Preventive Care Guidelines | Presbyterian Healthcare Services

Preventive care services include screenings, immunizations and physical exams that help you to stay healthy. Regular preventive care can also help to identify a health condition before you begin to experience symptoms--and early detection can mean the difference between continuing good health and illness. Keep in mind that your healthcare provider is the best source to answer questions about your health and that these guidelines are for healthy children and adults.

Presbyterian Preventive Healthcare Guidelines
Children and Adolescent Guidelines
Adult Preventive Healthcare Guidelines
Pregnancy Preventive Healthcare Guidelines

What preventive care do you need?

Children and Adolescent Guidelines
From infancy through age 20, learn about the recommended exams, screenings and immunizations.
Adult Guidelines
From ages 21 to 65 and older, learn about when screenings, tests and immunizations (yes, it’s true: you’re never too old for immunizations!) are recommended.
Pregnancy Guidelines
From your first visit with your healthcare provider through to your baby’s birth, learn about the recommended screenings and what to discuss with your doctor during your pregnancy.

Children and Adolescent Preventive Healthcare Guidelines

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.
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/shoulder 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/shoulder belts Bicycle, motorcycle, all terrain vehicle (ATV) helmet use Pool safety

*Subject to benefit plan and its limitations.

Adult Preventive Healthcare Guidelines

Ages 21-64	Ages 65 and older
Breast cancer screening
Mammogram (special x-ray of breast) every 1-2 years for women 40 and older.
Cervical cancer screening
Pap 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 testing
At 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 rubella
Once 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.

Pregnancy Preventive Healthcare Guidelines

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 healthcare 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.

Presbyterian Preventive Healthcare Guidelines

What preventive care do you need?

Children and Adolescent Guidelines

Adult Guidelines

Pregnancy Guidelines

Children and Adolescent Preventive Healthcare Guidelines

Infancy - Age 1

Ages 1 – 10

Ages 11 - 20

Adult Preventive Healthcare Guidelines

Ages 21 - 64

Ages 65 and older

Pregnancy Preventive Healthcare Guidelines

What to expect

Discuss with your practitioner

Prenatal tests

Other potential prenatal screenings

What to expect

Discuss with your practitioner

Potential prenatal screenings

Discuss with your practitioner

Potential prenatal screenings