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Lecture 4

NURS 3524 Lecture Notes - Lecture 4: Elastic Fiber, Glasgow Coma Scale, Trachea

Course Code
NURS 3524
Mavoy Bertram

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NURS 3524 wk 4
Paediatric Assessment
NURS 3524 –Health & Healing Fall 2014
At the end of this presentation you will gain knowledge of how to:
Perform a general pediatric assessment using the Paediatric Assessment Triangle
Recognize an acutely ill child
Perform a primary assessment
Paediatric & Adult Differences
Approach to the Paediatric Patient
Children are not “mini” versions of adults
There are structural, physiologic and developmental, physical differences between the two
Some of the differences:
They have a larger head & shorter neck
Tracheal rings are softer and can collapse more easily
Large tongue
Small airway diameter
Obligate nose breathers
Fewer alveoli with less recoil & elastic tissue
Ribs are more horizontally aligned and at baseline already maximally expanded,
Diaphragm – major muscle of breathing
Nares have little supporting cartilage
Smaller body surface area
Greater percent total body weight to water
Body surface area to weight ratio is higher than adults
Limited glycogen stores
Metabolic rate is faster with twice the oxygen consumption
Comparison of adult and infant airway
Approaching a child….
Determine their level of understanding
Take a few minutes to speak with child and parent(s)
Ask parents for guidance how to interact with child*
Observe child for clues to readiness – eye contact, questions
Utilize tools to convey information to small children (developmental)
Family presence & involvement
Coping with distraught or very ill child
Pediatric Assessment Triangle
Pediatric Assessment Triangle
General Assessment Tool
Evaluates appearance, breathing and circulation
Conducted across the room in approximately 60 seconds (LOOK and LISTEN)
Determines if the child is “sick” or “not sick”
General Appearance
Looks good
Looks bad
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