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Peds > Pediatric Assessment ppt (up to but not including Health Supervision) > Flashcards

Pediatric Assessment ppt (up to but not including Health Supervision) Flashcards

Exam 1

1
Q

Health assessment components in pediatrics

A

Health interview and history.

Observation of the parent–child interaction.

Assessment of the child’s emotional, physiologic, cognitive, and social development.

Physical assessment.

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2
Q

What is crucial for proper assessment of the family’s needs?

A

*Behavioral observations are crucial to proper assessment of the family’s needs.

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3
Q

Nurse role when assessing a pediatric patient

A

Establish rapport and trust.
Demonstrate respect for the child and parent/caregiver.
Approach child in a developmentally appropriate manner.
Communicate effectively by listening actively, demonstrating empathy, and providing feedback.
Observe systematically.
Obtain accurate data.
Validate and interpret data accurately.

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4
Q

Therapeutic communication

A

Active listening.
Using open-ended questions.
Identifying and eliminating barriers to communication.
Establishing rapport.

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5
Q

What is the foundation of an accurate health assessment

A

Health interview

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6
Q

Health history includes:

A

Demographics
Chief complaint
History of present illness
Past health history
Review of systems
Family health history
Developmental history
Functional history
Family composition
Resources
Home environment

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7
Q

Demographics

A

simple, non-intrusive; never assume who parent is

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8
Q

Chief complaint

A

Reason for the visit

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9
Q

History of present illness

A

Onset, duration, characteristics, and course (location, signs, symptoms, exposures, etc.).

Previous episodes in the child or family members.

Any changes in environment/daily routine.

Previous testing or therapies; what makes it better or worse.

What the concern means to the child and family.

Inquiry about any exposure to infectious/toxic agents.

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10
Q

Past health history

A

Prenatal or perinatal history, past illnesses, other developmental concerns.

Prior history of illnesses, accidents, or injuries.
Any operations or hospitalizations.

Diet (specifics) and allergies (type and reactions).
Immunization status.

Any OTC or prescription medications child is taking.
Menstrual history in adolescent females.

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11
Q

Health history: Development

A

Developmental: meeting milestones

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12
Q

Health history: Functional

A

Functional: Daily Routine; Sleep, safety, Dental, Physical play, nutrition, etc.

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13
Q

Assessment

A

General appearance, vital signs [PAIN – FLACC or Pain Faces], body measurements (height, weight, head circumference, BMI on appropriate growth charts), activity level, orientation, mood, and pain assessment.

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14
Q

Physical examination- what is the technique?

A

Inspection

Palpation

Percussion

*Auscultation

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15
Q

What is the largest body organ?

A

Skin

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16
Q

What does the skin reveal?

A

reveals nutrition, respiratory, cardiac, endocrine, and hydration status at a glance.

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17
Q

Inspecting variations in skin color and causes:

A

Pallor, central and peripheral cyanosis, jaundice, redness, etc.

Descriptive about lesions

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18
Q

Hair and Nails: What can dry brittle nails indicate?

A

Nutritional difficiency

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19
Q

Coarse dry hair can indicate what?

A

Thyroid or nutritional deficiency

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20
Q

In children, what you you assess about a child’s head?

A

Always assess symmetry (face and muscle movement)

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21
Q

What are the two fontanels

A
  1. Anterior
  2. Posterior
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22
Q

Anterior Fontanels

A

closed between 9-18 months

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23
Q

Posterior Fontanels

A

Posterior: smaller; closes between shortly after birth and 2 months

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24
Q

What are you checking for with the necks of babies?

A

Symmetry, webbing, ROM, lymph nodes

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25
Q

What are you checking for with the ears of the babies?

A

EARS: Symmetry, placed no lower than the eyes, skin tags

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26
Q

How to check inner ear of young infant/child

A

*Pull down earlobe of young infant/child

27
Q

How to check inner ear of young older child

A

*Pull up on outer edge of pinna in older child

28
Q

What are you assessing for eyes of babies?

A

EYES: Symmetry, spacing, epicanthal folds, accommodation (focusing at different distances),

PERRLA (pupils equal round reactive to light and accommodation), extraocular motility (tracking), Hirschberg test (small dot in reflected eye symmetrically in each eye)

29
Q

Hirschberg test

A

(small dot in reflected eye symmetrically in each eye)

30
Q

For nose, what are you checking for?

A

symmetry, patency, drainage, piercings

31
Q

For Mouth and Throat, what are you checking for?

A

Lips for inflammation, lesions, edema; teeth; tonsils pink, uvula midline, no exudate

32
Q

For the Thorax and Lung assessment what do you start with?

A

Begin assessment by observing shape and contour and determining work of breathing.

33
Q

For thorax and lungs, what else are you assessing?

A

Observe rate and respiratory effort—easy, labored?

Note retractions or use of accessory muscles to breathe.

Listen for unusual sounds—wheezing, stridor, crackles, or diminished

Describe cough if present—dry, hacking, wet, productive.

Play games to get child to cooperate with deep breathing!

34
Q

For breasts, what are you assessing?

A

Breasts: Assess based on Tanner Stage 1-5

35
Q

When observing a child’s heart what do you assess?

A

Observe posture, color, symmetry, clubbing, vein distention, apical impulse (can be visible) at point of maximum intensity (PMI)

Pulses, warmth, cap refillWh

36
Q

What is a common finding in children (having to do with the heart)

A

Murmur: common finding in children.

37
Q

How is a heart murmur graded?

A

Grading is based upon how loud the murmur is:

Grade I (soft and intermittent) to Grade VI (loud, can be heard without the stethoscope touching chest).

38
Q

When assessing a murmur, what should you note?

A

Note the anatomic location where the murmur is best heard.

Note where and if murmur radiates to other parts of the chest.

39
Q

In children, how should you divide the abdomen?

A

Divide into 4 quadrants as in adult.

40
Q

In children, what are you assessing for in the abdomen

A

Inspect for size, shape, symmetry; infant and toddler will be rounded, check cord in infants.

41
Q

In the abdomen, what are you auscultating for?

A

Auscultate bowel sounds

42
Q

What is the order of operations of assessing the abdomen?

A
  1. Inspect
  2. auscultate
  3. Percuss
  4. Palpate
43
Q

How do you palpate the abdomen?

A

first light and then deep. Monitor pain, organs

(liver, spleen, kidneys rarely palpated)

44
Q

When palpating the abdomen, what is expected?

A

Should be soft, nontender, nondistended
Report firmness, tenderness, or masses

45
Q

When assessing the musculoskeletal, what does that include?

A

Includes clavicles, shoulders, spine, extremities, joints and hips. Determining range of motion. Tone.

46
Q

Assessing the clavicle and shoulder, what are you checking for?

A

Clavicles & Shoulders: tenderness, crepitus, strength

47
Q

Assessing the spine, what are you checking for?

A

Spine: posture, alignment, scoliosis

48
Q

When assessing extremities what are you checking?

A

Extremities: move spontaneously , gait

49
Q

Genu varum

A

bow legs

50
Q

How long does genu varum last?

A

until 2-3 years

51
Q

Genu valqum

A

knock knee

52
Q

How long does Genu valqum last?

A

until 7 years old

53
Q

Neurologically, what are you assessing?

A

Level of Consciousness:

Balance and Coordination:

Sensory:

Reflexes

Developmental:

54
Q

Level of consciousness

A

alertness and attentiveness

55
Q

Balance and Coordination

A

controlled by cerebellum: Gait, Romberg, heel to shin, rapid alternating movements, finger to finger, finger to nose

56
Q

Sensory is assessing

A

Sensory: cranial nerves, vision, hearing, tasting, smelling, sharp and dull

57
Q

Reflexes are assessing

A

Reflexes: primitive and protective reflexes. Deep tendon reflexes

58
Q

Development, what should be done?

A

utilize screening tools

59
Q

What assessment should you leave until the end

A

Genitalia/anus

60
Q

What scale is used to assess genitalia and anus?

A

Tanner scale

61
Q

Tanner scale

A

used for girls and boys to categorize degree of pubertal development.

62
Q

How is the Tanner Scale recorded?

A

Recorded as Tanner Stages I–IV.

63
Q

What is included in the tanner scale?

A

breast and pubic hair distribution for girls.
pubic hair, penis and scrotum size for boys.

64
Q

When assessing anus, what is being checked?

A

Anus: assess for fissures, rash, hemorrhoids, skin tags

Peds (15 decks)

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