Fn2 test1[1].txt

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Author:
abrisson05
ID:
151392
Filename:
Fn2 test1[1].txt
Updated:
2012-05-01 09:04:58
Tags:
FN2 34 assess child
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ch34 assess child
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  1. Guideline for performing physical exam
    • Perform assessment in appropriate, monthreatening area
    • Provide time to play and get acquainted
    • Observe behaviors that signal childs readiness to cooperate
    • Begin with nonthreatening manner for youn child and fearful child
    • Begin with most cooperative child to model behavior
    • Involve child in the process
    • Examine in a comfortable and secure position
    • Organized sequence
    • Reassure the child throughout, especially about bodily concerns during puberty
    • Discuss findings with family at the end
    • Praise child for cooperation, give reward
  2. Measurements
    • Ht
    • Wt
    • Length
    • Head circumference
  3. Vital signs
    • Temp
    • Pulse
    • Resp
    • Bp
  4. General survey
    • Nutrition
    • Personality
    • Interaction
    • Posture
    • Development
    • Speech
  5. Skin
    • Color
    • Texture
    • Temp
    • Moisture
    • Turgor
  6. Lymph nodes
    • Note size
    • Mobility
    • Temp
    • Tenderness
  7. Head and neck
    • General shape and symmetry
    • Range of motion
    • Palpate skull
  8. Eyes
    • Compare size of pupils, shape, movement
    • PERRLA
    • Inspect structures
    • Fundus
    • Vision testing- ocular alignment, visual acuity, peripheral vision, color vision
  9. Ears
    • Symmetry
    • Location
    • External structures
    • Tympanic membrane
  10. Nose
    • Symmetry
    • Mucus memrbanes
    • Septum
    • Patency
  11. Mouth and throat
    • Move tongue around
    • Uvula
    • Gums
    • Lips
    • Teeth
    • Tonsils
  12. Chest
    • Size
    • Shape
    • Symmetry
    • Movement
    • Breast development
    • Bony landmarks
  13. Lungs
    • Observe respirations for rate, rhythm, depth, quality
    • Auscultate
  14. Heart
    • PMI
    • Capillary refill
    • Peripheral pulses
    • Auscultate
  15. Abdomen
    • Order of assessment
    • Contour & movement
    • Quadrants
    • Femoral pulses
  16. Genitalia
    • Matter of fact approach, respect privacy
    • Males- penis, urethral opening, scrotum & testes, hair distribution
    • Females- labia minora & majora, urethral opening, vaginal opening
    • Anus- presence
  17. Back
    • Spine for curvature
    • Tufts of hair, dimples, or discoloration
  18. Extremities
    • Length
    • Size
    • Temp
    • Color
    • Bowleg or knock-knee
    • Muscle strength
  19. Neurological
    • Balance and coordination
    • Gait
    • Body movements
    • Fine & gross motor per development
    • Reflexes & cranial nerves
  20. Growth charts
    • Standing heights replace length once children can stand
    • Head circumference measured until age 5
    • BMI calculated based on childs wt and ht (or length) and is calculated as kg or wt/m2 of ht
    • Bmi is useful for determining if childs ht and wt are in proportion
    • Children below 10th% indicate undernutrition
    • Children over 90% indicate overnutrition
  21. Newborn and infant <6months exam
    • Rocking or clicking noises may help when infant begins to get distressed
    • Keep exam sequence flexible
    • Promote parent-infant bonding and face-to-face interaction
  22. Infants>6months exam
    • Keep in parents lap and hold against parents chest for some steps
    • Observe level of activity, mood, and responsiveness
    • Use toys to distract
    • Use feet to hands approach
  23. Toddlers exam
    • Stranger anxiety
    • Tell child what you will do each step and the expectation of cooperation instead of asking
    • Demonstrate equipment
    • Feet to head approach
    • Parents control and set limits on movement, play, behavior, or social interaction
    • Parents may be overprotective, which can cause child to be demanding, dependent
    • Offer child choices when possible
  24. Preschoolers exam
    • Parents lap or exam table
    • Lap underpants on
    • Give positive feedback
    • Play with equipment
    • Do head, eyes, ears, mouth, last
    • Recognize association b/w body parts &problems with chronic conditions
    • May believe thoughts and behaviors cuased condition
    • Emphasize treatment is not a punishment for wrongdoing
    • Use play for child to learn self-care, perform activities, feel sense of accomplishment
  25. School-age child exam
    • Exam table
    • Gown to cover underpants
    • Head to toe suquence
    • Understands more about management of conditions
    • Try to interact with child of same age and condition
  26. Adolescent exam
    • Protect modesty
    • Provide reassurance about normal growth progression
    • Head to toe sequence
    • Ongoing development of identity, body image, self-concept
    • Become more aware of difference from peers
  27. Standardized vision charts
    • Cannot be used to test vission until understands directions and can cooperate
    • About 3-4y/o
  28. Hearing loss result of
    • Birth trauma
    • Frequent ear infections
    • Meningitis
    • Antibiotics
  29. Hearing assessment
    • Infants and toddler- widen eyes, breifly stop activity, or turn head toward sound
    • Preschool and older children - use whispered words to evaluate hearing of children over 3y/o
  30. Normative blood pressures
    • Newborn (1-3days) - 65/41
    • 1mo-2yr - 95/58
    • 2-5yr - 101/57

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