NSG-434 Exam 1
Parent/caregiver communication - answers-Encourage parents/ caregiver to talk
-Directing the focus to keep on the subject
-Listening and cultural awareness are important for effective communication
-Look for clues, verbal leads, and signals from the parent/ caregiver
-Using silence can help the parent/caregiver gather their thoughts and develop answers
for questions asked
-Being empathetic
-Providing anticipatory guidance (ex: client diagnosed with leukemia who will undergo
chemotherapy)
-Avoiding communication blocks for both the nurse and the parent/caregiver
communicating with children - answer-Until infants reach the age at which they
experience stranger anxiety, they readily respond to any firm, gentle handling and quiet,
calm speech.
-Play is an effective way of communicating with younger children
-Children younger than 5 years of age are egocentric.
-Younger school-age children rely less on what they see and more on what they know
when faced with new problems
-Functional aspect of all procedures, objects, and activities
-What is going to take place and why it is being done to them specifically
-School-age children have a heightened concern about body integrity
-As children move into adolescence, they fluctuate between child and adult thinking and
behavior
-Privacy and confidentiality is important to them
General Tips:
-Avoid sudden or rapid advances, broad smiles, extended eye contact, and other
gestures that may be seen as threatening.
-Talk to the parent if the child is initially shy.
-Communicate through transition objects (such as, dolls, puppets, and stuffed animals)
before questioning a young child directly.
-Give older children the opportunity to talk without the parents present.
-Assume a position that is at eye level with the child.
-Speak in a quiet, unhurried, and confident voice.
-Speak clearly, be specific, and use simple words and short sentences.
-State directions and suggestions positively.
-Offer a choice only when one exists.
-Be honest with children.
,-Allow children to express their concerns and fears.
-Use a variety of communication techniques.
history taking - answer-The format used for history taking may be (1) direct, in which the
nurse asks for information via direct interview with the informant, or (2) indirect, in which
the informant supplies the information by completing some type of questionnaire.
-Informant: the person(s) who furnishes the information
-Chief complaint: specific reason
-Present illness: narrative of the chief complaint
-Analyzing of symptom(s): assessment includes type, location, severity, duration, and
influencing factors
-Birth History: health during pregnancy, the labor and delivery, and infant's condition
immediately after birth
-Dietary History
-Previous Illnesses, Injuries, and Operations: begin with a general question
-Allergies: ask about commonly known allergic disorders; unusual reactions to drugs,
food, or latex products;
reactions to other contact agents, such as poisonous plants, animals, household
products, or fabrics
-Current Medications: vitamins, antipyretics (especially aspirin), antibiotics,
antihistamines, decongestants, nutritional supplements, or herbs and homeopathic
medications
-Immunizations
-Growth and Development:
-Review the child's growth including the following:
•Measurements of weight, length, and head circumference at birth
•Patterns of growth on the growth chart and any significant deviations from previous
percentiles
-Habits:
•Behavior patterns, such as nail biting, thumb sucking, pica (habitual ingestion of
nonfood substances), rituals ("security" blanket or toy), and unusual movements (head
banging, rocking, overt masturbation, walking on toes)
•Activities of daily living, such as hours of sleep and arising, duration of nighttime sleep
and naps, type and duration of exercise, regularity of stools and urination, age of toilet
training, and daytime or nighttime bedwetting
•Unusual disposition; response to frustration
•Us
Nutritional Assessment - answer-Dietary intake: recall of food consumption, especially
amounts eaten, is frequently unreliable
-Clinical examination of nutrition: hair, skin, mouth, eyes
-Evaluation of nutritional assessment: malnourished, at risk, well nourished,
overweight or obese
, sequence of the examination - answer-Head-to-toe sequence for assessing adult clients
-Sequence for pediatric assessments generally altered to accommodate child's
developmental needs
-Use chronological age as the main criteria
goals of pediatric assessment - answer-Minimize stress and anxiety associated with
assessment of various body parts
-Foster trusting nurse-child-parent relationships
-Allow for maximum preparation of child
-Preserve security of parent-child relationship, especially with young children
-Maximize accuracy and reliability of assessment findings
preparation of the child - answer-Child's perception of painful procedures
-Cooperation usually enhanced with parent's presence
-Age-appropriate techniques
-Positioning and preparation
-Although the physical examination consists of painless procedures, for some children
the use of a tight arm cuff, probes in the ears and mouth, pressure on the abdomen,
and a cold piece of metal to listen to the chest are stressful.
-For infants and toddlers, perform traumatic procedures last.
-Encourage parent/caregiver to assist with holding the child.
-Important to get down on a child's level; kids won't trust you unless you do
-Don't touch children unless they give you permission (which they do in various ways)
-Never hold a child down or ask a parent to hold them down for a procedure
physical examination - answerGrowth Measurements:
-Growth charts
-Length
-Height
-Weight
-Skin full thickness and arm circumference
-Head circumference
-Physical growth parameters include weight, height (length), skinfold thickness, arm
circumference, and head circumference.
-Values for these growth parameters are plotted on percentile charts, and the child's
measurements in percentiles are compared with those of the general population.
-It is important to use the correct measurement tools for the child.
-Because growth is a continuous but uneven process, the most reliable evaluation lies
in comparing growth measurements over time because they reflect change.
Weight:
-Weight is measured with an electronic or appropriately sized balance beam scale
Head Circumference:
Parent/caregiver communication - answers-Encourage parents/ caregiver to talk
-Directing the focus to keep on the subject
-Listening and cultural awareness are important for effective communication
-Look for clues, verbal leads, and signals from the parent/ caregiver
-Using silence can help the parent/caregiver gather their thoughts and develop answers
for questions asked
-Being empathetic
-Providing anticipatory guidance (ex: client diagnosed with leukemia who will undergo
chemotherapy)
-Avoiding communication blocks for both the nurse and the parent/caregiver
communicating with children - answer-Until infants reach the age at which they
experience stranger anxiety, they readily respond to any firm, gentle handling and quiet,
calm speech.
-Play is an effective way of communicating with younger children
-Children younger than 5 years of age are egocentric.
-Younger school-age children rely less on what they see and more on what they know
when faced with new problems
-Functional aspect of all procedures, objects, and activities
-What is going to take place and why it is being done to them specifically
-School-age children have a heightened concern about body integrity
-As children move into adolescence, they fluctuate between child and adult thinking and
behavior
-Privacy and confidentiality is important to them
General Tips:
-Avoid sudden or rapid advances, broad smiles, extended eye contact, and other
gestures that may be seen as threatening.
-Talk to the parent if the child is initially shy.
-Communicate through transition objects (such as, dolls, puppets, and stuffed animals)
before questioning a young child directly.
-Give older children the opportunity to talk without the parents present.
-Assume a position that is at eye level with the child.
-Speak in a quiet, unhurried, and confident voice.
-Speak clearly, be specific, and use simple words and short sentences.
-State directions and suggestions positively.
-Offer a choice only when one exists.
-Be honest with children.
,-Allow children to express their concerns and fears.
-Use a variety of communication techniques.
history taking - answer-The format used for history taking may be (1) direct, in which the
nurse asks for information via direct interview with the informant, or (2) indirect, in which
the informant supplies the information by completing some type of questionnaire.
-Informant: the person(s) who furnishes the information
-Chief complaint: specific reason
-Present illness: narrative of the chief complaint
-Analyzing of symptom(s): assessment includes type, location, severity, duration, and
influencing factors
-Birth History: health during pregnancy, the labor and delivery, and infant's condition
immediately after birth
-Dietary History
-Previous Illnesses, Injuries, and Operations: begin with a general question
-Allergies: ask about commonly known allergic disorders; unusual reactions to drugs,
food, or latex products;
reactions to other contact agents, such as poisonous plants, animals, household
products, or fabrics
-Current Medications: vitamins, antipyretics (especially aspirin), antibiotics,
antihistamines, decongestants, nutritional supplements, or herbs and homeopathic
medications
-Immunizations
-Growth and Development:
-Review the child's growth including the following:
•Measurements of weight, length, and head circumference at birth
•Patterns of growth on the growth chart and any significant deviations from previous
percentiles
-Habits:
•Behavior patterns, such as nail biting, thumb sucking, pica (habitual ingestion of
nonfood substances), rituals ("security" blanket or toy), and unusual movements (head
banging, rocking, overt masturbation, walking on toes)
•Activities of daily living, such as hours of sleep and arising, duration of nighttime sleep
and naps, type and duration of exercise, regularity of stools and urination, age of toilet
training, and daytime or nighttime bedwetting
•Unusual disposition; response to frustration
•Us
Nutritional Assessment - answer-Dietary intake: recall of food consumption, especially
amounts eaten, is frequently unreliable
-Clinical examination of nutrition: hair, skin, mouth, eyes
-Evaluation of nutritional assessment: malnourished, at risk, well nourished,
overweight or obese
, sequence of the examination - answer-Head-to-toe sequence for assessing adult clients
-Sequence for pediatric assessments generally altered to accommodate child's
developmental needs
-Use chronological age as the main criteria
goals of pediatric assessment - answer-Minimize stress and anxiety associated with
assessment of various body parts
-Foster trusting nurse-child-parent relationships
-Allow for maximum preparation of child
-Preserve security of parent-child relationship, especially with young children
-Maximize accuracy and reliability of assessment findings
preparation of the child - answer-Child's perception of painful procedures
-Cooperation usually enhanced with parent's presence
-Age-appropriate techniques
-Positioning and preparation
-Although the physical examination consists of painless procedures, for some children
the use of a tight arm cuff, probes in the ears and mouth, pressure on the abdomen,
and a cold piece of metal to listen to the chest are stressful.
-For infants and toddlers, perform traumatic procedures last.
-Encourage parent/caregiver to assist with holding the child.
-Important to get down on a child's level; kids won't trust you unless you do
-Don't touch children unless they give you permission (which they do in various ways)
-Never hold a child down or ask a parent to hold them down for a procedure
physical examination - answerGrowth Measurements:
-Growth charts
-Length
-Height
-Weight
-Skin full thickness and arm circumference
-Head circumference
-Physical growth parameters include weight, height (length), skinfold thickness, arm
circumference, and head circumference.
-Values for these growth parameters are plotted on percentile charts, and the child's
measurements in percentiles are compared with those of the general population.
-It is important to use the correct measurement tools for the child.
-Because growth is a continuous but uneven process, the most reliable evaluation lies
in comparing growth measurements over time because they reflect change.
Weight:
-Weight is measured with an electronic or appropriately sized balance beam scale
Head Circumference:
