Pediatric Assessment

Question 1

If the child is under 2 what should you get the circumference of?

Answer 1

Head, chest, and abdomen

Question 2

Normal vital signs for newborn - 1 year of age

Answer 2

Resp: 30-60
HR: 100-170
BP: 65/45

Question 3

Normal vital signs for a 1 -4 year of age

Answer 3

Resp: 20-40
HR: 70-110
BP: 90/55

Question 4

Normal vital signs for 5 - 12 years of age

Answer 4

Resp: 16-22
HR: 60-95
BP: 100/60

Question 5

Normal vital signs for over 12 years of age

Answer 5

Resp: 12-20
HR: 60-95
BP: 120/80

Question 6

What impacts children’s vital signs?

Answer 6

stress, fear, activity, and crying

Question 7

Normal oral temp

Answer 7

98.6 (37.0)

Question 8

Normal rectal temp

Answer 8

99.6 (37.6)

Question 9

Normal axillary temp

Answer 9

97.6 (36.5)

Question 10

A child is not febrile unless what?

Answer 10

unless the temp is above 100.4 (38.0)

Question 11

In infants and toddlers when should you auscultate?

Answer 11

when they are quiet and save the eyes and ears for last

Question 12

What do you assess in infants and toddlers?

Answer 12

head to toe development and considerations

Question 13

What do you assess in preschool age children?

Answer 13

head to toe if possible

Question 14

What do you assess in school age and adolescence?

Answer 14

head to toe and genitalia for last

Question 15

What is Erythema Toxicum?

Answer 15

“baby acne”

Question 16

What is eczema?

Answer 16

inflammatory, painful itching disease of the skin

Question 17

What are mongolian spots?

Answer 17

bluish discoloration over buttocks and base of spine, probably present on at least one of the parents. Benign and will usually fade in 1-2 years.

Question 18

What do you assess with the eyes?

Answer 18

PERALA
anisocoria
check for eye drainage
visual tracking

Question 19

What is anisocoria?

Answer 19

When one pupil is a different size than the other

Question 20

What do you assess with the ears?

Answer 20

check placement
canal more horizontal in infants
assess language skills
check for drainage

Question 21

If the ears are below ear level what could this indicate?

Answer 21

downsyndrome

Question 22

Who are the obligatory nose breathers?

Answer 22

neonates

Question 23

What teaching is necessary for parents of a neonate?

Answer 23

teach parents to clear nasal passages prior to feeding

Question 24

what do you assess with the mouth?

Answer 24

• examine palate, tongue, and gums
• assess dentition prior health problem in children
• frequent swallowing postop nasopharyngeal surgeries may indicate bleeding

Question 25

what do you assess with neck and lymph nodes?

Answer 25

- neck mobility | - palpate nodes: cervical, post auricular, supraclavicular, inguinal, axillary

Question 26

How much has the brain grown by 2 years of age?

Answer 26

75%

Question 27

How much has the brain grown by 6 years of age?

Answer 27

90%

Question 28

when do the skull sutures close but not ossify?

Answer 28

10-12 years of age

Question 29

what is not fully developed in the brain?

Answer 29

the blood brain barrier and water can always pass through

Question 30

what type of breathers are babies?

Answer 30

abdominal breathers

Question 31

What does the respiratory look like in babies?

Answer 31

- airways are small in diameter - trachea is short and narrowest portion at cricoid ring so you need to use uncuffed ET tubes - chest wall compliant - lungs are noncompliant - the respiratory muscles lack power/tone - alveoli is decreased number and compliance

Question 32

What do you assess with respiratory?

Answer 32

``` color- cyanosis requires 5 grams of desaturated hgb to be visible rate excursion effort-retractions breath sounds ```

Question 33

what does the oxyhemoglobin dissociation curve do?

Answer 33

relates oxygen saturation and partial pressure of oxygen in blood determined by how readily hemoglobin acquires and releases oxygen

Question 34

What do you assess with the abdomin?

Answer 34

- examine while the child is quiet - elimination pattern - liver- 2 cm or less below the LICM - palpate spleen - infants/toddlers dont localize pain

Question 35

what is important with cardiovascular in children?

Answer 35

right and left ventricles are similar in size at birth | * Kids are rate dependent

Question 36

Where is the PMI in infants and toddlers?

Answer 36

2-4 ICS, left of the MCL

Question 37

where is the PMI in preschool age children?

Answer 37

4-5 ICS MCL 7 & up -5th ICS, right of MCL

Question 38

What is the CBV in infants

Answer 38

80 cc/kg

Question 39

what is the CBV in children?

Answer 39

75 cc/kg

Question 40

What is the CBV in adolescents?

Answer 40

70 cc/kg

Question 41

What are early signs of decreased cardiac output?

Answer 41

- pulse rate- tachycardia - skin- mottled, pale and cool extremities - increased capillary refill time is greater than 2 seconds - LOC -decreased sensorium - Urine output is decreased - metabolic acidosis

Question 42

what are late signs of decreased cardiac output?

Answer 42

decompensation: hypotension & bradycardia

Question 43

What is the normal urine output for a child?

Answer 43

1.0-2.0 cc/kg

Question 44

what is the normal urine output for a child postop?

Answer 44

0.5cc-1.0cc/kg

Question 45

What do you assess with Renal/GU?

Answer 45

history of UTIs - examine external genitalia - assess for pubertal changes - menstrual history - testicles descended

Question 46

How do you give medications to children?

Answer 46

based on weight mg/kg the dose is different for each child

Question 47

what happens when the WBCs differentiate?

Answer 47

shift to the left

Question 48

What does an increase in bands indicate?

Answer 48

bacterial infection or inflammatory process

Question 49

What are monocytes?

Answer 49

(2-8%) macrophages-phagocytosis, remove debris from wounds engulf foreign particles role in dissolving clots -elevated with chronic bacterial/viral infections, rise with acute bacterial infections if extensive or prolonged

Question 50

Lymphocytes

Answer 50

25-45 % - produced in thymus, lymph, marrow, spleen, tonsils, combat viral infections - provide humoral & cell mediated immunity - elevated-mono, CMV, Mumps, Rubella - Decreased- aids, after burns or trauma

Question 51

What is the metabolic assessment?

Answer 51

- increased BMR - neonates-nonshivering thermogenesis - may need additional glucose supplies under stress - stress, IV fluid, gluccocorticoids, & DM increase blood sugar

Question 52

Where are gastric tubes?

Answer 52

Nasogastric (NG) Orogastric (OG) Gastrostomy (GT)

Question 53

Where are duodenal/jejunal tubes?

Answer 53

Gastro-Jejunal (GJ) | Transpyloric (TP)

Question 54

how do you obtain a urine collection from a small child?

Answer 54

clean and dry the perineum | -apply adhesive to perineum. penis should be inside opening males