INSTRUCTIONS. Complete the following exercises by answering the question in the space provided. After you have completed all the questions, scroll to the bottom of the page and check your answers.
1. List four differences between infants/children and adults.
a. ________________________________________.
b. ________________________________________.
c. ________________________________________.
d. ________________________________________.
2. Complete these statements of points to consider when you are conducting a physical examination of an infant or child.
a. An infant (less than 6 months old) does not mind his clothes being removed for a physical examination, but a child _________ old does not want to have his clothes removed for a physical examination. In fact, this child does not want to be touched.
b. In what two age groups should the physical examination be conducted toe-to-head rather than the usual head-to-toe sequence?
_________________________
_________________________
c. A child ____________ of age should be left on his mother’s lap while you examine him.
d. An adolescent needs reassurance that, in spite of the current illness or trauma, he is basically _________________.
e. A child who is __________ old may be examined on a chair or a bed. He likes to help out during the examination.
3. List three general principles to remember in dealing with a child who is ill.
a. ________________________________________.
b. ________________________________________.
c. ________________________________________.
4. Match the definition in column II with the name of the pediatric emergency in column I. Write the correct Roman number (I, II, etc.) on the appropriate line in column I.
| A ____ Status asthmaticus
B. ___ Croup C. ___ Meningitis D. ___ Seizures E. ___ Anaphylactic shock F. ___ Acute asthma G. ___ Febrile convulsions |
I. A condition caused by abnormal discharging of a group or groups of neurons in the brain.
II. A severe type of allergic reaction sometimes caused by insect stings (bee stings), inhaled substances (chemical powders), and injected substances (penicillin). III. Fever-caused convulsions which sometimes occur in a child up to six years of age. IV. A congestive pulmonary disease characterized by attacks of wheezing and difficulty in breathing. V. An inflammation of the meninges of the brain and/or the spinal cord. VI. A severe, prolonged asthma attack that does not respond to conventional methods of treatment. VII. A common viral, sometimes bacterial infection which causes obstruction in a child’s upper airways. This condition usually occurs at night after the child has gone to bed. A whooping sound can be heard when the child breathes in. |
5. The illness in which the epiglottis becomes inflamed (swelling and turning a “cherry-red” color) is ________________________.
6. A child with a low grade fever, some respiratory distress such as wheezing, and who is under the age of one year is likely to have ________________________.
7. Sudden infant death syndrome may be defined as _____________________________________________________________________.
8. Initial treatment for a child with croup includes:
a. Administering __________________________ by mask.
b. Initiating an IV of dextrose in water.
c. Placing the child in the ________________________________ position.
d. Transporting the child to _______________________________________
9. A child is having a status asthmaticus attack. His pulse becomes ___________. _____________________. His blood pressure ______________________.
10. A child having an asthma attack may have used an over-the- counter bronchodilator. If he has, he must not be given the medication _____________. Taken after the use of an OCB, this medication can cause the child to have severe circulatory disease or ___________________________________.
11. It is very important for you to do a thorough neurological examination when you are helping a child having seizures. The reason for this is ______________________________________________________.
12. List four signs/symptoms of epiglottitis.
a. ________________________________________.
b. ________________________________________.
c. ________________________________________.
d. ________________________________________.
13. Follow this procedure when performing CPR on a child:
a. Establish an airway and stabilize the child’s _________________________.
b. Make sure the child is breathing and has a __________________________.
c. Control bleeding by using _____________________ rather than a tourniquet.
d. Treat the child for shock by keeping him ________________ (what position?)
e. Immobilize any neurological or musculoskeletal injuries, taking care not to _______________________________________________________.
14. When a child’s vital signs begin to change for the worse, the changes occur__________________. (slowly or rapidly?)
15. In comparison to the same vital signs in adults, younger children have:
a. ______________________blood pressure than adults. (Lower or Higher)
b. ______________________ pulse rates than adults. (Lower or Higher)
c. ___________________ respiratory rates than adults. (Lower or Higher)
16. List four areas to check when you are performing a neurological assessment of a child.
a. ________________________________________.
b. ________________________________________.
c. ________________________________________.
d. ________________________________________.
Check Your Answers
1. You are correct if you listed any four of the following:
In proportion to their respective bodies, a child’s head is larger than an adult’s head.
A baby’s temperature control mechanism is immature and unstable.
Children have smaller airways with more soft tissue and a narrowing at the cricoid cartilage.
The tracheal opening and the esophagal openings of children are closer together than the same openings in adults.
Children dehydrate easily.
Children have less blood than adults.
Children have faster heart rates than adults.
The extremities of children are likely to appear mottled because of an immature temperature control rather than the result of poor circulation.
Children have more skin surface area in relation to body weight than adults.
A child has less muscle and fat mass than an adult.
A child’s abdominal organs are relatively larger than an adult’s.
A child’s diaphragm is lower than the diaphragm of an adult. paras 3-2a through l)
2. a. Two to three years.
b. Infants; two to three years of age.
c. 6 to 24 months.
d. Healthy.
e. Four to five years. (paras 3-4b(1) and (2), c(1)(a) and (b), c(1)(a)4., c(1)(b)3., para 3-4d(1), (3))
3. Be calm, patient, and gentle.
Be honest. Never lie to a child patient.
Try not to separate the child from his parents. (paras 3-6a through c)
4. A — VI
B — VII
C — V
D — I
E — II
F — IV
G — III
(paras 3-9, 3-10, 3-10a(3), a(6)(c ) NOTE, 3-12, 3-13, 3-15, 3-16, 3-17)
5. Epiglottitis. (para 3-11)
6. One year.
Bronchiolitis. (paras 3-14b(1) through (3))
7. The sudden, unexplained death of an infant without any warning. (para 3-8a)
8. a. Humidified oxygen.
b. (no answer required)
c. Most comfortable breathing.
d. A medical treatment facility. (paras 3-10b(1) through (4))
9. His pulse becomes weaker and faster.
His blood pressure falls. (para 3-13b(3))
10. Epinephrine.
Cardiac arrhythmias. (para 3-12b NOTE)
11. The differences in the first and subsequent neurological examinations indicate the direction of a child’s condition. (para 3-15b(4))
12. Pain on swallowing.
Frequent drooling.
High fever, possibly.
Respiratory distress. (paras 3-11a(1) through (4))
13. a. Spine.
b. Heart beat.
c. Pressure.
d. Flat.
e. Try to straighten out any obvious deformity. (paras 3-19a through e)
14. The child’s condition deteriorates rapidly. (para 20a(4))
15. a. Lower.
b. Higher.
c. Higher. (para 3-20b(1))
16. You are correct if you listed any four of the following:
Level of consciousness.
Pupils of the eyes.
Physical assessment of the upper body.
Response to stimuli.
Movements of the extremities.
Fluid from ears. (paras 3-21a through f)