Pediatric Assessment and Exam Flashcards
3 major types of pediatric visits?
- Well child
- Acute illness
- Chronic illness
How is infant age categorized in first year of life?
Gestational age
Characteristics and what to look for in 1-4 yo visit?
○ Usually very anxious ○ Try to make friends first ○ Parental report vs. direct observation: speech delay, motor delay, TRY TO OBSERVE ○ Gait abnormalities/variations ○ Eye problems (lazy eye)
Characteristics of first year of life?
○ MUST classify by birth weight and gestational age
○ Developmental delay v. range of milestones
○ Mostly observation vs. parental report
○ Examine child in parents lap/arms
○ Plagiocephaly
○ Murmurs
Characteristics of 5-10yo?
○ School problems develop
○ Missed milestones (teacher v. parents)
○ Scoliosis
○ Murmurs
Tanner stage for males / females?
◊ Male: genital development / pubic hair growth
● Precocious puberty before age 9
● Delayed puberty: no evidence by age 14
◊ Female: based on breast development and pubic hair
● Precocious puberty before age 8
● Delayed: no signs by 13 or no menarche by 16
What are gravity and parity?
○ Gravida (G): number of pregnancies
○ Para (P): full term deliveries, preterm deliveries, abortions, living
◊ Ex: G3P2,0,1,2
Normal cardiac findings in children?
Innocent (benign, flow, functional) murmurs are:
● (i) Systolic
● (ii) I-III/VI
● (iii) Musical
● (iv) @LSB
● (v) Non-radiating
● (vi) Unassociated with other cardiac findings
How to assess growth chart for child?
IMPORTANT TO LOOK AT CURVE AND NOT JUST ONE POINT
How is obesity determined with age?
◊ Overweight: BMI between 85th and 95th %ile
◊ Obese: BMI >95%ile
How is temperature taken in children?
● Rectal until age 3, then oral
● NOT axillary or tympanic
How does pulse move with age?
● Decreases with age
How does respiratory rate move with age?
● Decreases with age
Movement of BP with age? Whose BP should be taken
● Increases with age
- Three yo and up
When is stranger anxiety considered normal?
9-15 months
When examining siblings who should be examined first?
Oldest
What order should procedures be done in for childhood exam?
- Least to most distressing
◊ End with genitalia, throat, and ears (you may need the parents help)
Until what age should parent be in room?
11
What is most important indicator of infant health?
Somatic growth
How is length measured in
Measure supine on measuring board/tray
What should head circumference be measured?
● Measure during first 2 years of life
Breathing patterns and tachypnea cutoffs in infants?
◊ Diaphragmatic breathing is predominant and thoracic excursion is minimal
◊ Tachypnea cutoffs:
● 0-2 mo >60/min
● 2-12mo >50/min
Pattern of rectal temp in infant?
Average rectal temp is higher in infancy and early childhood (99) until after age 3
Average childhood increase in height?
◊ >2 yo children grow at least 5 cm/year (increases during puberty)
