Pediatric Physical Assessment Flashcards
1
Q
Communicating with Families
A
-
Communicating w/ parents
> encouraging parents to talk
> directing the focus
> listening & cultural awareness
> using silence
> being empathetic
> providing anticipatory guidance
> avoiding blocks to communication
> communicating through an interpreter
2
Q
Communicating with Children
A
- Communication r/t development of thought process
- Infancy: ?s directed to parents
-
Toddler: ?s directed to parents 1st, then toddler
> egocentric (analogies)
> don’t want to lose control -
Preschool
> let parents stay in room
> body integrity
> blame themselves -
School years
> explanations/rationales
> encourage them to communicate fears -
Adolescence
> talk to like an adult
> privacy & confidentiality
3
Q
History Taking
A
- Birth hx
- Dietary hx
- Previous illness, injuries, & operations
- Allergies
- Current meds
- Immunizations
- Growth & development
- Habits
- Reproductive hlth hx
- Family hlth hx
> geographix location - Family structure
- Psychosocial hx
> mental hlth concerns - Review of systems
4
Q
General Approaches Toward Examining Child
A
-
Sequence of examination
> head-to-toe sequence
> altered to accommodate child’s developmental needs
> use chronological & developmental age -
Goals of pediatric assessment
> observe for readiness to cooperate
> minimize stress & anxiety associated w/ assessment of various body parts
> foster trusting nurse-child-parent relationships
> allow for max preparation of child
> preserve security of parent-child relationship
> max accuract of assessment findings
5
Q
Sequence of Assessment
A
- Newborn: 1st RR, 2nd HR; least invasive to most (diaper last)
- Toddlers: make them comfortable, RR, HR, diaper last
- Preschool: offer gown, explain everything
- School age: normal assessment
- Adolescent: treat like adult
6
Q
Growth Measurements
A
- Growth charts
- Length: 1st 2yrs take laying down
- Height: after 1st 2yrs take standing up
- Weight: 1st 2yrs take diaper off
- Head circumference: 1st 3yrs
7
Q
Vital Signs - Temperature
A
- Temportal
- Tympanic: wait until 2yrs
- Oral: at 5yrs
- Axillary: 1st 5yrs
- Rectal: only in emergencies
8
Q
Vital Signs - Pulse
A
- Apical: most accurate
-
Radial: can use around 2yrs
> still need to feel for them
9
Q
Vital Signs - Respirations
A
- Belly breathers
- Count for a full minute
10
Q
Vital Signs - Blood Pressure
A
- Start taking in PCP office around 3yrs
- Heart defects: 4 point BPs
11
Q
Vital Signs - Oxygen Saturation
A
Take on feet
12
Q
Physical Assessment - General
A
-
General appearance
> clothes
> affect -
Skin
> bruising
> pigment
> scars - Lymph nodes
- Extremities
-
Head & neck
> hair
> ROM
> helmets more common
13
Q
Eyes
A
- External structures
-
Internal structures
> preparing child - Funduscopic examination
14
Q
Vision
A
- PERRLA
- Visual acuity; hard to assess
- Peripheral vision
-
Color vision
> red reflex; checking for cataracts, want the reflex -
Ocular alignement
> looking for lazy eye
> Strabismus (needs to be detected by 4-6yrs)
> cover test: eye should not need to adjust
> corneal light reflex
> amblyopia: blindness from severe lazy eye tht is not treated
15
Q
Ears
A
- External structures
-
Internal structures
> positioning child -
Otoscopic examination
> 3 or younger: pull pinna down & back
> Older than 3: pull pinna up & back - Auditory testing
