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PedsOldPPL Flashcards

(98 cards)

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1
Q

In the red reflex test ______ is normal and _____ is abnormal

A

red : white

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2
Q

What is amblyopia?

A

a “lazy eye”

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3
Q

If amblyopia is not correct, what risk do you run?

A

muscular atrophy

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4
Q

Is a protuberant abdomen normal or abnormal in a pediatric patient?

A

normal

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5
Q

what kind of test do you use to check liver size?

A

scratch test

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6
Q

T of F The testes should be in the scrotal sac in children > 12 months

A

TRUE

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7
Q

When would you check the external female genetalia in a pediatric patient?

A

If there is scratching or dysuria

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8
Q

What is genu valgum?

A

Knock Knees

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9
Q

What is genu varum?

A

Bow legs

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10
Q

What age can you begin doing assessment in the same order as the adult assessment?

A

5-10 years old

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11
Q

When does assessment for beginning of puberty begin?

A

5-10 years old

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12
Q

What do you assess in a pregnant woman?

A

Hormonal changes lead to multiple anatomical and emotional changes during pregnancy and postpartum, Increased blood volume, Increased cardiac output, Vascular changes, Musculoskeletal changes, Increase in breast size, Integumentary changes, Genital changes (Vagina, cervix, uterus, ovaries, and external genitalia).

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13
Q

What history is taken for a pregnant woman?

A

LMP, contraception use, menstrual history, past pregnancies and outcomes, complications from births, Establish EDD- Naegele?s Rule-add 7 days to firm LMP and add three months, Medications and substance use, History of past or current interpersonal violence, Diet and general nutritional status, General past immunizations, medical, surgical, and family history, Much more that will be covered in obstetrical course

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14
Q

How does the physical exam of a pregnant women differ from a non pregnant woman?

A

Assessment of the fetus

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15
Q

When is the fundus of the uterus first palpable?

A

12 weeks gestation in normal weight women

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16
Q

If a woman is 16 weeks pregnant how figh should the fundus be?

A

16cm from th symphasis pubis

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17
Q

At how many weeks should the fundus be palpable at the umbilicus?

A

20 weeks gestation

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18
Q

When can fetal heart tones be heard with the doppler? What is the normal rate?

A

10 weeks, 110-160, location on the maternal abdomen should be recorded

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19
Q

When should fetal movement be felt by the women? When can it be felt daily?

A

18 weeks, 28 weeks

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20
Q

What is Leopold’s manuevers used to assess?

A

fetal position

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21
Q

A fetus is breech if __________after 35 weeks

A

fetal heart tones are heard above the maternal umbillicus

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22
Q

How do vital signs change in aging populations?

A

Blood pressure ? systolic hypertension with widened pulse pressure often occurs, Heart rate and rhythm ? pacemaker cells decline and affect response to physiologic stress, Respiratory rate unchanged, Changes in temperature regulation lead to susceptibility to hypothermia- may not show fever if have an infection, Decreased pain perception may lead to late entry to care

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23
Q

How do skin, hair, nails, eyes, and hearing change during aging?

A

Skin- more fragile, loses elasticity and ?wrinkles?, actinic purpura or purple spots occur, brown spots occur, increased risk skin cancer, Nails- more brittle, especially toes, Hair- thins and becomes gray, Eyes- visual changes, loss of periorbital fat, pupils smaller, Hearing- decreases

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24
Q

How does the musculoskeletal system change during aging?

A

Musculoskeletal- decreased muscle mass and decreased ability to exercise, chest wall stiffens, dorsal curve in spine, shortening of height as spine compresses, difficulty with balance, increase risk of osteoarthritis

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25
How does he cardiovascular system change during aging?
Cardiovascular- systolic aortic murmurs, carotid bruits, cardiac leaflets may become stenotic, increased stiffening of arterial walls and decreased peripheral circulation
26
How does the nervous system change during aging?
Nervous system- mental status, sensory loss, and decreased motor responses, difficulty learning and retaining new information, may have ?benign forgetfulness? or may have functional impairment
27
How do genetalia change during aging?
Female genitalia- menses cease around age 50, external structures become pale and lose architecture, vasomotor instability often present 10-15 years after menopause, urge incontinence, painful intercourse and vaginal dryness due to lack of estrogen, may have decreased interest in sexual activity, Male genitalia- prostate enlarges, may have difficulty urinating either starting or stopping stream
28
How do breast change during aging?
Female breasts-glandular tissue atrophies and is replaced with fat, nipples become pale, risk for breast cancer increases
29
What are some things to pay close attention to with the elderly?
ADL impairment- loss of appetite, fatigue, pain, dizziness, weakness
30
What is involved in the health history of elder adults?
Ask about problems with activities of daily living, Medications- compliance, ease in obtaining, patient concerns, ?poly-pharmacy? issues, Nutrition- how many meals each day and who prepares them, fresh fruits and vegetables, how much white flour sugar and salt, Pain, Substance use, Advance directives, family involvement in care, Changes in affect
31
What is the sixth vial sign for elderly adults?
Functional status- focus on maintaining function and independence
32
What does the 10 minute Geriatric screener ask about changes in?
Vision, Hearing, Leg mobility, Urinary incontinence, Nutritional status and weight loss, Memory, Depression, Physical disability
33
T/F the development stage of the child influences the manner in which the assessment is performed
TRUE
34
Health hx for infants and children include
feeding patterns, type of food, breastfed vs bottle-fed, bowel patterns, developmental hx, immunization hx, recent changes in home (ill family members), childcare (home, daycare, preschool, school)
35
3 areas of assessment for infants & children are
physical development, cognitive development, social/emotional development
36
which assessment of infants & children is in-depth
Physical. Cognitive and social are general assessments
37
what are the general stages of development
newborn, infant, early childhood, middle childhood, adolescence
38
newborn age range is
birth up to 28 days
39
infant age range is
28 days to 12 months
40
early childhood age range is
12 to 48 months; toddler = 12 to 24 months; preschooler = 24 months to 48 months
41
middle childhoon age range is
5 to 10 years
42
adolescence age range is
11 to 20 years; early 11 to 13, middle 13 to 16, late 16 to 20
43
axillary temp is taken on
neonates and infants
44
temporal temp is taken in
children 3 months or older
45
tympanic temp is taken in
children 6 months or older
46
oral temp is taken in
children 4+ years
47
what is assessed using the APGAR scale
heart rate, resp effort, muscle tone, reflex irritability, color
48
a score of 0 indicates what
heart rate-absent, resp effort-absent, muscle tone-flaccid, reflex/irritability-no response, color-blue all over/pale
49
a score of 1 indicates
heart rate-below 100, resp effort-weak/irreg/gasping, muscle tone-some flexion of arms & legs, reflex/irritability-grimace or weak cry, color-body pink, hands/feet blue
50
a score of 2 indicates
heart rate-above 100, resp effort-good/crying, muscle tone-well flexed/active movements of extremities
51
when are APGAR scales perfromed
at 1 minute and again at 5; if score is less than 7 at 5 minutes check again at 10
52
0-4 score at 1 minute indicates
severe neurological depression
53
5-7 score at 1 minute indicates
some neurological depression
54
8-10 score at 1 minute indicates
vigorous newborn - NORMAL
55
T/F a score of 7 is normal for the "5 minute score"
False!! a score of 0-7 is high risk for neruological impaitment and organ system dysfunction; 8-10 is normal
56
what is included in a neonatal assessment
general assessment of posture/behavior/skin, heart, lungs, head, abdomen (inspect cord), extremities (including hip asses & genitourinary), nervous system
57
a perterm baby is how many weeks
<36 + 6 weeks
58
a term baby is how many weeks
37 to 42 weeks
59
a post-term baby is how many weeks
42 + 1 day
60
a low birth weight is
<2500 grams
61
a normal birth weight is
2500 to 4000 grams
62
high birth weight is
> 4000 grams+A30
63
AGA =
average for gestational age
64
SGA =
small for gestational age
65
LGA =
large for gestational age
66
ballard score assess what
physical findings in neonates that corrlate to gestational age
67
what is DDST
denver developmental screening tool; performed by a nurse in outpatient pediatric settings
68
T/F milestones screens are usually done prior to physical exam and may be part of health hx for infants
TRUE
69
T/F the mouth and ears should be assessed first in an infant physical exam
FALSE! The mouth and ears should be examined last to avoid inducing a stress response in the child; the heart and lungs should be first!
70
T/F infancy is the most rapid period of growth
TRUE. Birth weight dbls during the first 6 months and triples by 12 months; length increases by 50% at 12 months
71
T/F it is ok if a baby has jaundice w/in the first 24 hours of life
FALSE! This is usually a severe problem and most likely an issue with the liver
72
posterior fontanelle closes at what age
around 2 months
73
anterior fontanelle closes when
between 4-26 months
74
T/F palpation of fontanelles injures the infant
False. Palpation does not injure the infant and is an important assessment of health and growth
75
head assessment of an infant includes
palpation for symmetry, patency, and consistency; note age at closure
76
when inspecting the head what should also be assessed
eyes, ears, nose, mouth, and neck
77
what is important when inspecting the eyes
inspect sclera, pupils, presence of red reflex
78
what is important when inspecting the ears
note position on head (low set), hearing screening
79
what is important when inspecting the nose
know that infants are nasal breathers from birth to 2 months
80
what is important when inspecting the mouth
gums, palate, tongue, and swallow relfex
81
at what age do teeth appear
at 6-26 months; 1 tooth per month after first one
82
what is important when inspecting the neck
mobility; lymph nodes are difficult to assess due to their short necks
83
T/F chest is normally barrel shaped in infants
True!
84
what should be assessed in the abdomen and genitalia of infants
inspect shape- normally round, umbilicus- should be dry and fallen off by 2 wks, bowel sounds- should be present, liver- palpable at 1-2cm below costal margin, males- both testes should be descended in scrotal sac, females- may have slight vaginal discharge from maternal estrogen
85
what does a tuft of hair at the top of gluteal crease indicate
closed spina bifida
86
what should be inspected in the musculoskeletal system
palpate clavicles for fractures during birth <2 months, palpate hips, legs, and feet for abnormalities
87
what is being checked for when ortolani sign is used
hip dysplasia
88
T/F bow legs are normal up to 18 months
True.
89
what motor mvmt is appropriate for 2 months
rolling over
90
what motor mvmt is appropriate for 6 months
sitting
91
what motor mvmt is appropriate for 8 months
pulling up to stand
92
what motor mvmt is appropriate for 11 months
standing
93
what motor mvmt is appropriate for 12 months
walking
94
T/F if a click is felt during the ortolani test is it a normal finding
FALSE! This is not a normal finding; really important nursing assessment on infants
95
what is the rooting reflex
head-turning and sucking mvmts elicited by stroking face/cheeck of infant; NORMAL finding
96
what is the tonic neck reflex
when head is turned to one side baby lifts opposite arm and leg
97
what is a normal finding in the babinski reflex in an infant (not normal in adults)?
dorsiflexion of the great toe and fanning of the other toes
98
what is the normal finding for the plantar flexion in an infant?
toes curl away from the ankle

Health Assessment (8 decks)

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