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33 Cards in this Set
- Front
- Back
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What are important rules to communicating with children?
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G - Approach gently and quietly
O - Give older child opportunity to talk A - Avoid analogies and metaphores L - Avoid long sentences with scary words T - Be Truthful D - Make it developmentally appropriate I - Give instructions clearly and + manor C - Give Choices E - Eye level GO ALT DICE |
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How can you understand communication from an infant?
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Nonverbal
Crying communicates Use parents with interpretation of cry |
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What is important to understand about early childhood and communication?
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focus on child in communication
explain what, how, and why use words he or she will understand Be consistent (don't smile with pain) |
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What is important to understand about adolescent communication?
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Be honest to gain trust
Aware of privacy: have confidential time with them Regression with pain and illness Importance of peers |
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What are the goals of the pediatric assessment?
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minimize stress and anxiety with assessment of body parts
Foster RN-Child-Parent relationships Allow for Max prep Preserve security of parent-child relationship Max accuracy of assessment findings |
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What is the sequence for assessing the pediatric child?
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Head-to-toe sequence for adults
Child assessment: altered to accommodate the childs developmental needs assess problem area last |
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How can you collect health assessment data?
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Observation
Interviewing the parent Interviewing the child Physical exam |
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What is important to understand with physical assessments on infants?
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Don't wake the baby
Examine on parents lap if possible Leave diaper on Comfort measures (pacifier/bottle) Talk softly Start with heart and lung sounds Ear and throat exam last |
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What is important to understand with physical assessments on toddlers?
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Examine on parent lap if uncooperative
use play therapy distract with stories let them play with equipment call by name praise frequently quickly do exam |
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What is important to understand with physical assessments on preschool exam?
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allow parent to be within eye contact
explain what you are doing in simple terms let them feel equipment offer available choices to the child use games to get child to cooperate |
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What is important to understand with physical assessments on School Age?
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Allow choice of having parent present
privacy and modesty ask if the child has any concerns or questions explain procedures and equipment interact with child during exam be matter of fact about examining genitals |
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What is important to understand with physical assessments on adolescents?
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Ask about parent in the room: should have private interview time
information in matter-of-fact manner |
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What should you assess about the general appearance of a child?
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facial expression
posture hygiene behavior development fit |
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What is important to do with VS on infants and toddlers?
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count RR first
count apical HR for 1 min (<2yo) second BP third T last |
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What is important to understand about RR in children?
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Count for 1 min
Rate will be elevated with crying or fever Under one year count abdominal movements Panic levels: <10 or >60 |
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What is the RR HR and Systolic BP for and infant?
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RR 30-60
HR 100-160 BP >60 or strong pulse |
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What is the RR HR and Systolic BP for toddler
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RR 24-40
HR 90-150 BP >70 or strong pulses |
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What is the RR HR and Systolic BP for preschoolers
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RR 22-34
HR 80-140 BP >75 |
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What is the RR HR and Systolic BP for School Age
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RR 18-30
HR 70-120 BP >90 |
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How should you assess skin hair and nails?
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inspect and palpate
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What should you assess about the head?
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measured at age 3
Check fontanels (anterior 12-18mo, posterior 2mo) Shape (flat head from back to back sleep) |
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What should be assessed about the neck?
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symmetry
palpate for masses or lymph nodes |
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What should be assessed about the eyes?
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External structures
internal structures Vision from parent report Infants should be able to focus on one object by 3-4mo (binocularity) |
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What should be assessed about the ears?
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placement
pull pinna down and back <3yo |
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What should be assessed about the mouth?
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palate
condition of teeth number of teeth tooth eruption appliances brushing |
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What should be assessed about the throat?
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tonsils
uvula oropharynx use tongue blade on the side of the tongue |
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What should be assessed about the thorax and the lungs?
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Inspection: RR and effort (retractions?)
Auscultation: Hard to distinguish between upper airway sounds and lung sounds in infants |
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What are the possible sites of retractions?
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Observe while the child is sleeping:
Supraclavicular Suprasternal Intercoastal Subcostal Substernal |
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Where can you assess the apical pulse in children?
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<7 = 5th intercostal LMCL
>7 = 4th intercostal |
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What should be assessed about the abdomen?
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Inspect: shape countour (hernia)
Auscultate: BS Palpate: lightly first, then deeper R coastal margin: Liver L coastal margin: Spleen |
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What should be assessed about the genitalia and anus?
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Tanner stages: 1-5
1 prepubertal 5 adult genitalia |
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What should be assessed about the musculoskeletal areas?
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Spine for scoliosis or posture
Strength and tone Knocked knee (common 3-8yo but grow out of it) Bowlegged (in toddlers and persists until lower back muscles developed) Flat Foot |
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What should be assessed about the neurolgic system?
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balance and coordination
reflexes games used to assess |
