Chapter 4- Communication, Physical, and Developmental Assessment Flashcards
Most important component of effective communication
Listening
Major blocks to listening
environmental distraction
premature judgement
Anticipatory guidance
providing families information on normal growth and development and nurturing childbearing practices
What components of the communication process will convey the most significant message?
nonverbal components
Egocentric
see things only in relation to themselves and from their point of view
What children are egocentric?
children younger than 5
Universal language of children
play
Biochemical tests for assessing nutritional status include analysis of:
Plasma
blood cells
urine
tissues from liver, bone, hair, and fingernails
Common lab procedures for nutritional status
hemoglobin
hematocrit
transferrin
albumin
creatinine
nitrogen
Main criteria for assessing each body system
Using developmental and chronologic age
Physical exam position of Infant
Before able to sit alone: supine or prone (prefer parents arms)
before 4-6 months on exam table
After able to sit alone: sitting in parents lap whenever possible
If on table have parent in full view
Physical exam position of Toddler
Sitting or standing on or by parent
Prone or supine position in parent’s lap
Physical exam position of preschool child
Prefer standing or sitting
Prone or supine
Prefer parent’s closeness
Physical exam position of school-age child
Prefer sitting
cooperative in most positions
Younger child prefers parent’s presence
Older may prefer privacy
Physical exam position of adolescent
Same as school age
Offer parents presence
BMI
[weight in pounds/ (height in inches x height in inches)] x 703
Skin fold thickness sites
triceps
subscapula
suprailiac
abdomen
upper thigh
Core temperature
reflects the temp of the blood flow through the carotid arteries to the hypothalamus
Rectal temp for children
37 c to 37.5 c ( 98.6 F to 99.5 F)
Neonate core temp
36.5 c to 37.6 c (97.7 F to 99.7 F)
Electronic intermittent thermometers
Measure pts temp at oral, rectal, and axillary sites
Infrared thermometers
measure temp by collecting emitted thermal radiation from a particular site
Electronic continuous thermometer
measure temp during the administration of general anesthesia, treatment of hypothermia or hyperthermia, and other situations that require continuous monitoring
Orthostatic hypotension (OH)
decrease in BP when standing position
Define: Syncope;
Vertigo;
Cerebral hypoperfusion
Synscope: fainting
Vertigo: dizziness
Cerebral hypo perfusion: decreased blood flow to the brain
Common cause of OH
Cause induced by:
Hypovolemia
diuretics, vasodilator medications, prolonged immobility or bed rest
Other causes of OH
Dehydration
Diarrhea
Emesis
Fluid loss from sweating/excretion
alcohol intake
dysrhythmias
DM
sepsis
Hemorrhage
Skin turgor used for
estimates adequate hydration and nutrition
Craniosynostosis
premature closure of sutures
Limited range of motion and head and neck may indicate
wryneck or torticollis, the child holds the head to one side with the chin pointing toward the opposite side, a result of injury to the sternocleidomastoid muscle
Sternum’s three parts
Manubrium: uppermost portion, can be felt at base of neck
Body: largest segment of the sternum and forms the sternal angle
Xiphoid: small, moveable process at end of body
Barrel Chest
chest is round
Pigeon Chest
sternum protrudes out
Evaluate respirations for: (4)
rate
rhythm
depth
quality
