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NURS 202 > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

What grows in a predictable pattern? Children’s…
a) growth
b) behaviour
c) both

A

c) both

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2
Q

What is a primary goal during pediatric assessment?

A

increase comfort as much as possible

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3
Q

What is the first step in a pediatric assessment?

A

observation

very important***

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4
Q

General Considerations for Infant Assessment

A

goal: establishing trust

parent should be present, in full view

young infant: place infant in supine on table, or parent’s chest

older infant: as much in parent’s lap

1-2 hours after the infant is fed

don’t have to be in clothes

warmth, eye contact, smile

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5
Q

How to sequence infant assessment

A

least distressing steps first

FIRST: heart, lung, abdominal sounds

LAST: eye, ear, nose, throat, Moro/startle reflex

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6
Q

General Considerations for Toddler Assessment

A

goal: developing autonomy

greet child and parent, but focus more on parent initially

position: parent’s lap

dislike being restrained

get parent to help you hold child still

security object - blanket, toy

wearing clothes for as much as possible

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7
Q

How to sequence toddler assessment

A

Some objective data as you collect the history

Begin with “game” - e.g. cranial nerve testing

Start with non threatening areas

LAST: eye, ear, nose, throat

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8
Q

What is the best way to pose a question to a toddler?
a) Can I listen to your heart?
b) Would you like me to listen to your heart or tummy first?

A

b) Would you like me to listen to your heart or tummy first?

give limited options

do not offer a choice when there is none - child will respond “no”

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9
Q

General Considerations for Preschool Assessment

A

goal: developing initiative

Position:
parent present, may be on parent’s lap
older - on table, with parent present

can talk - use simple, short explanations

leave clothes on

offer limited options

have them help you

use games

feedback, reassurance

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10
Q

How to sequence preschool assessment

A

FIRST: thorax, abdomen, extremities, and genitalia

LAST: head, eye, ear, nose, and throat

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11
Q

General Considerations for School-Age Assessment

A

goal: developing industry

developing social competence, desiring approval

Position:
sitting on exam table

decide whether parent, sibling should be present

small talk

undress on their own, drape

demonstrate equipment

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12
Q

How to sequence school-age assessment

A

head-to-toe

same as adult

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13
Q

General Considerations for Adolescent Assessment

A

goal: self-identity

PRIVACY

self-conscious, introspective

peer values and acceptance

sitting on exam table, NO parents

feedback - body is healthy and developing normally, wide variation

treat them like a teenager - not a child, not an adult

health teaching

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14
Q

How to sequence adolescent assessment

A

head-to-toe

genitalia last, quickly

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15
Q

Signs of Child Abuse (4)

A

1) child avoids eye contact

2) no separation anxiety, expected for age

3) parent disgusting by child’s odour, sounds, drooling, stools

4) deprivation of physical or emotional care

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16
Q

What is the best indicator of a child’s general health?

A

physical growth

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17
Q

Concerning aspects of growth (4)

A

1) below 5th, above 95th percentile with no genetic explanation

2) wide percentile difference between height and weight

3) steady growth then stops

4) no growth spurts during infancy, adolescence

18
Q

Order of vitals in infants

A

REVERSE order

respiration –> pulse –> temperature (may have to take rectally)

19
Q

Infants and young children have _____ variations in normal temperature
a) narrower
b) wider

A

b) wider

a result of less effective heat control mechanisms

20
Q

Children get higher fevers up to _____°C

A

40.5°C

21
Q

Assessing pain in child

A

assess subjectively and objectively

non-verbal behaviours

vital signs (changes from baseline)

Wong-Baker Faces Scale

other paediatric pain scales as appropriate

22
Q

Landmark for infant and toddler pulse

A

apical pulse (chest)

4th intercostal space

FULL minute

23
Q

Is sinus arrhythmia normal in children and adolescents?

A

yes

24
Q

What is an especially important indicator during a pediatric cardiovascular assessment

A

cap refill

< 3 seconds

25
Q

What is an important indicator of hydration status in children?

A

mucous membranes

children can become dehydrated very easily*

26
Q

When assessing an infant’s respirations, where should you watch?

A

abdomen

do more diaphragmatic breathing

FULL minute

27
Q

Examples of respiratory distress in children

A

nasal flaring

head bobbing

tracheal tug

clavicular indrawing

28
Q

During an assessment of a newborn, you note that they have a lusty cry. What should your next step be?
a) document and proceed with the rest of the assessment
b) notify the physician

A

a) document and proceed with the rest of the assessment

normal

cry full of strength and energy

29
Q

Bad kind of cry

A

hypertonic

high-pitched, don’t settle easily, e.g. withdrawal

30
Q

When does the anterior fontanelle close?

A

12 - 18 months

31
Q

When does the posterior fontanelle close?

A

2 - 3 months

32
Q

Which of the following fontanelle characteristics is normal?
a) tense
b) sunken
c) soft
d) firm

A

c) soft

and flat

anything else = bad

33
Q

Infant measurements to take (4)

A

1) weight (without diaper)

2) length

3) head circumference

4) chest circumference

1st year of life: head = chest circumference

34
Q

Moro/Startle Reflex

A

hold baby, support neck, kinda drop them quickly

startled look

arms will fling out sideways with the palms up and the thumbs flexed

until 4 months

35
Q

Rooting Reflex

A

tickle cheek

head should turn to the side that you tickle

up to 4 months

36
Q

Sucking Reflex

A

with gloved hand, should suck finger

up to 12 months

37
Q

Palmer Grasp Reflex

A

will wrap hands around finger

up to 4 months

38
Q

Tonic Neck Reflex

A

baby supine, relaxed, or sleeping, turn the head to one side with the chin over the shoulder

note ipsilateral extension of the arm and leg, and flexion of the opposite arm and leg

up to 6 months

39
Q

Babinski Reflex

A

bottom of foot

toes should splay out

up until 24 months

40
Q

Stepping Reflex

A

hold infant upright under the arms, with the feet on a flat surface

note regular alternating steps

disappears before voluntary walking begins

41
Q

When examining the ear in the children, pull the pinna
a) up
b) down and back

A

b) down and back

NURS 202 (6 decks)

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