Health History
This interviewing technique helps ensure accuracy in pediatric health histories.
What is using open-ended questioning?
These are expected normal findings in a newborn's head.
What are open anterior and posterior fontanelles, no bulging or sunken fontanels, & present head lag?
The young child's pulse and respirations should be counted for this length of time.
What is one full minute?
When interviewing adolescents, nurses should emphasize this to encourage honesty.
What is confidentiality (within legal limits)?
These are considerations for approaching the physical exam with a newborn or infant.
What is least invasive to most invasive, auscultate when quiet, have parent help, & do exam well in advance of next feeding.
This finding in the toddler’s vital signs should be assessed further.
T 36.8 C; HR 115; RR 45; BP 95/50
What is the respiratory rate?
Sudden changes in a child’s behavior during an interview may suggest this.
What is emotional distress or trauma?
The sequence of the physical examination for children should be based on these.
What is the developmental age, his or her level of cooperation, and severity of the illness?
This is the vital sign that is in the expected range for a 6-month-old infant.
T 101.2 F, HR 82, RR 30, BP 68/32
What is the respiratory rate?
When collecting a pediatric health history, nurses interview both the caregiver and the child to validate information and support these key principles of care.
What family-centered care, collaboration, shared-decision making, and autonomy?
This is the difference between a Mongolian spot vs. a bruise.
What is a Mongolian spot is a harmless blue-gray birthmark (no color changes) flat, present at birth, and painless; whereas a bruise is red/purple with subsequent color changes as it heals, tender, and appears after injury?
This finding requires further assessment for an 8-year-old child.
T 37.1 C, HR 88, RR 18, BP 82/50
What is the blood pressure?
This interviewing approach ensures pediatric nurses obtain accurate health information while respecting developmental level, family dynamics, and the child’s voice.
What is a developmentally appropriate, family-centered, and child-inclusive approach?
Because of the position of the heart in young children, the apical pulse in the area of point of maximum intensity (PMI) is palpated at these intercostal spaces (ICS) along the midclavicular line.
What is 3rd - 4th ICS medial to the child's left MCL (up to 4 years of age), 4th ICS at the left MCL (4-6 years of age), 5th ICS lateral to the left MCL (7 years and older)?
This pediatric patient requires immediate nursing intervention.
Newborn (HR 150), Infant (RR 28), Toddler (BP 70/30), School-age (99.9 F)
What is the toddler with the BP of 70/30 (hypotension is a late and critical sign of pediatric shock)?