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Preventive Healthcare Guidelines

Children and Adolescents

 

Infancy- Age 1

Ages 1-10

Ages 11-20

Tot-to-Teen Health Check

(complete examination that includes vision, hearing, development, and behavioral health screening)

Visit your PCP for this complete exam at birth and when your child is 1, 2, 4, 6, 9, and 12 months of age.Visit your PCP for this complete exam when your child is 15, 18, and 24 months, and 3, 4, 5, 6, 7, 8, 9 and 10 years of age.Visit your PCP for this complete exam when your child is 11, 12, 13, 14, 15, 16, 17, 18, 19, and 20 years of age.
Blood lead screening

At 12 months

At 24 months

 
Laboratory (lab) tests

Ask your PCP if your child needs any laboratory (lab) tests

Immunizations*

Ask your PCP or nurse at every office visit if your child needs immunizations. (See immunization schedule (.pdf) or Programa de Vacunas para los Niños y los Adolescentes que "Hecho al Año" (.pdf)

Screening for Chlamydia (a curable sexually transmitted disease that can lead to infertility)  All sexually active females 24 and younger and for others at increased risk. Discuss with your PCP.
Screening for rubella  Once for all females of childbearing age by history of vaccination or blood test.
Screening for high blood pressure Blood pressure measurements at every well child visit starting at age 3.
Screening for obesity Screen children age 6 and older for obesity
Health Education and Development Counseling

Age-appropriate health education and development counseling should encompass some of the following:

Infancy - Age 1

  • Baby bottle tooth decay
  • Breastfeeding for child's health
  • Iron-enriched formula (less than age 1)
  • Impact of second-hand smoke
  • Sleep positioning
  • Smoke detectors
  • Hot water temperature less than 120 degrees F
  • Child safety seats

Ages 1 - 10

  • Regular physical activity
  • Healthy diet
  • Dental Care
  • Not using tobacco and impact of second-hand smoke
  • Prevention of household injuries
  • Smoke detectors
  • Hot water temperature less than 120 degrees F
  • Window/stair guards
  • Safe storage/removal of firearms
  • Remove or lock up poisons and cleaning supplies
  • Lock up prescription drugs
  • Cardiopulmonary Resuscitation (CPR) training for parents/caretakers
  • Put Poison Control number at each telephone
  • Air bag safety
  • Child safety car seats
  • Lap/should belts
  • Bicycle, motorcycle, All terrain vehicle (ATV) helmet use
  • Pool safety

Ages 11 - 20

  • Regular physical activity
  • Healthy diet
  • Dental Care
  • Not using tobacco and impact of second-hand smoke
  • Prevention of illegal drug use and underage drinking
  • Prevention of Human Immunodeficiency Virus (HIV) and other sexually transmitted infections (STIs)
  • Prevention of unintended/mistimed pregnancies
  • Prevention of household injuries
  • Smoke detectors
  • Safe storage/removal of firearms
  • Airbag safety
  • Child safety car seats
  • Lap/should bets
  • Bicycle, motorcycle, All terrain vehicle (ATV) helmet use
  • Pool safety

 *Subject to benefit plan and its limitations.

Children and Adolescent Preventive Healthcare Guidelines 2012-2013 
 
Directrices de la atencion medica con fines de prevencion para los ninos y los adolescentes en 2012 y 2013

Adults

 

Ages 21-64

Ages 65 and older

Breast cancer screeningMammogram (special x-ray of breast) every 1-2 years for women 40 and older.
Cervical cancer screeningPap smear testing for women ages 21-65 every 3 years.
Screening for Chlamydia

(a curable sexually transmitted disease that can lead to infertility)

All sexually active women 24 and younger and for others at increased risk.

Discuss with your PCP.

 All sexually active women at increased risk.

Discuss with your PCP.

Screening for colorectal (intestine/gut) cancer

For all individuals ages 50-75:

  • By testing for blood in stool every year for everyone 50 and older.
  • Discuss sigmoidoscopy or colonoscopy with your PCP.
Screening for Type 2 Diabetes

Discuss with your PCP.

Blood pressure check

At least every 2 years.

Lipid/cholesterol testingAt least every 5 years for men ages 35 and older.

At least every 5 years for women 45 and older.

Screening for osteoporosis* (bone thinning)

For women age 64 and younger at increased risk.

Discuss with your PCP.

For women ages 65 and older.

Discuss with your PCP.

Screening for abdominal aortic aneurysm (a heart problem) Men ages 65-75 who have ever smoked (one-time test).
Height, weight, and obesity

Height, weight, and Body Mass Index (BMI) at every office visit.

Screening for rubellaOnce for all women of childbearing age by history of vaccination or blood test. 
Testing for tuberculosis

Discuss with your PCP.

Screening for depression

Discuss with your PCP.

Screening for behavioral health problems (mental health and drug abuse)

First PCP visit.

Testing for hearing and vision problems Discuss with your PCP.
Immunizations** (shots)

Ask your PCP about immunizations you may need.

Flu shot every year.
Tetanus booster
Shingles (Herpes Zoster) vaccine for ages 60 and older (one-time vaccine).
Pneumococcal vaccine
Health Education and Counseling

Age-appropriate health education and counseling should encompass some of the following:

Ages 21 - 64

  • Regular physical activity
  • Healthy diet Adequate calcium intake
  • Not using/quitting tobacco
  • Avoid alcohol misuse
  • Prevention of HIV infection and other sexually transmitted infections (STIs)
  • Prevention of unintended/mistimed pregnancies
  • Prevention of injuries (motor vehicle, household, and recreational)
  • Discussion of prevention of chronic diseases for perimenopausal and postmenopausal women
  • Use of aspirin for members at risk for heart disease:
    • Men ages 45-79 years
    • Women ages 55-79
Ages 65 and older
  • Regular physical activity
  • Healthy diet
  • Not using/quitting tobacco
  • Avoid alcohol misuse
  • Prevention of injuries (motor vehicle, household, and recreational)
  • Fall prevention
  • Prevention of HIV infection and other sexually transmitted infections (STIs)
  • Discussion of prevention of chronic diseases for perimenopausal and postmenopausal women
  • Use of aspirin for members at risk for heart disease:
    • Men ages 45-79 years
    • Women ages 55-79 years

*Subject to Medicare coverage guidelines.
**Subject to benefit plan and its limitations.

Adult Preventive Healthcare Guidelines 2012-2013

Directrices de la atencion medica con fines de prevencion para los adultos en 2012 y 2013


Pregnancy

  • Visit a practitioner as soon as you think you might be pregnant.
  • Your practitioner will tell you how often you need to visit after your first visit, usually every four weeks until your last trimester, then every two weeks, and then every week during the last month.
  • You will need to visit your practitioner again 4-6 weeks after you deliver your baby.
  • Follow these guidelines in addition to those listed for your age.

Weeks 4 - 28

What to expect

At your first visit with your health care practitioner you may receive a full physical exam, take blood for lab tests, calculate your due date, receive a breast exam, pelvic exam to check your uterus (womb), and cervical exam, including a Pap test.

Discuss with your practitioner

  • Balanced nutrition, ideal caloric intake and weight gain
  • Multivitamin with folic acid
  • Flu shot
  • Tobacco cessation/effects of passive smoking
  • Alcohol/other drug use
  • Lap/shoulder belts

Prenatal tests

  • Your blood type and Rh factor
  • Anemia
  • Infections, such as sexually transmitted infections (STIs)
  • Signs that you are immune to rubella and chicken pox

 

Other potential prenatal screenings

  • Amniocentesis (check for certain birth defects)
  • Chorionic villus (check for certain birth defects)
  • First trimester screen and Ultrasound exam
  • Maternal serum screen (AFP) (detect higher risk of chromosomal disorders or neural tube defects)

Weeks 28 - 36

What to expect

Keeping track of your baby's movements is a good way to detect any signs of distress or if a doctor's care is needed.  Discuss the monitoring of fetal movements with your practitioner.

Discuss with your practitioner

  • Balanced nutrition, ideal caloric intake and weight gain
  • Multivitamin with folic acid
  • Flu shot
  • Tdap booster
  • Tobacco cessation/effects of passive smoking
  • Alcohol/other drug use
  • Lap/shoulder belts

 

Potential prenatal screenings

  • Glucose challenge screening (check for mother's risk of gestational diabetes)
  • Glucose tolerance test (test to diagnose for gestational diabetes)
  • Nonstress test (test for fetal distress)
Weeks 36 - birth

Discuss with your practitioner

  • Rubella after delivery, if needed
  • Breastfeeding for child's health benefits
  • Infant safety car seats
  • Importance of postpartum visit (follow-up visit for mom after baby is born)
  • Birth control (at postpartum visit)

 

Potential prenatal screenings

  • Biophysical profile and Ultrasound exam
  • Group B streptococcus infection (check for bacteria that can cause pneumonia or serious infection in newborn)

 

Be sure to set up your postpartum visit no later than 4-6 weeks from your delivery date.

 

Pregnancy Preventive Healthcare Guidelines 2012-2013

Directrices de la atencion medica con fines de prevencion para las mujeres en cinta 2012 y 2013

 

  1. American Academy of Family Physicians. Available at: http://www.aafp.org/online/en/home/html. Accessibility verified April 18 2012.
  2. American Academy of Pediatrics. Available at: http://www.aap.org. Accessibility verified April 18 2012.
  3. Centers for Disease Control and Prevention. Immunization Schedules. Available at http://www.cdc.gov/vaccines/recs/schedules/default.htm. Accessibility verified April 18 2012.
  4. Hagan, JF, Shaw, JS, Duncan, PM, eds. Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents. 3rd ed. Illinois: American Academy of Pediatrics; 2008. Available at: http://brightfutures.aap.org/3rd_Edition_Guidelines_and_Pocket_Guide.html. Accessibility verified April 18 2012.
  5. Lemnos, JA, Lockwood, CJ, eds. Guidelines for Perinatal Care. 6th ed. American Academy of Pediatrics [and] the American College of Obstetricians and Gynecologists; 2007.
  6. National Cancer Institute. Breast Cancer; Detection and Diagnosis; Mammograms. Available at: http://www.cancer.gov/cancertopics/wyntk/breast/page6. Accessibility verified April 18 2012.
  7. State of New Mexico Medical Assistance Division, New Mexico Administrative Code 8.305.8.16. Standards for Preventive Health Services. Available at: http://www.nmcpr.state.nm.us/nmac/parts/title08/08.305.0008.htm. Accessibility verified April 18 2012.
  8. Tot-to-Teen Health Checks are federally mandated for Medicaid as part of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Services. Available at: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Benefits/Early-Periodic-Screening-Diagnosis-and-Treatment.html. Accessibility verified April 18 2012.
  9. Womenshealth.gov. Pregnancy. Available at: http://www.womenshealth.gov/pregancy/. Accessibility verified April 18 2012.
  10. U.S. Preventive Services Task Force: Available at: http://www.uspreventiveservicestaskforce.org. Accessibility verified April 18 2012.

 Content reviewed/revised 06/10/12 [MPC061260]
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