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Nursing 410- Pediatrics > Week 1 - Pediatric Physical Exam > Flashcards

Week 1 - Pediatric Physical Exam Flashcards

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1
Q

Where is the apical pulse located?

2 part answer

A

over the mitral valve

4th intercostal space, left mid-clavicular

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2
Q

Which pulse gives you the best assessment when you can’t assess the apical pulse?

A

Brachial pulse

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3
Q

How long should you assess respirations for in PEDs

A

1 minute

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4
Q

Where are respirations assessed?

A

front, sides, back

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5
Q

What is the appropriate width for the bladder of a blood pressure cuff?

A

40% of the circumference of the upper arm (midway)

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6
Q

When can it be appropriate to assess BP on the leg

A

when child is <1 year

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7
Q

what are some comfort measures used in pediatrics?

A
  • rattle
  • sugar water
  • pacifier
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8
Q

age-appropriate techniques: infant

A
  • examine on parents lap

- comfort measures

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9
Q

age-appropriate techniques: toddler

A
  • examine quickly

- let them play w/ equipment

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10
Q

age-appropriate techniques: preschooler

A

explain what you are doing

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11
Q

age-appropriate techniques: school-age

A
  • privacy/modesty

- elicit their participation

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12
Q

age-appropriate techniques: adolescent

A

confidentiality

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13
Q

What is the Flax score, and when is it used?

A

Pain scale

used for non-verbal children

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14
Q

Newborn Reflexes: Rooting

A

3-4 months

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15
Q

Newborn Reflexes: Palmar Grasp

A

3-4 months

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16
Q

Newborn Reflexes: Plantar Grasp

A

8-10 months

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17
Q

Newborn Reflexes: Tonic Neck

A

3-4 months

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18
Q

Newborn Reflexes: Moro Refelx

A

4 months

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19
Q

Newborn Reflexes: Stepping

A

1 month

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20
Q

Newborn Reflexes: Babinski

A

1 year

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21
Q

US Children’s Bureau established

A

1912

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22
Q

Maternity & Infant act

A

1921

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23
Q

National School Lunch Program

A

1946

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24
Q

Head Start est.

A

1964

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25
Q

WIC est. (Women, Infants, Children)

A

1966/1974

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26
Q

SSI for Disabled Children

Supplemental Security Income

A

1976

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27
Q

Bright Futures

A

1990

28
Q

FMLA

family and medical leave act

A

1993

29
Q

Children’s Health Act

A

2000

30
Q

Affordable Care Act

A

2010

31
Q

Birth to Five: watch me thrive

A

2014

32
Q

WHO definition of “Health”

A

A state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity

33
Q

Role as Pediatric Nurse

A

Promote and assist the child and family in maintaining optimal levels of heath

34
Q

How to carry out role as pediatric nurse:

A
  • focus on the family (family-centered, culturally competent)
  • Provide atraumatic therapeutic care (minimize physical/psychological stress for children/families)
  • Use EBP (base plan of care on research)
35
Q

3 ways to promote optimal levels of health/care:

A
  1. family-centered/competent care
  2. atraumatic care
  3. EBP
36
Q

promote optimum growth + development through health…

A

health education

37
Q

be an ___, an ___, and a ____

A

advocate, educator, manager

38
Q

Serve pt.’s as a ____, _____, and ___

A

collaborator, care coordinator, consultant

39
Q

What to know/do for Informed Consent

A
  • does parent/guardian understand what they’re signing
  • assess parent/legal guardians understanding (assess)
  • clarify/resolve knowledge deficits
  • ensure consent forms are signed/complete
  • Serve as witness to consent process
  • children >8 = assent form?
40
Q

How old must a child be in order to sign an assent form?

A

> 8 yo

41
Q

What is Pediatric Assent

A

takes into account the child’s perspective of how they want their healthcare to proceed

42
Q

5 thins an Assent does:

A
  1. affirms child’s participation
  2. helps the child to understand their condition
  3. Informs child of their Tx/ care (what to expect)
  4. Cannot be unduly influenced
  5. ascertains child’s willingness to participate
43
Q

T/F. A parent CANNOT override Assent.

A

False

44
Q

T/F. The assent will NOT go in the child’s chart

A

False

45
Q

Genetic influences on child health (4)

A
  • Sex & gender
  • Race
  • Genetically linked diseases
  • Temperament (genetic + environmental influences)
46
Q

What is the Temperament Theory?

A

Describes how a child interacts w/ the environment

47
Q

T/F- a child’s temperament has a corresponding influence on those around the child (positive or negative).

A

True

temperament may affect the family unit

48
Q

T/F- a parent does NOT react to the child based upon the child’s temperament

A

False

(infants are characterized as easy, difficult or challenging, or slow to warm up

49
Q

T/F- a child typically only fits into one temperament subgroup.

A

False

a child may be a combination of these types

50
Q

What are the subgroups of “Temperament”? (3)

A
  1. easy
  2. difficult / challenging/ highly reactive
  3. slow to warm up
51
Q

T/F- an assessment of temperament should be made initially, during the first encounter with the child.

A

False

temperament should be assessed after multiple encounters

52
Q

T/F- a child who is highly reactive and reacts to new experiences by withdrawing in frustration is classified as having a “slow to warm up” temperament

A

False

(highly reactive and reacts to new experiences by withdrawing in frustration is classified as having a “difficult [challenging or highly reactive] temperament”

Rationale: children w/ a “slow to warm up” temperament may initially complain, react with mild passive resistance, need more time to warm up. “Easy” children adapt quickly to new experiences

53
Q

Biological influences on health

A
  • genetics
  • in utero exposure to teratogens
  • postpartum illness (mother cannot care for child)
  • nutrition
  • exposure to hazardous substances
  • maturation
  • exposure to stressful events
54
Q

Lifestyle influences on child health

A
  • patterns of eating
  • exercise
  • use of tobacco
  • drugs
  • alcohol
  • methods of coping w/ stress
55
Q

T/F- the lifestyle of parents doesn’t necessarily determine the lifestyle of the children.

A

False

e.g.- inactive parents who eat poorly teach their children the same behavior (results- diabetes, obesity, heart disease)

56
Q

Types of stress affecting children:

A
  • Societal (starting school, new babysitter)
  • Family stress (conflict in home, divorce, new baby)
  • Societal (poverty, lack of basic needs
  • Physical (illness, trauma, normal growth/development
57
Q

coping with stress may be expressed with which kind of symptoms?

A

somatic symptoms

58
Q

can prior experience w/ stress contribute to ability to respond positively to stress?

A

yes

59
Q

What is coping influenced by? (2 elements)

A
  1. Temperament

2. Developmental stage

60
Q

What is Resilience?

A

The qualities that enable an individual to cope with adverse events and stress and still function completely and have positive outcomes

61
Q

Two Protective factors promoting Resiliency

A
  1. Internal

2. External

62
Q

Internal resiliency

A

ability to take control, be proactive and having responsibility for own decisions

  • understanding/accepting own limits & abilities
  • being goal-directed, knowing when to continue or stop
63
Q

Externa Resiliancy

A
  • having caring relationships

- having positive learning environments and positive influences in the community

64
Q

4 barriers to health care

A
  1. Financial (lack of insurance, cost of med.’s)
  2. Ethnic (cultural expectations encourage obesity in children)
  3. Sociocultural (language/cultural barriers)
  4. Health care delivery system (fragmented care)
65
Q

T/F- The role of the family is limited to providing physical care to child.

A

False

Rationale: parents (guardians) impart the rules and expected behaviors of society through teaching and discipline techniques as well as caring for the physical and emotional needs of the growing child

66
Q

UNICEF/WHO - major problems for global child health (diseases)

A
  • Acute respiratory infections (pneumonia)
  • Malnutrition (micronutrient deficiency)
  • Diarrhea (r/t lack of clean water/sanitation)
  • vaccine-preventable disease (measles
  • malaria
  • preterm birth complications (birth asphyxia)
  • poor health care of pregnant and nursing mothers

Nursing 410- Pediatrics (1 decks)

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