QUESTIONS AND CORRECTLY WELL DEFINED ANSWERS 100% GUARANTEED
PASS!!!
PCP as care coordinators - DETAILED ANSWER--These children require heath
maintenance, illness prevention, and developmental surveillance
-Traditional primary care needs - needed for routine vaccinations, common
disease management, and family support and guidance
-Collaboration among clinicians, case managers, family members, home care and
school professionals, clinics, hospitals, and community-based services
-Gatekeeper and care coordinator - collaboration for all needs
-PCHH - patient-centered health home - ideal model for managing complex health
care needs
Differences between CSHCN (children with special health care needs) and without
special needs - DETAILED ANSWER-Table 7.1
-Mental health problems - ADD, mood disorders, autism, tic disorders -Atopic and
rheumatic disorders - asthma, JRA, lupus
,-Endocrine and metabolic diseases - growth disorders, adrenal disorders,
disorders of sex development, thyroid disorders, inborn errors of metabolism,
DM, pituitary disorders
-Congenital, genetic, or chromosomal defects - rare genetic diseases/syndrome
-Premature and/or very low birth weight infants
-Severe injuries or burns
-Static or progressive neurologic and neuromuscular disorders - CP, global
developmental delays, muscular dystrophy, spina bifida, seizure disorders
-Respiratory disorders - cystic fibrosis
-CV disorders - cardiac defects, long-term effects of acquired CV disease
-GI disorders - IBD
-Childhood cancers
-Family psychosocial concerns - trauma/abuse, homelessness, undocumented
immigration status, overwhelming needs with limited resources
Subspecialty care - DETAILED ANSWER--PCPs review notes and recommendations,
looking for missing or duplicate items
-May have an interdisciplinary clinic available
Tertiary care - DETAILED ANSWER--PCP makes sure family has documentation of
child's condition, medications, etc. and knowledge of when to go to a higher level
of care
Homecare and community services - DETAILED ANSWER--PCP in charge of
arranging and recognizing the need for services
,Technology dependence and medication - DETAILED ANSWER--Complex equipment
such as home ventilators, enteral feeding pumps, wheelchairs, hospital beds, and
nerve stimulations may be needed
-Low-tech supplies may include respiratory or feeding tubing, special formulas or
diets, urinary catheters, and ostomy bags
-Ongoing family education is essential to ensure the safe and effective use or all
devices and to make sure that families know how to fix common complications
without seeking urgent care
-Medications - be aware of polypharmacy - this leads to an increased risk of drug
interactions and confusion about dosing and administration
-Ongoing review of medication necessity and limiting the use of medication to
compounding pharmacies; PCPs can help find compounding pharmacies as
many of these kids require liquid medications and cannot swallow pills
Costs and family burden - DETAILED ANSWER--Out-of-pocket costs and time spent
caring for CSHCN can be significant and may lead to higher level care when care
needs are not met
-CSHCN are at risk for fragmented care, with poor team communication, crisis-
driven health care, and insufficient caregiver support
Government resources for CSHCN - DETAILED ANSWER--Medicaid - many rely on
this as their sole health care coverage
-SSI - provides financial help with care costs if the child has severe functional
limitations caused by a physical and/or cognitive impairment likely to last longer
than a year or to result in the child's death
-Durable Medical equipment (DME) and reimbursement - essential to fill out
paperwork properly
, Community and school-based services - DETAILED ANSWER--Early intervention,
public school services, financial assistance programs, respite care services, and
support groups
-Many developmental, educational, and psychosocial support services are
provided in school settings by government and community
-Smaller school districts lack resources to provide these services
Early intervention - DETAILED ANSWER--From birth to age 3
-May include developmental, speech, physical, and occupational therapy,
audiology, assistive medical technology, family training assistance, social work
services and service coordination
-PCPs should refer any child with suspected disabilities or developmental delays
to EI services for evaluation and therapy
-Services are generally free, but other services may be billed so referral to social
work may be needed
-After age 3, CSHCN transition to services through the public school system -
IDEA and section 504 ensures free, appropriate education in
the least restrictive environment possible for all children
-Children with disabilities receive educational support in either general or special
education classrooms, therapies including speech and OT, health care services
needed during the school day, and emotional, behavioral, and psychologic
services
-PCPs should encourage parents of children receiving EI to contact their school
before third birthday - they may be eligible for a 504 or IEP