N381: Chapter 4 (Communication and Physical Assessment of the Child)

Open-ended

Which type of questions should you ask parents and patients?

Least traumatic to most traumatic - auscultate heart, lungs, and abdomen, palplate, percuss, then progress to head-to-toe

When assessing an infant, what should the assessment order be?

Traumatic - eyes and ears

What should be assessed last in infants and toddlers?

Genitalia

What should be assessed last in school-age or adolescent patients?

Recumbent

In which position should infants up to 36 months be assessed for height, weight, and head circumference?

Standing

In which position should children older than 37 months be assessed in for height, weight, and BMI?

≥100.4º

In children, which temperature is considered a fever?

Axillary

Through which route should the patient's temperature be assessed?

RR > HR > BP > Temperature

In which order should VS be assessed in?

Axillary or rectal if needed and >1 month

Through which route is temperature assessed for kids between 0-2?

Axillary, tympanic, oral, rectal

Through which route is temperature assessed for kids between 2-5?

Oral, axillary, tympanic

Through which route is temperature assessed for kids older than 5?

Apical pulse for a full minute

How should HR be assessed in a child under 2?

Radial pulse for a full minute

How should HR be assessed in a child over 2?

stethoscope

In children, observe abdominal movement for a full minute in order to count respirations, or use a ____.

higher, lower

In children, the blood pressure is usually ___ in the lower extremities and ____ in the upper extremities.

coarctation of the aorta

In _____, the BP is lower in the lower extremities and higher in the upper extremities.

Hypotonia

Condition with decreased muscle tone in an infant, with the infant being unresponsive.

genetic syndromes like CP or down syndrome

Hypotonia is an early sign of many...

Infant is unable to protect airway, breathe effectively, or clear secretions

In hypotonia, what is the most concerning?

Hypertonia

Condition with increased muscle tone and seizures in an infant.

Increased ICP, like in meningitis, hydrocephalus, or encephalitis

Hypertonia is a sign of...

Respiratory failure, hypoglycemia, and hypothermia

Infants with hypertonia are at a high risk for...

Craniosynostosis

The premature closing of the fontanels is known as...

Torticollis

Limited ROM of the neck, characterized by holding the head to one side.

3-4 months

Infant should have ocular alignment by...

Strabismus

Cross-eyed.

Amblyopia

Lazy eye.

Up and back

When assessing ears, what direction do you pull children over 3's ears?

Down and back

When assessing ears, what direction do you pull children under 3's ears?