Transcript PowerPoint - Austin Community College

Pediatric Assessment
& Communication with the
Pediatric Patient
Presented by
Marlene Meador RN, MSN, CNE
Considerations and
strategies for cooperation:
Remember developmental age (why is
this crucial to success?) p 802 table 32.3
 Honesty
 Involve child- speak directly to the child
 Involve parents when appropriate
Barriers to Communication
Language
Cultural differences
Distraction
Stress/conflict
Quick Question?
What is the best way to
ruin the relationship
between the nurse and
child client?
More questions?
 What is the best nursing rationale
for a nurse allowing the parent to
administer medications to the
hospitalized child?
 Can you name another reason?
Adapting the physical
assessment to children:
 Physical proximity to the
child/patient
 Physical contact
 Sequence of assessment
Why is an accurate history
the single most important
component of the physical
examination?
Substantive data
Objective data
Three types of health history
 Complete or initial
 Conception
to current status
 Well or interim
 Previous
well visit to current visit
 Problem-oriented or episodic
 Information
related to current problem
Two types of assessment:
 Primary- ABCDE’s
 Airway,
breathing, circulation, LOC
(disability, & exposure)
 Secondary
 VS,
pain, history and head-to-toe
assessment and inspection
 Height/weight, diagnostic testing
Adaptations in Emergency
Assessment
 S- signs and symptoms
 A-allergies
 M-medications and immunizations (OTC
and herbal)
 P- prior illness or injury
 L- last meal and eating habits
 E- events surrounding illness/injury
Obtaining a history:
 Open-ended questioning
 Re-phrase rather than repeat
 Listen actively (reflective reply)
 Cultural differences
 Avoid judgmental questions
Give an example of each type of question
with a more therapeutic version.
Priority
Assessment!
What are the areas of
priority assessment?
Priority Assessment!
AirwayBreathingCirculationVS-
Obtaining a Health History
 Presenting illness/injury
 Onset of symptoms
 Type of symptoms
 Location
 Duration
 Severity
 Aggravating factors
 Lab findings
 Previous or current illness
Obtaining a Health History
 Birth History
 Prenatal
care (onset and duration)
 Mother’s age and health at time of birth
 Mother’s history of illness, injuries
 Mother’s impression of pregnancy (also
significant other’s impression)
Obtaining a Health History
 Familial or Inherited Disorders
 Chromosomal
disorders in other family
members
 Height and weight
 Diabetes
 Cardiovascular disease
 Asthma/ reactive airway disease
 Allergies
Assessment Findings: head to
toe (page 817-847)
 Head (eyes, ears, hair, shape, FOC)
 Chest- cardiac, respiratory, excursion- shape
 Abdomen- size, shape, tone
 Musculoskeletal- posture, tone, symmetry
 Neuro- reflexes
 Skin- including hair
 Genitalia- age appropriate
Quick Review:
 Why is it important for the nurse to know
the normal range of vital signs specific
to the age of patients?
Table 33-1
How does the nurse prioritize
assessment findings?
 Stay alert to what would cause harm…
 Is this an acute need? Or at risk for?
 How does the nurse select the
intervention?
 How do you evaluate the effectiveness
of the intervention?
What physical and
psychosocial findings suggest
abuse or neglect?
 Dress
 Grooming and personal hygiene
 Posture and movements
 Body image
 Speech and communication
 Facial characteristics and expressions
 Psychological state
When would the nurse notify
CPS?
 What are the nurse’s legal obligations
 What are the nurse’s ethical
obligations?
Please contact Marlene Meador RN, MSN
if you have any questions or concerns
regarding this information.
[email protected]
512-422-8749