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NUR 240 > Peds exam 1 > Flashcards

Peds exam 1 Flashcards

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1
Q

developmental approach to exam:

newborns/infants under 6 months

A

allow parents to be involved
keeps things as normal as possible
start with the least distressing (“foot to head” or “out to in”)

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2
Q

developmental approach to exam:
infants over 6 months

A

exam the patient on the parents lap
exam feet and hands first then the trunk

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3
Q

developmental approach to exam:
toddlers

A
  • demonstrate instruments to alleviate anxiety
  • do not ask the child if you can do something rather explain what you are going to do
  • offer choices when possible
  • start with hands and feet then progress to more invasive procedures
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4
Q

developmental approach to exam:
preschoolers

A

allow child to examine equipment before use
allow choices
use distraction to gain cooperation

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5
Q

developmental approach to exam:
school aged children

A
  • often want to help with them exam
  • head to toe exam is appropriate (by age 6)
  • child likes to learn about their body during exam –> teach them and allow for participation
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6
Q

developmental approach to exam:
adolescents

A
  • MODESTY is very important
    exams should be conducted without others present (unless asked otherwise)
  • build rapport and ask any “private questions”
  • any time a rectal, breast, or anorectal exam is conducted a chaperone should be present (can be a parent but should have another staff to protect self)
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7
Q

length is measures during what age
measure how?

A
  • infant to 24 months (2 years)
  • which a measuring board or tape measure on bed
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8
Q

get standing height at what age
how?

A

after age 2
stadiometer (standing)

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9
Q

Head circumference
done until what age?
how?

A

done until age 3
wrap tape measure around head at supraorbital prominence, above the ears & around occipital prominence
measure 2x (to check)

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10
Q

Chest circumference
done until what age?
how?

A

done until1 year
measure across nipple line

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11
Q

how to weight an infant

A

measure in kg
remove clothing
zero scale to account for diaper

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12
Q

weight of an infant

A

weight doubles by 5-6 months
weight triples by 1 year old

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13
Q

Heart rate for neonate

A

awake: 100-180
asleep: 80-160

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14
Q

Heart rate for infant

A

awake: 100-160
asleep: 75-160

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15
Q

Heart rate for toddler

A

awake: 80-110
asleep: 60-90

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16
Q

Heart rate for Preschool

A

awake: 70-110
asleep: 60-90

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17
Q

Heart rate for school aged

A

awake: 65-110
asleep: 60-90

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18
Q

Heart rate for adolescents

A

awake: 60-90
asleep: 50-90

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19
Q

Auscultation of heart rate

A

auscultate apical pulse for one full minute

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20
Q

where to look for the respiratory rate

A

under 6: observe the abdomen
over 6: observe the chest

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21
Q

head vs chest circumference

A

head is about 2 cm larger that chest circumference at birth
at 2 years of age when the chest circumference surpasses head c.

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22
Q

respiratory rate for infant

A

30-60

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23
Q

respiratory rate for toddler

A

24-40

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24
Q

respiratory rate for preschool

A

22-34

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25
respiratory rate for school age
180-30
26
respiratory rate for adolescent
12-16
27
temperature route that is most reliable
orally (considered a core temp) can do axillary temp in children under 4 years
28
hypothermia in infants
when axillary temp is below 36.5 could indicate sepsis
29
the more premature the ___ chance of heat loss
greater
30
fever
38 C
31
calculate a normal systolic BP
90 mmHg + (2 x age in years)
32
pediatric SBP hypotension (5th percentile) term neonates
under 60 mmHg
33
pediatric SBP hypotension infants 1 mo - 12 mo
under 70 mmHg
34
pediatric SBP hypotension children 1-10 years
under 70 mmHg + (2 x age in years)
35
pediatric SBP hypotension over 10 years
under 90 mmHg
36
do BP last for young children -- upsetting
37
four limb BP when screening for
congenital heart defect
38
location to assess skin color on dark-skinned patients
palms of hands and soles of feet
39
mottling indicates
poor perfusion common in sepsis
40
skin should be
warm soft dry
41
where to evaluate skin turgor
abdomen
42
primary lesions
macules, papules, vesicles, pimples skins initial response to injury or infection
43
secondary lesion
scars, ulcers, fissures, scratches, picking/digging result of irritation infection, delayed healing
44
cap refill
less than 2 sec
45
inspection of hair
look for lice on hair shafts
46
hair loss in a child may be from
tight braids or skin lesions such as ringworm
47
hypothyroidism can cause
coarse brittle hair
48
the fontanelle should feel
flat and flush/soft
49
tense or bulging fontanelle indicates
increased intracranial pressure
50
a sunken fontanelle below the margin of the skull indicates
dehydration
51
posterior and anterior fontanelle closes at what age
posterior: 2-4 mo anterior: 1-2 years (usually 18 mo)
52
red reflex
present = normal
53
white reflex is
referred to as leukocoria and a retinoblastoma
54
visual acuity for children 3-6 years old
use snellen picture cards
55
sunset sign
retracted eye lids or hydrocephalus
56
ear exam for child under 3
pull pinna down and back
57
ear exam for child over 3
pull pinna up and back
58
indications of hearing loss
babbles as a young infant but does not keep babbling or does not develop speech after 6 months no speech by age 2
59
signs of respiratory distress
nasal flaring retractions head bobbing
60
what should be check for an ill baby before feeding
check nasal patency infants don't automatically open their mouth to breathe when their nose is occluded, suction nose before feeding
61
tonsil grade 4+ can indicate (tonsils that "kiss")
Mono OSA chronic allergies
62
tonsils of 3+ can indicate
viral infections strep throat
63
Erickson stages
trust vs mistrust
64
Piaget stages
65
pectus carnatum
when the sternum protrudes increased AP diameter pigeon chest
66
pectus excavatum
sternum is depressed decreased AP diameter funnel chest
67
where to watch respiratory rate for children over 6
watch chest rise and fall
68
where to watch respiratory rate for children under 6
watch abdomen the diaphragm is the primary muscle used for breathing in infants and young children
69
crepitus
normally heard with a pneumothorax crinkly sensation that is palpated 'produced by air escaping subcutaneous tissue
70
decreased tactile fremitus indicates
air trapped in lung asthma
71
increased tactile fremitus indicates
lung consolidation pneumonia
72
stridor
high pitched normally only heard on inspiration (sometimes heard without a stethoscope) Narrowed trachea and larynx croup or anaphylaxis
73
wheezing
lower airway problem (bronchioles) normally heard on expiration (sometimes both)
74
preferred peripheral pulse locations
over 1 year: radial pulse under 1 year: brachial
75
preferred central pulse location
over 1: carotid under 1: femoral
76
light palpation of abdomen
should be done first evaluates tenderness, the liver, and defects of the abdominal wall
77
deep palpation of abdomen
detects masses if an enlarged kidney or mass is detected, do not continue to palpate the kidney, pressure on kidney mass may release cancer cells (cause metastasis)
78
inguinal, genital, or perineal assessment position for young children
position them on the parents lap with their legs spread apart or in a position of comfort
79
downward bowing of the penis may be caused by
chord associated with hypospadias
80
cremasteric reflex
touch the inner thigh of each legs to stimulate the testicle and scrotom to rise intact T12, L1, and L2
81
no cremasteric reflex
could indicate testicular torsion (surgical emergency)
82
testicular torsion
red or swollen testicle have about 4 hours from when the testicle flips to restore blood flow before the testicle dies
83
first stage of female pubertal development
breast budding normal occurs between 9 and 14
84
spine alignment
stand behind the child, observe the height of the shoulders and hips have child bend forward ** No lateral curve should be present in either position
85
ortolan-Barlow maneuver
checks infants for hip dislocation or subluxation
86
ch 6 in book for reflexes

NUR 240 (18 decks)

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