Peds Chapter 29

Cyanosis

A bluish tone to the skin indicating reduced(deoxygenated) hemoglobin.

Recumbent Length

A patient's length measured while the patient is lying down.

Stature

A person's standing height.

Mrs. J brings her 11 month old daughter to the clinic because she is "sleeping poorly and tugging at her ear when she is awake." Based on the information provided, the nurse can correctly record which of the following? A. Chief complaint B. Present illness C. Past medical history D. Symptom analysis

A. Chief complaint

Which of the following components is not a part of the past history in a pediatric health history? A. Symptom analysis B. Allergies C. Birth history D. Current medications

A. Symptom analysis

A father brings his 12 month son in for a well infant exam. The nurse knows that the best approach to the physical exam for this patient will be to: A. have the infant sit on the parent's lap to complete as much of the exam possible. B. place the infant on the examining table with parent out of view. C. perform examination in head to toe direction. D. completely undress the child and leave him undressed during the exam.

A. have the infant sit on the parent's lap to complete as much of the exam as possible.

Anthropometry

An essential parameter of nutritional status; the measurement of height, weight, head circumference, proportions, skinfold thickness, and arm circumference.

Tympanic Membrane

Appears translucent, light pearly pink, or gray.

Mrs. G has brought her daughter Karen to the clinic as a new patient. Karen, age 12, requires a physical exam so she can play volleyball. Which of the following techniques used by the nurse to establish effective communication during the interview process is not correct? A. The nurse introduces himself or herself and asks the names of all family members present. B. After the introduction, the nurse is careful to direct questions about Karen to Mrs. G because she is not the best source of information. C. After the introduction and explanation of her role, the nurse begins the interview by saying to Karen, "Tell me about your volleyball team." D. The nurse chooses to conduct the interview in a quiet area with few distractions.

B. After the introduction, the nurse is careful to direct questions about Karen to Mrs. G because hse is not the best source of information.

Assessment of family interactions and roles, decision making and problem-solving, and communication is known as assessment of: A. family structure B. family function C. family composition D. home and community environment

B. family function

The nurse is measuring a 20 month old child's length. The most accurate method to obtain this measurement is with: A. sitting on the mom's lap. B. laying on a recumbent measuring board. C> laying on the exam table paper. D. standing with head and shoulders against a tape measure on the wall.

B. laying on a recumbent measuring board.

In examining pediatric patients, the normal head to toe sequence is often altered to accommodate the patient's developmental needs. With this approach, the nurse will; A. increase the stress and anxiety associated with the assessment of body parts. B. record the findings according to the normal sequence. C. hinder the trusting nurse-child relationship D. decrease the security of the parent-child relationship

B. record the findings according to the normal sequence.

In eliciting a chief complaint, it would be inappropriate for the nurse to: A. limit the chief complaint to a brief statement restricted to one or two symptoms. B. use labeling-type questions such as "How are you? Are you sick?" to facilitate information exchange. C. record chief complaint in the child's or parent's own words. D. use open-ended neutral questions to elicit information.

B. use labeling-type questions such as "How are you? Are you sick?" to facilitate information exchange.

Peristalsis

Bowel sounds.

Which of the following methods to record dietary intake would the nurse suggest as most reliable for providing qualitative information about the child's diet? A. 12-hour recall B. 24 hour recall C. Food diary for 3 day period D. Food frequency questionnaire

C. Food diary for 3 day period

Which component of the pediatric health assessment is illustrated by the following? "Nausea and vomiting for 3 days. Started with abdominal cramping after eating a hamburger at home. No pain or cramping at present. Unable to keep any foods down but able to drink clear liquids without vomiting. No temperature elevation; no diarrhea." A. Chief complaint B. Past history C. Present illness D. Review of systems

C. Present illness

Scoliosis

Lateral curature of the spine.

The dietary history of a pediatric patient includes: A. a 12-hour dietary intake recall B. a more specific, detailed history for the older child. C. financial and cultural factors that influence food selection. D. criticism of parents' allowance of nonessential foods.

C. financial and cultural factors that influence food selection

Adolesence

Children are often willing to discuss their concern with an adult outside the family and often welcome the opportunity to interact with a nurse.

Early Childhood

Children focus communication on themselves; experiences of others are of no interest to them.

Infancy

Children primarily use and respond to nonverbal communication.

School-Age Years

Children require explanation sand reasons why procedures are being done to them.

When conducting an assessment of the child, the nurse communicates with the child's family. Which of the following does the nurse recognize as not productive in obtaining information? A. Obtaining input from the child, verbal and nonverbal. B. Observing the relationship between parents and child. C. Using broad, open-ended questions. D. Avoiding the use of guiding statements to direct the focus of the interview.

D. Avoiding the use of guiding statements to direct the focus of the interview.

Which of the following best describes the appropriate use of play as a communication technique in children? A. Small infants have little response to activities that focus on repetitive actions like patting and stroking. B. Few clues about intellectual or social developmental progress are obtained from the observation of children's play behaviors. C. Therapeutic play has little value in reduction of trauma from illness or hospitalization. D. Play sessions serve as assessment tools for determining children's awareness and perception of illness

D. Play sessions serve as assessment tools for determining children's awareness and perception of illness.

The nurse knows that the best description of the sexual history for a pediatric health history: A. includes a discussion of plans for future children. B. allows the patient to introduce sexual activity history. C. includes a discussion of contraception methods only when the patient discloses current sexual activity. D. alerts the nurse to the need for sexually transmitted disease screening.

D. alerts the nurse to the need for sexually transmitted disease screening.

Anticipatory guidance should: A. view family weakness as a competence builder. B. focus on problem resolution. C. base interventions on needs identified by the nurse. D. empower the family to use information to build parenting ability.

D. empower the family to use information to build parenting ability.

Of the following behaviors, the behavior that indicates to the nurse that the child may be reluctant to participate and cooperate during a physical exam is: A. talking to the nurse. B. making eye contact with the nurse. C. allowing physical touching. D. sitting on parent's lap, playing with a doll

D. sitting on parent's lap, playing with a doll

List eight components of a complete pediatric health history

Identifying information, chief complaint, present illness, past history, review of systems, family medical history, psychosocial history, sexual history

Ecchymosis

Large diffuse area that is usually black and blue; caused by hemorrhage of blood into skin; typically result of injury

Pallor

May be a sign of anemia, chronic disease, or shock.

Strabismus

Occurs when one eye deviates from the point of fixation; sometimes called "cross eye"

Palpation

Placing the hands against the skin to feel for abnormalities and tenderness.

Erythema

Redness that may be a result of increased blood flow from climatic conditions, local inflammation, infection, skin irritation, allergy, or other dermatoses or may be caused by an increased number of red blood cells as a compensatory response in chronic hypoxia.

Family

Refers to all those individuals who are considered by the family member to be significant to the nuclear unit.

Family Structure

Refers to the composition of the family.

Cremasteric Reflex

Response of the testes to stimulation by cold, touch, emotional excitement, or exercise.

Petechiae

Small, distinct, pinpoint hemorrhages 2mm or less in size; can denote a type of blood disorder such as leukemia.

Chief Complaint

Specific reason for the child's visit to the clinic or hospital.

Review of Systems

Specific review of each body system.

Binocularity

The ability to visually fixate on one visual field with both eyes simultaneously.

Tissue Turgor

The amount of elasticity in the skin; determined by grasping the skin on the abdomen or arm between thumb and index finger, pulling it taut, and quickly releasing.

Empathy

The capacity to understand what another person is experiencing within that person's frame of reference.

Auscultation

Using a stethoscope to evaluate breath sounds.

Jaundice

Yellow staining of the skin usually caused by bile pigments.