Peds Physical Assessment

Question 1

communication with the parents/caregiver

Answer 1

-Encourage parents/caregiver to talk
-Directing the focus
-Listening and cultural awareness
-Using silence
-Being empathetic
-Providing anticipatory guidance
-Avoiding communication blocks

Question 2

anticipatory guidance

Answer 2

understanding expected growth and development of their child, what is the next developmental milestone ect

Question 3

Stranger anxiety

Answer 3

the fear of strangers that toddlers commonly display

Question 4

intervention for stranger anxiety

Answer 4

leave child in parents lap, talk at eye level, let them see the tools you are using

Question 5

Children younger than 5 are egocentric this means…

Answer 5

they think the whole world revolves around them

Question 6

infant

Answer 6

newborn to 12 months old

Question 7

toddler

Answer 7

12-36 months

Question 8

transitional object

Answer 8

comfort item like a blanket, pacifier, doll, ect

Question 9

preschool

Answer 9

36mo./3-5years

Question 10

what is important to school aged children

Answer 10

body integrity: they are concerned about body changes and physical ability
-Can be at risk for bullying if they are considered “different”

Question 10

school age

Answer 10

6-12 years

Question 11

adolescent

Answer 11

12-18 years

Question 12

Performing a health history

Answer 12

-Identifying information (Informant, most likely the parent)
-Chief complaint
-Present illness (Analyzing a symptom or symptoms)

Question 13

Birth History

Answer 13

health during pregnancy, the labor and delivery, and infant’s condition immediately after birth

Question 14

Allergies health history

Answer 14

Ask about commonly known allergic disorders
unusual reactions to drugs, food, or latex products
reactions to other contact agents, such as poisonous plants, animals, household products, or fabrics.

Question 15

Review the child’s growth including the following:

Answer 15

• Measurements of weight, length, and head circumference at birth
• Patterns of growth on the growth chart and any significant deviations from previous percentiles

Question 16

Nutritional Assessment

Answer 16

-Dietary intake
-Clinical examination of nutrition (Hair, skin, mouth, eyes)
-Evaluation of nutritional assessment (Malnourished, At risk, Well nourished, Overweight or obese)

Question 17

Sequence of the Examination for peds patient

Answer 17

usually a head to toe direction is used but in children, the order is often altered to accomodate the childs developmental needs

Question 18

Goals of Pediatric Assessment

Answer 18

Minimize stress: Keep it calm.
Build trust.
Prepare child: Get ready together.
Preserve security: Keep comfort.
Ensure precision.

Question 19

when checking the symptoms fo a patient, what else is important to ask

Answer 19

symptoms the child doesn’t have right now, but previously had before doctor visit (previous illness

Question 20

Weight and height are taken for:

Answer 20

medication dosages and for parameter of growth development and health status

Question 21

Birth weight __ at 6 months and __ at 12 months

Answer 21

Doubles at 6 months, and triples at 12 months

Question 22

occipital frontal circumference

Answer 22

Infant Head Circumference w/tape measure- across eyebrow above ear and around back to occipital

Question 23

chronological age

Answer 23

actual age (years and months)

Question 24

developmental age

Answer 24

A measure of a child’s development (in body size or motor skill or psychological function) expressed in terms of age norms, emotional ability

Question 25

for infants and toddler, traumatic procedures during assessment should be done…

Answer 25

last

Question 26

when preparing child for an assessment

Answer 26

Encourage parent/caregiver to be present and assist with holding the child.

Question 27

until what age should you use the recumbent length board and two measurers

Answer 27

until the child is 2 years of age and is able to stand alone

Question 28

how to measure childs recumbent length

Answer 28

(1) holding the head in midline
(2) grasping the knees together gently
(3) pushing down on the knees until the legs are fully extended and flat against the table.

Question 29

height assessment

Answer 29

Measure height by having the child, with the shoes removed, stand as tall and straight as possible.
Be certain the child’s back is to the wall or other vertical flat surface, with the head, shoulder blades, buttocks, and heels touching the vertical surface.

Question 30

where are respirations in an infant commonly seen

Answer 30

in abdominal movements because respirations are primarily diaphragmatic

Question 31

AAP recommends all children over age 3 have blood pressure taken at

Answer 31

ALL exams (often annually)

Question 32

Adolescents with BP > 120/80 is

Answer 32

hypertensive

Question 33

too small of a cuff size can lead to

Answer 33

falsely elevated values

Question 34

too large of a cuff size can lead to

Answer 34

inaccurate low values

Question 35

Flattening of one part of the head, such as the occiput, may indicate

Answer 35

that the child continually lies in this position

Question 36

Preparing the Child for the ophthalmoscopic examination

Answer 36

showing the child the instrument, demonstrating the light source and how it shines in the eye, and explaining the reason for darkening the room

Question 37

Ocular Alignment: normal

Answer 37

by 3 to 4 months of age, children are able to fixate on one visual field with both eyes simultaneously (binocularity).

Question 38

strabismus

Answer 38

cross-eye, one eye deviates from the point of fixation. If the misalignment is constant, the weak eye becomes “lazy,” and the brain eventually suppresses the image produced by that eye

Question 39

If strabismus is not detected and corrected by 4 to 6 years of age…

Answer 39

blindness from disuse, known as amblyopia, may result.

Question 40

Positioning the Child: otoscopic examination

Answer 40

-position the child properly and gently restrain (sit on parent’s lap and hold parent’s hands)
-Older children usually cooperate and do not need restraint
-Prepare them for the procedure by allowing them to play with the instrument, demonstrating how it works, and stressing the importance of remaining still
-A helpful suggestion is to let them observe you examining the parent’s ear
-Restraint is needed for younger children, because the ear examination upsets them

Question 41

Mouth and Throat assessment

Answer 41

k the child to open the mouth wide; to move the tongue in different directions for full visualization; and to say “ahh,” which depresses the tongue for full view of the back of the mouth (tonsils, uvula, and oropharynx) (the use of a tongue blade (preferably flavored) to depress the tongue may be needed)

Question 42

Genitalia assessment

Answer 42

child is still supine
Adolescents, inspection of the genitalia may be left to the end of the examination
The best approach is to examine the genitalia matter-of-factly, placing no more emphasis on this part of the assessment than on any other segment
It helps to relieve children’s and parents’ anxiety by telling them the results of the findings; for example, the nurse might say, “Everything looks fine here.”

Question 43

Tanner stages

Answer 43

sexual-maturing ratings are based on predictable stages of puberty that are based on primary and secondary sexual characteristics.)

Question 44

when is bowlegged normal

Answer 44

Toddlers are usually bowlegged after beginning to walk until all of their lower back and leg muscles are well developed

Question 45

when is bowlegged abnormal

Answer 45

lateral or asymmetric bowlegs that are present beyond 2 to 3 years of age, particularly in African-American children, may represent pathologic conditions requiring further investigation