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Child Exam

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Lecture notes of 6 pages for the course ATI Maternal Newborn & Peds at Duke University School Of Medicine (Child Exam Notes)

Instelling
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Voorbeeld van de inhoud

Ana de Luca


Semiology Pedi
neuropsychomotor development → is craniocaudal →
first firms the neck, then the trunk, then hip, then lower
limbs;

atrica - Four to five months you have to be firming your neck!
Observes at birth to verify if it was born well and if there
was a good response in the face of resuscitation
Period ranging from 0 to 19 years incomplete;
maneuvers;

- Anamnesis; Expects that at birth the child will instill his cardiac output,
- Physical examination; acquire HR above 100, cry (demonstrates that lung
- Complementary exams; expanded to ensure gas exchange) + flexion tone
(lower limbs flexed in relation to the abdomen and upper
To arrive at the diagnosis; limbs flexed in relation to the thorax);


ANAMNESIS In the fetal period, it has the placenta and umbilical → the
rightleft circulation ofthe → does not pass through the
Discussions about asking the child himself his/her lungs;
symptoms and clinical signs from 4/5 years on, and not to When the child is born, the left-right shunt is still
the interlocutor; present = a part of the blood at birth is not fully
oxygenated → when it expands lungs and cries →
What differentiates the anamnesis of the adult and the arterial canal is closed and blood passes → from the
child well is the personal history,becausein the adult lung → ae → VE → aorta;




does not punctuate both the psychomotor development
(when he started walking, he took out diapers), which are
important information in children;
- obstetric history: pregnancy, prenatal, neonatal..
Neonatal = first 28 days of life → if she had a problem, if
she went out with the mother of motherhood, weight,
length, head circumference, food..

Chronic non-communicable diseases do not have as
much impact on the child as knowing of infectious
diseases, malformations, inborn errors of metabolism..

Socioeconomic conditions = child is a fragile being;
obligation of the health agency, state, family, school to
protect the child;
- to themedic air, prescribe conduct, need to think if the
family can buy, affordable food ...

DNPM:




Because of this, mild hypoxemia at birth is normal!

, Ana de Luca

Apgar expects 8/9 in the first minute and 10 in the fifth
minute, when the arterial canal has already closed, blood
has been oxygenated and child acquires pink coloring;




Thepgars in the first minute less than or equal to 7 or in
the fifth minute = Low Apgar = sign that the child may
have had some degree of suffering → explains a 7-
month-old child who did not affirm neck, child who does
not breastfeed well,..

Good apgar, good weight, good height and com 9/10
months begins to have impaired development is a totally
different story of a child who had apgar low at birth (may
have had neonatal anoxia ), while the onewho had
normal Apgar may be metabolic disease, some genetic
syndrome,...

AGE RATING

Children in the neonatal period become more susceptible
to infectious risks,cardiovascular and pulmonary injury,
because it does not yet have many intrinsic mechanisms
of self-protection;

School = behavior, attention deficit, hyperatividade,..

CLASSIFICATION OF RN

Fundamental to see weight, comfirst and compare with
gestational age;
INTERGROWTH CHART:
- 39 weeks and 4.5kg = overweight child → large for
gestational age;worries because the mother probably
has high blood glucose levels and the fetus produces
a lot of insulin →develops hypoglycemia in the
neonatal period.

PHYSICAL EXAMINATION

Naked child, quiet environment and good lighting;

Follow sequence of physical examination:
Physical examination always has to be global, because the
signs and sintomas in the child are very nonspecific;


- General aspect and vital data;
- Anthropometric measurements;
- Evaluation of organs and systems;

GENERAL

- Level of consciousness;

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Geschreven in
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