Paediatric Exam 1 Assessment

newborn age range - birth to 1 month Infant age range - Birth - 12 months toddler age range: - 1-3 years preschool age range: - 3-5 years school age range: - 6-12 years Adolescent age range - 12-18 years Older infants prefer to be ..... - undressed (EXCEPT DIAPER) Do ... wake a sleeping baby - NOT when should you auscultate heart, lungs & abdomen on an infant? - when they're quiet Goal during first year of life: - Focus on expected growth and developmental milestones Observations alone may be your most valuable tool in assessment by finding: - ▪ General level activity ▪ Overall mood ▪ Parent-child interaction ▪ Turning to Sound: Hearing Check ▪ Smiling at toy: Vision Check ▪ Developmental areas: rolling, crawling, etc. You should perform ..... .... 1st in kids & temperature last - respiratory rate Infants' temperature is taken .... - rectally To take rectal temperature: - 1. Position the child appropriately 2. Lubricate the end of the probe 3. Hold legs firmly 4. Place probe▪ ½ inch for newborns ▪ ¾ inch for infants ▪ 1 inch for preschoolers & older DO NOT DO RECTAL if: - Rectal bleeding, profuse bleeding, immunocompromised, neutropenic precautions, and specific order saying no. Oral temperature not accurate until about ... years of age. - 5 what to look for in respiratory exam of infant? - Listen to child's respiratory rate for 1 full minute (irregular breathing) o Look at child's chest o Feel the child's chest o Listen w/ stethoscope Infants HR drops significantly during .... - sleep toddler age range: - 1 years old - 2-3 years old tips for toddler assessment? - Make examination into a game ▪ Use age-appropriate language ▪ Inspect body through play "tickle toes" ▪ Use minimal physical contact initially ▪ Avoid lying (painful or traumatic procedures last) ▪ Separation Anxiety ▪ Hints: this age can be fun or challenging due to developmental stage of stage of these children focus area for toddler assessment: - o Verbal skills o Motor skills o Speech pattern & Clarity o Hearing ability o Visual Acuity o Emerging independence (behavior) normal new born respiratory rate: - 30-55 normal 1 year respiratory rate - 25-40normal 3 year respiratory rate - 20-30 normal 6 year respiratory rate - 16-22 normal 10 year respiratory rate - 16-20 normal 17 year respiratory rate: - 12-20 An apical pulse should be taken: - ▪ All children younger than 2 years ▪ All children with a cardiac condition (especially if taking digoxin) Radial pulse once .. years of age & older - 2 normal heart rate for new born: - 100-170 normal heart rate for infant to 2 years: - 80-130 normal heart rate for 2-6 years old: - 70-120 normal heart rate for 6-10 years old: - 70-110 normal heart rate for 10-16 years old: - 60-100 average SBP or DBP that is ≥95th percentile for gender, age, and height on at least 3 separate occasions -screening now recommended at birth - hypertension -Age 13 years & older, use adult guidelines blood pressure measured routinely starting at age .... - 3 Infant normal BP parameters: - 65-80 systolic, 40-50 systolic In children 1 year and older, estimated BP norms: - Systolic: 80 + (2 x age in years) Diastolic: 2/3 of systolic