Assessments Flashcards
In regards to neuro issues, assess/ask about…
NV
HA
Gait changes
Loss of motor function
Visual disturbances
LOC changes
Irritability
Altered muscle tone
Trauma
Poor feeding
Lethargy
Fever
Pain
Delays in growth and development
Toxins
Included in head to toe for neuro…
LOC
VS
Head, face, neck
CN
Motor
Reflex
Sensory
ICP
CN tested in Doll’s eyes
3, 4, and 6
SS Cushing’s triad
Increased systolic BP
Decreased pulse
Altered respiratory pattern
SS type 1 chiari malformation
Neck pain
HA
Lower extremity spasticity
(Ss start in adolescence to adulthood)
Ss type 2 chiari
(Detected prenatal or at birth)
Weak cry
Stridor
Apnea
GI Disturbances
Chronic aspiration
Long feeding time
Weight loss
Progressive hydrocephalus
Ss shunt infection
Elevated VS
Poor feeding
Vom
Decreased responsiveness
Seizures
Inflammation
Ss shunt malfunction
Vom
Drowsy
HA
Ss bacterial meningitis
Sudden onset
Resp illness/sore throat
Fever and chills
HA
Vom
Photophobia
Stiff neck
Rash
Irritable
Drowsy and lethargic
Muscle rigidity
Seizure
Subtle ss bacterial meningitis in infants
Poor suck and feed
Weak cry
Lethargic
Vomiting
Kernig
1 leg perpendicular- look for pain at spine or inability to extend
Brudzinski sign
Neck flexed with knees to chest - look for spine pain or resistance
Triad ss of shaken baby syndrome
Retinal hemorrhage
Brain swelling
Subdural hematoma
Ss croup
Hoarseness
Barking cough
Stridor
RSV ss
Profuse runny nose
Low grade fever
Pharyngitis
Cough and wheeze
Poor feeding
Ss cystic fibrosis
Thick mucus
Increased infection
Decreased pancreatic enzymes
Hypersecretion of gastric acids
Salty skin
Ss tetralogy of fallot
Cyanosis during crying or feeding
Ss HF
Weight gain or decrease
Difficulty feeding
Fatigue
Dizzy
Irritable
Exercise intolerance
SOB
Tired quickly when sucking
Syncope
Decreased # wet diapers
Ss infective endocarditis
Intermittent fever
Fatigue
Anorexia
Flu like
Petechiae at eyes, mouth, or limbs
Signs of extracardiac emboli (rt endocarditis)
Roth spots
Janeway lesions
Osler nodes
Black lines
Ss rheumatic fever
Carditis
Arthritis
Jerking (chorea)
Fever
Joint pain
Strep infection or sore throat
Erythema
Murmur
Subq nodules
Characteristics (not ss) of CM
Increased heart size
Poor contractility
Decreased EF
Asymmetrical septal hypertrophy
Ss Kawasaki
High fever unresponsive to Abx
Chills
HA
Malaise
Extreme irritability
Rashes (strawberry tongue, erythema)
Peeling
Vom and dia
Pain
Edema
Jaundice
Swollen lymph nodes at neck
Labs/VS for Kawasaki
Tachycardia
Increased platelets
Decreased hemoglobin
Signs of cardiac disorder
Cyanosis
Irregular HR
Edema
Clubbing
Fever
Retractions
Increased WOB
Visible abnormal pulsations
Abdominal distention
RF dehydration
Vom and dia
Decreased oral intake
Sustained high fever
DKA
Burns
Palpation of this may indicate pyloric stenosis
Hard movable “olive” at RUQ
UTI ss infants
Fever
Irritability
Vom
FTT
Jaundice
UTI ss children
Fever
Vom
Dysuria
Frequency
Hesitancy
Urgency
Pain
Hematuria leading to urine looking like tea/cola/dirty green could be due to…
Acute glomerulonephritis
RF for vulvovaginitis
Bacteria or yeast
Chemicals in bubble bath, soap, perfumes
Poor hygiene
Tight pants
DTR infant
Brisk
Characteristics of Developmental Dysplasia of the Hip
Dislocation
Subluxation
Dysplasia
Discoloration
“Clunk” sound
Muscular dystrophy ss
Large calves
Frequent falls
Unbalanced
Hard to raise arms
Will lose ability to ambulate
What is Gowers sign?
Can’t get up off floor in usual way
Cerebral palsy ss
Motor impairment
Spasticity
Weakness
Ataxia
Drooling that leads to dehydration, dental enamel erosion, odor, and skin issues
Included in neurovascular checks
Color
Sensation
Edema
Movement
Pulses
Ss ASD
HF
SOB
Fatigue
FTT
Ss VSD
HF (SOB, fatigue, FTT)
Ss PDA
HF
Frequent respiratory infections
Fatigue
FTT
Warning signs of cancer related to…
Tumors leading to compression, infiltration, or obstruction
Changes in blood cells
Ss iron deficiency anemia
Weak
Fatigued
Delayed growth
Concave nails (spooning!)
Lead poisoning can lead to…
Behavioral and learning problems
Encephalopathy
Impaired hearing
Seizures
Brain damage
Decreased growth
Anemia
Kidney damage
Sickle cell ss and why
Pain, tachycardia, tachypnea, and hypoxia due to decreased circulation/clumping of cells due to inability to squeeze through vessels
Ss acute lymphoblastic leukemia
Fever
Infection
Fatigue
Pallor
Bleeding and bruising
Pain
HA
NV
Leukemia ss
Swollen lymph nodes
Fever
Night sweats
Nose bleeds
Infections
Easy bleeding
Pain
Red spots
Weight loss
Ss brain tumor
NV
HA
Gait
Blurry
Seizure
Motor
Weak
Swallow problems
Behavior/personality
Irritable, FTT, delay in very young
Neuroblastoma seen in…
Abdomen
Ss and complications of retinoblastoma
Cat’s eye/whitewash glow
Metastasis to brain, other eye, lymph, bone, liver
Sarcomas
Ss acute adrenal crisis
Vom
Dehydration
Hyponatremia
Hyperkalemia
Hypotension
Tachycardia
Shock
Ss DKA
NV, anorexia
Lethargy and decreased LOC
Decreased turgor
Abdominal pain
Kussmal
Fruit breath
Ketones in urine and blood
Tachycardia
Coma and death
Criteria for dx intellectual disability
Before 18 yo
IQ <70
Deficits in 2 of the following: communication, academics, health and safety, home living, leisure, self care, self direction, work
Warning signs infant autism
No imitate
No interest
No eye contact
Delayed language
No imagination play
Losing language and social milestones
Neuro assessment in emergency
Awake
Verbal
Pain
Unresponsive
Ss shock
Pallor
Hypotension
Brady or tachyC
Resp distress
Delayed cap refill
Weak distal pulse
Qs to ask when assessing a poisoning
Time and type of toxin
Route
Med bottle available?
Did kid have ss: NVA, abdominal pain, disorientation, altered gait, slurred speech?
Did caregiver call poison control?
Has any tx been performed?
SI or depression?
Ss sinusitis
Nasal discharge
Cough
Fever
Halitosis
Facial pain
Eyelid edema
Irritability
Poor appetite
Ss neuroblastoma
Lump in abdomen
Lump in chest
Bone pain
Eye bruising
Alterations that may occur in poisoning
BP
Temp
Resp
Pupils
Pay close attention to mental, skin moisture and color, and bowel sounds
Ss pyloric stenosis
Projectile vomiting
Hunger
Weight loss
Dehydration
Olive
Ss arteriovenous malformation
Hemorrhaging
Seizures
HA
Vision
Speech
Memory
Paralysis
