Upload
kin-yuri
View
13
Download
0
Embed Size (px)
Citation preview
CARE FOR PEDIATRIC PATIENTSChester Bigay
• Patient History: (Subjective information)
• Obtained from..• The client/ parent interview• Chart, Medical Records
• Includes: • Family History• Past Medical History; medications;
allergies • History related to current need for care
or treatment• Chief Complaint
• - Current issue being cared
• Physical Exam (mostly objective information) • Objective Information:
• Vital Signs, height, weight (if applicable)• Head to Toe assessment
• Should include focused exams by system: Inspection, Auscultation, Percussion, alpation
• Focused Assessments• What systems? How often?
• Subjective information: • Symptoms r/t system assessing
• (Ie. pain, tenderness)
COMPONENTS OF A COMPREHENSIVEASSESSMENT
NORMAL VALUES
NORMAL VALUES
NORMAL VALUES
Airway / BreathingRespiratory rate• Respiratory effort• Air entry• adequate• adventitious breath sounds
Circulation• Skin Temperature• Heart rate• regularity/rhythm/rate
• Pulses• strength and regularity• central vs. peripheral
• Perfusion• capillary refill• skin color (e.g. pale, mottled
BASIC HEAD TO TOE ASSESSMENT
Neurological• Level of consciousness• Mental status, interaction• Activity, movement, muscle tone• Age appropriate responses
GI/GU• Bowel sounds• Appetite• Bowel movement/Emesis• Hydration status• Urine output• Moist oral mucosa• Skin Turgor• Fontanelle
BASIC HEAD TO TOE ASSESSMENT
Red Flags of Respiratory Distress• Tachypnea• Mechanics of breathing• Retractions• Nasal flaring• Head bobbing• Grunting on exhalation• Prolonged expiratory phase
• Diminished air entry• Change in breath sounds• Stridor• Wheezing
Late signs• Skin color changes-dusky/cyanotic• Inaudible air entry• Apnea/irregular respiration• Changes in level of
consciousness/activity• Bradycardia
WARNING SIGNS
Red Flags of Cardiovascular Collapse• Tachycardia• Altered perfusion• Skin• Prolonged capillary refill > 2 sec• Increased core to skin temperature
gradient• Brain• Altered level of
consciousness/activity• Decreased response, “worried”
appearance • Kidneys• Decreased urinary output
<1ml/kg/hr
• Decrease in pulse quality
• Late signs• Decreased response to pain• Flaccid tone• Hypotension• Bradycardia
WARNING SIGNS