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PEDS
Chapter 4-Communication and Physical and Developmental Assessment of the Child
| Question | Answer |
|---|---|
| COMMUNICATION | Introduce self-intension and Provide privacy developmentally appropriate-INVOLVE PATIENT in communication Avoid long sentences, medical jargon; think about “scary” words |
| How to communicate with parent? I AM GOING TO GIVE YOUR ARM A HUG , TO SEE HOW YOUR HEART BEAT | ALWAYS STAY FOCUS WHO GIVE HX? BE EMPATHETIC |
| WHAT IS Developmentally appropriate FOR INFANTS? | Nonverbal-crying Nurse could hold or caregiver can hold the infant |
| Developmentally appropriate-EARLY CHILDHOOD(Toddler) | Include child in communication Have toys /books present as a distraction Be consistent-avoid asking question(egocentric) explain what how and why-USE WORDS CHILD KNOWS |
| Developmentally appropriate-School-Age | concern about skin integrity-shy want explanations and reasons reassurance that they are ok |
| Developmentally appropriate-Adolescent | Privacy need-INFORM them that everything will be confidential i.e-abdominal pain=when was the last time you had sex? Acknowledge peer influence developmental regression can occur BE TOTALLY HONEST |
| HEALTH HISTORY SHOULD INCLUDE: | CC, PI(present illness) who else is sick? Temp(route)- SUBJECTIVE vs OBJECTIVE Current meds-dosage+frequency IMZ-where? PSYCHOSOCIAL HX FMHX SEXUAL HX REVIEW OF SYSTEMS |
| Nutritional Assessment IS: | Diet HX-Last time at at restaurant Food Dairy-24h recall and food record Dietary intake-ask child-FAV RESTAURANT,FOOD(MOM COOKS) |
| NUTRITIONAL STATUS | Evidence of adequate /nutritional deficiencies Measure BMI HGB |
| Goals of Pediatric Assessment IS TO: | FOSTER NURSE-CHILD-PARENT RELATIONSHIP MINIMIZE STRESS AND ANXIETY START FROM NON INVASIVE TO INVASIVE ALLOW LOTS OF PREPARATION TIME TO CHILD MAXIMIZE ACCURACY OF FINDINGS |
| How do we measure growth ? | Recumbent (supine)length or infants (up to age 36 months )+ weight and head circumference standing height + weight after age 37 months HEAD, CHEST , ABDOMINAL CIRCUMFERENCE |
| How do we measure growth ? | Plot information on growth chart By gender and prematurity (if appropriate) Less than 5th or greater than 95th percentile considered outside expected parameters for height, weight, head circumference |
| What is most important with PEDS? | MEET THE FAMILY AT THEIR LEVELS. GATORADE INCREASE BP |
| WHEN do you stop measuring head circumference ? | Stop at 18-2 years |
| THE NURSE SHOULD KNOW THAT THE FIRST VITAL TAKE IS? | Respirations FIRST -30-60 RR (before disturbing the child) Count apical heart rate SECOND 120-160 BPM; 80> IF SLEEPING Blood pressure (if applicable) THIRD- Temperature LAST-unless they are older and do not mind |
| Early Childhood 1-4 years of age , THE NURSE SHOULD EXPECT? | GROWTH SPURTS-after 2years of age they gain 2-3 kg. and grow 5 cm./year |
| Gross motor skills develop ? | QUICKLY-most can walk by 15 months old and run by 2 years old, peddle a tricycle by 3years. |
| ONE COMMON DISEASE AMONG CHILDREN IS? | DOWN SYNDROME-CLINICAL REPRESENTATION- PALMAR LCREASES-SMALL EARS |
| THE SIMPLE WAY TO NOTE LYMPH NODES? | PEA SIZE, MARBLE, GOLF-BALL SIZE KIDS ALWAYS CERVICAL LYM |
| WHY IS IT IMPORTANT TO USE RIGHT BP CUFF? | The most common “cause” of elevated blood pressure is from improper cuff size |
| WHAT INCREASE BP RESULT? | Renal and cardiac conditions are commonly the cause of elevated BP in children |
| WHAT INCREASE BP RESULT? | Crying, exercise, anxious, nervous feelings will cause BP to be elevated |
| CAN INFANTS BE BORN WITH CONGENITAL CATARACT? | YES-THIS MAKES IT IMPOSSIBLE TO SEE RED REFLEX |
| Sign is respiratory distress are? | grunting, retracting and nasal flaring ORTHOPNEA OR TACHYPNEA, STRIDOR, CYNOSIS, PALLOR, ABNORMAL BREATH SOUND |
| WHAT IS INCLUDE IN ABDOMINAL PHYSICAL ASSESSMENT? | CHECK FOR UMBILICUS SIZE HERNIAS, HYGIENE , ESPECIALLY WITH YOUNG CHILDREN |
| GENITALIA ASSESSMENT? | MATTER-OF-FACT, ALWAYS INSURE PRIVACY, REINFORN=CE SAFETY AND HYGIENE |
| IS ANAL REFLEX NORMAL? | YES, AND GLUTEAL FOLD ASS WEL |
| WHAT IS HYPOSPADIAS? | Urethral opening is located below the glans penis or anywhere along the underside of the penile shaft-VENTRAL SURFACE OF PENIS CAN NOT BE CIRCUMCISED -FORESKIN COVER HOLES |
| HOW IS IT TREATED? | Nursing assessment of every male newborn Requires surgical correction |
| WHAT IS HYDROCELE? | IT'S AN ACCUMULATION OF FLUID IN SCROTUM NON-COMMUNICATING-fluid from mesothelial, lining of tunica vaginalis, no connection w/ peritoneum COMMUNICATING-lack of process vaginalis closure, connecting w/ peritoneum DISAPPEAR BY 1YEAR |
| HOW IS IT TREATED? | SURGICAL PROCEDURE FOR OUTPATIENT SURGICAL REPAIR IF COMMINICATING PERSIST AFTER 1YEAR CHECKING WITH LIGHT, IT SHOULD TRANSLUMINATED TEMPORARY EDEMA OR DISCOLORATION OF SCROTUM RESOLVE SPONTANEOUSLY |
| WHAT IS CRYPTORCHIDISM? | Failure for 1 or 2 testes to descend normally through the inguinal canal into the scrotum could b e due to retractile or undescended (cryptorchid) testes TESTES BACK UP IN THE STOMACH |
| HOW IS IT TREATED? | IF SPONTANEOUS UNDESCENDED CONGENITAL TESTES DOESNT OCCUR AFTER 6 MONTHS, SURGICAL REPAIR WILL BE DONE IN THE FOLLOWING YEAR. INFECTION PREVENTION AND PAIN CONTROL CLEANLINESS OF OPERATIVE SITE |
| WHAT IS EPISPHADIAS? | URETHRAL OPENING ON DORSAL OPENIING OF PENIS FAILURE OF URETHRAL TO CLOSE NORMALLY |
| HOW IT IS TREATED? | |
| WHAT IS EXTROPHY BLADDER? | OPEN INSIDE-OUT-BLADDER WITH INNER SURFACE EXPOSED AND THE DORSAL URETHRA ON THE LOWER ABDOMINAL WALL |
| HOW IT IS TREATED? | COMPLETE REPAIR OF BLADDER EXSTROPHY W/IN 72HOURS OF BIRTH OR DELAYED FOR ABOUT 2 MONTHS PREVENT TRAUMA OF THE EXPOSED MUCOSA |
| WHAT IS OBSTRUCTIVE UROPATHY AND HOW IS IT TREATED? | IT IS CONGENITAL RENAL IMPAIREMENT THAT LIMITED OR MAY POTENTIALLY LIMIT NORMAL RENAL DEVELOPMENT COULD BE UNILATERAL OR BILATERAL NURSES SHOULD ASSIS WITH DIAGNOSTIC PROCEDURE AND HELP CHILDREN/PARENTS IW/ COPING |
| WHAT IS PHIMOSIS AND HOW IS IT TREATED?? | IT IS A NARROWING OR STENOSIS OF THE PREPUTIAL OPENING OF THE FORESKIN, THAT PREVENT RETRACTION OF THE FORESKIN OVER THE GLANS PENIS IT IS TREATED BY: Gentle daily HYGIENE+manual retraction, Topical Corticosteroid Ointment Application or Circumcision. |
| AT WHAT AGE HE MONGOLIAN SPOT DISAPPEAR? | NORMAL AND DISAPPEAR BY 2 YEARS OF AGE. THEY ARE IRREGULAR BLUE SPOT ON SACRAL AND GLUTEAL REGIONS. SEEN IN AFRICAN, HISPANIC, ASIAN AND NATIVE AMERICAN NEWBORNS |
| WHAT ARE COMMON AMNORMALITIES? | BOWLEG, (Genu VARUM)KNOCK-KNEE(Genu VAGUM) |
| WHAT ARE REFLEXES? | automatic, action that your body does in response to something — without you even having to think about it. |
| INFANCY IS: | THE MOST RADIP GROWTH, BECAUSE THEIR BRAIN IS ABSORBING EVERYTHING. Read to them, sing, pray , do anything. |
| WHAT IS A PREPUCE? | IT IS A FORESKIN THAT COVERS THE URETHRAL OPENING AT A NEWBORN'S PENIS GLANS(OPENING) IT SHOULD NOT BE RETRACTED |
| WHAT ARE THE DIFFERENT TYPE OF HEAT LOSS? | EVAPORATION:BODY HEAT LOSS TO MOISTURE(MOST CMMON ONE) RADIATION:H.L FROM INDIRECT CONTACT TO COOLER SOLID OBJECT, INDIRECTLY T CONDUCTION:H.L FROM DIRECT CONTACT W/ A COOLER SOLID OBJECTER SKIN-TO-SKIN: KANGAROO CARE CONTACT-FOSTERING MATERNAL BOND |
| HOW OFTEN SHOULD A NEWBORN BATH? | 2-3 TIMES WEEKLY FOR THE FIRST 2-4 WEEKS WITH A PLAIN WARM SPONGE. CLEANING IS CEPHALAUCODAL(HEAD-TO-TOE) DO NOT CRUB VIGOROUSLY TO REMOVE VERNIX-ALLOW TO FALL OFF INDEPENDTLY SKIN PH 5 |
Created by:
Seka_nurse
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