Pediatric Assessment 2 Flashcards
Adolescent Psychosocial Assessment
if adolescent is at risk for danger, use HEEADSSS screening tool
HEEADSSS Screening Tool
Home environment; Employment and education; Eating; Activities; Drugs; Sexuality; Suicide/depression; Safety
2 main reasons why children become distressed
respiratory disorders and blood loss
if putting child on oxygen then
have parent hold child and then parent put oxygen on child
for preschool assessment work
distally
children are not just small adults
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
when performing pediatric assessment
start distally, leave eyes/ears/nose for last, check muscle/skeletal system
acute assessment
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)
Health History
Reason for seeking health care; Family History; Prenatal History; Postnatal History; Developmental History; Personal History; Medications; Risk Factors
Building rapport
Involve the parent; Explain purpose; Provide Privacy and remove as many distractions as possible; Open-ended questions, but one question at a time.
principles of communication
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
Developmentally Appropriate Communication with infants
Nonverbal and Crying as communication (Types of cries - hunger/wet/pain)
with children want to use
Transitional Objects ex. teddy bear; to distract child while assessing
Developmentally Appropriate Communication early childhood
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
Developmentally Appropriate Communication School Aged
Want explanations and “reasons why”; Concern about body integrity; Reassurance needed
Developmentally Appropriate Communication Adolescent
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
children’s play
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)
using play to help child get better ex.
using tea party as a way to get child to take PO meds
therapeutic art - why do you do this?
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
use 24 hr recall for dietary intake because
looking at adequate nutrition and nutrition deficit
mal nutrition in children can cause
behavioral changes
now have to talk about obesity in children
because now having more and more pts w/ diabetes and obesity; can lead to heart disease
poor nutrition can lead to
growth, development, and cognitive delay and effect ability to fight infection
clinical exam is based on
review of symptoms and chief complaint
