Peds Assessment Flashcards
Should you allow children to explore or control them? How should you talk to them just in general?
Is restraining a child sometimes necessary?
Explore.
You need to really work with them. Give them a narrative of what you’re doing.
Yes, but we want to avoid restraining them of course.
Are adult and children assessments similar?
Yes, it’s just gathering information and history.
Why is it so important to check immunization status in children?
The immunizations can sometimes hint at what the diagnosis is.
Before you do a developmental assessment, what do yo need to know first?
You need to know the norms, baseline, trends.
T/F
Children grow slowly
Fasle!
Children from infant to 18 grow very fast.
If there’s a discrepancy between the height & weight trend percentiles, what should you consider as the nurse?
How much time do you have to address discrepancies in childhood?
There could be a problem.
Growth hormone replacement might be needed.
Well, growth hormone replacement for instance should only really be done before growth plates close. There’s usually a window of time before some things can be fixed.
What are some other discrepancies that could be a clue there’s a failure to thrive?
Growth Mannerism Appearance Communication skills Vitals
We generally put a lot of emphasis on development and growth.
Purpose of measuring head circumference of newborn?
Why is this so important?
Standard of measurement?
What if the head size of a baby all of a sudden is abnormally large?
Can be done to get a baseline or for evidence of brain development.
The skull has to allow for rapid brain growth & if sutures fuse too early, the brain growth becomes a problem.
Around brow line.
If the head size is larger than usual, it could mean IOP.
You have a patient that measures in the 5th percentile for height and weight. What would you conclude?
Other clue this finding is normal?
The height and weight are proportional so it sort of makes sense they’d be small.
If the parents are smaller, the child may be smaller.
Your patient is in the 95th percentile weight and a 10th percentile on height , could this be an issue?
What do you need to do as a nurse next?
Yes!
The 95th percentile weight is high meaning heavy.
The 10th percentile height is short.
A short, overweight child is a discrepancy.
As nurse you should try to figure out the reason for this. Genes? Nutrition? Health concern?
When looking at immunizations for a child, what should you check?
What types of charts are there?
Check and see if they are up to date and know how to read charts.
Charts for recommendation schedule
How to catch someone up
Disease/condition that alters use of vaccine. Sometimes a disease makes you need a vaccine. Sometimes you need to avoid it.
Why should the general public take vaccines for those who can’t?
Have immunizations helped children?
The vaccination keeps cases low so the possibility of a cancer patient contracting the virus/illness is less.
Yes, children are able to live much healthier lives.
Do children and adults wear the same sized BP cuffs?
Are the VS norms the same for each age?
What is the most important piece of vital signs?
No, children’s are smaller. And there are actually many sizes.
The same VS for a baby are not going to be the same for a full frown child!
The trends in relation to the other conditions going on in children.
Where should you do an infant temperature reading?
What about smaller children?
Axillary since you probably won’t be able to get under the tongue.
Axillary is best. Tympanic & scans is not as accurate. But it really just depends on age. Rectal temp is most accurate but people don’t want that. Only use rectal if there is a concern.
What age do we typically do the normal oral temp?
Unless?
Around 5
Unless they’re unconscious or have a disability.
Why do we need to compare the condition with the trends?
If the trends make sense along with the condition, that is a good sign. But if they don’t that means either you’re wrong or something else is wrong.
A dehydrated child has a high HR. Is this good or bad? Does it make sense?
What if it doesn’t make sense?
Bad but it does make sense because they are COMPENSATING. Which is good. Because if they weren’t compensating, then they are close to a dangerous, critical condition.
If it doesn’t make sense, then you need to investigate ASAP.
T/F
Children probably won’t like being assessed.
Probably true. Main point is that you need to consider that the child will be uncomfortable and you have to figure out how to deal with it.
When is the best time to auscultate lungs of an infant or small child?
Eyes & ears?
Do it when they’re quiet.
Do eyes and ears last.
Is it ok to let a child handle the tools that you’re going to use?
Yes. This may help them feel more comfortable. Just make sure the tools aren’t dangerous.
At what point of the assessment should you do an older school age and adolescent’s genital exam?
Do it last to preserve modesty.
Can parents help out during the exam of infants and small children?
Yes, it can help give a child security.
