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Semester 5 PMNM Exam 8 > Peds Exam and Eval > Flashcards

Peds Exam and Eval Flashcards

1
Q

Family centered care

A

a philosophy of an individual or institution

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2
Q

Family participation in healthcare - vital role ine

A

POC
Evaluation
Delivery of care

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3
Q

Family centered care - in PT - vital with a pediatric patient

A

Caregivers are a necessity
Education - HEP
Equipment needs
Reports childs wants/needs/concerns

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4
Q

Family centered care - principles of family centered care

A

1 Mutual respect, trust, honesty, open communication
2 Empower the family - they make decisions
3 Serve as teacher, mentor, facilitator, advocate
4 Member of transdisciplinary team

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5
Q

What is the purpose of your exam

A

1 Diagnostic info - often a team approach to diagnose
2 Screening - are they typical or atypical
3 Problem solving
4 Plan of care

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6
Q

What are the models of care in pediatrics

A 
Direct
Integrated
Consultative
Monitoring
Collaborative
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7
Q

What are the models of care in pediatrics - Direct

A

You provide therapy to an individual

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8
Q

What are the models of care in pediatrics - Integrated

A

Often in school environment (in their natural environment)

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9
Q

What are the models of care in pediatrics - Consultative

A

someone is usually having you come in to see them – maybe SLP wanting you to come in to help them with a position of their extremity to use while speaking

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10
Q

What are the models of care in pediatrics - Monitoring

A

often in school environment but can be outpatient, I am not going to provide therapy to you but I may come in and check on you with a consult to make sure things are continuing along

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11
Q

What are the models of care in pediatrics - Collaborative

A

as a team you are approaching the patient dysfunctions together, can happen in outpatient and/or in school

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12
Q

Environmental considerations

A

Natural environment like home, school, day care
Furnishings in environment
Presence of parents
Child clothed

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13
Q

Things to consider

A

What are the standardized measures for that diagnosis
Diagnosis and understanding of primary and secondary impairments
Normal development - what do you expect for a child at this age

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14
Q

Considerations before the exam begins

A

Family dynamics

Families understanding of the reason for PT referral

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15
Q

Considerations for the PT - Examination

A 
OBSERVE
ENGAGE
Establish rapport - start slow
Be flexible and spontaneous
Use play creatively 
Be tactful and choose your words carefully
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16
Q

Examination - History

A

Medical history (delivery, gestational age)
Maternal history or family hx
Growth and development
Current activity level or present function (games they play, nap schedule)
Family, school environments

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17
Q

Patient/Family Goals

A

Primary concerns
Your expectations vs. family expectations
Childs goals

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18
Q

CP - ANS

A

Skin temp, color, breathing pattern, nasal flaring, pupils

19
Q

Tests and Measures - Disposition

A

Level of alertness
Communication
Tolerance to activity/interactions

20
Q

Musculoskeletal

A

Postural alignment
PROM
AROM
Strength - tone? look for synergistic mvmnt patterns vs. isolated control

21
Q

Musculoskeletal - Alignment

A

What is childs preferred alignment
Can they actively/passively reach neutral alignment
What is the alignments impact on force production
LOOK AT ALIGNMENT IN ALL POSITIONS!

22
Q

Musculoskeletal - Head control is dependent on

A

a good base of support

Need to look at head, shoulder girdle, trunk, and pelvis

23
Q

Musculoskeletal - Hip

A

Wt bearing in full stance
If child is non wb - need xray by 2 yr
Dislocation/Sublux

24
Q

Musculoskeletal - ex of tests

A

Barlows
Ortolanis
Craigs
Leg length discrepancy

25
Q

Musculoskeletal - ex of tests - Barlows

A

Looking for hip dysplasia - abd, ER, and anterior glide to pop back in

26
Q

Musculoskeletal - ex of tests - Ortolanis

A

flex hips, add, IR, and do glide to check and see if comes out of acetabulum

27
Q

Musculoskeletal - ex of tests Craigs

A

For femoral anteversion and retroversion

28
Q

Musculoskeletal - ex of tests leg length discrepancy

A

Medial mall to umbilicus

Medial mall to ASIS

29
Q

Musculoskeletal - Common Knee measures

A

Genu Valgum/Varum - Q angle
Tibial torsion
Thigh foot angle

30
Q

Musculoskeletal Ankle common measures

A

Talocrural DF/PF
Rearfoot motion (inv/ev)
Forefoot adduction - metatarsus adductus (measuring foot to hindfoot relationship)

31
Q

Neuromuscular

A

Reflex integration

Tone/Spasticity

32
Q

Neuromuscular - functional exam

A 
Supine
Prone
Sitting
Standing (static vs. dynamic) 
Gait and stairs
Transitions
33
Q

Balance - how does it develop

A 
TEST IN ALL POSITIONS
Head righting
Equilibrium rxns 
Protective
Tilting rxns
34
Q

Neuromuscular - what do we look at to assess standing balance

A

Ankle strategies
Hip strategies
Equilibrium/Trunk rxns
Stepping rxns

35
Q

Neuro - sensory exam

A 
Vision
Hearing
Vestibular
Reflexes
Sensory integration
36
Q

Motor responses

A

Balance between agonists/antagonists as age appropriate

Force production - timing, scaling

37
Q

How do we assess motor responses

A

Play!
Object manipulation - pick them up, pass them, reach across midline for them, manipulate them, throw them, catch them, bounce them

38
Q

What else do we assess with motor responses

A

Isolated movement in extremeties
Isolated movement between extremeties
Dissociation

39
Q

Functional skills

A

Feeding/Eating
Dressing/Bathing
Mobility/Transfers

40
Q

Equipment

A

Fit and function
Home
School
Transportation

41
Q

Integumentary - record

A

Bruises, areas of redness

42
Q

Diagnosis/Prognosis

A

Identify impairments, activity limitations, and issues with participation
Consider future needs - wellness across lifespan
Think how it will impact them as they grow and age
Determine optimal outcome
Socioeconomic impact

43
Q

Plan of Care

A

Develop STM and LTG based on exam and patient/family goals
Progress will be slow
Goals need to be measurable

Semester 5 PMNM Exam 8 (8 decks)

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