Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.
-
Upload
osborne-maxwell -
Category
Documents
-
view
219 -
download
2
Transcript of Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.
![Page 1: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/1.jpg)
Alecia Hollis, R.N., MSNSMCC Associate Degree Nursing Instructor
![Page 2: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/2.jpg)
![Page 3: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/3.jpg)
Performing Physical ExamSteps of the Physical exam
InspectionPalpationAuscultation
![Page 4: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/4.jpg)
Developmental Consideration
Copyright ©2009 Wolters Kluwer Health/Lippincott Williams & Wilkens
![Page 5: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/5.jpg)
Performing Physical ExamGeneral Appearance Measurement of Vital Signs
Temperature Pulse Respiratory Rate
Measuring Oxygen Saturation Blood Pressure Pain Assessment
SYSTEMATIC APPROACH
![Page 6: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/6.jpg)
AgeHeart Rate (beats/min)
Blood Pressure (mm Hg)
Respiratory Rate (breaths/min)
Premature
120-170 * 55-75/35-45† 40-70†
0-3 mo
100-150 * 65-85/45-55 35-55
3-6 mo
90-120 70-90/50-65 30-45
6-12 mo
80-120 80-100/55-65 25-40
1-3 yr
70-110 90-105/55-70 20-30
3-6 yr
65-110 95-110/60-75 20-25
6-12 yr
60-95 100-120/60/75 14/22
12 > yr
55-85 110-135/65/85 12-18
http://www.emedicinehealth.com/pediatric_vital_signs/article_em.htm
![Page 7: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/7.jpg)
Blood pressure
Copyright ©2009 Wolters Kluwer Health/Lippincott Williams & Wilkens
![Page 8: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/8.jpg)
Body Measurements Length or HeightWeight
Weight for LengthBody Mass Index
Monitoring Equipment
![Page 9: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/9.jpg)
WeightWeight Status Category Percentile Range
Underweight Less than the 5th percentileHealthy weight 5th percentile to less than
the 85th percentileOverweight 85th to less than the 95th
percentileObese Equal to or greater than the 95th
percentile
http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html
![Page 10: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/10.jpg)
http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html
![Page 11: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/11.jpg)
External Structures
![Page 12: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/12.jpg)
Copyright ©2009 Wolters Kluwer Health/Lippincott Williams & Wilkens
![Page 13: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/13.jpg)
Strabismus
http://www.uofmhealth.org/health-library/zm6098
![Page 14: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/14.jpg)
Vision AssessmentStandardized Vision ChartCriteria for referral3 to 4 years---20/50 or less in
either eye5 years old----20/40 or less in
either eye6 years old---20/30 or less in
either eyeA difference in vision between
the eyes of two lines or more on the Snellen eye chart.
Any problems with ocular alignment
Data from American Academy of Opthalmology, Pediatric Opththalmology/Strabismus Panel, (2007). Preferred Practice Pattern Guidelines. Pediatric eye evaluations San Francisico, CA
![Page 15: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/15.jpg)
Warning signs for ReferralsLearning problemsFrequent headachesVisual complaints (child frequently won’t
recognize problem)Failed vision screen or concerns on eye examAcute eye injury Worsening infection, pain, discharge
![Page 16: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/16.jpg)
Corneal Abrasion
en.wikipedia.org insighteyespecialists.com
![Page 17: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/17.jpg)
Corneal Ulcer
accesspediatrics.mhmedical.com
![Page 18: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/18.jpg)
External StructuresInspect the Pinna
(external ear)Inspect the external
auditory canal for drainage
sonoworld.com
![Page 19: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/19.jpg)
External Structures
clinicaladvisor.com
![Page 20: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/20.jpg)
Internal structure
quizlet.com
anatomybox.com
![Page 21: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/21.jpg)
http://www.webmd.com/cold-and-flu/ear-infection/middle-ear
![Page 22: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/22.jpg)
Internal Structures
http://www.earcentergreensboro.com/medical-education/ear_tubes.php webmd.com
![Page 23: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/23.jpg)
Hearing Screening
lathamcenterspws.blogs.
![Page 24: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/24.jpg)
Hearing LossConductive hearing loss –Occurs due to problems in the outer or middle ear; normal bone conduction
Sensorineural hearing loss---Refers to nerve damage (VIII) in the inner ear.
0-20 (or 25) db NORMAL
20-45 db Mild
46-65 db Moderate
65-90 db Severe
>90 db May not hear a sound
![Page 25: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/25.jpg)
Hearing lossHearing Aids Cochlear Implants
ww.medicalhomeportal.org/living-with-child/assistive-technology/hearing-aids
http://www.macrobusiness.com.au/2011/09/did-you-hear-about-cochlear/
![Page 26: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/26.jpg)
Nose
http://training.seer.cancer.gov/anatomy/respiratory/passages/nose.html
![Page 27: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/27.jpg)
Assessment of Nose
http://www.atitesting.com/ati_next_gen/skillsmodules/content/physical-assessment-child/equipment/ap_ear_nose_throat.html
![Page 28: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/28.jpg)
Assessment of Mouth and Throat
Copyright ©2009 Wolters Kluwer Health/Lippincott Williams & Wilkens
![Page 29: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/29.jpg)
Lips
http://medicalpicturesinfo.com/wp-content/uploads/2011/08/Angular-Cheilitis-5.jpeg
realmagick.com
![Page 30: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/30.jpg)
Tongue
http://www.chicanol.com/heridas-en-la-lengua/
![Page 31: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/31.jpg)
Mouth
http://sleepmedicineboardreview.wordpress.com/2011/10/25/tonsil-size-scoring/
![Page 32: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/32.jpg)
Gums and Teeth
http://pediatricdentistrynorth.com/special-offers/tooth-eruption/
![Page 33: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/33.jpg)
Neck
![Page 34: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/34.jpg)
CardiovascularInspectionPalpationAuscultation
![Page 35: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/35.jpg)
Cardiovascular
Atitesting.com
![Page 36: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/36.jpg)
Auscultation
![Page 37: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/37.jpg)
Listening Sites for Auscultation
S2S2
S1
Kyle, T.& Ricci, S. (2009). Maternity and Pediatric Nursing. Philadelphia, PA: Lippincott Williams & Wilkins
![Page 38: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/38.jpg)
Heart Sounds
mediconweb.com
![Page 39: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/39.jpg)
Listening Sites for AuscultationHeart Sound Sites where heard
bestSites where heard softly
S1 Apex of the heartTricuspid and Mitral area
Base of heartAortic area and Pulmonic
S2 Base of the heartAortic and Pulmonic area
Apex of the heartTricuspid and Mitral area
Physiologic splitting Pulmonic area
S3 MitralLondon, Marcia (2014). Maternal & Child Nursing Care: New Jersey, Pearson.
![Page 40: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/40.jpg)
www.texasheart.org
![Page 41: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/41.jpg)
Respiratory
http://vereburn.com/index.php?main_page=index&cPath=29_2672
![Page 42: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/42.jpg)
Wheeze or StridorWheezes occur when air flows rapidly
through bronchi that are narrowed nearly to the point of closure.
Wheezes is lower airwayAsthma = expiratory wheezes
A stridor is upper airwayInflammation of upper airway or FB
42
![Page 43: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/43.jpg)
Lung sounds
![Page 44: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/44.jpg)
Possible Sites for Retractions
Bowden & Greenberg
![Page 45: Alecia Hollis, R.N., MSN SMCC Associate Degree Nursing Instructor.](https://reader035.fdocuments.us/reader035/viewer/2022062322/5697bf911a28abf838c8e51e/html5/thumbnails/45.jpg)
Respiratory Distress
www.nationwidechildrens.org