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NUR 240 > Peds exam 1 > Flashcards

Peds exam 1 Flashcards

1
Q

developmental approach to exam:

newborns/infants under 6 months

A

allow parents to be involved
keeps things as normal as possible
start with the least distressing (“foot to head” or “out to in”)

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2
Q

developmental approach to exam:
infants over 6 months

A

exam the patient on the parents lap
exam feet and hands first then the trunk

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3
Q

developmental approach to exam:
toddlers

A
  • demonstrate instruments to alleviate anxiety
  • do not ask the child if you can do something rather explain what you are going to do
  • offer choices when possible
  • start with hands and feet then progress to more invasive procedures
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4
Q

developmental approach to exam:
preschoolers

A

allow child to examine equipment before use
allow choices
use distraction to gain cooperation

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5
Q

developmental approach to exam:
school aged children

A
  • often want to help with them exam
  • head to toe exam is appropriate (by age 6)
  • child likes to learn about their body during exam –> teach them and allow for participation
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6
Q

developmental approach to exam:
adolescents

A
  • MODESTY is very important
    exams should be conducted without others present (unless asked otherwise)
  • build rapport and ask any “private questions”
  • any time a rectal, breast, or anorectal exam is conducted a chaperone should be present (can be a parent but should have another staff to protect self)
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7
Q

length is measures during what age
measure how?

A
  • infant to 24 months (2 years)
  • which a measuring board or tape measure on bed
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8
Q

get standing height at what age
how?

A

after age 2
stadiometer (standing)

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9
Q

Head circumference
done until what age?
how?

A

done until age 3
wrap tape measure around head at supraorbital prominence, above the ears & around occipital prominence
measure 2x (to check)

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10
Q

Chest circumference
done until what age?
how?

A

done until1 year
measure across nipple line

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11
Q

how to weight an infant

A

measure in kg
remove clothing
zero scale to account for diaper

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12
Q

weight of an infant

A

weight doubles by 5-6 months
weight triples by 1 year old

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13
Q

Heart rate for neonate

A

awake: 100-180
asleep: 80-160

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14
Q

Heart rate for infant

A

awake: 100-160
asleep: 75-160

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15
Q

Heart rate for toddler

A

awake: 80-110
asleep: 60-90

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16
Q

Heart rate for Preschool

A

awake: 70-110
asleep: 60-90

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17
Q

Heart rate for school aged

A

awake: 65-110
asleep: 60-90

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18
Q

Heart rate for adolescents

A

awake: 60-90
asleep: 50-90

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19
Q

Auscultation of heart rate

A

auscultate apical pulse for one full minute

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20
Q

where to look for the respiratory rate

A

under 6: observe the abdomen
over 6: observe the chest

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21
Q

head vs chest circumference

A

head is about 2 cm larger that chest circumference at birth
at 2 years of age when the chest circumference surpasses head c.

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22
Q

respiratory rate for infant

A

30-60

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23
Q

respiratory rate for toddler

A

24-40

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24
Q

respiratory rate for preschool

A

22-34

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25
Q

respiratory rate for school age

A

180-30

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26
Q

respiratory rate for adolescent

A

12-16

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27
Q

temperature route that is most reliable

A

orally (considered a core temp)
can do axillary temp in children under 4 years

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28
Q

hypothermia in infants

A

when axillary temp is below 36.5
could indicate sepsis

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29
Q

the more premature the ___ chance of heat loss

A

greater

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30
Q

fever

A

38 C

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31
Q

calculate a normal systolic BP

A

90 mmHg + (2 x age in years)

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32
Q

pediatric SBP hypotension (5th percentile) term neonates

A

under 60 mmHg

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33
Q

pediatric SBP hypotension infants 1 mo - 12 mo

A

under 70 mmHg

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34
Q

pediatric SBP hypotension children 1-10 years

A

under 70 mmHg + (2 x age in years)

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35
Q

pediatric SBP hypotension over 10 years

A

under 90 mmHg

36
Q

do BP last for young children – upsetting

A
37
Q

four limb BP when screening for

A

congenital heart defect

38
Q

location to assess skin color on dark-skinned patients

A

palms of hands and soles of feet

39
Q

mottling indicates

A

poor perfusion
common in sepsis

40
Q

skin should be

A

warm soft dry

41
Q

where to evaluate skin turgor

A

abdomen

42
Q

primary lesions

A

macules, papules, vesicles, pimples
skins initial response to injury or infection

43
Q

secondary lesion

A

scars, ulcers, fissures, scratches, picking/digging
result of irritation infection, delayed healing

44
Q

cap refill

A

less than 2 sec

45
Q

inspection of hair

A

look for lice on hair shafts

46
Q

hair loss in a child may be from

A

tight braids or skin lesions such as ringworm

47
Q

hypothyroidism can cause

A

coarse brittle hair

48
Q

the fontanelle should feel

A

flat and flush/soft

49
Q

tense or bulging fontanelle indicates

A

increased intracranial pressure

50
Q

a sunken fontanelle below the margin of the skull indicates

A

dehydration

51
Q

posterior and anterior fontanelle closes at what age

A

posterior: 2-4 mo
anterior: 1-2 years (usually 18 mo)

52
Q

red reflex

A

present = normal

53
Q

white reflex is

A

referred to as leukocoria and a retinoblastoma

54
Q

visual acuity for children 3-6 years old

A

use snellen picture cards

55
Q

sunset sign

A

retracted eye lids or hydrocephalus

56
Q

ear exam for child under 3

A

pull pinna down and back

57
Q

ear exam for child over 3

A

pull pinna up and back

58
Q

indications of hearing loss

A

babbles as a young infant but does not keep babbling or does not develop speech after 6 months

no speech by age 2

59
Q

signs of respiratory distress

A

nasal flaring
retractions
head bobbing

60
Q

what should be check for an ill baby before feeding

A

check nasal patency
infants don’t automatically open their mouth to breathe when their nose is occluded, suction nose before feeding

61
Q

tonsil grade 4+ can indicate (tonsils that “kiss”)

A

Mono
OSA
chronic allergies

62
Q

tonsils of 3+ can indicate

A

viral infections
strep throat

63
Q

Erickson stages

A

trust vs mistrust

64
Q

Piaget stages

A
65
Q

pectus carnatum

A

when the sternum protrudes
increased AP diameter
pigeon chest

66
Q

pectus excavatum

A

sternum is depressed
decreased AP diameter
funnel chest

67
Q

where to watch respiratory rate for children over 6

A

watch chest rise and fall

68
Q

where to watch respiratory rate for children under 6

A

watch abdomen
the diaphragm is the primary muscle used for breathing in infants and young children

69
Q

crepitus

A

normally heard with a pneumothorax
crinkly sensation that is palpated
‘produced by air escaping subcutaneous tissue

70
Q

decreased tactile fremitus indicates

A

air trapped in lung
asthma

71
Q

increased tactile fremitus indicates

A

lung consolidation
pneumonia

72
Q

stridor

A

high pitched
normally only heard on inspiration (sometimes heard without a stethoscope)
Narrowed trachea and larynx
croup or anaphylaxis

73
Q

wheezing

A

lower airway problem (bronchioles)
normally heard on expiration (sometimes both)

74
Q

preferred peripheral pulse locations

A

over 1 year: radial pulse
under 1 year: brachial

75
Q

preferred central pulse location

A

over 1: carotid
under 1: femoral

76
Q

light palpation of abdomen

A

should be done first
evaluates tenderness, the liver, and defects of the abdominal wall

77
Q

deep palpation of abdomen

A

detects masses

if an enlarged kidney or mass is detected, do not continue to palpate the kidney, pressure on kidney mass may release cancer cells (cause metastasis)

78
Q

inguinal, genital, or perineal assessment position for young children

A

position them on the parents lap with their legs spread apart or in a position of comfort

79
Q

downward bowing of the penis may be caused by

A

chord associated with hypospadias

80
Q

cremasteric reflex

A

touch the inner thigh of each legs to stimulate the testicle and scrotom to rise
intact T12, L1, and L2

81
Q

no cremasteric reflex

A

could indicate testicular torsion (surgical emergency)

82
Q

testicular torsion

A

red or swollen testicle
have about 4 hours from when the testicle flips to restore blood flow before the testicle dies

83
Q

first stage of female pubertal development

A

breast budding
normal occurs between 9 and 14

84
Q

spine alignment

A

stand behind the child, observe the height of the shoulders and hips
have child bend forward
** No lateral curve should be present in either position

85
Q

ortolan-Barlow maneuver

A

checks infants for hip dislocation or subluxation

86
Q

ch 6 in book for reflexes

A

NUR 240 (18 decks)

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