Examination and Documentation of the Pediatric Client

Question 1

5 parts of the Guide to PT Practice in the examination process

Answer 1

1. Examination
2. Evaluation
3. Diagnosis
4. Prognosis
5. Intervention

Question 2

Term: a classification system used to focus on positive patient abilities and identify patient goals in order to guide our practice

Answer 2

International Classification of Functioning, Disability and Health (ICF)

Question 3

2 parts that the ICF organizes information into

Answer 3

1. Functioning

2. Disability

Question 4

Term: the process of obtaining an history, performing a systems review, and selecting and administering tests and measure to gather data about the patient/client

Answer 4

Examination

Question 5

Term: a dynamic process in which the PT makes clinical judgments based on data gather during the examination

Answer 5

Evaluation

Question 6

Term: both the process and the end result of evaluating examination data, which the PT organizes into defined clusters, syndromes, or categories to help determine the prognosis and the most appropriate intervention strategies

Answer 6

Diagnosis

Question 7

Term: determination of the level of optimal improvement that may be attained through intervention and the amount of time required to reach that level; includes the plan of care

Answer 7

Prognosis

Question 8

Term: purposeful and skill interaction of the PT with the patient/client using various PT methods and techniques to produce changes in the condition that are consistent with the diagnosis and prognosis

Answer 8

Intervention

Question 9

ICF Category: physiologic and psychologic functions of the body

Answer 9

Body functions

Question 10

ICF Category: organs, limbs, trunk and components

Answer 10

Body structures

Question 11

ICF Category: performance of a task or action

Answer 11

Activity

Question 12

ICF Category: physical, social, and environment in which people conduct their lives

Answer 12

Environmental factors

Question 13

ICF Category: involvement in life situations- home, school, community activities and organizations, social relationships with friends

Answer 13

Participation

Question 14

ICF Category: background of a person’s life and living that is not part of the health condition

Answer 14

Personal factors

Question 15

Component of PT Exam: systemic gathering of data to determine why the client is seeking PT services, interview

Answer 15

History

Question 16

Component of PT Exam: examination of the anatomical/physiological status of CV/pulm, integumentary, MS and NM systems and communication, affect, cognition, language, learning style

Answer 16

Systems review

Question 17

Component of PT Exam: used to investigate diagnostic hypothesis generated during the history and systems review

Answer 17

Tests and measures

Question 18

When examine the pediatric client, do we used the top-down or bottom-up approach.

Answer 18

Top-down
“Beginning with the end in mind”
Plan the intervention based on the desired outcome/goal

Question 19

Name 3 parts of the subjective examination of the pediatric client.

Answer 19

Birth/medical history (GA at birth/birth weight, current age, medical complications, ongoing medical concerns)
Developmental history (milestones)
Social history, functional status/activity level
Communication abilities
Cognition
Home/childcare/school environment
Current complaints/concerns

Question 20

Name 3 parts of the tests and measures that can be taken for pediatric clients.

Answer 20

Assistive device
Orthotics
Gait/locomotion/balance/mobility
Motor function
Posture
ROM
Self-care
Ventilation/respiration
Home/school/play
Pain
Arousal, attention, cognition

Question 21

Name 3 specific tests and measures that can be taken for pediatric clients.

Answer 21

Anthropometrics
ADL
Strength (MMT, dynamometer, functional)
Functional ROM
Reflexes
Balance assessments
Standardized assessment

Question 22

Full-term new boss have limited hip and knee ___________ and greater ___________ when compared to adults.

Answer 22

extension

dorsiflexion

Question 23

MMT is reliable in children with ____ and Down Syndrome, but not reliable in children with ____.

Answer 23

DMD

CP

Question 24

Hand held dynamometers are reliable for ages as young as ___ years.

Answer 24

2

Question 25

Isokinetic's are reliable for ages as young as ____ years.

Answer 25

6

Question 26

Use findings of tests and measures to determine impairments of body __________ and ___________.

Answer 26

``` function structure ```

Question 27

Use findings of observation, mobility assessments and/or standardized assessments to determine _________ limitations.

Answer 27

activity

Question 28

Use findings of observation and interview to determine restrictions in ____________.

Answer 28

participation

Question 29

Name 3 special considerations when examining an infant.

Answer 29

``` Time of day (feeding and nap time) Parents' schedules Natural environment Naturalistic observation Examination may be in random order based on desires/needs of the infant ```

Question 30

Name 3 special considerations when examining a young child.

Answer 30

``` Time of day (nap time) One or both parents' schedules Natural environment Naturalistic observation Comprehensive developmental assessment- cognitive, motor, social, speech-language and self-help in natural environment ```

Question 31

Name 3 special considerations when examining a preschooler or school-aged child.

Answer 31

``` Schedule Natural environment Naturalistic observation Team approach Comprehensive developmental assessment- cognitive, motor, social, speech-language and self-help in natural environment ```

Question 32

Name 4 components that should be included in goals/outcomes.

Answer 32

Determined in collaboration with the child, parent, teacher, and/or other team members Related to functional skills Focused on participation and activities Realistic and achievable Easily understood and free of professional jargon Goals not intervention Statement of the behavior to be achieved When and under what conditions the behavior will be achieved Measurement criteria used to determine achievement

Question 33

What does the SMART acronym for goals/objectives stand for?

Answer 33

``` Specific Measurable Attainable Routine-based Tied to a functional priority ```

Question 34

What does the ROUTINE acronym for goal strategies stand for?

Answer 34

``` Routine-based Outcome-related Understandable Transdisciplinary Implemented by teacher/family Non-judgmental Evidence-based ```

Question 35

A premature birth is less than ____ weeks GA.

Answer 35

37

Question 36

A low birth weight (LBW) is less than _____ grams. A very low birth weight (VLBW) is less than _____ grams. An extremely low birth weight (ELBW) is less than _____ grams. Small for gestational age (SGA) is less than the ____ percentile.

Answer 36

2500 1500 1000 10th

Question 37

What are 2 reasons why an infant from the NICU would receive a PT referral?

Answer 37

Infants who show signs of CNS impairment Specific neuromuscular or orthopedic problems Multiple medicinal or genetic problems Other symptoms that put infant at risk for developmental problems

Question 38

Name 2 purposes of the examination/evaluation.

Answer 38

Identify participation restrictions, particularly barriers to normal development Identify activity limitations, particularly in terms of parent-child interaction Identify body structure/function impairments that require intervention Identify methods of positioning and handling and ways to adapt the environment to optimize development

Question 39

What does the APGAR score stand for?

Answer 39

``` Activity Pulse Grimace Appearance Respirations ```

Question 40

A HR of 90 ppm would be scored as a ___ on the APGAR scale.

Answer 40

1

Question 41

A respiration description of good, crying would be scored as a ___ on the APGAR scale.

Answer 41

2

Question 42

A muscle tone description of limp would be scored as a ___ on the APGAR scale, while some flexion would be scored as a ___.

Answer 42

0 | 1

Question 43

A grimace description of cough or sneeze would be scored as a ___ on the APGAR scale, while no response would be scored as a ___.

Answer 43

2 | 0

Question 44

A color description of blue, pale would be scored as a ___ on the APGAR scale, while body pink, extremities blue would be scored as a ___.

Answer 44

0 | 1

Question 45

The APGAR scores are done at 1 min and 5 min after birth. A score of ___ to ___ at 1 minute is normal. A score of ___ to ___ at 1 and 5 minutes indicates risk of neonatal death.

Answer 45

8 to 10 | 0 to 3

Question 46

Name 5 complications of prematurity.

Answer 46

``` Compromised respiration (respiratory distress syndrome) Bronchopulmonary Dysplasia Chronic lung disease Feeding problems Seizures Amniotic band syndrome Myelomeningocele Microcephaly Intraventricular hemorrhage (IVH) Periventricular Leukomalacia (PVL) ```

Question 47

Name 2 test and measures done in the NICU.

Answer 47

``` Active movements and posture Muscle tone Reflexes Feeding Standardized assessments ```

Question 48

The following test are done for the ___________ infant: - Neurobehavioral Assessment of Premature Infants (NAPI) - Test of Infant Motor Performance (TIMP) - Neonatal Neurobehavioral Examination (NNE) - Neonatal Behavioral Assessment Scale (NBAS) - Preemie-Neuro

Answer 48

premature

Question 49

Name 3 neonatal signs of physiological stress.

Answer 49

``` Increased/decreased HR Deceased RR Increased BP Decreased O2 sat Apnea Bradycardia Skin color change ```

Question 50

Name 3 neonatal signs of behavioral stress.

Answer 50

``` Gaze aversion Finger spays Trunk extension Facial grimace Leg extension Drowsiness Hyper alertness ```

Question 51

Name 3 self-calming neonatal coping methods.

Answer 51

``` Hand to mouth Sucking Flexed posture Hands/feet to midline Closing eyes/gaze aversions Drowsy state ```

Question 52

Name 3 assisted calming neonatal coping methods.

Answer 52

``` Nestling, positioning in flexion Holding in flexion Rocking Swaddling Quiet voice ```