THE MERCK MANUAL HOME HEALTH HANDBOOK
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Preventive Health Care Visits

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Annual health care visits allow doctors and other health care practitioners to monitor physical growth and sexual maturation and provide advice and counseling. Height, weight, and blood pressure should be monitored at every yearly health care visit. Overweight and obesity are common in the United States and are associated with heart disease and type 2 diabetes (formerly called non—insulin-dependent diabetes). Examination of the skin for acne, evaluation of the degree of sexual maturation, and examination of the back for scoliosis are particularly important in adolescence.

Routine health care also includes a review of the immunization record and administration of recommended vaccines (see Newborns and Infants: Vaccinating Infants and ChildrenFigures). Screening tests, such as a blood cholesterol level test for obese adolescents or those with a family history of high cholesterol, also may be done. Tuberculosis testing may be done for adolescents with a history of exposure or for those who have traveled to areas of the world where tuberculosis is prevalent.

Most of a routine health care visit involves a psychosocial screening interview and counseling. The screening interview includes questions regarding the home environment, academic achievement and goals, activities and hobbies, engagement in risk-taking behaviors, and emotional health. Counseling revolves usually around physical and psychosocial development, healthy lifestyles, and injury prevention. Counseling typically includes wide-ranging topics such as

  • The importance of wearing seatbelts
  • The dangers of drinking and driving
  • The danger of becoming drug or alcohol dependent
  • Responsible sexual behavior
  • Violence prevention

Doctors also may encourage activities such as participation in sports, the arts, and community service. Most doctors interview and examine adolescents privately, although parents may be invited to participate and share concerns and receive their own counseling and guidance at the beginning or end of the visit.

Last full review/revision February 2009 by Sharon Levy, MD, MPH

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