COMMUNICATION & PHYSICAL ASSESSMENT OF THE CHILD AND FAMILY: Flashcards
Communication Techniques for infants:
- Infants respond to non-verbal ques- smile!
- speak to child on their eye level
- Allow infant to stay in care-givers lap
- Use songs or play
- Avoid appearing threatening
Communication techniques for children:
- Allow warm up time
- Avoid appearing Threatening
- Build rapport with caregiver
- Use play
- Assume position at eye level
- Allow child to touch equipment
- Be honest - (dont say it wont hurt/ taste good)
- Offer choices only when one exists
- Avoid words children may take literally
Communication Techniques for adolescents:
- Decide if it’s appropriate to speak to teen or parent first.
- Be respectful
- Avoid judgment or criticism
Assessment of Infants and toddlers:
- infant: 0-1
- toddler: 1-3
- Allow to stay near caregiver
- Inspect body through play/songs
- Perform the least stressful procedure first:
— BP & temp last - Auscultate while quiet
— Best while asleep - Allow inspection of equipment
Assessment of preschoolers:
- age: 3-5
- Allow position of comfort
- If cooperative- head to toe
- Allow inspection of equipment
- Use games/praise
- Give choices if available
Assessment of school age children:
- 6-12
- Head to Toe
- Respect Privacy
- Explain Procedures and findings
- Make it into a game/ they love rules
Assessment of Adolescents:
- Head to Toe
- Allow for privacy
- Explain findings
- Emphasize normalcy of Development as compared to other adolescents their age
Growth
The increase in physical size
Development
Progressive increase in skill and capacity of function
How do developmental stages occur?
At a predictable rate
- Nurses use anticipatory guidance to predict upcoming developmental tasks.
Growth Measurements
- Growth Charts- 0-2 yrs
- WHO Chart and CDC for 2yrs and older
- Concerns: Sudden change, below or above average percentiles, unexpected results based on heredity and genetics
- Infants- weight, length, Head, chest and abdominal circumference
First sign of puberty: girls
*first sign is development of breast buds (8-13yrs)
Menses- 2 yrs after breast buds.
First sign of puberty: boys
*first sign- testicular enlargement- (9.5-14yrs)
Physical assessment:
SKIN:
- Color
- Bruises, lesions, rashes
- Temperature, texture
- Capillary refill time: tip of finger/ not nail bed
- Edema
- *Infant: any of the newborn skin conditions
Physical assessment:
Eyes, Ears & Mouth
- EYES: Placement and alignment
- EARS: examine for placement and alignment
- MOUTH: external & internal
- TEETH: lose teeth @ 5-6 years
- NOSE: external
- NECK: inspect and palpate
Infant BP:
- BP ON LEG
- BP ON ARM @ 2 YO
Blood Pressure Concepts:
- Choose a Cuff with bladder that =40% of upper arm circumference for accuracy.
- If appropriate size is not available, use oversized, not undersized cuff.
- BP done once a shift- infants BP done only if they have a cardiac or other issue
Pediatric Vital Signs:
Pulse
- Count for full minute.
- Infant:120-160bpm
- 2-10yrs= similar to adults
Pediatric Vital Signs:
RR
Infants: 30-60
Similar to adults between 7yr-10yr
Pediatric Vital Signs:
BP:
only check once per shift unless otherwise indicated.
Pediatric Vital Signs:
Temp
By accuracy: R.O.A.T.
Temp: Routes:
- Rectal: most accurate.(contraindicated for infants less than 1 month)
- Oral: is accurate in older children
- Axillary: is least intrusive, but may be inaccurate.
- Tympanic and temporal artery: is least accurate (may be a couple degrees higher than reading
