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Pediatrics. Ch.22
Assessment - Physical Survey
| Question | Answer |
|---|---|
| When should a physical survey be done | Once each shift/clinic visit |
| What is a physical survey | Head to toe review |
| What is a priority of the physical survey | Obtaining vital signs |
| How might the nurse hold or parent hold an infant for an ear exam | Close to the chest with one hand immobilizing the head |
| How might 2 people hold the infant for an ear exam | The nurse holds the arms above the child’s head and prevents movement of the head with the thumbs and the parent or assistant can hold the hips of thighs |
| How might the nurse assist with an ear exam | Properly restrain the child in a position that will enable safe and quick assessment by the health care provider |
| What is often the first sign of shock or body stress in infants or children | Tachycardia |
| What is a late sign of shock in children and why | Drop in blood pressure – compensatory mechanism that is activated early |
| What is considered an acute emergency during a physical assessment of a child | Hypotension |
| Why is hypotension considered an acute emergency in children | It is a late sign of shock |
| What findings should be immediately reported | Extreme irritability or Unequal pupil response to light |
| When does the anterior fontanelle usually close | 18 months |
| Before 18 months, how should the anterior fontanelle feel upon palpation | Flat to the contour of the head |
| What might a sunken anterior fontanelle indicate | Dehydration |
| What might a bulging anterior fontanelle indicate | Increased intracranial pressure (ICP) |
| How does increased ICP manifest in an older child or adult | Increase in systolic blood pressure, Widening pulse pressure, Irregular respirations, Bradycardia |
| Why do the signs of increased ICP in an infant differ from that of an older child | Open fontanelles allow brain swelling to occur |
| What may be the only sign of increased ICP in an infant | decreased LOC |
| What is treated as a medical emergency in infants and young children | Bradycardia |
| How can an adult’s body respond to a need for more effective cardiac output if the heart slows | Increased stroke volume |
| How can an infant’s body respond to a need for more effective cardiac output | Increased heart rate only |
| Why is bradycardia considered a medical emergency in infants and young children | Their bodies are unable to produce an increased stroke volume when the heart slows |
| What may occur when an infant or young child’s body must increase cardiac output | Fatigue, Heart failure |
| What may be a normal result of the infant’s immature temperature control mechanism | Skin mottling |
| What are infants prone to, as a result of their large body surface area and high metabolic rate | Fluid loss, Hypothermia, Cold stress |
| Why are infants prone to fluid loss, hypothermia, and cold stress | Large body surface area and high metabolic rate |
| Why should an accurate weight be recorded for infants and children | Medications are based on milligrams per kilogram of body weight |
| How can an infant’s temperature be taken | Via axilla or ear |
| Upon auscultation, how should lungs sound | Clear |
| When looking at the chest rise and fall, what should be the motion description | Symmetrical |
| Where should active bowel sounds be heard | All four quadrants |
| What should skin be observed for | Rash, Lesions |
| What is placed under and over the infant when the weight is recorded | Barrier – Nurse’s hand |
| What should a nurse wear when handling a nude infant | gloves |
Created by:
futurenurse
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