History taking and examination in paeds Flashcards
Pre term
Term
Post term
Pre term - <37 weeks
Term - 37+0-41+6
Post term - >41+6
What is neonatal age?
From 0-28 days
Infancy = up to a year
What are the headings for a paeds history?
Name and age
HPC
Birth and perinatal hx
Feeding hx
Immunisation hx
Developmental hx
PMH
DH and allergies
SH - named SW?
FH
What do you need to ask in birth and perinatal hx?
- Brief antenatal hx, mode of delivery, gestation
- Birth weight - remains the working weight until the current weight is more than birth weight
- Any resus? Admission to NNU?
- When did they open their bowels for the first time and pass urine? - should be w/i 24 hours-48 hours
When is the heel prick test done?
5 days
What do you need to ask about in feeding hx?
Breast or bottle or NGT?
How much and how often?
When weaned?
IF age appropriate - what are they eating now? By 1y should be eating family foods mashed/chopped up
Any probs while feeding?
When are the immunisations in children?
Don’t need to know the different jabs
Birth - BCG if at risk, not for everyone
2m
3m
4m
12m
3/4 years
14 years
What aspects of development are important?
- Gross motor
- Fine motor and vision
- Speech and hearing
- Social
Any worries at home or school?
What are the red flags of development?
Social - not smiling by 10w
Gross motor - not sitting up by 12 months, not walking by 18months
Fine motor - hand preference by 12 months, not having pincer grasp by 12m
Speech - not knowing 2-6 words by 18 months
Regression of development
What is worrying about early hand preference?
Sign of a stroke
What are the qs to ask about in fever in a child?
Duration
Measuring temp?
Rash? Resp sx? Excessive crying? Lumps? Joint probs? D+V?
Recent travel?
Contacts?
Feeding? Urine output?
Convulsions?
PMH
How do you calculate PEWS?
Potential score = 0-6:
1. Nurse/family concern
2. RR
3. Resp distress
4. O2 administration
5. HR
6. Conc level (decreased conc = point)
