Health Assessment Of Children Flashcards

1
Q

Never assume people with child are what?

Ask child or family what

A

Never assume its the parents

Ask child or family who is in the room

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2
Q

Communicating with infants

Observe what and listen to what

A

Observe nonverbals

Listen to vocalizations

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3
Q

Communicating with early childhood (toddlers and preschoolers 1-6)

They take everything how?

A

Take everything literally so be careful

Egocentrism (so focus all on them) (nice shirt)

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4
Q

Communicating with school-age

A

Explain steps

Show interest in their interest

Encourage them to vocalize fears

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5
Q

Communicating with adolescents

A

Goes between child and adult thinking

Seek permission for sensitive info and physical exam

Privacy and confidentiality is important

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6
Q

We will get wt, ht, and head circumfrence until what age?

A

3

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7
Q

Pediatric physical assessment (prior to doing it)

A

Introduce self

Take time to play first

Look before touch

Eye level with child

Provide distractions

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8
Q

Peds physical assessment (explaining steps)

A

Use dolls, puppets or drawings to show what happens

Allow child to manipulate equipment first

Examine in comfortable position (even with parent)

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9
Q

Peds vital signs
Temp locations

A

Rectal (birth-5y/o)

Axillary (any age)

Oral (as early as 3y/o)

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10
Q

How long to measure 1st HR

Where to get BP on peds

A

Apical 60 seconds

Lower leg for BP

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11
Q

Peds assessment head and neck

A

Larger heads in infants in ratio to body

Assess fontanels if appropriate for age

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12
Q

Peds neuro system and mental status

A

note verbalization (cries, laughs, coos)

Pupil assessment
Eye contrack/tracking

Social smile?

If infant assess: fontanels, primitive vs protective reflexs

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13
Q

Central vs peripheral pulses

A

Central:
Apical, femoral, carotid

Peripheral:
Radial, pedal

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14
Q

Look before you touch or touch before you look?

A

Look before you touch

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15
Q

GI & GU

A

Pattern of elimination

Urine: color, clarity, odor

Stool: often/much, color, consistency

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16
Q

When changing diaper assess what

A

Redness

Diaper rash

Discharge

Circumcision if male

17
Q

Musculoskeletal

Gross motor milestone
Assess spine

A

Gross motor milestones:
Crawling, walking, sitting unsupported

Assess spine:
no dimples/tufts of hair, no lateral curvature
(Spina bifida)

18
Q

Pain signs

Infants vs toddlers

A

Infants:
-loud cry
-rigid body
-withdrawal from pain
-facial expression

Toddlers:
-loud cry/screaming
-verbalization
-thrashing
-avoid stimilus
-non cooperation
-cling to caregiver

19
Q

Pain signs

School-age vs adolescent

A

School-age: (similar toddler)
-Stalling behavior
-muscular ridgity

Adolescent:
-verbal expression
-muscle tension

20
Q

Common misconceptions with pain (6)

A

-do not feel or respond to pain
-cant tell you where they hurt
-do not remember pain
-if child is active they are not in pain
-they always tell the truth about pain
-they cannot be addicted to pain meds

21
Q

Different pain scales and when to use them
NIPS
FLACC
Wong-baker faces
Oucher pain scale
0-10

A

NIPS (neonatal infant pain scale)
-up to one year old (behavioral scale)

FLACC (face, legs, activity, cry, consolability)
-2months - 7y/o
-can be used with non-verbal and cognitively impaired (when not alert/awake)

Wong-baker faces (3+ y/o)

Oucher pain scale (3-13y/o)

0-10 (5+y/o)

22
Q

Non-pharmacological interventions

A

Distract
Relax
Meditate/guided imagery
Containment (swaddling)
Nonnutritive sucking and sucrose
Kangaroo care
Massage
Hot/cold compress

23
Q

Pharmacological interventions

Type of meds and names

A

Mild-mod:
-acetaminopen
-NSAIDS

Mod-severe: (opioids)
-morphine
-hydromorphone
-fentanyl

24
Q

Give meds how

A

Scheduled/routinely

NOT PRN

25
Q

ORAL

Its the what route

Names

A

Preferred route

-acetaminophen
-Nsaids

Opioids:
Hydrocodone w/ acetaminophen (Hycet)
Oxycodone w/ acetaminophen (Roxicet)

26
Q

IV

IVP Bolus vs PCA pump

A

IVP bolus:
-morphine
-hydromorphone
-fentanyl

patient controlled analgesia (PCA pump)
-basal (slow continuous rate)
-bolus (1dose)
-combination

27
Q

IM is what

A

Not recommended (it hurts)

28
Q

Reassess after pain meds when

A

30min-1hr