Pediatric Assessment 2

Question 1

Adolescent Psychosocial Assessment

Answer 1

if adolescent is at risk for danger, use HEEADSSS screening tool

Question 2

HEEADSSS Screening Tool

Answer 2

Home environment; Employment and education; Eating; Activities; Drugs; Sexuality; Suicide/depression; Safety

Question 3

2 main reasons why children become distressed

Answer 3

respiratory disorders and blood loss

Question 4

if putting child on oxygen then

Answer 4

have parent hold child and then parent put oxygen on child

Question 5

for preschool assessment work

Answer 5

distally

Question 6

children are not just small adults

Answer 6

they don’t regulate temp, have soft spots till 18 months old, head is larger than body, have high risk for metabolic disorders, less lung volume so they use abdominal muscles to breathe, between 12-18 months kidneys to excrete urine effectively, tongue is larger, oral passages for airway are smaller so risk for infection

Question 7

when performing pediatric assessment

Answer 7

start distally, leave eyes/ears/nose for last, check muscle/skeletal system

Question 8

acute assessment

Answer 8

Compensate with increase respiratory and heart rate (have child sitting up w/ parent if possible, try to not make them cry because that requires more oxygen for them, adjust techniques to child’s demand)

Question 9

Health History

Answer 9

Reason for seeking health care; Family History; Prenatal History; Postnatal History; Developmental History; Personal History; Medications; Risk Factors

Question 10

Building rapport

Answer 10

Involve the parent; Explain purpose; Provide Privacy and remove as many distractions as possible; Open-ended questions, but one question at a time.

Question 11

principles of communication

Answer 11

Make communication developmentally appropriate; Get on the child’s eye level; Approach child gently and quietly; Always be truthful; Give child choices as appropriate; Avoid analogies and metaphors; Give instructions clearly; Give instructions in a positive manner; Avoid long sentences, medical jargon; think about “scary” words; Give older child the opportunity to talk without parents present

Question 12

Developmentally Appropriate Communication with infants

Answer 12

Nonverbal and Crying as communication (Types of cries - hunger/wet/pain)

Question 13

with children want to use

Answer 13

Transitional Objects ex. teddy bear; to distract child while assessing

Question 14

Developmentally Appropriate Communication early childhood

Answer 14

Focus on child in your communication; Explain what, how, and why; Use words child will recognize; Be consistent: don’t smile when doing painful things

Question 15

Developmentally Appropriate Communication School Aged

Answer 15

Want explanations and “reasons why”; Concern about body integrity; Reassurance needed

Question 16

Developmentally Appropriate Communication Adolescent

Answer 16

Be honest with them - honesty will gain their trust; Be aware of privacy needs - privacy is from their viewpoints; Think about developmental regression - especially w/ pain, become more aggressive or emotional; Realize importance of peers

Question 17

children’s play

Answer 17

Children’s “work”; Child’s “developmental workshop” (how they learn and mature); As therapeutic intervention; As stress reliever for child/family; As pain reliever/distracter; As barometer of illness (Has their playing at home changed? ex. too sick to play, getting better, starting to play again)

Question 18

using play to help child get better ex.

Answer 18

using tea party as a way to get child to take PO meds

Question 19

therapeutic art - why do you do this?

Answer 19

For understanding child’s thoughts and feelings that he can’t verbalize (how child can express themselves); Missing people in picture; What is drawn first is likely very important; Color choices show emotion; Use to create discussion about what he’s feeling; ALSO Developmental assessment tool

Question 20

use 24 hr recall for dietary intake because

Answer 20

looking at adequate nutrition and nutrition deficit

Question 21

mal nutrition in children can cause

Answer 21

behavioral changes

Question 22

now have to talk about obesity in children

Answer 22

because now having more and more pts w/ diabetes and obesity; can lead to heart disease

Question 23

poor nutrition can lead to

Answer 23

growth, development, and cognitive delay and effect ability to fight infection

Question 24

clinical exam is based on

Answer 24

review of symptoms and chief complaint

Question 25

Head-to-toe sequence for assessing adult clients (Inspection, Palpation, Auscultation, Percussion) but for pediatric assessments

Answer 25

Sequence for pediatric assessments generally altered to accommodate child’s developmental needs

Question 26

Goals of Pediatric Assessment

Answer 26

Minimize stress and anxiety associated with assessment of various body parts; Foster trusting nurse-child-parent relationships; Allow for maximum preparation of the child; Preserve the security of parent-child relationship; Maximize accuracy of assessment findings

Question 27

Preparation of the Child

Answer 27

Child’s perception of painful procedures; Cooperation usually enhanced with parent’s presence; Age-appropriate techniques