Class 1 TLO 3.1 Physical Assessment - Child

Question 1

Vital Signs

NEWBORN

Answer 1

T 97.7-99.1 F 36.5-37.3 C (axillary)
PR 100-150
RR 35-55
BP 65-95/30-60

Question 2

Vital Signs

2 YEARS

Answer 2

T 97.5-98.6 F 36.4-37 C (axillary)
PR 70-110
RR 20-30
BP girls 85-91/43-47 boys 84-92/39-44

Question 3

Vital Signs

4 YEARS

Answer 3

T 97.5-98.6 F 36.4-37 (axillary)
PR 65.110
RR 20-25
BP girls 88-94/50/54 boys 88-97/47-52

Question 4

Vital Signs

10 YEARS

Answer 4

T 97.5-98.6 F 36.4-37 C (oral)
PR 60-95
RR 14-22
BP girls 98-105/59-62 boys 97-106/58-63

Question 5

Vital Signs

16 YEARS

Answer 5

T 97.5-98.6 F 36.4-37 C (oral)
PR 55-85
RR 12-18
BP girls 108-114/64-68 boys 111-120/63-67

Question 6

Physical assessment technique by age

INFANT BIRTH TO 6 MONTHS

Answer 6

• responsive to human faces
• do not mind being undressed (leave diaper on male)
• patient in parents arms/lap
• auscultate heart, lungs, abdomen
• evaluate primary reflexes (palmer/planter grasps, placing, stepping tonic neck reflexes.
• uncomfortable procedures last (abduction of hips, speculum tympanic membrane, Moro reflex

Question 7

Physical assessment technique by age

INFANT FROM 6-12 MONTHS

Answer 7

• do not mind being undressed (leave diaper on male)
• patient in parents arms/lap
• auscultate heart, lungs, abdomen
• evaluate primary reflexes (palmer/planter grasps, placing, stepping tonic neck reflexes.
• provide toys
• uncomfortable procedures last (ear, oral)

Question 8

Physical assessment technique by age

TODDLERS

Answer 8

• more challenging
• form supportive relationship with parent
• provide toys
• use age appropriate words
• describe whats being done
• portions can be done while clothed
• uncomfortable procedures last
• resistance/crying common
• soothing/comforting child

Question 9

Physical assessment technique by age

PRESCHOOLERS

Answer 9

• more cooperative than toddler
• parents nearby
• head to toe
• can undress themselves
• allow child to participate
• uncomfortable procedures last

Question 10

Physical assessment technique by age

SCHOOL AGE

Answer 10

• establish trust
• asks child questions he/she can answer
• talk about friends, school
• encourage parent to support/reinforce child’s participation
• head to toe
• sensitive to child’s modesty
• teach about body and personal care
• answer questions openly, simple terms

Question 11

Physical assessment technique by age

ADOLESCENTS

Answer 11

• most comfortable, straight forward, non-condescending
• openly discuss exam
• most cases adolescents examined w/o parent
• genital exam during middle of exam
• expected to undress and wear gown

Question 12

Hemoglobin values by age (part of CBC test)

Answer 12

newborn: 14-24 g/dl
0-2 wk: 12-20 g/dl
2-6 mo: 10-17 g/dl
6 mo-1 yr: 9.5-14 g/dl
1-6 yr: 9.5-14 g/dl
6-18 yr: 10-15.5 g/dl

Question 13

Hematocrit values by age (part of CBC test)

Answer 13

newborn: 44-64%
2-8 wk: 39-59%
2-6 mo: 35-50%
6 mo-1 yr: 29-43%
1-6 yr: 30-40%
6-18 yr: 32-44%

Question 14

Total white blood count value by age (part of CBC test)

Answer 14

Newborn: 9000-30,000/mm3
Child <2 yr: 6200-17,000/mm3
Adult/child >2 yr: 5000-10,000/mm3

Question 15

Platelet count value by age (part of CBC test)

Answer 15

Newborn: 150,000/mm3
Premature infant: 100,000-300,000/mm3
Infant: 200,000-475,000/mm3
Child: 150,000-400,000/mm3

Question 16

Urinalysis (UA) normal findings

Answer 16

Appearance: clear
Color: Amber/Yellow
Odor: aromatic
PH 4.6-8.0
Protein 0-8 mg/dL 
Specific gravity 1.005-1.030

Question 17

Serum K blood (potassium) value by age

Answer 17

Newborn: 3.9-5.9 mEq/L
Infant: 4.1-5.3 mEq/L
Child: 3.4-4.7 mEq/L
Adult/Elderly: 3.5-5.0 mEq/L

Question 18

Serum Na++ blood (sodium) value by age

Answer 18

Newborn: 134-144 mEq/L
Infant: 134-150 mEq/L
Child: 136-145 mEq/L
Adult/Elderly: 136-145 mEq/L

Question 19

Formula for calculating daily fluid requirements for children
DAILY MAINTENANCE FLUID REQUIREMENT AND RATES

Answer 19

Weight based
10 kg or less: 100 mL/kg/day

10-20 kg: 1000 mL/day + 50 mL/kg/day for each added kg over 10-20 kg

Over 20 kg: 1500 mL/day + 20 mL/kg/day for each additional kg over 20 kg

Question 20

Techniques for physical examination

Answer 20

Inspection: visual
Palpation: touch
Percussion: tapping with fingers
Auscultation: listening

Question 21

General guidelines for assessment of child

Answer 21

Flexibility is essential
Several observations at once
Least distressing first
Games/puppets/dolls etc
Kind but firm approach
Do not ask for cooperation
Explain procedures
Exam painful areas last