Pediatric Health Assessment and Health Supervision

Flashcards for reviewing pediatric health assessment and health supervision concepts, including health history, physical examination techniques, developmental surveillance, vital signs, Tanner staging, and immunization administration guidelines.

What aspect of the pediatric health history assesses a child's daily routine?

Functional history

How should a nurse approach interviewing and physically examining a $16\text{-year-old}$ adolescent during a health assessment?

Explain confidentiality to both the teen and caregiver, interview them together and separately, ask the caregiver to wait outside the room to provide privacy for the physical examination, and perform the genital exam last in a head-to-toe sequence.

What is the recommended sequence of physical examination techniques in pediatric patients, moving from least invasive to most invasive?

Observe (inspection), auscultation, palpation, and percussion.

For what age range should head circumference be routinely measured in healthy children?

Ages $0\text{ to }35\text{ months}$

Up to what age should a child's length be measured in a lying position?

Up to $24\text{ months}$ of age

What percentile range on pediatric growth charts is considered the normal growth range?

Between the $5\text{th}$ and $95\text{th}$ percentiles

How is Body Mass Index (BMI) categorized for children ages $2\text{ to }20$ on growth charts?

Less than the $5\text{th}$ percentile is underweight, between the $85\text{th}$ and $95\text{th}$ percentiles indicates risk for overweight, and greater than the $95\text{th}$ percentile indicates risk for obesity.

What are the normal heart rate and respiratory rate ranges for an infant?

Heart rate of $80\text{--}150\text{ beats per minute}$ and respiratory rate of $25\text{--}55\text{ breaths per minute}$.

What are the normal heart rate and respiratory rate ranges for an adolescent?

Heart rate of $55\text{--}95\text{ beats per minute}$ and respiratory rate of $12\text{--}20\text{ breaths per minute}$.

In children younger than what age is the radial pulse difficult to palpate?

Younger than $2\text{ years}$ of age

What is the clinical definition of cyanosis, and how does it differ from pallor in pediatric patients?

Cyanosis is a blueness of the lips, tongue, oral mucosa, or trunk caused by hypoxia or circulatory collapse. Pallor is a decreased pinkness in light-skinned children or an ashy-gray color in dark-skinned children caused by anemia, shock, fever, or syncope.

What are the expected physical findings regarding the anterior fontanel and strabismus in healthy infants?

The anterior fontanel should be open and flat up to $18\text{ months}$, and intermittent strabismus is considered a normal finding up to $6\text{ months}$ of age.

Up to what age is a positive Babinski reflex considered normal in infants, and when do deep tendon reflexes (DTRs) decrease to normal levels?

A positive Babinski reflex is normal until $12\text{ months}$ of age, and brisk DTRs present in the newborn decrease to normal by $5\text{ months}$.

What physical secondary sex characteristics are evaluated on the Tanner Staging Scale for girls and boys?

For girls: breast development and pubic hair distribution. For boys: pubic hair, scrotum size, and penis length.

What is the recommended health supervision visit schedule for pediatric patients from birth through age $21\text{ years}$?

Birth, $1\text{ week}$, $1\text{ month}$, $2\text{ months}$, $4\text{ months}$, $6\text{ months}$, $9\text{ months}$, $12\text{ months}$, $15\text{ months}$, $18\text{ months}$, $24\text{ months}$, $30\text{ months}$, $36\text{ months}$, and annually from ages $3\text{ to }21\text{ years}$.

What are the three main components of a pediatric health supervision visit?

1. Developmental surveillance and screening, 2. Injury and disease prevention, and 3. Health promotion.

What are the five components of developmental surveillance performed during a pediatric visit?

1. Noting and addressing parental concerns, 2. Obtaining a developmental history, 3. Using the appropriate screening assessment, 4. Making accurate observations, and 5. Consulting with relevant professionals.

At what specific ages is the Modified Checklist for Autism in Toddlers (M-CHAT) recommended to be administered?

At $18\text{ months}$ and $24\text{ months}$ of age

What is the difference between universal screening and selective screening?

Universal screening tests an entire population regardless of individual risk, whereas selective screening is performed only when a risk assessment indicates the child has one or more risk factors for a disorder.

What distance must be marked and maintained between a child's heels and the vision screening chart during an eye examination?

$20\,ft$ ($6.10\,m$) from the chart at eye level.

How do active immunity and passive immunity differ?

Active immunity is acquired when a person's own immune system generates an immune response, whereas passive immunity is produced when immunoglobulins of one person are transferred to another.

What needle size and documentation elements are required when administering pediatric vaccines?

Use a $23\text{--}25\text{-gauge}$ needle. Required documentation includes: date of administration, vaccine name, lot number and expiration date, manufacturer's name, site, route, Vaccine Information Sheet (VIS) provided, facility name, and name of person administering.

Which vaccines are specified to be administered via the subcutaneous route?

IPV, MMR, Varicella, and MPSV4.