Vitals/General
The recommended route for toddler's temperature
What is axillary?
Other options are tympanic, oral (if child is corporative), rectal (if exact measurement necessary -core temperature)
The age in which irises have their permanent color
What is 6-12 months?
This may indicate respiratory distress (provide at least 3)
What is nasal flaring, retractions, DIB, adventitious breath sounds, low o2 saturations, cyanosis, and stridor?
This finding would indicate an abnormality of the joint
What is crepitus or redness? (either will get credit)
Joints should be stable and symmetric with full ROM without crepitus or redness
Elicited by stroking the outer edge of the sole of the foot
What is Babinski reflex?
Babinski is elicited by stroking the outer edge of the sole of the infant's foot toward the toes. The infants toes fan upward and out. This is expected between birth and 12 months. (ATI chapter 2, p. 10)
BP reading should be compared with which standard measurement
What is National High Blood Pressure Education Program Group on High Blood Pressure in Children and Adolescents?
(see ATI, Chapter 2, pg. 7)
Normal pupillary response
What is PERRLA?
Pupils are equal, round, reactive to light, and accommodating
The shape of an infant and toddler abdomen
What is rounded?
Shape of abdomen should be symmetric and without protrusions around the umbilicus, without tenderness or guarding. Peristaltic waves can be visible in thinner children.
Infants and toddlers have rounded abdomens.
Children and adolescents have flat abdomens.
Bowel sounds should be heard every 5-30 seconds
This is the direction that feet should face while walking
What is forward?
(this is totally a gimme)
Bowlegged or knock-knee appearance is a common abnormal finding. However, feet should face forward while walking
The infant turns their head toward the side that it touched and starts to suck
What is sucking and rooting reflexes?
This is elicited by stroking an infant's cheek or the edge of an infants mouth. The infant turns their head toward the side that it touched and starts to suck. This is expected from birth to 4 months.
An action that enhances child's comfort during an assessment
What is
(credit for any of the following)
perform examination in nonthreatening environment
play and develop rapport prior to exam
keep room warm and well lit
keep medical equipment out of sight until needed
provide privacy
explain each step of the exam to the child
examine in secure comfortable position
examine in organized sequence
encourage child and family to ask questions
specific age appropriate play
Infants will do this to indicate hearing in intact
What is turn toward sounds?
Heart sounds are best auscultated when the client is in which two positions (must include both)
What is sitting and reclining?
Auscultation should be done in both sitting and reclining position
S1 & S2 should be clear and crisp (without gallops or murmurs)
S1 heart sound is louder at the apex of the heart
S2 heart sound is louder near the base of the heart
This finding over the spine of an infant could indicate spina bifida
What are dimples or tufts of hair?
Toddlers should have spines without dimples or tufts of hair. They should be midline with an overall C-shaped lateral curve
Arms and legs symmetrically extend, then abduct while fingers spread to for C shapes
What is Moro reflex?
Elicited by allowing the head and trunk of an infant in a semi-sitting position to fall backward to an angle of at least 30 degrees. The infants arms and legs symmetrically extend, then abduct while fingers spread to for C shapes. Expected ages birth to 6 months.
The location that a toddler may feel most comfortable during an exam
What is parent's lap?
Examine the child in a secure comfortable position. Toddler's may feel most comfortable in their parent's lap.
An expected finding when assessing a child's internal ear
What is cerumen?
Other acceptable answers:
Light reflex at 5 or 7 o'clock
Pearly pink or gray tympanic membrane
Bony landmarks visible
Vesicular, or soft, swishing sounds are best heart in this location
What are the lungs?
Inspiration is longer and louder than expiration, and vesicular, or soft, swishing sounds are best heart over the most of the lungs
Appears squat with short legs and protuberant abdomens (developmental stage)
What is toddlers?
The cranial nerve associated with rooting and sucking in infants
What is cranial nerve V (trigeminal)?
In children and adolescents the trigeminal nerve is assessed by clenching teeth together. Also, client is able to detect touch on face with eyes closed.
The two age groups in which privacy is most important during an exam
What is school-age (older), and adolescents?
Provide privacy-determine whether older school-age children and adolescents prefer a caregiver to remain during examination.
DOUBLE JEOPARDY: At least five things included in the assessment of eyes
What is
Eyebrows
Eyelids
Eyelashes
Conjunctiva
Lacrimal apparatus
Sclera (whites of the eyes)
Cornea
Pupils
Irises
Visual Accuity
Peripheral visual fields
Extraocular movements
Color Vision
Internal exam (done by advanced provider)
ATI, Chapter 2, page 9
This is a cardiac response that it commonly associated with respirations in children
What is sinus arrythmias?
May hear cardiac rhythm irregularities that are normal with respirations in pediatric clients.
The normal appearance of the length, position, and size of extremities
What is symmetrical?
What is expected findings of cranial nerve IX (glossopharyngeal)?
ATI: Chapter 2, page 11