Communication Strategies with Families - Answers Introduction, purpose, provide privacy
Demonstrate interest in and concern for child
Ask one question at a time
Involve the children
Be honest with the child
Choose the language style and terms used by parents/child
Observe behaviors and listen
Respiratory rate - Answers Anatomic: Fewer and smaller alveoli, and less lung volume
Physiologic: Until ~ age 10 - must faster respiratory rate
Cardiac output - Answers Anatomic: Rate dependent, not stroke volume dependent
Physiologic: More rapid heart rate
Diaphragm - Answers Anatomic: Diaphragm is the primary breathing muscle
Physiologic: CO2 is not effectively expired when distressed. Susceptible to metabolic acidosis
Kidneys - Answers Anatomic: Until about 12-18 months, kidneys do not effectively concentrate urine
Physiologic: Electrolyte secretion and absorption is not optimally controlled. At risk for dehydration b/c
they need a lot more fluid
Pertinent Basic Chemistry Differences -Sodium - Answers Wider normal range in neonates and infants
Pertinent Basic Chemistry Differences- Potassium - Answers Higher upper limit in neonates/infants
Upper limit decreases with age
Pertinent Basic Chemistry Differences- Carbon Dioxide - Answers Much lower in children <2 years
compared to adults
Pertinent Basic Chemistry Differences-Bilirubin concentration - Answers Unconjugated high at birth
Decreases over a few days
Infant Approach - Answers -Parental presence to provide security
-Physical comfort
, -Use distraction when distressed
-Smile and talk soothingly, be flexible with when to exam
Infant Sequence of Assessment - Answers -Heart, lungs, and abdomen; then head to toe
- Procedures that provoke crying: assess at end of exam
Infants Notes - Answers Infants > 6 months - it is vital to have parental presence (sitting in mother's lap -
infant may have separation anxiety)
Toddlers/Young Children (Age 1-3) Approach - Answers -Child could be active, curious, shy, and/or
cautious
-Control - give the child choices (however, be careful with your words. The child may not always have a
choice)
-Demonstrate use of examining tool on parent/object
-Explain each procedure
Toddlers/Young Children (Age 1-3) Sequence of Assessment - Answers -Feet to head, least to most
invasive
*Only age group assessing from feet to head.*
Toddlers/Young Children (Age 1-3) Notes - Answers - Parental presence (have child sitting in mother's
lap due to possible stranger and separation anxiety)
Preschoolers/Other Children (Age 3-5) Approach - Answers -Assess willingness to separate from parent
-Cooperation increases with age
-Allow touch and play with equipment (allow child to play with another stethoscope)
-Control - give the child choices (again, be careful.)
-Explain each procedure
Preschoolers/Other Children (Age 3-5) Sequence of Assessment - Answers Head to toe is possible here
Preschoolers/Other Children (Age 3-5) Notes - Answers -Parental presence necessary if unwilling to
separate from parent
School Age Children (Age 6-12) Approach - Answers -Modesty becomes important (have child where a
robe if feeling uncomfortable)
-Give control by offering choices (if possible)