Physical Assessment Flashcards

1
Q

how do you communicate with parents

A

-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

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2
Q

when communicating with a small child, what should you do

A

keep the child on the parent’s lap if possible

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3
Q

how should you communicate with a pediatric patient

A

-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

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4
Q

how should you appropriately communicate with infants

A

-nonverbal
-crying as communication (types of cries)

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5
Q

how should you appropriately communicate with an early childhood child (toddlers and preschoolers)

A

-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

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6
Q

how do you appropriately communicate with a school aged child

A

-use concrete terms
-allow child to touch and practice with medical equipment
-ensure personal possessions will not be harmed or lost
-therapeutic play

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7
Q

how do you appropriately communicate with adolescents

A

-be honest with patients
-may require detailed explanation of treatments
-more privacy needs
-can have developmental regression during times of stress
-peers are important

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8
Q

what information do you collect when doing a history intake?

A

-chief complaint
-history of present illness
-family history
-interval history: diet, previous illness, injuries, allergies, medications, immunizations, growth & developement

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9
Q

explain what play is

A

-the universal language aka the child’s work
-developmental workshop
-can serve as therapeutic intervention, stress reliver, pain reliever, distractor, barometer of illness

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10
Q

what are the general approaches to examining a child

A

-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

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11
Q

what are the goals of the pediatric assessment

A

-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

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12
Q

explain what you need to know about growth measurements

A

-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)

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13
Q

when a growth measurement score is below the 5th percentile or more than the 95th percentile, what does that mean

A

outside of the expected parameters

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14
Q

what do we call patients who fall below the 5th percentile

A

failure to thrive

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15
Q

T/F - it is important to note the trend of growth and not the individual measurements

A

true

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16
Q

name the 5 vital signs that you need to take for peds patients

A

-temperature
-blood pressure
-heart rate
-respiratory rate
-pain

17
Q

what order should you do vital signs in infants & toddlers

A

-count respirations
-count apical heart rate
-measure blood pressure
-temperature (can be done at anytime but rectal should be done last)

18
Q

where can you take the blood pressure on pediatric patients

A

-brachial artery
-radial artery
-popliteal artery
-posterior tibial artery

19
Q

what are you looking at for general appearance of patients

A

-subjective impression of appearance
-nutrition status
-behavior/personality
-interactions with parents, siblings, nurse
-posture
-development
-speech

20
Q

what are the three types of temperament

A

-easy (regular)
-difficult (not regular)
-slow to warm up (somewhere in the middle)

21
Q

what are you looking for on the patients head

A

-fontanels presence: sunken or bulging
-shape: NCAT (normal)
-EENT
-facies: general appearance of face

22
Q

what are you looking for in a neurological assessment

A

-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

23
Q

what are you looking for in a respiratory assessment

A

-rate & rhythm
-work of breathing
-breath sounds

24
Q

what is the most common cause of arrest in peds patients

A

respiratory with drowning

25
Q

what are signs of ped respiratory distress

A

-nasal flaring
-sternal retractions
-tripoding
-use of accessory muscles
-tachypnea
-cyanotic

26
Q

what are you looking for in a cardio assessment

A

-pulses
-activity level
-skin color (pallor or mottling)
-heart rate
-pulse quality
-cap refill time

27
Q

what are you looking for in a GI assessment

A

-ab shape and size
-distention (shiny appearance)
-auscultation
-palpation
-self positioning (guarding & pain)
-skin color

28
Q

what is the most common cause of GI pain

A

constipation

29
Q

what are you looking for in a GU assessment

A

urine output: color, amount, odor

30
Q

children can decomposate faster in which body system

A

GI

31
Q

is dehydration a bigger or smaller issue in young children

A

bigger due to higher percentage of body water

32
Q

what do you look for in a musculoskeletal assessment

A

-history
-developmental variations (toe walking, bow legs)
-symptoms:loss of movement or strength, pain
-deformities
-look for trauma, injections, tumors, juvenile arthritis

33
Q

what are you looking for in integumentary assessment

A

-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

34
Q

what are you looking for in a psychosocial assessment

A

-family composition
-child’s place in the home
-what is home and who lives there
-daycare
-illness in family
-behavioral

35
Q

what should you avoid putting in a patient’s chart

A

don’t use WNL, appropriate, intact, normal