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12 Month Assessment/Plan

posted 2010-04-01, updated 2019-12-22

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[textarea default="Normal growth and development
Injury prevention and health promotion issues discussed: ***shoes cover feet and need not be expensive/use of car restraints/poisoning information/choking information/Syrup of Ipecac/nutritional guidance/day care issues***
***No immunizations/DTaP/DTaP-Hib/IPV/HBV-Hib/Hib/Hepatitis B/Hepatitis A/HPV/MMR/MMR-V/Varivax/PCV-7/Influenza*** given today. Side effects, risks, and benefits of immunizations discussed. 
Lead risk (Exposed to home built before 1950, before 1978 under renovation, sibling/playmate w/ lead poisoning?): ***No/Yes, ordered testing***
TB risk (Close contact with person with TB, live in area where TB is common, recent immigrant?): ***No/Yes, ordered testing***
Fe deficiency risk (low birth weight, prematurity, low iron formula?): ***No/Yes, ordered testing***
Return to clinic at 15 months of age, or sooner if concerns arise. Approved for all routine preventive medicine services, including immunizations. Abuse/neglect, functional status, nutrition and pain assessed and no further evaluation is needed."]

Normal growth and development
Injury prevention and health promotion issues discussed: ***shoes cover feet and need not be expensive/use of car restraints/poisoning information/choking information/Syrup of Ipecac/nutritional guidance/day care issues***
***No immunizations/DTaP/DTaP-Hib/IPV/HBV-Hib/Hib/Hepatitis B/Hepatitis A/HPV/MMR/MMR-V/Varivax/PCV-7/Influenza*** given today. Side effects, risks, and benefits of immunizations discussed. 
Lead risk (Exposed to home built before 1950, before 1978 under renovation, sibling/playmate w/ lead poisoning?): ***No/Yes, ordered testing***
TB risk (Close contact with person with TB, live in area where TB is common, recent immigrant?): ***No/Yes, ordered testing***
Fe deficiency risk (low birth weight, prematurity, low iron formula?): ***No/Yes, ordered testing***
Return to clinic at 15 months of age, or sooner if concerns arise. Approved for all routine preventive medicine services, including immunizations. Abuse/neglect, functional status, nutrition and pain assessed and no further evaluation is needed.