NPS- Pediatric Assessment Flashcards
Explain obtunded
drowsy state, may have a decrease gag reflex and cough… patient should be admitted and assessed emergently
What is Euphoria
Drug overdose
If a patient is panicked what would you start thinking is wrong with the patient?
They cannot breath…. hypoxia, PTX, asthma attack
What are some assessments of daily living?
eating, dressing, walking, bathing, grooming, toilet use
Marasmus
inadequate energy intake which is normally seen in 6-18 mo
Kwashiorkor
lack of protein with normal energy intake, child will also have a protruding belly and edematous face and limbs
What does the Glasgow Coma Scale (GCS) monitor?
Eye opening
verbal response
motor response
If a patients GCS is low is that good or bad?
bad
13-15 high
9-12 moderate
3-8 is severe
A patients Glasgow coma scale is 5… what does that indicate?
Severe ! This isbad
You are trying to get a focused medical history or a patient….Using SAMPLE what is being assessed?
S- signs and symptoms
A- Allergies
M-Medications
P-Past medical history
L- Last meal eaten
E- Events leading to current illness or injury
What is subjective symptoms
Coming from the patient, their own opinion
Orthopnea
Difficulty breathing except when in the upright position
When a patient is feeling run down, nausea, weak, fatigue, headaches
General Malaisse
When a patient is feeling neusea, run down, and tired…. what should you consider?
electrolyte imbalance
Explain Dysphagia
difficulty swallowing and hoarseness
Normal WBC in pediatrics
5,000-10,000/mm
Normal Glucose in Peds
54-117 mg/dL
What is the gold standard test for cystic fibrosis
The Sweat Test or Sweat Chloride Test
Explain the Sweat Test
- Pilocarpine is injected into the skin to stimulate sweat production
- 2 + tests are necessary to dx. CF
- Normal value is <30 mmol/L
- CF is confirmed when value is >60 mmol/L
When is CF confirmed?
When sweat test is >60 mmol/L
What is used in the sweat test to produce sweat?
pilocarpine
excessive fluid in the tissue is known as what?
Pitting edema- ankles and feet also known as pedal edema
What is peripheral edema caused by?
fluid OL, CHF, and renal failure
What med is used to help with pedal edema?
Lasix, diuretic therapy
Clubbing of fingers is caused by what?
chronic hypoxemia
Venous distention occurs with what?
Fluid OL and CHF
Erythema
Redness of the skin
Pectus Carinatum
Anterior protrusion of the sternum
Pectus Excavatum
depression of part or all of the sternum
Kyphosis
Hunchback or convex spinal curve
Scoliosis
”s”
Lateral curvature of the spine
Kyphoscoliosis
combo of both and causes a severe restrictive impairment
Barrel chest
result of chronic air trapping/hyperinflation
What diseases most commonly result in barrel chest?
Asthma and CF
when would you see unequal movement in chest ?
atelectasis
PTX
Flail chest
An intubated patient with an ETT in one lung
Normal RR for an infant
30-60 bpm
Normal RR for toddler 1-3 yo
24-40
normal RR for a pre-schooler 4-5 yo
22-34
Eupnea
Normal RR, depth, and rhythm
What would cause an increase in RR
fever
hypoxia
pain
anxiety
metabolic acidosis
Oligopnea
Decrease in RR
What would cause a decrease in RR
sleep (normal)
drugs
alcohol
metabolic disorders
define apnea
cessation of breathing for >20 seconds
Explain Cheyne Stokes
gradually increasing then decreasing RR lasting from 30-180 seconds with periods of apnea in between
Cheyne Stokes and Biot’s breathing most commonly indicates what type of injury?
brain injury/CNS problem
Kussmaul’s
increased RR, usually over 20 bpm, with increased depth, irregular, and breathing sounds labored
What is the most common reason for Kussmauls breathing>
diabetic, metabolic acidosis
Normal HR for 1-2 yo
80-130
Normal HR for 2-6 yo
10-120
Normal HR for 6-10 yo
70-110
Normal HR for 10-16 yo
60-100B
Bradycardia indicates what?
Heart failure, shock, CODE/EMERGENCY
What should you do if a patients HR changes more than 20 BPM from BL during a therapy?
this is an adverse reaction
STOP therapy, notify RN and MD, document in chart
If there is a change in rhythm what should you do?
further monitoring
Explain paradoxical pulse or pulsus paradoxus
pulse/BP varies with respiration and may indicate air trapping such as status asthmaticus
Tactile fremitus- what would cause increased transmission
consolidation
PNA
Tactile fremitus- What would cause decreased transmission?
pleural effusion
lung cysts
bullae
PTX
If a patient reports tenderness in chest or abdomen, what should you do?
further investigation
Bronchial breath sounds that are heard over the trachea or bronchi are considered what?
normal
bronchial breath sounds that are heard over the lung periphery (lower in the lungs) would indicate what?
consolidation
Adventitious breath sounds means what?
abnormal
crackles indicate what?
fluid
unilateral wheeze indicates what?
foreign body aspiration
stridor- supraglottic swelling is causes by what?
epiglottitis
Describe tx for stridor
- topical vasoconstrictor ( rac epi) for swelling and edema
- sx’ing and or bronch for secretions and foreign body aspiration
- intubation for marked or profound swelling and epiglotisis
Pt has marked/severe stridor, what should be done?
intubation
A 1 yo BP is 70/40… is this normal or abnormal?
normal
A 7 yo BP is 120/80…is this normal or abnormal?
abnormal…this is high
Increased BP indicates what?
cardiac stress & hypoxemia
Decreased BP indicates what?
poor perfusion & shock
