Pediatric Physical Assessment Flashcards

1
Q

principles of communication

A

make it developmentally appropriate
get on eye level
approach gently and quietly
be truthful
give them as many choices as possible

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2
Q

how to perform a health history

A

identifying information
chief complaint
present illness
past history
current meds
immunizations
pain history
psychosocial history
family med history
sexual history
ROS

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3
Q

age classifications for newborns, infants, toddlers, preschool, school age, adolescents

A

birth to 1 month
1 month to 12 month
1 year to 3 year
3-5 years
6-11 years
12-18/20 years

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4
Q

how to obtain growth measurements

A

recumbent length for infants up to 36 months + weight and head circumference

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5
Q

what is considered outside expected paramaters for height, weight, and head circumference

A

less than 5th or greater than 95th percentile

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6
Q

appropriate approach to examine a young infant

A

parents lap or on exam table
listen toh eart lungs first
undress, keep them in diaper, covered
distraction*

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7
Q

appropriate approach to examine an older infant

A

able to sit unsupported
stranger anxiety
sit on parents lap
prevent prolong eye contact
address the parents
instrucive procedures last

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8
Q

appropriate approach to examine a toddler

A

sitting or standing
separation anxiety so keep parents in view
talk with parents first
utilize play
instrusive procedures last
let htem handle the equipment
have parent remove clothing
transitional objects
demonostrate assessment on a toy
praise and reward

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9
Q

appropriate approach to examine a preschool age

A

lying, standing, sitting, keep parents close
cooperative modified head to toe
play games
instrusive procedures last
let them handle equipment
self undress
demonstrate
tell a story
educate with exam
leave on underpants

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10
Q

appropriate approach to examine a school age or adolescent

A

sitting
address child first
head to toe assessment
privacy, self undress
teach about bodily functions and health habits
offer choices

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11
Q

what to assess for general appearance

A

faces
posture
position
body movement
hygiene
nutrition
behavior
development

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12
Q

skin assessment

A

color
texture
temperature
moisture
tissue turgor
pigment lesions
accessory structures- hair and nails

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13
Q

head and neck

A

shape
symmetry
head control
head posture
ROM of neck

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14
Q

anterior fontanel should be closed around when:

A

12-18 months

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15
Q

the posterior fontanel cranial sutures close by when:

A

6-8 weeks

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16
Q

what is plagiocephaly

A

flat head

17
Q

what is craniosynotosis

A

premature closing of sutures, or ICP

18
Q

eyes assessment

A

size
shape
symmetry
conjunctiva
cornea
pupils
fundoscopic exam
(fundus, red, reflex, blood vessels)
vision testing
(ocular alignment, visual acuity, peripheral vision, color vision)

19
Q

strabismus

A

eye misalignment
normal up until 3 months of age

20
Q

age 3-8 need objective vision screening how often

A

yearly

21
Q

what are tests for visual acuitiy for ages 3-5

A

illiterate E or HOTV

22
Q

what ages use the Snellen chart

A

6+

23
Q

ear assessment

A

external structures: position, cerumen
internal structures: landmarks, light reflex

24
Q

nose assessment

A

external structures: position and placement, nasal flaring
internal structures: mucosa, turbinates, septum
nasal drainage and odor

25
Q

tonsil sizing

A

1- normal
2- normal
3- viral pharyngitis, strep
4- airway obstructions

26
Q

chest and back assessment

A

size, shape, symmetry
movement
nipples
breast development
scapular symmetry
spinal curvature
ROM

27
Q

pectus excavatum

A

sternum is compressed in, concerned about heart or blood vessels
common in scoliosis

28
Q

pectus carinatum

A

pigeon chest
sternum protrudes outward
can affect pulmonary function

29
Q

respiratory assessment

A

rapid rate
adventitious vs oral sounds
chest wall more compliant
infant- chest rounded
neonates-obligatory nose breath
under 6-7 years - abominal breathing
flaring/grunting/retractions

30
Q

cardiac assessment

A

under 7- PMI @ 4th ICS, laterl to MCL
over 7- PMI @ 5th ICS, lateral to MCL
cap refill <2
sinus arrythmia is normal
assess heart upright and supine

31
Q

abominal assessment

A

inspection, auscultation, palpation
contour
movement
umbilicus
hernias
bowel sounds
palpation

32
Q

tanner scale

A

puberty changes into adolescence (1-5)

33
Q

male genitalia assessment

A

male structures: penis glans and shaft, urethral meatus, scrotum and testes
hair distrubution
tanner stage
anus

34
Q

female genitalia assessment

A

structures: labia majora/minora, clitoris, urethral orifice, vaginal orifice
hair distrubiution
tanner stage
anus

35
Q

musculosketal and extremity exam

A

hips (infants)
bowleggedness (until 2 years)
knock knees (2-7 yers)
appearance of flatfoot (infants)
tibial torsion
babinski (normal until 18 months)
muscle strenght
gait
sole and palm creases

36
Q

bowleg

A

genu varum

37
Q

knock knee

A

genu valgum

38
Q

neurological assessment

A

balance and coordination
finger to nose test
heel to shin
romberg test
reflexes- triceps, biceps, patellar, achilles
cranial nerves