CM Approach to Physical Exam in Pediatrics Flashcards
What are some general principles for Pediatric Physical Exams?
Use methods appropriate for age and stage in development, use child-appropriate language, gamification and distractions when possible.
Why should you be flexible with a pediatric exam?
The sequence of the exam may vary with child and chief concern.
Where should you exam a pediatric patient?
Wherever he/she is most comfortable, possibly on a parents lap, but move them as needed.
Should you exam pediatric patient’s on skin?
Yes, drape as needed.
Which portions of the pediatric exam should be done first?
Do the least threatening portions first, as well as the portions where the child must remain silent (heart and lungs).
What portions of a physical exam should you do last?
The portions to do last include ones that cause discomfort/anxiety, such as looking in the ears/throat, as well as ones the child reports as scary.
What should you pay special attention to in pediatric physical exams?
Skin rashes.
What should you pay special attention to in neonatal physical exams?
Keep them as warm as possible.
How does resting heart and respiratory rate change as a child ags?
Resting heart and respiratory rate are faster at birth, and slow as children age.
How does blood pressure change as a child ages?
Blood pressure is lower at birth and increases throughout childhood to normal adult values (120/80).
What does a heart sound indicate in children?
Heart murmurs do not always indicate cardiac disease, and can be “innocent”.
What are possible causes of congenital heart disease that do not present with a murmur?
Poor blood flow, minimal obstruction to blood flow such as large VSD.
Ergo murmur does not always correlate with heart disease in children.
What traits of a murmur are useful in identifying causes?
Location, timing, and character of the murmur help identify cause.
Name an example of a normal abnormal sound in children?
Extra heart sounds (S3) may be normal in children.
