Pediatric Assessment, Vital Signs, and Pain - Pediatric Nursing - Principles | @LevelUpRN

Level Up RN
15 Dec 202111:11
EducationalLearning
32 Likes 10 Comments

TLDRIn this informative video, Meris from Level Up RN discusses key components of pediatric assessment, emphasizing the importance of understanding a child's unique needs. The video covers general appraisal, health history, birth history, and immunization status. It highlights the order of vital signs, starting with respiration and ending with temperature, to minimize distress for young children. Age-appropriate pain assessment tools, such as the cries scale for neonates and the FLACC scale for toddlers, are detailed. Physical growth and development measurements, including length, weight, and head circumference, are explained, with a focus on tracking growth trends rather than specific percentiles. The video concludes with a discussion on expected vital signs for infants and children, noting differences from adult norms, and the appropriate use of pain scales based on the child's age and cognitive abilities. Meris also poses quiz questions to reinforce the material, encouraging active learning and engagement.

Takeaways
  • 👶 General assessment for children includes looking at their appearance, hygiene, and clothing, similar to adults, but with a focus on the child's birth history and family health history.
  • 🤱 When assessing a child's health history, it's important to communicate with caregivers, especially for younger children, and inquire about premature birth, NICU stay, and birth trauma.
  • 💉 Immunization status is crucial for children, and healthcare providers should be aware of any missed or overdue vaccinations.
  • 🩺 The order of vital signs for pediatric assessment should start with counting respirations, followed by apical heart rate, blood pressure if indicated, and temperature last to minimize agitation.
  • 📏 Physical growth and development in children involve measuring length/height, weight, and head circumference, along with assessing fine and gross motor skills.
  • 📊 Anthropometric data should be plotted on the correct graph based on the child's gender, any specific health conditions, and ethnicity, with attention given to trends rather than specific numbers.
  • 🚨 Children with measurements below the 5th percentile or above the 95th percentile require further investigation to ensure there are no underlying issues.
  • 🌡️ Expected vital signs for infants and children differ from adults, with higher pulse and respiration rates but lower blood pressure.
  • 😖 Pain assessment in children requires age-appropriate scales, such as the cry scale for neonates, FLACC scale for toddlers, faces scale for children over 3, and a numeric scale for those 8 and older.
  • 🧍‍♂️ Length is used to measure children who cannot stand upright, while height is used for those who can, reflecting the same measurement with different terminology.
  • 🧠 Cognitive and psychosocial development is also assessed in children, including their vocabulary, social interactions, and ability to make eye contact or smile.
Q & A

  • What are the key components of pediatric assessment discussed in the video?

    -The key components include general appraisal, health history, birth history, immunization status, vital signs, pain assessment, physical growth and development, anthropometric data, and expected vital signs.

  • Why is it important to assess a child's birth history during pediatric assessment?

    -A child's birth history is important because it can reveal factors like premature birth, time spent in the NICU, and any birth trauma, which can influence the child's current health and what further assessments may be needed.

  • What is the correct order to obtain vital signs from a child, especially a small one?

    -The correct order is to first count the respirations, then measure the apical heart rate, followed by blood pressure if indicated, and lastly, take the temperature.

  • Why is the order of obtaining vital signs important for small children?

    -The order is important because small children can get agitated easily and start to cry, which can affect the accuracy of their vital signs. Measuring respirations first, when the child is calm, helps to get a more accurate reading.

  • What is the significance of using an age-appropriate scale for pain assessment in children?

    -Using an age-appropriate scale is crucial because children, especially younger ones, may not have the abstract thinking ability to rate their pain numerically as adults can. Different scales like the FLACC or faces scale are used for different age groups to accurately assess pain.

  • How does the video define the term 'anthropometric data'?

    -Anthropometric data refers to the measurements of the physical body, including height, weight, and head circumference. These measurements are plotted on growth charts to monitor a child's physical development.

  • What is the normal range for systolic blood pressure in infants?

    -The normal systolic blood pressure range for infants is 65 to 90 mmHg.

  • What is the significance of plotting a child's anthropometric data on the correct graph?

    -Plotting on the correct graph allows healthcare providers to accurately monitor the child's growth trends and identify any sudden changes in growth patterns, which may indicate a health issue. The correct graph may vary based on the child's gender, any specific health conditions, or ethnicity.

  • At what percentile levels do children's measurements typically warrant further investigation?

    -Children who are below the 5th percentile or above the 95th percentile on growth charts typically require further investigation to ensure there are no underlying health issues.

  • What are the expected ranges for pulse and respirations in infants and children?

    -For infants, the normal pulse range is 100 to 160 beats per minute, and respirations are expected to be 30 to 60 breaths per minute. For children, the pulse range is 70 to 120 beats per minute, and respirations are 20 to 30 breaths per minute.

  • When is the numeric pain scale appropriate to use for assessing a child's pain?

    -The numeric pain scale, where 0 is no pain and 10 is the worst pain, is appropriate for children who are eight years old or older, as they are more likely to have developed the abstract thinking required to use this scale.

  • What are the normal vital sign ranges for an infant, according to the video?

    -For an infant, the normal vital signs are a temperature between 97.4 to 99.6 degrees Fahrenheit (36.3 to 37.6 degrees Celsius), a pulse between 100 to 160 beats per minute, respirations between 30 to 60 breaths per minute, and a systolic blood pressure of 65 to 90 mmHg with a diastolic pressure of 45 to 65 mmHg.

Outlines
00:00
😀 Introduction to Pediatric Assessment

Meris from Level Up RN introduces the video's focus on key components of pediatric assessment, recommending the use of their pediatric nursing flashcards for a deeper understanding. She emphasizes the general appraisal of a child's appearance and hygiene, health history, and birth history, including details like prematurity and NICU stay. Meris also discusses the importance of knowing a child's immunization status and the correct order to assess vital signs to minimize agitation in children. Pain assessment using age-appropriate scales and physical growth and development measurements are also covered, including the importance of plotting anthropometric data on the correct graph and monitoring trends rather than specific numbers.

05:02
🌡️ Understanding Vital Signs in Infants and Children

This paragraph delves into the expected vital signs for infants and children, highlighting the differences compared to adults. It covers the normal ranges for temperature, pulse, respirations, and blood pressure specific to infants and children. Meris points out that pulse and respiration rates are higher in children, while blood pressure is lower. She also discusses various pain assessment scales suitable for different age groups, from the cry scale for neonates to the numeric pain scale for children eight years and older, noting the importance of using age-appropriate methods for assessing pain in children.

10:10
📊 Pain Assessment Scales and Quiz Invitation

Meris concludes the video by addressing the appropriate use of the faces pain scale, which is suitable for individuals over three years old. She invites viewers to participate in a quiz to test their knowledge on the video's content, specifically asking which vital sign should be obtained first when assessing an infant and which vital signs are out of the normal limits for an infant. She also encourages viewers to subscribe to the channel, share the video, and provide feedback on what they found helpful.

Mindmap
Keywords
💡Pediatric Assessment
Pediatric assessment refers to the evaluation of a child's health status, which includes observing their physical appearance, hygiene, and behavior. It is a crucial part of pediatric nursing and is the main theme of the video. The script discusses various components of this assessment, such as general appraisal, health history, and immunization status, which are all essential for understanding a child's health needs.
💡Health History
Health history is the collection of information regarding an individual's health, including family medical background, personal health, and medications. In the context of the video, it is particularly relevant to pediatric assessment as it often involves communication with caregivers due to the child's age. The script emphasizes the importance of understanding a child's birth history, such as preterm birth or NICU stay, which can impact health expectations and further assessments.
💡Immunization Status
Immunization status pertains to the record of vaccinations a child has received. It is a key component in pediatric assessments as it helps healthcare providers ensure that children are up-to-date with their vaccinations, which is vital for preventing diseases. The video script highlights the need to inquire about any missed or overdue immunizations and the importance of catch-up vaccinations if necessary.
💡Vital Signs
Vital signs are the measurable indicators of a person's state of health, including body temperature, pulse, respiration rate, and blood pressure. The video script emphasizes the importance of the order in which these are assessed, especially in children, to minimize distress. It also provides specific normal ranges for infants and children, highlighting differences from adult vital signs.
💡Anthropometric Data
Anthropometric data refers to the measurements of the human body, such as height, weight, and head circumference. In the video, it is mentioned that these measurements are plotted on growth charts specific to gender, condition, and ethnicity. The focus is on the trend of these measurements over time rather than specific percentiles, with particular attention given to children who fall outside the 5th or 95th percentiles, indicating a need for further investigation.
💡Pain Assessment
Pain assessment involves evaluating a patient's level of pain, which is essential for providing appropriate pain management. The video script discusses age-appropriate scales for assessing pain in children, such as the FLACC scale for toddlers and the faces scale for children over three years old. It emphasizes the challenge of translating pain into a numerical value for children, who may lack the abstract thinking required for such an assessment.
💡Growth and Development
Growth and development pertain to the physical, cognitive, and social progress of a child. The video script mentions measuring length or height, weight, and head circumference, as well as assessing fine and gross motor skills. It also covers the evaluation of cognitive and psychosocial development, which are critical aspects of pediatric nursing and overall child health.
💡Cognitive Status
Cognitive status refers to a person's current mental abilities, including memory, attention, and problem-solving skills. In the context of the video, assessing a child's cognitive status is part of the comprehensive evaluation performed by pediatric nurses. It is particularly important in understanding a child's developmental progress and identifying any potential developmental delays or concerns.
💡Psychosocial Development
Psychosocial development involves the emotional and social growth of a child, including their ability to form relationships, express emotions, and adapt to social situations. The video script highlights the importance of assessing this aspect of a child's well-being, as it is integral to their overall health and can impact their behavior and interactions with others.
💡Growth Charts
Growth charts are graphical representations used to track and evaluate a child's physical development over time. The video script explains that these charts are specific to gender, health conditions, and ethnicity, and that they are used to plot anthropometric data. The trend of a child's growth, rather than specific measurements, is the primary focus when using these charts to monitor a child's development.
💡Developmental Milestones
Developmental milestones are the expected achievements in a child's growth and development, such as the ability to roll over, walk, or speak. The video script touches on assessing these milestones, which is a standard part of pediatric assessments. It mentions evaluating a child's language skills, such as the number of words they know, and social interactions, like smiling and making eye contact, as part of this process.
Highlights

Pediatric assessments involve a general appraisal of the child's appearance, hygiene, and clothing, similar to adult assessments.

Health history assessment includes family history, medications, and personal health history, with additional focus on birth history for children.

Immunization status is crucial for children, as it may affect further medical needs and catch-up schedules.

Vital signs in children should be assessed in a specific order to minimize agitation: respirations first, then heart rate, blood pressure if indicated, and lastly temperature.

Pain assessment in children requires age-appropriate scales, as they may not conceptualize pain numerically like adults.

Physical growth and development include measuring length/height, weight, head circumference, and assessing fine and gross motor skills.

Anthropometric data should be plotted on the correct graph based on gender, health conditions, and ethnicity to track growth trends.

Significant deviations in growth percentiles (below 5th or above 95th percentile) require further investigation.

Expected vital signs for infants and children differ from adults, with higher pulse and respiration rates but lower blood pressure.

Normal vital signs for infants include a pulse of 100-160 beats per minute and a systolic blood pressure of 65-90 mmHg.

The FLACC scale is used for pain assessment in children aged two months to seven years, focusing on facial expressions, leg movement, activity, cry, and consolability.

The faces scale, with six drawings of faces rating pain from 0 to 5, is appropriate for children aged three years and older.

The numeric pain scale, rated from 0 to 10, is suitable for children aged eight years and older, reflecting their ability for abstract thinking.

When assessing infants, the nurse should obtain the respiration rate first while the child is calm.

Vital signs out of normal limits for an infant include a blood pressure of 72/50 and a pulse of 158 beats per minute.

The faces pain scale can be used for children after they are three years old.

Subscribe to Level Up RN for more educational content and resources on pediatric nursing.

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Pediatric AssessmentNursing EducationHealth HistoryImmunization StatusVital SignsPain ManagementGrowth DevelopmentAnthropometric DataClinical PracticeNursing FlashcardsHealthcare Training