Pediatric Assessment and Management

Course overview

Objectives List steps of patient assessment for a pediatric patient to an adult patient Describe developmental stages and how they affect vital signs and assessment findings in a pediatric patient Identify common childhood illnesses and their presenting signs and symptoms Explain differences in fluid resuscitation and pharmacological management in pediatric patients Content Information Covered 1 Pediatric Anatomical Variations and Assessment Head compared to an adults Compared to the body the head is proportionally larger in size The head contributes a larger portion of the bodys surface area than in adults Anterior and posterior fontanelles open Implications for the health care provider Airway compared to an adults Chest and lungs compared to an adults Abdomen compared to an adults Extremities compared to adults Skin and body surface area compared to an adults Thinner with less subcutaneous fat Larger surface area to body mass Implications for the health care provider Respiratory system compared to an adults Tidal volume of breaths is smaller ten to fifteen milliliters per kilogram Higher oxygen demand per kilogram of body weight two times that of an adult Smaller lung oxygen reserves Implications for the health care provider Nervous system and spinal column compared to an adults Continually evolves throughout childhood allowing development of new abilities Brain tissue is more fragile and prone to bleeding from injury Subarachnoid space is relatively smaller offering less cushioning to the brain Brain requires nearly twice the cerebral blood flow as an adults Brain and spinal cord are less well protected by a thinner skull and spinal column Spinal column Implications for the health care provider Metabolic differences compared to an adult Infants and children have limited glucose stores Infants and children are prone to hypothermia due to increased body surface area Newborns and infants less than one month are most susceptible to hypothermia Implications for the health care provider 2 Growth and Development Infancy birth to two months Physical development Cognitive development Emotional development Implications for the health care provider Two to six months Physical development Cognitive development Emotional development Implications for the health care provider Six to twelve months Physical development Cognitive development Emotional development Implications for the health care provider Toddler years Twelve to eighteen months Physical development Cognitive development Emotional development Implications for the health care provider Eighteen to twenty four months Physical development Cognitive development Emotional development Implications for the health care provider Preschool years two to five years Physical development Cognitive development Emotional development Implications for the health care provider Middle childhood years six to twelve years Physical development Cognitive development Emotional development Implications for the health care provider Adolescence twelve to twenty years Physical development puberty begins Cognitive development Emotional development Implications for the health care provider Pediatrics Specific Pathophysiology Assessment and Management Respiratory Compromise Pathophysiology Assessment Upper airway obstruction Lower airway disease Pneumonia Foreign body lower airway obstruction Pertussis Cystic fibrosis Bronchopulmonary dysplasia BPD Chronic lung disease occurring in premature infants treated with positive pressure ventilation and high oxygen concentrations Recurrent respiratory infections and exercise induced bronchospasm Management Non Cardiogenic Shock Introduction Pathophysiology compensated versus decompensated Assessment Management Cardiac Introduction Epidemiology Anatomic and physiologic differences in children Pathophysiology Shock in children compensated versus decompensated Cardiogenic versus noncardiogenic shock Assessment History age sweating while feeding