An approach to assessing children- summary Flashcards
What are the aims and objectives of a paediatric assessment?
Understand the components of a paediatric assessment including development
Recognise key differences in assessing children
Develop a multisystem approach to children
Describe the range of techniques used to facilitate examination
Make a basic assessment of each system
What is essential for an effective paediatric assessment?
A holistic multi-system approach
More than one problem may exist
More than one system may be involved
How does age influence the assessment of children?
Guides approach to history taking and examination
Common pathologies differ
Conditions manifest differently at different ages
What should you prepare for before encountering a child in a clinical setting?
Know the child’s name, age, and sex
Observe the child before starting the assessment
Understand the likely differential diagnosis
Know what conditions need to be ruled out
True or False: A good history is a key step to making a diagnosis in paediatrics.
True
What should be included in the birth history during a paediatric assessment?
Detail depends on age and presentation
Some features may be very relevant years later
What are the main childhood objectives?
- To grow
- To develop and achieve their potential
- To attain optimal health
- To develop independence
- To be safe
- To be cared for
- To be involved
What are key developmental fields to consider in child development?
Sequence of events in each domain
Normal development patterns
Milestones achievement
Fill in the blank: Developmental assessment is important for ______.
[Reassurance and showing progress]
What factors influence child development?
- Genetics (Family, race, gender)
- Environment
- Positive early childhood experience
- Antenatal and postnatal factors
What is the significance of milestones in child development?
Achievement of key development skills
Variation of what is normal
Refer if not achieved by limit age (2 SDs from mean)
What are common sources of infective contacts for children?
School and nursery
What is the role of play in paediatric assessments?
Essential and clinically helpful
Provides insight into the child’s development
What should be documented after a paediatric assessment?
Date, time, who was present, and who gave the history
What is the purpose of the Red Book in child health?
Progress recorded in the Red Book
Overview of health and development
What components are included in the UK Healthy Child Programme?
- Health promotion
- Developmental screening (including hearing)
- Immunisation
- Parental (carer) observations and concerns
What is a key consideration for developmental assessment?
How do they move their body around?
What do they do with their hands?
How do they communicate?
What can they do for themselves?
True or False: Parents with concerns are usually incorrect.
False
Fill in the blank: Loss of skills or regression is ______ and needs further referral and investigation.
[very worrying]
What are typical ages for key skill areas in child development?
- 6 months
- 12 months
- 2 years
- 3 years
What is the role of a paediatrician?
To diagnose and treat children’s health issues
A paediatrician is a medical doctor specializing in the care of infants, children, and adolescents.
What is recorded in the Red Book?
Child’s health and development progress
The Red Book is a personal health record for children in the UK.
What are the main components of the Healthy Child Programme?
- Health promotion
- Developmental screening (including hearing)
- Immunisation
- Parental observations and concerns
The programme aims to improve child health and wellbeing through various health services.
What is the purpose of the newborn examination?
To assess the health and development of newborns
This includes blood spot screening and hearing screening by Day 28.
What is the recommended age for the first health visitor visit?
6-8 weeks
This visit is crucial for assessing the infant’s health and development.
What is the focus of the 27-30 month review?
Assessing developmental milestones and health status
The review can be extended to a maximum of 32 months.
What does the ABCDE method stand for in paediatric examination?
- Airway
- Breathing
- Circulation
- Disability
- Exposure
This method is used to systematically assess a child’s health status.
What are the key observations to make during a general examination?
- Appearance
- Play
- Interaction
- Observations
These observations can provide insights into the child’s overall health.
True or False: Developmental skills should be assessed during a paediatric examination.
True
Assessing developmental skills is crucial for understanding the child’s growth and developmental stage.
Fill in the blank: It is essential to build _______ with children during examination.
rapport
Rapport helps in making the child comfortable, leading to a more effective examination.
What aspects should be observed in the respiratory system?
- Effort
- Noise
- Rate
- Recession
- Oxygen saturation
- Nebulization
Observations in the respiratory system help in identifying respiratory distress or abnormalities.
What is the significance of observing the abdomen during a paediatric examination?
To detect tenderness, masses, and organomegaly
These factors are crucial for diagnosing gastrointestinal issues.
What are some tips for successfully examining children?
- Use child-friendly language
- Recognize normality
- Leave unpleasant things to the end
- Be honest
- Develop play skills
These tips help in creating a positive experience for the child during examination.
What is the importance of communication in paediatric assessments?
To gather accurate information and build rapport
Effective communication is essential for understanding the child’s needs and concerns.
What should be the approach when examining the legs and feet of a child?
- Assess mobility
- Observe changing posture
- Evaluate movements and tone
This assessment helps in identifying musculoskeletal issues.
What should be avoided during a paediatric examination?
Performing a rectal exam unless done by senior staff
Rectal examinations are sensitive and should be approached with caution.
Fill in the blank: A creative approach in paediatric examination often involves using _______.
play
Play can serve as a clinical tool to gather information while keeping the child engaged.
Key stages when taking a history of child patient?
indroduction
PC
HPC
Birth history
past medical history
immunisatios
development
- any concerns, walking, words, speech
drugs, allergies
family and social history
school and nursery
parental social history impacts on child’s health
- smoking/alcohol/drugs/occupatinn/stress
