Anticipatory Guidance for Neonates to Adolescents Table Example

Anticipatory Guidance for Neonates to Adolescents Table Example

Anticipatory Guidance for Neonates to Adolescents Table Example
Anticipatory guidance helps family, caregivers, and others know what to expect according to the child’s growth and development. The guidance is done through collaboration between the healthcare provider and the caregiver. It is sometimes thought of as a type of counseling. Nurse practitioners working in pediatric primary care need to be experts on anticipatory guidance. There are excellent resources available and these are being updated as technologies and environments change.
This Assignment will demonstrate your ability to describe age-specific anticipatory guidance for the child and the family. Additionally, you will then have a reference table for quick glance created by you for future encounters with pediatric individuals and their families. Anticipatory Guidance for Neonates to Adolescents Table Example.
This assignment has a template that you will use to fill in the relevant elements of the anticipatory guidance per age group. The columns provide guidance to the specific areas such as safety and immunizations. If there is an area that is not applicable, such as oral health in infancy-newborn group, then place N/A in the box.
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Age Group
Physical Development and Mental Health
Physical Activity and Nutrition
Oral Health
Safety Concerns
Immunizations

Infancy- Newborn Visit
Stimulate baby’s brain. Sing, read, talk to baby. Turn off TV, radio, and smartphones. Babies do not learn language from TV. Learning from physical contact and touch. This helps sooth babies. Risk of sudden death syndrome big and infants. Babies should sleep on their backs to reduce the risk. Do not use wedge or other products. Protect baby in the first month of life and do not allow many people to handle. Avoid crowds. Make caregivers wash hands often, especially after changing diaper. Immunizations are important well baby as an infant. Avoid sun exposure. If outdoors use baby sunscreen.
• Breastfed babies feed 8-12 in 24 hours. Mother must take prenatal and avoid alcohol.
• Prepare and store formula safely.
• Hold baby up right one bottle feeding.
• Sign of hunger sucking, rooting, and facial grimacing.
• Assess if breastfed babies eating enough by having 5-6 wet diapers.
• Breastfeed babies usually have loose stools.
• Babies usually burp naturally, or gently tap back.
Oral care is important from birth. Dental habits begin. Clean gums after feeding with moistened washcloth. Gently massage gums. Do not put infant to bed propped up with bottle.
Sudden infanct death syndrome. Sleep asphyxiation. Falls. Physical abuse.  Living situation and food security. Exposure to tabacco. Maternal alcohol and substance abuse.
 Hepatitis B (HepB)-1st dose

Infancy-First Week Visit
Continue newborn recommendations. Stimulate babies’ brain by singing, reading, talking to baby. Do not use TV, radio, for smart devices to sue the baby. Risk of sudden death syndrome continues. Do not use wedge for other products well baby is asleep. Avoid crowds and make caregivers wash hands often, especially after changing diaper. Stimulate baby to wake up for feedings. Calm distressed babies with stroking head or gentle rocking.
• Breast feeding is optimal nutrition.
• Breast fed babies feed 8 to 12 times in 24 hours.
• encourage mothers to continue taking prenatal and avoid alcohol.
• Prepare and store formula accordingly.
• Breast fed babies have looser bowel movements.
• Formula fed babies should drink 2 ounces every 2 23 hours, can have more if still hungry.
• Prop baby up for bottle feedings.
• Signs of hunger include sucking, routing, and facial grimacing.
• Assess breast fed babies by number of wet diapers.
• Gently tap babies back for natural burping.
Dental habits begin. Clean gums after feeding with moistened washcloth. Gently massage gums. Do not put infant to bed propped up with bottle.
Sudden infanct death syndrome. Sleep asphyxiation. Falls. Physical abuse.
N/A
Anticipatory Guidance for Neonates to Adolescents Table Example

Infancy-1 Month Visit
Continue to follow infant to 1-week recommendations. Baby begins to follow parents with eyes. Offer visual stimulation. Continue to stimulate baby by singing, reading, and talking too baby. Assist in self soothing by placing baby in crib while awake or drowsy and by offering pacifier. Calm baby by stroking head or gently rocking. While baby is awake start “tummy time” To strengthen neck muscles and avoid positional plagiocepharly.
• Breast feeding continues to be optimal nutrition.
• Breast fed babies eat every 1 to 3 hours during the day, and every 3 hours at night time.
• Mothers should continue to take prenatal and avoid alcohol and foods that may upset baby.
• Store formula accordingly.
• Bottle fed babies should be propped up for feedings.
• Formula fed babies should drink 24 to 27 ounces per day
Dental habits begin. Clean gums after feeding with moistened washcloth. Gently massage gums. Do not put infant to bed propped up with bottle.
Sudden infanct death syndrome. Sleep asphyxiation. Falls. Physical abuse.
Hepatitis B (HepB)- 2nd dose

Infancy-2 Month Visit
Babies begin to have their own temperament, personality. Parents to pay attention to babies’ cues. Continue to stimulate by holding, cuddling, singing, and talking too baby. Develop sleep schedule for naps in night time sleep. Please baby in bed when drowsy. Continue to avoid television, radio and digital media. “Tummy time” while awake. Come baby by stroking head, gently rock walking and riding in stroller. Monitor babies head for plagiocepharly.
• Breast feeding continues to be optimal nutrition.
• Breast fed babies should wet 5 to 6 diapers a day.
• Breast fed babies should soil 3 to 4 diapers a day.
• Breast fed babies have looser bowel movements.
• Breast fed babies do not need extra fluid.
• Breast fed babies should be feeding 8 to 12 times in 24 hours.
• Breast feeding mothers should continue to take prenatal and avoid alcohol and other foods that may irritate babies’ stomach.
• Formula fed babies should feed 6 to 8 times in 24 hours.
• Total formula given should be 26 to 28 ounces.
• Prepare and store formula accordingly.
• Baby should be held upright while feeding.
• Do not lay baby down and prop up bottle.
Dental habits begin. Clean gums after feeding with moistened washcloth. Gently massage gums. Do not put infant to bed propped up with bottle.
Anticipatory Guidance for Neonates to Adolescents Table Example
Sudden infanct death syndrome. Sleep asphyxiation. Falls. Physical abuse.
• Hepatitis B (HepB)-2nd dose. Rotavirus (RV1)- 1st dose
• Diphtheria, tetanus, & acellular pertussis3 (DTaP: <7 yrs)- 1st dose • Haemophilus influenzae type b (Hib)- 1st dose • Pneumococcal conjugate (PCV13)- 1st dose • Inactivated poliovirus (IPV:<18 yrs)- 1st dose Infancy-4 Month Visit Continue encouraging self-calming methods. Stimulate baby by talking, playing, holding, cuddling, reading, and singing. Encourage sleep routine, nap and bedtime. Continue to avoid television, radio, and digital media as entertainment. Tummy time while baby is awake. Provide safe opportunities for exploration. • Breast feeding continues to be optimal nutrition. • Iron supplementation as needed. • Encourage save pumping and storage. • Formula fed babies should be drinking 30 to 32 ounces a day. • Prepare and store formula accordingly. Teething begins. Swollen gums and increase salivary flow. Give cold washcloth or teething ring. Dental habits begin. Clean gums after feeding with moistened washcloth. Gently massage gums. Do not put infant to bed propped up with bottle. Dental decay can begin. Avoid sharing utensils. Wash Pacifiers. Sudden infanct death syndrome. Sleep asphyxiation. Falls. Physical abuse. • Rotavirus (RV1)- 1st dose • Diphtheria, tetanus, & acellular pertussis3 (DTaP: <7 yrs)- 2nd dose • Haemophilus influenzae type b (Hib)- 2nd dose • Pneumococcal conjugate (PCV13)- 2nd dose • Inactivated poliovirus (IPV:<18 yrs)- 2nd dose Infancy-6 Month Visit Continue to encourage self-calming methods and infant's independence. Infant attention span increases. Continue to avoid television, radio and digital media as entertainment. Infant can sit in high chair. Engage an interactive talk, play, singing, and reading. Continue daily routines. Provide safe exploring time. • Breast feeding is encouraged for at least 6 months. • Breast feeding can continue. • Solid foods can begin to be introduced. • Only introduce one solid food at a time, in case allergies occur. • Feed foods rich in iron. • Infants can start for solid food feedings, so they can see and talk to others. • Thoroughly wash vegetables and fruits. • Avoid high sugar juices. • Dilute juices with water. • Do not switch formula fed babies to milk. Dental habits begin. May have first tooth by 6-8 months, start to use a child's soft bristled toothbrush with no toothpaste. Massaging the gum tissues. Give cold washcloth or teething ring. Limit frequency and number of sweetened beverages and foods. Should not walk around with bottle in mouth. Regularly check for suspicious small white or brown spots on teeth. Give water with fluoride. Fluoride brushing at pediatric checkups. Dental decay can begin. Avoid sharing utensils. Wash Pacifiers. Falls. Foreigh body in airways and nonairway. Physical abuse. Anticipatory Guidance for Neonates to Adolescents Table Example • Hepatitis B (HepB)- 3rd dose • Diphtheria, tetanus, & acellular pertussis3 (DTaP: <7 yrs)- 3rd dose • Pneumococcal conjugate (PCV13)- 3rd dose • Inactivated poliovirus (IPV:<18 yrs)- 3rd dose • Influenza (IIV)- Annually Infancy-9 Month Visit Daily routines are important. Provide greater opportunities for safe exploration and independence. Provide interaction with others to avoid separation anxiety and cultivate new social skills. Provide cause and affect toys. Continue to stimulate infant with talking, playing, singing, and reading and avoid television, radio, or digital entertainment. Begin consistent positive discipline. Limit or avoid the word no. Redirect with distractions. • Infants begin to feed self at meal time. • Provide safe table solid foods. • Introduce drinking cups. • Begin plan for weaning off formula feeding. • Whole milk not recommended yet. • Provide 3 balanced meals a day and 2 to 3 snacks. • Breast feeding continues to be encouraged. Anticipatory Guidance for Neonates to Adolescents Table Example Dental habits begin. May have first tooth by 6-8 months, start to use a child's soft bristled toothbrush with no toothpaste. Massaging the gum tissues. Give cold washcloth or teething ring. Limit frequency and number of sweetened beverages and foods. Should not walk around with bottle in mouth. Regularly check for suspicious small white or brown spots on teeth. Give water with fluoride. Fluoride brushing at pediatric checkups. Dental decay can begin. Avoid sharing utensils. Wash Pacifiers. Falls. Poisioning. Foreign body in airway or nonairway. • Hepatitis B (HepB)- 3rd dose • Inactivated poliovirus (IPV:<18 yrs)- 3rd dose • Influenza (IIV)- Annually Early Childhood-12 Month Visit Continue to support daily routine with time for family interaction. Child is now walking. Is exploring independently. Encourage interaction with other children, and family members to diminish separation anxiety. Continue to avoid television and digital entertainment. Continue consistent positive discipline and distractions. Introduce timeouts and praise good behavior. Limit naps to one a day and follow good sleep hygiene. • Breast feeding is not discouraged as supplemental nutrition to solid food. • Self-feeding is important for independence, child deciding how much to eat. • Avoid small, hard foods. Sit down family meals should be well balanced. • Provides 3 balanced meals a day and 2 to 3 snacks. First dental appointment before first birthday or within 6 months after first tooth. Brush teeth twice a day with plain water. Regularly check for suspicious small white or brown spots on teeth. Schedule an appointment with dentist if signs of decay. Continue to take steps to avoid passing decay causing germs to your child. Falls from furniture. Poisioning. Burns. Foreign body in airway or nonairways. • Hepatitis B (HepB)- 3rd dose • Haemophilus influenzae type b (Hib)- 3rd dose • Pneumococcal conjugate (PCV13)- 4th dose • Inactivated poliovirus (IPV:<18 yrs)- 3rd dose • Influenza (IIV)- Annually • Measles, mumps, rubella (MMR)- 1st dose • Varicella (VAR)- 1st dose • Hepatitis A (HepA)- 1st dose in 6-18 month 2nd dose Early Childhood-15 Month Visit Child becoming an individual, allow to choose between 2 acceptable options. Speak reassuringly to child to reduce separation and stranger anxiety. Speak simple clear words and phrases avoiding baby talk to promote language development and communication. Maintain daily and sleeping routines. Encourage healthy sleep hygiene. Do not use TV or digital media as entertainment or "babysitter". Environment modification to avoid tantrums and conflict. Continue consistent positive discipline and distractions. Praise good behavior. Use timeouts and avoid or limit the word no. Become an example and do not use aggression. Children begin to buy at this age. • Child determines how much they eat. • Provide healthy options. • Provide 3 balanced meals a day and 2 to 3 healthy snacks. • Avoid foods that are high in sugar, salt, and fat. • Dilute high sugar juices with water. • Do not let child sleep with bottle in their mouth. Anticipatory Guidance for Neonates to Adolescents Table Example First dental appointment before first birthday or within 6 months after first tooth. Brush teeth twice a day with plain water. Regularly check for suspicious small white or brown spots on teeth. Schedule an appointment with dentist if signs of decay. Continue to take steps to avoid passing decay causing germs to your child. Falls from furniture. Poisioning from household items. Burns. Foreign body in airway or nonairways. • Hepatitis B (HepB)- 3rd dose • Diphtheria, tetanus, & acellular pertussis3 (DTaP: <7 yrs)- 4th dose • Haemophilus influenzae type b (Hib)- 3rd dose • Pneumococcal conjugate (PCV13)- 4th dose • Inactivated poliovirus (IPV:<18 yrs)- 3rd dose • Influenza (IIV)- Annually • Measles, mumps, rubella (MMR)- 1st dose • Varicella (VAR)- 1st dose • Hepatitis A (HepA)- 1st dose in 6-18 month 2nd dose Early Childhood-18 Month Visit Anticipate an increase in separation anxiety and new situations. Spend quality time daily with child to stimulate learning. Be consistent most discipline, time out, and praising good behavior. Begin toilet training and encourage visiting the bathroom every 2 hours. Speak simple clear words and phrases, avoiding baby talk to promote language development and communication encourage healthy sleep hygiene and avoid television or digital media before bedtime. Encourage communication and language development by Avoiding baby talk and talking about surroundings. If television and digital media is being introduced choose high quality programs and applications. limit to less than one hour per day. • Offer healthy variety of foods and snacks. • Provide 3 balanced meals a day and 2 to 3 healthy snacks. • Offer 16 to 24 ounces of milk a day. • Dilute high sugar juices with water. • Continue to offer new foods and encourage experimentation with touching food. First dental appointment before first birthday or within 6 months after first tooth. Brush teeth twice a day with plain water. Regularly check for suspicious small white or brown spots on teeth. Schedule an appointment with dentist if signs of decay. Continue to take steps to avoid passing decay causing germs to your child. Falls from furniture. Poisioning from household items. Burns. Foreign body in airway or nonairways. Anticipatory Guidance for Neonates to Adolescents Table Example • Hepatitis B (HepB)- 3rd dose • Diphtheria, tetanus, & acellular pertussis3 (DTaP: <7 yrs)- 4th dose • Inactivated poliovirus (IPV:<18 yrs)- 3rd dose • Influenza (IIV)- Annually • Hepatitis A (HepA)- 1st dose in 6-18 month 2nd dose Early Childhood-2 Year Visit Physically more independent from parents. "Terrible twos". Begin to think independently. Learning, social, and emotional changes that enhances how they explore their world. Follow 2-3 step direction. Sort shapes and colors. Imitate playmates and adults. Experience new emotions. Milestones include taking turns, kicking a ball, and playing make. • Encourage and teach healthier foods and drink options. • Water down juices. • Preferred foods changes from day to day. Introduce new foods • Encourage as much free play time as possible. • Limit television and screen time 1-2 hours Begin brushing with a pea-sized amount or small smear of fluoridated toothpaste. Teach child to spit out the toothpaste. Observe to insure child does not swallow the toothpaste. Falls from furniture. Poisioning. Transporatation injuries: pedestrian, motor vehicle occupant. • Influenza (IIV)- Annually • Hepatitis A (HepA)- 1st dose in 6-18 month 2nd dose Early Childhood-2.5 Year Visit Maintaining regular family routines is important for mental development. Encourage physical activity with outdoor family outings. Offer safe environments for emerging independence. Continue to stimulate language development and proper communication by reading and speaking to child with correct grammar. Limit TV and social media use to less than one hour of age appropriate entertainment. Encourage child to interact with others by considering preschool programs, play dates or play groups. Praise sharing and cooperative play. Offer 2 acceptable choices to promote independence. Encourage toilet training by dressing child appropriately. Offer bathroom breaks every 1 to 2 hours with praise if child uses toilet. • Provide 3 balanced meals a day and 2 to 3 healthy snacks. • Encourage and teach healthier foods and drink options. • Preferred foods changes from day to day. Introduce new foods • Encourage as much free play time as possible. • Dilute high sugar juices with water. All the primary teeth should have come into the mouth. Regularly check for suspicious small white or brown spots on teeth. Schedule an appointment with dentist if signs of decay. Continue to take steps to avoid passing decay causing germs to your child. Falls from furniture. Transportation injuries: pedestrian, Motor vehicle occupant. Poisioning. • Influenza (IIV)- Annually Anticipatory Guidance for Neonates to Adolescents Table Example Early Childhood-3 Year Visit Milestone include ride a tricycle, use safe scissors, distinguish genders, help with undressing and dressing self, play with other children, sing a song, and recall a story. Begin to focus on other adults and children their age. Start to identify colors and shapes. Show affection to others. Hop on 1 foot. Very independent from family. Interactions with others begin to shape personality. • Parents should eat meals with child. • Set examples of good eating habits. • Limit foods high in sugar, salts, and fats. • Limit screen time to 1-2 hours and encourage outdoor play. • Interact with child with play equipment Child should have stopped using the pacifier and/or sucking his/her thumb. Continue to take steps to avoid passing decay causing germs to your child. Falls from furniture. Transportation injuries: pedestrian, Motor vehicle occupant. Poisioning. • Influenza (IIV)- Annually Early Childhood-4 Year Visit Child becomes ready for school. Encourage child to play with others of their age visit preschool with child and become involved. Encourage child to talk about what they learned. Encourage talking and reading and give child the opportunity to finish a sentence. Become example to child and have respectful behavior, apologize, praise, and be grateful to others. Encourage child to play outside. Limit television and digital entertainment to one to 2 hours of appropriate programming. • Continuously encourage appropriate hydration. • Give 16 to 24 ounces of low fat or fat free milk daily. • Juice should be limited to 4 ounces a day. • High sugar juices should be diluted with water. • Continue to offer healthy snacks. • Limit foods high in sugar, salt, and fats. • Be an example and eat balanced meals. Regularly check for suspicious small white or brown spots on teeth. Schedule an appointment with dentist if signs of decay. Continue to take steps to avoid passing decay causing germs to your child. Falls on playground. Transportation injuries: bicycle injuries, motor vehicle occupant, pedestrian. Poisioning • Diphtheria, tetanus, & acellular pertussis3 (DTaP: <7 yrs)- 5th dose • Influenza (IIV)- Annually • Measles, mumps, rubella (MMR)- 2nd dose • Inactivated poliovirus (IPV:<18 yrs)- 4th dose • Varicella (VAR)- 2nd dose Middle Childhood-5 and 6 Year Visits Milestone include: dressing self, catching a ball easily, and tying their shoes. Self independence is important for child. Relationship begin with people other then their family, in school. Social, mental and physical skills improve quickly with increases their confidence. Describing experiences, thoughts and feelings increases. More focus on other and less on self. Thinks in regard to the future. Conceptualizing world. Focuses on friendship and teamwork. Needed to be liked and accepted. • Able to make food choices at school. • Limit access to foods high in sugars, salts, and fats. • Needs 1 or more hours of physical activity a day. • Limit screen time to 1-2 hours of quality programing. • Encourage active play. • Parents set health eating during mealtimes and active lifestyle. Begin to teach child how to brush their own teeth. Children should be able to brush unsupervised by the age of 6 or 7. Regularly check for suspicious small white or brown spots on teeth. Schedule an appointment with dentist if signs of decay. Continue to take steps to avoid passing decay causing germs to your child. Bi-annual regular dental checkup. Children begin to lose teeth. Falls on playground. Transportation injuries: bicycle injuries, motor vehicle occupant, pedestrian. Anticipatory Guidance for Neonates to Adolescents Table Example • Diphtheria, tetanus, & acellular pertussis3 (DTaP: <7 yrs)- 5th dose • Inactivated poliovirus (IPV:<18 yrs)- 4th dose • Influenza (IIV)- Annually • Measles, mumps, rubella (MMR)- 2nd dose • Varicella (VAR)- 2nd dose Middle Childhood-7 and 8 Year Visits Teach child skills of nonviolent conflict resolution. Offer safe zone to talk about possible bullying. Child still looking for affection with parents. Encourage independence and responsibility. praise appropriately discuss home and school rules and possible consequences. Puberty begins so open conversation for open door policy. Encourage learning readiness by establishing healthy bedtime hygiene and well-balanced breakfast. Children enjoy and are successful when caregivers show interest in school and their activities. • Encourage healthy food choices at school. • limit access 2 foods that are high in sugars, saults, and fats. • Offer balanced meals full of vegetables and fruit. • Teach children to stop eating when they are satisfied and only eat when hungry. • Encourage one or more physical activity a day to minimize risk of obesity. Begin to teach child how to brush their own teeth. Children should be able to brush unsupervised by the age of 6 or 7. Regularly check for suspicious small white or brown spots on teeth. Schedule an appointment with dentist if signs of decay. Continue to take steps to avoid passing decay causing germs to your child. Bi-annual regular dental checkup. Children continue to lose teeth. Sports injuries. Physical violence: school and parental. Bullying. Transportation injuries: bicycles injuries, motor vehicle occupant, pedestrian. • Influenza (IIV)- Annually Middle Childhood-9 and 10 Year Visits Become responsible. Significant physical changes. Puberty affects girls before boys. Physical changes awareness. Heightened body image can cause eating disorders. Changes in school increases responsibility concepts. Child begins to place importance to friends. Healthy relationship is important. Children affected by bullying can suffer depression. Self-image affects how they deal with peer pressures. Emotionally important to have friends of the same sex. Very independent from family. Conventionalizes others point of view. Increased attention span. • Provide plenty of fruits and vegetables. • Limit foods high in sugars, salt, and fats. • Keep television out of bedrooms. • Limit social media and phone time. • Limit screen time to 1-2 hours. • Encourage participation of physical activity to at least 1 hour a day. • Age appropriate and enjoyable physical activity.  At least 3 (running, climbing trees, jump rope). Permanent teeth come into empty spots. Educate child about limiting frequency and number of sweetened beverages and foods. Educate about good oral hygiene. Schedule an appointment with dentist if signs of decay. Bi-annual regular dental checkup. Sports injuries. Physical violence: school and parental. Bullying. Transportation injuries: bicycles injuries, motor vehicle occupant, pedestrian. • Influenza (IIV)- Annually Anticipatory Guidance for Neonates to Adolescents Table Example Early Adolescence-11 to 14 Year Visits  Huge physical, mental, emotional, and social changes. Hormones changes begins to change emotions and bodies. Boys grow facial, pubic hair, voices deepen. Girls grow pubic hair, grow breasts, and start their periods. Physical changes affect self-image and they think others view them. Physical appearance affects what they wear, how they do their hair. Peer pressure to use alcohol, tobacco products, and drugs, and to have sex. All the changes can lead to eating disorders, depression, and thoughts of suicide. Choices are based around their friends, sports, studying, and school. Develop their own personality and interests that may not the same as parents. Less affection showed towards parents with bursts of short temper. Struggle with high expectations and lack of confidence. • Encourage physically activity. • Join team sports or take up an individual sport. • Help with household chores (mowing the lawn, caring for pets). • Encourage family mealtime. • Teach good eating habits by eating together and setting example. • Provide plenty of fruits and vegetables. • Limit foods high in sugars, salt, and fats. • Keep television out of bedrooms. • Limit social media and phone time. • Limit screen time to 1-2 hours. • Encourage participation of physical activity to at least 1 hour a day. Educate child about limiting frequency and number of sweetened beverages and foods. Educate about good oral hygiene. Schedule an appointment with dentist if signs of decay. Bi-annual regular dental checkup. If child needs braces this is the time that orthodontist begin to recommend.       ORDER A PLAGIARISM-FREE PAPER HERE Transportation injuries: motor vehicle occupant, pedestrian, bicycle. Homicide. Suicide. Bullying. Sports injuries: concussion, knee and ankle injuries. • Influenza (IIV)- Annually • Meningococcal MenACWY-D ≥9 mos; MenACWY-CRM ≥2 mon- 1st dose • Tetanus, diphtheria, & acellular pertussis (Tdap: ≥7 yrs) Middle Adolescence-15 to 17 Year Visits Changes in interaction with others, thought processing, and body image. Girl almost completely physically matured. Boys continue to mature. Self-image concerns are body size, shape, and weight which leads to eating disorders which in more common in girls. Developing their own unique personality and options. Romantic and sexual relationship develop. Friendships with friends continue to be the most important yet begin to have other interest. Preparing to starting college and have more independence, responsibilities. Working outside of the home. Less conflict with parents. Deeper capacity for caring and sharing. Continues to spend less time with parents and more with friends. Sadness and depression can develop do to school grades, substance abuse, unsafe sex practice. Concerned with future. • Provide plenty of fruits and vegetables. • Limit foods high in sugars, salt, and fats. • Keep television out of bedrooms. • Limit social media and phone time. • Limit screen time to 1-2 hours. • Encourage participation of physical activity to at least 1 hour a day. • 8-9 hours of sleep. Educate child about limiting frequency and number of sweetened beverages and foods. Educate about good oral hygiene. Schedule an appointment with dentist if signs of decay. Bi-annual regular dental checkup. Wisdom teeth begin to erupt. Transportation injuries: motor vehicle accidents. Homicide. Suicide. Bullying. Gangs. Sports injuries: concussion, knee and ankle injuries. • Influenza (IIV)- Annually • Meningococcal MenACWY-D ≥9 mos; MenACWY-CRM ≥2 mon- 2nd dose Late Adolescence-18 to 21 Year Visits Some late adolescence living away at colleges. Caregivers have a difficult time assessing Physical development and mental health. Teach adolescent how to manage conflict nonviolently. Discourage tobacco, cigarette, alcohol, and drug use. Stay connected and involved in school and extracurricular activities. Teach safe sex practices. Assess self-image concerns. • Caregivers have a difficult time assessing physical activity and nutrition if away at college. • Encourage annual physical examinations bi-annual dental visits. • Continue to encourage balanced meals with plenty of fruits and vegetables. • Encourage participation in physical activity to at least one hour a day. Educate child about limiting frequency and number of sweetened beverages and foods. Educate about good oral hygiene. Schedule an appointment with dentist if signs of decay. Bi-annual regular dental checkup. Wisdom teeth begin to erupt. Transportation injuries: motor vehicle accidents. Homicide. Suicide. Bullying. Gangs. Alcohol poisoning.  Sports injuries: concussion, knee and ankle injuries. • Influenza (IIV)- Annually Anticipatory Guidance for Neonates to Adolescents Table Example References Centers for Disease Control and Prevention. (2018). Birth-18 Years Immunization Schedule. Retrieved from: https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html Centers for Disease Control and Prevention. (2018). Developmental Milestones. Retrieved from https://www.cdc.gov/ncbddd/actearly/milestones/index.html Centers for Disese Control and Prevention. (2018). Positive Parenting Tips. Retrieved from https://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/index.html Hagan, J. F., American Academy of Pediatrics, Shaw, J. S., & Duncan, P. M. (2017). Bright Futures : Guidelines for Health Supervision of Infants, Children, and Adolescents (Vol. Fourth edition). Elk Grove Village, IL: American Academy of Pediatrics. Retrieved from http://search.ebscohost.com.libauth.purdueglobal.edu/login.aspx?direct=true&db=nlebk&AN=1471774&site=eds-live. Anticipatory Guidance for Neonates to Adolescents Table Example.

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