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Pediatric Nursing > Pediatric Assessment > Flashcards

Pediatric Assessment Flashcards

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1
Q

If the child is under 2 what should you get the circumference of?

A

Head, chest, and abdomen

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2
Q

Normal vital signs for newborn - 1 year of age

A

Resp: 30-60
HR: 100-170
BP: 65/45

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3
Q

Normal vital signs for a 1 -4 year of age

A

Resp: 20-40
HR: 70-110
BP: 90/55

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4
Q

Normal vital signs for 5 - 12 years of age

A

Resp: 16-22
HR: 60-95
BP: 100/60

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5
Q

Normal vital signs for over 12 years of age

A

Resp: 12-20
HR: 60-95
BP: 120/80

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6
Q

What impacts children’s vital signs?

A

stress, fear, activity, and crying

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7
Q

Normal oral temp

A

98.6 (37.0)

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8
Q

Normal rectal temp

A

99.6 (37.6)

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9
Q

Normal axillary temp

A

97.6 (36.5)

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10
Q

A child is not febrile unless what?

A

unless the temp is above 100.4 (38.0)

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11
Q

In infants and toddlers when should you auscultate?

A

when they are quiet and save the eyes and ears for last

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12
Q

What do you assess in infants and toddlers?

A

head to toe development and considerations

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13
Q

What do you assess in preschool age children?

A

head to toe if possible

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14
Q

What do you assess in school age and adolescence?

A

head to toe and genitalia for last

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15
Q

What is Erythema Toxicum?

A

“baby acne”

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16
Q

What is eczema?

A

inflammatory, painful itching disease of the skin

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17
Q

What are mongolian spots?

A

bluish discoloration over buttocks and base of spine, probably present on at least one of the parents. Benign and will usually fade in 1-2 years.

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18
Q

What do you assess with the eyes?

A

PERALA
anisocoria
check for eye drainage
visual tracking

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19
Q

What is anisocoria?

A

When one pupil is a different size than the other

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20
Q

What do you assess with the ears?

A

check placement
canal more horizontal in infants
assess language skills
check for drainage

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21
Q

If the ears are below ear level what could this indicate?

A

downsyndrome

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22
Q

Who are the obligatory nose breathers?

A

neonates

23
Q

What teaching is necessary for parents of a neonate?

A

teach parents to clear nasal passages prior to feeding

24
Q

what do you assess with the mouth?

A
  • examine palate, tongue, and gums
  • assess dentition prior health problem in children
  • frequent swallowing postop nasopharyngeal surgeries may indicate bleeding
25
Q

what do you assess with neck and lymph nodes?

A
  • neck mobility

- palpate nodes: cervical, post auricular, supraclavicular, inguinal, axillary

26
Q

How much has the brain grown by 2 years of age?

A

75%

27
Q

How much has the brain grown by 6 years of age?

A

90%

28
Q

when do the skull sutures close but not ossify?

A

10-12 years of age

29
Q

what is not fully developed in the brain?

A

the blood brain barrier and water can always pass through

30
Q

what type of breathers are babies?

A

abdominal breathers

31
Q

What does the respiratory look like in babies?

A
  • airways are small in diameter
  • trachea is short and narrowest portion at cricoid ring so you need to use uncuffed ET tubes
  • chest wall compliant
  • lungs are noncompliant
  • the respiratory muscles lack power/tone
  • alveoli is decreased number and compliance
32
Q

What do you assess with respiratory?

A 
color- cyanosis requires 5 grams of desaturated hgb to be visible
rate
excursion
effort-retractions
breath sounds
33
Q

what does the oxyhemoglobin dissociation curve do?

A

relates oxygen saturation and partial pressure of oxygen in blood determined by how readily hemoglobin acquires and releases oxygen

34
Q

What do you assess with the abdomin?

A
  • examine while the child is quiet
  • elimination pattern
  • liver- 2 cm or less below the LICM
  • palpate spleen
  • infants/toddlers dont localize pain
35
Q

what is important with cardiovascular in children?

A

right and left ventricles are similar in size at birth

* Kids are rate dependent

36
Q

Where is the PMI in infants and toddlers?

A

2-4 ICS, left of the MCL

37
Q

where is the PMI in preschool age children?

A

4-5 ICS MCL 7 & up -5th ICS, right of MCL

38
Q

What is the CBV in infants

A

80 cc/kg

39
Q

what is the CBV in children?

A

75 cc/kg

40
Q

What is the CBV in adolescents?

A

70 cc/kg

41
Q

What are early signs of decreased cardiac output?

A
  • pulse rate- tachycardia
  • skin- mottled, pale and cool extremities
  • increased capillary refill time is greater than 2 seconds
  • LOC -decreased sensorium
  • Urine output is decreased
  • metabolic acidosis
42
Q

what are late signs of decreased cardiac output?

A

decompensation: hypotension & bradycardia

43
Q

What is the normal urine output for a child?

A

1.0-2.0 cc/kg

44
Q

what is the normal urine output for a child postop?

A

0.5cc-1.0cc/kg

45
Q

What do you assess with Renal/GU?

A

history of UTIs

  • examine external genitalia
  • assess for pubertal changes
  • menstrual history
  • testicles descended
46
Q

How do you give medications to children?

A

based on weight
mg/kg
the dose is different for each child

47
Q

what happens when the WBCs differentiate?

A

shift to the left

48
Q

What does an increase in bands indicate?

A

bacterial infection or inflammatory process

49
Q

What are monocytes?

A

(2-8%)
macrophages-phagocytosis, remove debris from wounds engulf foreign particles role in dissolving clots
-elevated with chronic bacterial/viral infections, rise with acute bacterial infections if extensive or prolonged

50
Q

Lymphocytes

A

25-45 %

  • produced in thymus, lymph, marrow, spleen, tonsils, combat viral infections
  • provide humoral & cell mediated immunity
  • elevated-mono, CMV, Mumps, Rubella
  • Decreased- aids, after burns or trauma
51
Q

What is the metabolic assessment?

A
  • increased BMR
  • neonates-nonshivering thermogenesis
  • may need additional glucose supplies under stress
  • stress, IV fluid, gluccocorticoids, & DM increase blood sugar
52
Q

Where are gastric tubes?

A

Nasogastric (NG)
Orogastric (OG)
Gastrostomy (GT)

53
Q

Where are duodenal/jejunal tubes?

A

Gastro-Jejunal (GJ)

Transpyloric (TP)

54
Q

how do you obtain a urine collection from a small child?

A

clean and dry the perineum

-apply adhesive to perineum. penis should be inside opening males

Pediatric Nursing (4 decks)

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