NR 328 Pediatric health Assesment - Components of Pediatric Assessment | NR 328 Pediatric health Assesment - Chamberlain College of Nursing

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NR 328 Pediatric health Assessment - Components of Pediatric Assessment NR 328 Pediatric health Assessment - Chamberlain College of Nursing NR 328 Pediatric Health Assessment 9/26/20 2 Component... s of Pediatric Assessment • Health history • Physical Assessment • Developmental Assessment • Nutritional Assessment • Family Assessment • Pain Assessment9/26/20 3 Approaches • Consider developmental level • Get to know parent and child first • Use calming techniques • Start at periphery and move in • Use simple words of explanation • Praise cooperation!“Play is the child’s work” Family Quality of Life Caretaking Development FunctionHeight & Weight • Weight – Consistent measurement is the key – set the policy and stick to it • Why do we care? • Height – Infants until walking routinely – Toddlers and olderGeneral Measurements of Newborns • Head circumference – until 3 yrs (sutures) • Chest circumference • Abdominal circumferenceClinical Growth Chart9/26/20 8 Vital Signs • Consider activity state of child • Know norms for that age group • Resp. rate • Heart rate • BP • TemperaturePediatric Physical AssessmentPreparation • Infant • Toddlers • Preschool • School Age • Adolescent General Survey11 The Neuro Exam Infant vs. Older child • Alert? • Moving easily around room? • Scan with eyes? • Curious? • Head erect? • Muscle development uniform? •Skin, Hair and Nails • Color • Mucous membranes • Rough or smooth • Turgor • Hair distribution • NailsSeborrheic Dermatitis “Cradle Cap” • Can be on scalp, behind ears, and on eyelids • Cause • TreatmentEye exam • Epicanthal folds • Corneal Light reflex • Extra Ocular Movements • PERRLA • Vision 1. Hyperopia 2. Myopia 3. Astigmatism 4. Strabismus9/26/20 17 Eye examsEARS Startle, make sounds, speech Horizontal eustachian tube Eardrum PositionNose, Mouth, & Throat Nose Teeth Tonsils SinusesBaby Bottle Tooth Decay9/26/20 21 Respiratory Assessment • “Work of Breathing!” • Listen for stridor, wheezing, dysphonia, grunting • Oxygen saturations9/26/20 22 Cardiac Assessment • Take apical rates • Influences heart rate • Edema • Murmurs *Pulses are key to health/perfusion!23 Abdomen – Immature musculature – Abdominal breathing – Liver – Bladder – Look at signs of pain/guarding9/26/20 24 Palpating Penis/ScrotumAnus • “wink” • Continence ~age 5StoolingSpine • C-curve • Lordosis – toddler until 4-5 yrsMusculoskeletal • Long bones increase in length and thickness throughout childhood- at the shaft & epiphyses • Cartilage in smaller bones ossifies • Sutures fusePAIN AssessmentJust because children are small…. their PAIN can be BIG!Acute Pain • Most common • Injury or illness related • Easily managed – short termObservational Pain Assessment: • Hunger, fatigue, anger, & worry can change the VS, face, posture • Experience of pain is relative to interpretation!FACES SCALEPain Assessment: FLACC • Validated 2 mo-7 yr • Observe 1-5 min.Interventions: Non-pharmacologic • Care for basic needs – – hunger, thirst, toilet sleep, anxiety • Calm environment • Family presence • Distraction• Pinwheels & bubbles • Swaddle, kangaroo, mummy wrap • Breast or bottle feed • Music or videos • Toys and gamesMEDICATION ROUTESOral Medications • Tablets/Pills/Capsules •- - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - • IV Ketorolac – especially used in conjunction with other medsPharmacologic Agents: Opioids Morphine- PO, R, transdermal, IM, IV excellent analgesia, wide margin of safety Fentanyl- PO, R, lollipop, intranasal, IV Hydromorphone – PO, R, IV Codeine – PO, IM, SQ, IV With Acetaminophen IV- Monitor O2 sat, RR, HR [Show More]

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