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Chapter 6

Communication and Physical Assessment of Child

interviewing a specific form of goal directed communication
triage nurses are responsible for assessing children's symptoms and applying clinical judgement for further medical care via telephone report
perlcutionary stage (communicative development) (0 to 8-9 mos)l child shows reflexive to stimuli; child shows increasing purpose in action
emerging illocutionary stage (communicative development) (8-9 to 12-15 most) child communication intentionally w/ signals and gestures
conventional illocutionary-emerging locutionary stage (communicative development) (12-15 to 18-24 mos); child communicates intentionally w/ gestures, vocalizations, and verbalizations
egocentric children younger than 5yrs; they see things only in relation to themselves and from their point of view
direct (hx taking) the nurse asks for information via direct interview the informant
indirect (hx taking) the informant supplies the information by completing some type of questionnaire
Dietary Reference Intakes (DRIs) are a set of four nutrient based reference values that provide quantitative estimates of nutrient intake for use in assessing and planning dietary intake
Estimated Average Requirement (EAR) specific DRI; nutrient intake estimated to meet the requirement half the healthy individuals (50%) for a specific age and gender group
Recommended Daily Allowance (RDA) specific DRI; average daily dietary intake sufficient to meet the nutrient requirement of nearly all (97%-98%) healthy individuals for a specific age and gender group
Adequate Intake (AI) specific DRI; recommended intake level based on estimates of nutrient intake by healthy groups of individuals
Tolerable Upper Intake Level (UL) specific DRI; highest average daily nutrient intake level likely to pose no risk of adverse health effects; as intake increases above the UL, risk of adverse effects increases
anthropometry an essential parameter of nutritional status, is the measurement of height, weight, head circumference, proportions, skinfold thickness, and arm circumference in you children
biochemical tests available for assessing nutritional status and include analysis of plasma; blood cells; urine; and tissues from liver, bone, hair, and fingernails
length also called recumbent length; refers to the length taken when children are supine
height (stature) refers to the measurement taken when a child is standing upright
skinfold thickness one convenient measure of body fat; measure w/ special calipers at the most common site, triceps, subscapula, suprailiac, abdomen, and upper thigh
arm circumference an indirect measure of muscle mass
head circumference measure head circumference up to 36 months of age and in any child whose head is questionable
Birth to 2 years (temp routes) axillary; rectal- if definitive temperature reading is needed for infants older than 1 months of age
2 to 5 years(temp routes) axillary; tympanic; oral- when child can hold thermometer under tongue; rectal- if definitive reading is needed
Older than 5 years (temp routes) oral, axillary, tympanic
core temperature most closely reflects the temperature of the blood flow through the carotid arteries to the hypothalmus
normothermia a normal temperature state; when a child;s temperature is altered, receptors in the skin, spinal cord, and brain respond in attempt to achieve a normal state
electronic intermittent thermometers measure the pts temp at oral, rectal, and axillary sites; these are used as primary diagnostic indicators
infrared thermometers measure the pts temp by collecting emitted thermal radiation from a particular site (e.g., ear canal)
electronic continuous thermometer measure the pts thermometer during administration of general anesthesia, treatments of hypothermia or hyperthermia, and other situations that require continuous monitoring
apical impulse heard through a stethoscope held to the chest at the apex of the heart (most reliable)
oscillometry pressure changes are transmitted through the arterial wall to the pressure cuff, and the oscillations are detected by a pressure sensitive indicator
Doppler ultrasonography translates changes in ultrasound frequency caused by blood movement w/in the artery to audible sound by means of a transducer in the cuff
cuff size refers only to the inner inflatable bladder, not the cloth covering
normotensive if the BP is below the 90th percentile
orthostatic hypotension (OH) also called postural hypotension or orthostatic intolerance, often manifests as synocope, vertigo, or lightheadedness and is caused by decreased blood flow to the brain (cerebral hypoperfusion)
Created by: Tdmara86