Pediatric Communication and Assessment Flashcards
Identify developmentally appropriate communication techniques.
List the normal sequence in the physical examination of children and adolescents
Identify methods and pain assessment tools for assessing pain in the pediatric population
SLO for pediatric assessment and communication
you need to make sure that you’re talking to them at the _______ age
developmentally appropriate
COMMUNICATE ACCORDING TO PAITENTS ______ LEVEL
DEVELOPMENT
avoid sudden movements, speak on their level
Infants: use ______
peak a boo
Adolescents: need to encourage them to ______ feelings, also really like their peers
express
_______: need to encourage them to express feelings, also really like their peers
Adolescents
Neuro assessment for children: use the ____ scale
know this scale and different scenarios
AVPU, (alert, verbal, painful, unresponsive)
extremely sleepy, minimal stimulation with an IV placement.
lethargic
Resp rate for ages 3-6: _____ breaths per minute
20-30
3 yo 100/52 bp, hr 99, rr 45
what is abnormal?
( the rr is abnormal)
will be a test question with normal vital signs for children
t/f: your anxiety will make the parents and the children’s worse
true
temps on kids tend to be _____ than adults
higher
t/f: in children, their body hasn’t matured so it will go crazy with temps, not completely unusual to see a 103 temp
true
______ happen when your temp goes from 98 to 103 in like 15 minutes. A rapid change in temperature over a short time frame.
Seizures
rapid temp change ______ seizure threshold
decreases
What do you need to avoid when communicating with children?
metaphors
long sentences
the nurse asks if the child has been “coughing your head off” when assessing them. Is this communication developmentally appropriate?
no, it is a metaphor and they will likely take it literally
t/f: a 2 year old can understand a sentence if its short?
true
fear: potty, dark, shadows, sleeping alone, weather, loud noises.
Fears for 2-4 year olds
Fear: dark, fire, bad guys, taking tests, peer rejection, doctors and shots, bugs and animals.
Fears for 5-7 year olds
Fear: bad guys and ghosts, being home alone, dying, sickness, school failure, throwing up at school, peer rejection.
fears for 8 -11 year olds
Fear: their safety, sickness, throwing up at school, failure in school or in sports, school presentations, how they look to others, violence and global issues.
fears for 12-18 year olds
List the correct order for the following assessments that need to be done. Heart rate, blood pressure, temperature, respiratory rate.
Resp rate, heart rate, blood pressure, temperature. do painful/most invasive procedures last.
Health history: most reliable information usually comes from the ______*
caregiver
t/f: child is most reliable, go with what the child is saying versus what the parent is saying
true
acute appendicitis: they usually point right to the ______
belly button
Radial pulse: has to be at least ___ for it to be accurate
two. Take apical until theyre two
very useful bc it will tell you if there is an issue with circulation usually before they actually become hypoxic
capillary refill
if patient is under 30 days old, the ___ is really important. have to do this before you can move onto lumbar puncture stuff.
temp. (especially a rectal temp)
What color cap do you use for a rectal probe thermometer?
red cap
t/f; use play and talk at their eye level.
true
Developmentally appropriate quick neurological assessment: ______
AVPU
What does AVPU stand for?
child is alter
responsive to verbal stimuli
responsive to painful stimuli
unresponsive
do the most invasive procedure ______, and the least invasive procedure ______
last, first
Listen on teddy first
Tea party (increase fluid intake), crazy straw, fun
examples of using play
their throat is about the size of the patients ____
pinky finger
book recommends using tongue blade to move the tongue how?
side of tonge over instead of ontop
age 1 how do you take a tympanic temp?
pull pinna down and back
age 3 and older how do you take a tympanic temp?
pull pinna up and back
heart murmurs can be a result of ________ or some other physiological abnormality
fever or anemia
will probably ______ the diapers and count the number of diapers
weigh
Where do you check the skin turgor on a child?
Abdomen
Age (Example: Neonate-Increased muscle tone=acute pain)
Developmental level
Cause and nature of pain
Ability to express the pain
influences of pain management
Use bubbles, music, play a game, positive self-talk (When I am done, I will be able to…), guided imagery for pleasurable events, pacifier
Methods to prepare a child for a painful procedure
What scale do you use for an infant?
NIPS
and Cries
What are factors in a NIPS?
breathing
face
arms
legs
cry
arousal
all are 0-1 except crying which is 0-2
What are considerations for CRIES scale?
crying
oxygen requirement
changes to vital signs
facial expressions
sleeplessness
all scored at 0-2
What si the most common pain assessment scale for a child?
FLACC
What are components of the FLACC scale?
Face
Legs
Activity
Cry
Consolability
scored from 0-2
Moderate sedation: responds to ______
verbal commands
What is EMLA medication?
topical anesthetic prior to an IV insertion
What types of additional medication may be used for chronic pain in peds ?
antidepressants/anticonvulsants for chronic/neuropathic pain
What is Cognitive-Behavior therapy?
a psychological approach for pediatric pain
