample collection, 408–409 Urticaria chronic, treatment of, 476, 480 chronic idiopathic, treatment of, 458 in streptococcal pharyngitis, 389 treatment of, 470 Urushiol, 372, 374 609 Uveitis, differential diagnosis of, 267 Uvula examination of, 16 in streptococcal pharyngitis, 389 V Vaccine-modified varicella syndrome, 410 Vaginal discharge, in vulvovaginitis in prepubertal child, 429–432 Vaginitis, differential diagnosis of, 407 Vagitrol, for vulvovaginitis in prepubertal child, 432 Valacyclovir, for herpes simplex type 1, 310 Valtrex, for herpes simplex type 2, 314 Vancenase AQ, for seasonal rhinitis, 221 Vanceril See Beclomethasone, MDI Vanderbilt ADHD Diagnostic Parent Rating Scale, 576–578 Vanderbilt ADHD Diagnostic Teacher Rating Scale, 572–575 Vanos, 536 Vantin See Cefpodoxime Vaporizer(s) cool-mist, for viral croup, 415 steam, contraindications to, 415 Varicella, 315, 409–414 differential diagnosis of, 318 exposure to, atopic dermatitis and, 245, 247 treatment of, 445 Varicella (Var) vaccine, 524t Varicella-zoster immune globulin (VZIG), 413–414 Varicella-zoster virus (VZV), 315, 409 Variola, 411 Vaseline See also Petroleum jelly for diaper rash, 274 Vasomotor rhinitis, 220 V-Cillin See Penicillin VK Veetids See Penicillin VK Velosef See Cephradine Venereal warts, 435 See also Condyloma acuminata Ventolin See Albuterol (sulfate) Verbal abuse, 23 Verdeso, 535 Vermox See also Mebendazole adverse effects and side effects of, 370 for pinworm, 369–370 Verruca Freeze, for warts, 434 Verruca plantaris, 432–435 Verruca vulgaris, 432–435 atopic dermatitis and, 246 Vesicle(s) of herpes simplex type 1, 308–311 of herpes simplex type 2, 313–315 of herpes zoster, 316–317 of herpetic gingivostomatitis, 318–320 of impetigo, 323 of poison ivy/poison oak, 373–374 of scabies, 378 of varicella, 410–411 Vesicoureteral reflux, 408–409 Vibramycin See Doxycycline 11304-22_Index.qxd 610 11/26/08 2:34 PM Page 610 INDEX Vibra-Tabs See Doxycycline Vigamox, for bacterial conjunctivitis, 267 Vinegar wet packs, for tinea cruris, 398 Viral croup, 414–421 differential diagnosis of, 415, 416t–420t treatment of, 419t–420t Viral gastroenteritis, 421–425 Viral infection cervical adenitis in, 258–259 diarrhea caused by, 276, 278 hand-foot-and-mouth disease, 305–306 and otitis media, 349, 353–354 respiratory, and asthma, 231 treatment of, 235 and serum theophylline levels, 563 Vision assessment/anticipatory guidance about at 2-week well child visit, 33 at 2-month well child visit, 46 at 4-month well child visit, 51 at 6-month well child visit, 60 at 9-month well child visit, 71 at 12- to 15-month well child visit, 83 at 3-year well child visit, 116 at 6-year well child visit, 136 screening tests, schedule for, 13, 148 Vitamin(s), water-soluble, mineral oil therapy and, 271, 273 Vitamin C supplementation, indications for, 335 Vitamin D supplementation, 40 Vitiligo, differential diagnosis of, 402 Vocabulary development See Speech Voice changes, assessment/anticipatory guidance about, at 12- to 17-year well child visit, 157 Voiding cystourethrography, 408 Volvulus, 427 Vomiting acute, 425–429 treatment of, 427–429 with dysmenorrhea, 283 herpangina and, 307 in infants, 426–427 in otitis media, 350 in scarlet fever, 381 in streptococcal pharyngitis, 388 in viral gastroenteritis, 422–425 V-Sol Otic Solution, for external otitis, 297–298 Vulvovaginitis pinworm and, 369–370, 429–432 in prepubertal child, 429–432 Vygotsky, Lev, Vytone, 535 Vyvanse, for attention-deficit/hyperactivity disorder, 543 W Walking pneumonia, 346 Wariness, development of, assessment/ anticipatory guidance about, at 24-month well child visit, 110 Wart(s), 432–435 Wasps, allergic response to, 215–218 Water safety, 21 Weaning assessment/anticipatory guidance for, at 6-month well child visit, 63 from breastfeeding, 28 Weight in anorexia nervosa, 224–225 assessment/anticipatory guidance about at 3-year well child visit, 115 at 9- to 11-year well child visit, 145, 150 at 12- to 17-year well child visit, 156 pound/kilogram conversions, 514t Weight control, purging and, 249 Weight loss See Anorexia nervosa; Bulimia Well child care, See also Anticipatory guidance; Well child visit guidelines for, 2–8 Well child visit See also Anticipatory guidance at weeks, 30–38 at months, 38–48 at months, 48–57 at months, 57–68 at months, 68–80 at 12 to 15 months, 80–90 at 18 months, 90–101 at 24 months, 101–113 at years, 113–128 at years, 128–142 at to 11 years, 142–153 at 12 to 17 years, 153–164 physical examination at, 14–18 Westcort, 475, 535 Wet combing, for pediculosis capitis, 361 Wet Stop, 288, 290 Wheezing, 232, 234 in bronchiolitis, 247–248 in croup, 414–415 Whipworm, treatment of, 480–481 Whooping cough See Pertussis Wool, allergenicity, 291 Writing skills, assessment/anticipatory guidance about, at 6-year well child visit, 138 X Xeroderma, inflammatory, treatment of, 475 Xopenex See Levalbuterol Xylocaine, viscous solution for aphthous stomatitis, 230 for herpetic gingivostomatitis, 319 Y Yellow jackets, allergic response to, 215–218 Yersinia, diarrhea caused by, 276 Z Zafirlukast, 562 Zanamivir, for influenza, 329–330 Zinacef See Cefuroxime axetil Zithromax See also Azithromycin for pertussis, 366 Zmax See Azithromycin Zosyn See Piperacillin + tazobactam Zovirax, 310–317 See also Acyclovir for varicella, 412, 414 Zyrtec See also Cetirizine for Hymenoptera allergy, 217 for seasonal rhinitis, 221 Zyvox See Linezolid ... 11304-04 _Part II.qxd 22 2 11 /26 /08 10:03 AM Page 22 2 PART II Management of Common Pediatric Problems b Alocril ophthalmic: to drops in each eye, every 12 hours for children over years of age or... at junction of lower and middle thirds of nose C Clear mucoid nasal discharge D Pale edematous nasal mucosa 11304-04 _Part II.qxd 22 0 11 /26 /08 10:03 AM Page 22 0 PART II Management of Common Pediatric... duration of action (2) Immediate release at 50% (3) Useful if increased hyperactivity in AM (4) Can be sprinkled (5) Maximum dose 60 mg/d 11304-04 _Part II.qxd 21 2 11 /26 /08 10:03 AM Page 21 2 PART