Week 1 - Pediatric Physical Exam Flashcards
(66 cards)
1
Q
Where is the apical pulse located?
2 part answer
A
over the mitral valve
4th intercostal space, left mid-clavicular
2
Q
Which pulse gives you the best assessment when you can’t assess the apical pulse?
A
Brachial pulse
3
Q
How long should you assess respirations for in PEDs
A
1 minute
4
Q
Where are respirations assessed?
A
front, sides, back
5
Q
What is the appropriate width for the bladder of a blood pressure cuff?
A
40% of the circumference of the upper arm (midway)
6
Q
When can it be appropriate to assess BP on the leg
A
when child is <1 year
7
Q
what are some comfort measures used in pediatrics?
A
- rattle
- sugar water
- pacifier
8
Q
age-appropriate techniques: infant
A
- examine on parents lap
- comfort measures
9
Q
age-appropriate techniques: toddler
A
- examine quickly
- let them play w/ equipment
10
Q
age-appropriate techniques: preschooler
A
explain what you are doing
11
Q
age-appropriate techniques: school-age
A
- privacy/modesty
- elicit their participation
12
Q
age-appropriate techniques: adolescent
A
confidentiality
13
Q
What is the Flax score, and when is it used?
A
Pain scale
used for non-verbal children
14
Q
Newborn Reflexes: Rooting
A
3-4 months
15
Q
Newborn Reflexes: Palmar Grasp
A
3-4 months
16
Q
Newborn Reflexes: Plantar Grasp
A
8-10 months
17
Q
Newborn Reflexes: Tonic Neck
A
3-4 months
18
Q
Newborn Reflexes: Moro Refelx
A
4 months
19
Q
Newborn Reflexes: Stepping
A
1 month
20
Q
Newborn Reflexes: Babinski
A
1 year
21
Q
US Children’s Bureau established
A
1912
22
Q
Maternity & Infant act
A
1921
23
Q
National School Lunch Program
A
1946
24
Q
Head Start est.
A
1964
25
WIC est. (Women, Infants, Children)
1966/1974
26
SSI for Disabled Children
| Supplemental Security Income
1976
27
Bright Futures
1990
28
FMLA
| family and medical leave act
1993
29
Children's Health Act
2000
30
Affordable Care Act
2010
31
Birth to Five: watch me thrive
2014
32
WHO definition of "Health"
A state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity
33
Role as Pediatric Nurse
Promote and assist the child and family in maintaining optimal levels of heath
34
How to carry out role as pediatric nurse:
- focus on the family (family-centered, culturally competent)
- Provide atraumatic therapeutic care (minimize physical/psychological stress for children/families)
- Use EBP (base plan of care on research)
35
3 ways to promote optimal levels of health/care:
1. family-centered/competent care
2. atraumatic care
3. EBP
36
promote optimum growth + development through health...
health education
37
be an ___, an ___, and a ____
advocate, educator, manager
38
Serve pt.'s as a ____, _____, and ___
collaborator, care coordinator, consultant
39
What to know/do for Informed Consent
- does parent/guardian understand what they're signing
- assess parent/legal guardians understanding (assess)
- clarify/resolve knowledge deficits
- ensure consent forms are signed/complete
- Serve as witness to consent process
- children >8 = assent form?
40
How old must a child be in order to sign an assent form?
>8 yo
41
What is Pediatric Assent
takes into account the child's perspective of how they want their healthcare to proceed
42
5 thins an Assent does:
1. affirms child's participation
2. helps the child to understand their condition
3. Informs child of their Tx/ care (what to expect)
4. Cannot be unduly influenced
5. ascertains child's willingness to participate
43
T/F. A parent CANNOT override Assent.
False
44
T/F. The assent will NOT go in the child's chart
False
45
Genetic influences on child health (4)
- Sex & gender
- Race
- Genetically linked diseases
- Temperament (genetic + environmental influences)
46
What is the Temperament Theory?
Describes how a child interacts w/ the environment
47
T/F- a child's temperament has a corresponding influence on those around the child (positive or negative).
True
| temperament may affect the family unit
48
T/F- a parent does NOT react to the child based upon the child's temperament
False
(infants are characterized as easy, difficult or challenging, or slow to warm up
49
T/F- a child typically only fits into one temperament subgroup.
False
| a child may be a combination of these types
50
What are the subgroups of "Temperament"? (3)
1. easy
2. difficult / challenging/ highly reactive
3. slow to warm up
51
T/F- an assessment of temperament should be made initially, during the first encounter with the child.
False
temperament should be assessed after multiple encounters
52
T/F- a child who is highly reactive and reacts to new experiences by withdrawing in frustration is classified as having a "slow to warm up" temperament
False
(highly reactive and reacts to new experiences by withdrawing in frustration is classified as having a "difficult [challenging or highly reactive] temperament"
Rationale: children w/ a "slow to warm up" temperament may initially complain, react with mild passive resistance, need more time to warm up. "Easy" children adapt quickly to new experiences
53
Biological influences on health
- genetics
- in utero exposure to teratogens
- postpartum illness (mother cannot care for child)
- nutrition
- exposure to hazardous substances
- maturation
- exposure to stressful events
54
Lifestyle influences on child health
- patterns of eating
- exercise
- use of tobacco
- drugs
- alcohol
- methods of coping w/ stress
55
T/F- the lifestyle of parents doesn't necessarily determine the lifestyle of the children.
False
e.g.- inactive parents who eat poorly teach their children the same behavior (results- diabetes, obesity, heart disease)
56
Types of stress affecting children:
- Societal (starting school, new babysitter)
- Family stress (conflict in home, divorce, new baby)
- Societal (poverty, lack of basic needs
- Physical (illness, trauma, normal growth/development
57
coping with stress may be expressed with which kind of symptoms?
somatic symptoms
58
can prior experience w/ stress contribute to ability to respond positively to stress?
yes
59
What is coping influenced by? (2 elements)
1. Temperament
| 2. Developmental stage
60
What is Resilience?
The qualities that enable an individual to cope with adverse events and stress and still function completely and have positive outcomes
61
Two Protective factors promoting Resiliency
1. Internal
| 2. External
62
Internal resiliency
ability to take control, be proactive and having responsibility for own decisions
- understanding/accepting own limits & abilities
- being goal-directed, knowing when to continue or stop
63
Externa Resiliancy
- having caring relationships
| - having positive learning environments and positive influences in the community
64
4 barriers to health care
1. Financial (lack of insurance, cost of med.'s)
2. Ethnic (cultural expectations encourage obesity in children)
3. Sociocultural (language/cultural barriers)
4. Health care delivery system (fragmented care)
65
T/F- The role of the family is limited to providing physical care to child.
False
Rationale: parents (guardians) impart the rules and expected behaviors of society through teaching and discipline techniques as well as caring for the physical and emotional needs of the growing child
66
UNICEF/WHO - major problems for global child health (diseases)
- Acute respiratory infections (pneumonia)
- Malnutrition (micronutrient deficiency)
- Diarrhea (r/t lack of clean water/sanitation)
- vaccine-preventable disease (measles
- malaria
- preterm birth complications (birth asphyxia)
- poor health care of pregnant and nursing mothers
