The Peds NP: Pearls of Pediatric Evidence-Based Practice Becky Carson

Developmental surveillance and screening work best to identify delays when used together.  The AAP and CDC teamed up to create a standardized developmental milestone checklist in order to improve the longitudinal monitoring of pediatric milestones at home by caregivers.  This episode reviews their publication and discusses what went into the checklist, its strengths, and areas for further research.   View the CDC's website for the full checklist and read the article here.

When accelerated BSN student Sam Mahaney wanted more practical bedside application of his knowledge of pediatric cardiology, we sat down to discuss the approach to assessment and management of undiagnosed and undifferentiated congenital heart disease from a primary care perspective.  The primary care clinician should be on the lookout for red flags in the history and physical exam that might suggest critical congenital heart disease and screen appropriately.  This episode has helpful perspectives for both the nurse and advanced practice provider.

Infant dyschezia refers to the discomfort an infant experiences when bearing down against a closed anal sphincter, and is often misidentified as constipation by parents.  As long as red flags are absent, this functional, self-limited condition is easily diagnosed using the Rome IV Criteria.  In this episode, you will learn how to reassure parents and what contraindicated treatments should be discussed.  

Vision screening is one of the most important preventative health screenings that a primary care provider does at well visits.  But the infant eye exam can feel obtuse and complicated if you don't understand vision development, physical exam maneuvers, and red flags for referral.  Because of the risk of significant amblyopia if ocular pathology is left untreated, every pediatric provider should know how to complete an age-appropriate vision screening in an infant.

With national formula shortages over 40% and growing, the pediatric provider can encourage the establishment and maintenance of breastfeeding in moms who have chosen this path.  Breastfeeding isn't without struggles and woes, so providers can help support mothers by understanding these tips based on breastfeeding physiology and advising the pair when the process isn't as easy as it seems.

Two of the most common over-the-counter medications in pediatrics are not as simple and benign as you might think.  This episode uncovers the dark past of acetaminophen, the pearls and pitfalls of prescribing them, and how to talk to families about giving the medications safely.