COMMUNICATION & PHYSICAL ASSESSMENT OF THE CHILD AND FAMILY:

Question 1

Communication Techniques for infants:

Answer 1

• Infants respond to non-verbal ques- smile!
• speak to child on their eye level
• Allow infant to stay in care-givers lap
• Use songs or play
• Avoid appearing threatening

Question 2

Communication techniques for children:

Answer 2

• Allow warm up time
• Avoid appearing Threatening
• Build rapport with caregiver
• Use play
• Assume position at eye level
• Allow child to touch equipment
• Be honest - (dont say it wont hurt/ taste good)
• Offer choices only when one exists
• Avoid words children may take literally

Question 3

Communication Techniques for adolescents:

Answer 3

• Decide if it’s appropriate to speak to teen or parent first.
• Be respectful
• Avoid judgment or criticism

Question 4

Assessment of Infants and toddlers:

Answer 4

• infant: 0-1
• toddler: 1-3
• Allow to stay near caregiver
• Inspect body through play/songs
• Perform the least stressful procedure first:
  — BP & temp last
• Auscultate while quiet
  — Best while asleep
• Allow inspection of equipment

Question 5

Assessment of preschoolers:

Answer 5

• age: 3-5
• Allow position of comfort
• If cooperative- head to toe
• Allow inspection of equipment
• Use games/praise
• Give choices if available

Question 6

Assessment of school age children:

Answer 6

• 6-12
• Head to Toe
• Respect Privacy
• Explain Procedures and findings
• Make it into a game/ they love rules

Question 7

Assessment of Adolescents:

Answer 7

• Head to Toe
• Allow for privacy
• Explain findings
• Emphasize normalcy of Development as compared to other adolescents their age

Question 8

Growth

Answer 8

The increase in physical size

Question 9

Development

Answer 9

Progressive increase in skill and capacity of function

Question 10

How do developmental stages occur?

Answer 10

At a predictable rate
- Nurses use anticipatory guidance to predict upcoming developmental tasks.

Question 11

Growth Measurements

Answer 11

• Growth Charts- 0-2 yrs
• WHO Chart and CDC for 2yrs and older
• Concerns: Sudden change, below or above average percentiles, unexpected results based on heredity and genetics
• Infants- weight, length, Head, chest and abdominal circumference

Question 12

First sign of puberty: girls

Answer 12

*first sign is development of breast buds (8-13yrs)
Menses- 2 yrs after breast buds.

Question 13

First sign of puberty: boys

Answer 13

*first sign- testicular enlargement- (9.5-14yrs)

Question 14

Physical assessment:
SKIN:

Answer 14

• Color
• Bruises, lesions, rashes
• Temperature, texture
• Capillary refill time: tip of finger/ not nail bed
• Edema
• *Infant: any of the newborn skin conditions

Question 15

Physical assessment:
Eyes, Ears & Mouth

Answer 15

• EYES: Placement and alignment
• EARS: examine for placement and alignment
• MOUTH: external & internal
• TEETH: lose teeth @ 5-6 years
• NOSE: external
• NECK: inspect and palpate

Question 16

Infant BP:

Answer 16

• BP ON LEG
• BP ON ARM @ 2 YO

Question 17

Blood Pressure Concepts:

Answer 17

• Choose a Cuff with bladder that =40% of upper arm circumference for accuracy.
• If appropriate size is not available, use oversized, not undersized cuff.
• BP done once a shift- infants BP done only if they have a cardiac or other issue

Question 18

Pediatric Vital Signs:
Pulse

Answer 18

• Count for full minute.
• Infant:120-160bpm
• 2-10yrs= similar to adults

Question 19

Pediatric Vital Signs:
RR

Answer 19

Infants: 30-60
Similar to adults between 7yr-10yr

Question 20

Pediatric Vital Signs:
BP:

Answer 20

only check once per shift unless otherwise indicated.

Question 21

Pediatric Vital Signs:
Temp
By accuracy: R.O.A.T.

Answer 21

Temp: Routes:
- Rectal: most accurate.(contraindicated for infants less than 1 month)
- Oral: is accurate in older children
- Axillary: is least intrusive, but may be inaccurate.
- Tympanic and temporal artery: is least accurate (may be a couple degrees higher than reading