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Pediatric Patients
Evaluation and Care of Pediatric Patients
| Question | Answer |
|---|---|
| General Observation | How does the child look? What is their state of hygiene? How are they dressed? |
| Signs of Abuse | Injuries that are extremely unlikely given the child’s development. Inconsistent story between the child and the caregiver. Injuries that should have been avoided with basic parental Incompatibility between the story and the injury. supervision |
| The Health History : You will have this discussion with the parent, caretaker, or adolescent. Please and make sure to assess: | Family History , Meds, The child's personal health history , birth history , immunizations |
| Interviewing the Child & Adolescent | Be age-appropriate-Use toys/questions when talking w/ the child. Establish rapport- Showing interest in and in what they say. Listen -child’s comments should be listened and the child should be made to feel important. |
| The Pediatric Assessment Order of Vital Signs | The order in which you perform vital signs is very important in very small children because they are easily upset and may start to cry, which may affect their other vital signs. |
| Order of Vital Signs | count the respirations before even touching the child. This should be calm while they are sitting with a parent or a caregiver. If necessary, take the child’s BP. . measure their apical heart rate. take the child’s temperature. |
| Normal Respiratory Rate by Age | Infants (<1 y) 30-55 Toddler (1-2 y) 20-30 Preschool (3-5 y) 20-25 School-age (6-11 y) 14-22 Adolescent (12-15 y) 12-18 |
| Normal Heart Rate by Age | Age Awake Rate Sleeping Rate Neonate (<28 d) 100-165 90-160 Infant (1 mo-1 y) 100-150 90-160 Toddler (1-2 y) 70-110 80-120 Preschool (3-5 y) 65-110 65-100 School-age (6-11 y) 60-95 58-90 Adolescent (12-15 y) 55-85 50-90 |
| Normal Blood Pressure by Age Age - Systolic Blood Pressure - Diastolic Blood Pressure | Birth (12 h) 60-85 45-55 Neonate (96 h) 67-84 35-53 Infant (1-12 mo) 80-100 55-65 Toddler (1-2 y) 90-105 55-70 Preschool (3-5 y) 95-107 60-71 School-age (6-9 y) 95-110 60-73 Preadolescent (10-11 y) 100-119 65-76 Adolescent (12-15 y) 110-124 70-79 |
| Temperatures can be measured: | 01 Orally 02 Rectally 03 Axillary |
| A normal oral temperature range is | 36.4 degrees Celsius to 37.4 degrees Celsius (97.6 degrees Fahrenheit to 99.3 degrees Fahrenheit). |
| A rectal temperature is | usually 0.5 to 1.0 degrees higher than the oral measurement. |
| An axillary temperature usually measures | 0.5 degrees to 1.0 degrees lower than the oral measurement |
| Pediatric Pain Scales :The CRIES scale is an acronym: Crying, Requires O2, Increased vital signs, Expression, Sleepless for neonates, preterm, and full-term newborns | Because babies cry, it is the quickest/simplest way to assess the potential cause of their crying. s. Each of these is a variable scored on a scale of 0 – 2 (e.g., Crying: 0 = Not Crying; 1 = High Pitched; 2 = Inconsolable). |
| Pediatric Pain Scales :The FLACC scale is for children ages 2 months to 7 years. | FLACC stands for Face, Legs, Activity, Cry, and Consolability . Like the CRIES scale, this set of variables is scored on a scale of 0-2 |
| Pediatric Pain Scales :The FACES scale | is most common for children ages 3 and older. It uses six drawings of faces to help the patient rate their pain on a scale of 0 to 5 |
| Pediatric Pain Scales :The Oucher scale | is for children ages 3 to 13. It is like the FACES scale but uses photographs to help them rate their pain on a scale of 0 to 10 |
| Physical Growth & Development | When assessing a child’s physical growth and development there are several measurements to take including: Length or height , Weight , head circumference |
| Length or height | These are the same but are called “length” when a child cannot stand upright and “height” when they can stand. |
| Weight | An infant is weighed nude, lying on an infant scale, when older enough to sit, the child can be weighed while sitting. |
| Head circumference | This measurement is completed in younger children to ensure proper development. A paper or plastic tape measure is placed around the largest part of the head just above the eyebrows and around the most prominent part of the back of the head. |
| Psychosocial Development | Assess the child’s communication skills, how they play and what their temperament is like.. |
| Erik Erikson | was an ego psychologist who developed one of the most popular and influential theories of psychosocial development. This theory is based on biological, psychological, and social factors that a person may encounter during their life. |
| Cognitive Development | Cognitive milestones represent important steps forward in a child's development. This is where you assess your subject’s ability to communicate (vocabulary, gestures). Also take note of how they think as well as their problem-solving skills |
| Erik Erikson’s Stages of Psychosocial Development are as Follows: Trust vs Mistrust | (Infancy from birth to 18 months) Stage 1 |
| Erik Erikson’s Stages of Psychosocial Development are as Follows: Autonomy vs. Shame and Doubt | (Toddler years from 18 months to three years) Stage 2 |
| Erik Erikson’s Stages of Psychosocial Development are as Follows:Initiative vs. Guilt | (Preschool years from three to five) Stage 3 |
| Erik Erikson’s Stages of Psychosocial Development are as Follows: Industry vs. Inferiority | (Middle school years from six to 11) Stage 4 |
| Erik Erikson’s Stages of Psychosocial Development are as Follows: Identity vs. Confusion | (Teen years from 12 to 18) Stage 5 |
| Erik Erikson’s Stages of Psychosocial Development are as Follows: Intimacy vs. Isolation | (Young adult years from 18 to 40) Stage 6 |
| Erik Erikson’s Stages of Psychosocial Development are as Follows: Generativity vs. Stagnation | (Middle age from 40 to 65) Stage 7 |
| Erik Erikson’s Stages of Psychosocial Development are as Follows: Integrity vs. Despair | (Older adulthood from 65 to death) stage 8 |
| Care of Pediatric Patients | MA play a crucial role in caring for pediatric patients. They provide comprehensive care and services to children, including basic medical assessments, taking vital signs, administering injections, providing patient education, and more. |
| In addition to providing direct patient care, medical assistants also | provide emotional support for families of pediatric patients and ensure that their needs are me |
| Common Pediatric Condition : | Asthma , Head lice , impetigo , ringworm |
| Developmental Stages :Physical development | is the actual bodily changes that occur. |
| Developmental Stages : Intellectual-cognitive development | refers to the thinking skills the child is developing. |
| Developmental Stages :Psycho-emotional development | refers to the changes in feelings experienced during a particular period. |
| Developmental Stages: Social development | is the way a person relates to others. |
| Pediatric Development | Areas of growth and development include motor, sensory, and language development. |
| Motor Development | allows the child to develop more independence, encouraging sensory, cognitive, and language growth. |
| Motor development usually includes three areas of growth: | Reflexes, gross motor, and fine motor skills. |
| Reflexes refer to automatic responses to any stimulation. Common reflexes are listed below: | Breathing reflex Sucking reflex Rooting reflex Swimming reflex Grasping reflex Moro reflex: |
| Rooting reflex: | When brushing the cheek, the infant turns toward it to suck |
| Swimming reflex: | When held horizontally, begins stretching and swimming motion |
| Grasping reflex: | Grips when palms are touched |
| Moro reflex: | Startle to loud banging and other environmental stimuli |
| Gross motor skills include | Rolling ,Scooting ,Crawling, and Walking |
| Sensory Development | Vision and hearing are improving, along with depth perception and motion assessment. All of these sensory developments continue to promote further motor development |
| Visual development involves | increasing distances in sight as the brain matures. This maturation allows for better focus and increased tracking of objects as the child grows. Color perception also develops as the child grows. |
| Hearing improves in normal sensory development as the child matures | Varying pitches and frequencies can be differentiated. |
| Language Development | From infancy forward, the child begins with noises that elicit a response. This progresses to words, phrases, and sentences. |
| Be mindful of adolescents’ sensitivity toward rapid growth and physical, sexual, and social development when you prepare them for examination. | Adolescents and preadolescents often feel awkward and self-conscious about being examined. They may also prefer to dress alone and be alone with the licensed practitioner. |
| Assisting with an Exam for an Infant or Child | you will need to take some special considerations. The techniques you use to prepare an infant or child emotionally and physically should be modified based on the patient’s age and ability. |
| Emotional | Infants and toddlers are likely to be afraid of you because you are strangers. Approach these children slowly, smile, and use a gentle voice |
| Emotional - Children of preschool age are | sometimes uncooperative and challenging. Remain calm, perform the procedures quickly, and restrain the child (with assistance from the parent) when appropriate. To prevent children from getting injured, watch them at all times. |
| Physical | Base your choice of an exam position for children on each child’s age and ability to cooperate. |
| Pediatrics is the specialty that deals with | the care of children; some subspecialties include surgery, cardiology, and psychiatry |
| Pediatric appointments can range from | well-baby or well-child visits to track growth and development to illness or chronic conditions |
| During well-child visits the developmental and growth of the child is assessed including | physical, cognitive, and social development. All children have their own timeline however each child is documented according to national standards |
| .•The medical assistant is responsible for assisting the provider | , updating patient history, performing tests, measuring and weighing children, administering immunizations and providing support. |
| CDC’s table of considerations for immunizations include the following. | Ethical considerations Preterm birth Recent exposure to infectious disease Fever within the past 48 hr Immunodeficient family member in the household History of persistent, inconsolable crying longer than 3 hr within 48 hr after previous DTP/DTaP |
| The provider will determine when contraindications will | prevent, delay, or modify the administrations of vaccines or other pediatric procedures. |
| The medical assistant should be familiar with the CDC’s table of contraindications such as the following. | Severe allergic reactions to previous immunization Encephalopathy not attributed to another cause (Hep B, HPV) Hypersensitivity to yeast Children with asthma or wheezing Anatomic or functional asplenia Known severe immunodeficiency |
Created by:
CATCCMA