Nursing Assessment of the Pediatric Client Exam
Study Questions with Reliable Explanations
Why study pediatrics? - Answer -Because children are not small adults!
-Different anatomy and physiology, developmental stages, parent-child-sibling triads, etc.
-not just dealing with child; dealing with parents, siblings, other family members
Developmental considerations: Infant - Answer -Issues with attachment
*Separation (highest age risk)
*Stranger Anxiety (6-18 months)
Developmental considerations: Toddler - Answer -Disruption of routine/separation from parents
*Separation anxiety
*Loss of self-control
Developmental considerations: Preschool - Answer -Loss of self-control, fear of dark, injury
*Regression (highest age risk)
*Separation anxiety and fear of *Abandonment
*Inability to distinguish fact/ fiction
*Unable to understand reason for hospitalization
*May view as punishment
Developmental considerations: School Age - Answer -Loss of control/ privacy
-Fear pain, bodily injury, death
Developmental considerations: Adolescence - Answer -Aware of the physiologic, psychological and
behavioral causes of illness
-Concerned with appearance, body image
-Separation from peer group
,-Loss of control, privacy issues
Body Image: Toddler - Answer -Refer to body parts by name
-Avoid negative labels about physical appearance
-Recognize sexual differences by age 2
Body Image: Preschooler - Answer -Increasing comprehension of "desirable" appearances
-Aware of racial identity, differences in appearances, and biases
-Poorly defined body boundaries
-Fear that if skin is "broken" all blood and "insides" can leak out
-Intrusive experiences are frightening
Body Image: School Age - Answer -Body image influenced by significant others
-Increased awareness of "differences"
may influence feelings of inferiority
Body Image: Adolescent - Answer -Acute awareness of appearance, comparison of appearance with
others
-Blemishes/defects magnified out of proportion
Preparation of the Child - Answer -Child's perception of painful procedures
-Cooperation usually enhanced with parent's presence
-Age-appropriate techniques
Goals of pediatric assessment - Answer -Minimize stress and anxiety associated with assessment of
various body parts
-Foster trusting nurse-child-parent relationships
-Allow for maximum preparation of child
-Preserve security of parent-child relationship
-Maximize accuracy of assessment findings
, General rule of thumb - Answer -RR
-Listen to heart and lungs
-belly
-Do HEENT
-Genitalia last
Can do the bulk of the exam with child... - Answer -in caregiver's lap
-or while child is sleeping
DON'T KNOW WHAT THIS IS- WAIT UNTIL CLASS - Answer -Heredity and environment
-Gender differences vs. cultural expectations
-Disease
-Prenatal influences
-Socioeconomic status
-Interpersonal relationships
-Stress
-Television and mass media
General approaches toward examining the child - Answer -Head-to-toe sequence for assessing adult
clients
-Sequence for pediatric assessments generally altered to accommodate child's developmental needs
More on general approaches toward examining the child - Answer -Make communication
developmentally appropriate
-Get on child's eye level
-Approach child gently/quietly
-Always be truthful
-Give child choices as appropriate
Study Questions with Reliable Explanations
Why study pediatrics? - Answer -Because children are not small adults!
-Different anatomy and physiology, developmental stages, parent-child-sibling triads, etc.
-not just dealing with child; dealing with parents, siblings, other family members
Developmental considerations: Infant - Answer -Issues with attachment
*Separation (highest age risk)
*Stranger Anxiety (6-18 months)
Developmental considerations: Toddler - Answer -Disruption of routine/separation from parents
*Separation anxiety
*Loss of self-control
Developmental considerations: Preschool - Answer -Loss of self-control, fear of dark, injury
*Regression (highest age risk)
*Separation anxiety and fear of *Abandonment
*Inability to distinguish fact/ fiction
*Unable to understand reason for hospitalization
*May view as punishment
Developmental considerations: School Age - Answer -Loss of control/ privacy
-Fear pain, bodily injury, death
Developmental considerations: Adolescence - Answer -Aware of the physiologic, psychological and
behavioral causes of illness
-Concerned with appearance, body image
-Separation from peer group
,-Loss of control, privacy issues
Body Image: Toddler - Answer -Refer to body parts by name
-Avoid negative labels about physical appearance
-Recognize sexual differences by age 2
Body Image: Preschooler - Answer -Increasing comprehension of "desirable" appearances
-Aware of racial identity, differences in appearances, and biases
-Poorly defined body boundaries
-Fear that if skin is "broken" all blood and "insides" can leak out
-Intrusive experiences are frightening
Body Image: School Age - Answer -Body image influenced by significant others
-Increased awareness of "differences"
may influence feelings of inferiority
Body Image: Adolescent - Answer -Acute awareness of appearance, comparison of appearance with
others
-Blemishes/defects magnified out of proportion
Preparation of the Child - Answer -Child's perception of painful procedures
-Cooperation usually enhanced with parent's presence
-Age-appropriate techniques
Goals of pediatric assessment - Answer -Minimize stress and anxiety associated with assessment of
various body parts
-Foster trusting nurse-child-parent relationships
-Allow for maximum preparation of child
-Preserve security of parent-child relationship
-Maximize accuracy of assessment findings
, General rule of thumb - Answer -RR
-Listen to heart and lungs
-belly
-Do HEENT
-Genitalia last
Can do the bulk of the exam with child... - Answer -in caregiver's lap
-or while child is sleeping
DON'T KNOW WHAT THIS IS- WAIT UNTIL CLASS - Answer -Heredity and environment
-Gender differences vs. cultural expectations
-Disease
-Prenatal influences
-Socioeconomic status
-Interpersonal relationships
-Stress
-Television and mass media
General approaches toward examining the child - Answer -Head-to-toe sequence for assessing adult
clients
-Sequence for pediatric assessments generally altered to accommodate child's developmental needs
More on general approaches toward examining the child - Answer -Make communication
developmentally appropriate
-Get on child's eye level
-Approach child gently/quietly
-Always be truthful
-Give child choices as appropriate
