Physical Assessment Flashcards
how do you communicate with parents
-make contact with parents first
-introduce yourself
-establish parental roles
-ask how to address parents
-ensure privacy and confidentiality
-direct focus
-provide anticipatory guidance
-consider the need for a professional interpreter
when communicating with a small child, what should you do
keep the child on the parent’s lap if possible
how should you communicate with a pediatric patient
-make communication developmentally appropriate
-get on the child’s eye level
-approach the child while involving the parent or caregiver
-be truthful
-give the child choices as possible
-include play whenever possible
-ask simple questions
-give clear simple instructions
-use role play, dolls or models if possible
-avoid medical jargon
-give adolescents opportunity to talk without parent present
how should you appropriately communicate with infants
-nonverbal
-crying as communication (types of cries)
how should you appropriately communicate with an early childhood child (toddlers and preschoolers)
-allow child to sit on the parent’s lap
-let children touch equipment
-focus on child when communicating
-use words that they will recognize
-be consistent
-involve the parent if possible
-repeat info in simple terms
how do you appropriately communicate with a school aged child
-use concrete terms
-allow child to touch and practice with medical equipment
-ensure personal possessions will not be harmed or lost
-therapeutic play
how do you appropriately communicate with adolescents
-be honest with patients
-may require detailed explanation of treatments
-more privacy needs
-can have developmental regression during times of stress
-peers are important
what information do you collect when doing a history intake?
-chief complaint
-history of present illness
-family history
-interval history: diet, previous illness, injuries, allergies, medications, immunizations, growth & developement
explain what play is
-the universal language aka the child’s work
-developmental workshop
-can serve as therapeutic intervention, stress reliver, pain reliever, distractor, barometer of illness
what are the general approaches to examining a child
-quiet to active: performing what needs to be done while the child is quiet first (developmentally based)
-use communication techniques, play and parental assistance to complete the examination
*across the room to touching exam
what are the goals of the pediatric assessment
-minimize stress and anxiety
-building trust in the nurse, child and parent relationships
-allow child to have maximum preparation
-preserve security of parent-child relationship
-maximize accuracy of assessment findings
explain what you need to know about growth measurements
-recumbent length for infants up to 36 months plus weight and head circumference
-standing height plus weight plus body max index (BMI) after 37 months (stand like a statue)
when a growth measurement score is below the 5th percentile or more than the 95th percentile, what does that mean
outside of the expected parameters
what do we call patients who fall below the 5th percentile
failure to thrive
T/F - it is important to note the trend of growth and not the individual measurements
true
name the 5 vital signs that you need to take for peds patients
-temperature
-blood pressure
-heart rate
-respiratory rate
-pain
what order should you do vital signs in infants & toddlers
-count respirations
-count apical heart rate
-measure blood pressure
-temperature (can be done at anytime but rectal should be done last)
where can you take the blood pressure on pediatric patients
-brachial artery
-radial artery
-popliteal artery
-posterior tibial artery
what are you looking at for general appearance of patients
-subjective impression of appearance
-nutrition status
-behavior/personality
-interactions with parents, siblings, nurse
-posture
-development
-speech
what are the three types of temperament
-easy (regular)
-difficult (not regular)
-slow to warm up (somewhere in the middle)
what are you looking for on the patients head
-fontanels presence: sunken or bulging
-shape: NCAT (normal)
-EENT
-facies: general appearance of face
what are you looking for in a neurological assessment
-alertness: behavior, LOC
-reflexes: neonates, infants
-history of seizures, irritability, feeding pattern
-glasgow V child coma scale
-posture: flaccid, rigid
-pupil reactions
-developmental level: prematurity, chronic illness
what are you looking for in a respiratory assessment
-rate & rhythm
-work of breathing
-breath sounds
what is the most common cause of arrest in peds patients
respiratory with drowning
what are signs of ped respiratory distress
-nasal flaring
-sternal retractions
-tripoding
-use of accessory muscles
-tachypnea
-cyanotic
what are you looking for in a cardio assessment
-pulses
-activity level
-skin color (pallor or mottling)
-heart rate
-pulse quality
-cap refill time
what are you looking for in a GI assessment
-ab shape and size
-distention (shiny appearance)
-auscultation
-palpation
-self positioning (guarding & pain)
-skin color
what is the most common cause of GI pain
constipation
what are you looking for in a GU assessment
urine output: color, amount, odor
children can decomposate faster in which body system
GI
is dehydration a bigger or smaller issue in young children
bigger due to higher percentage of body water
what do you look for in a musculoskeletal assessment
-history
-developmental variations (toe walking, bow legs)
-symptoms:loss of movement or strength, pain
-deformities
-look for trauma, injections, tumors, juvenile arthritis
what are you looking for in integumentary assessment
-inspection and palpation
-focus on color, texture, temperature, turgor
-note any rashes, purpura and petechiae (communicable diseases, allergy)
-be aware of physiological and ethnic factors
what are you looking for in a psychosocial assessment
-family composition
-child’s place in the home
-what is home and who lives there
-daycare
-illness in family
-behavioral
what should you avoid putting in a patient’s chart
don’t use WNL, appropriate, intact, normal
