Pediatrics Vital Sign Changes

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Questions and Answers

What does a positive Ortolani test indicate in a newborn?

No hip issues detected

Hip dislocation is palpable

Hip is dislocated

Successful hip reduction (correct)

Which characteristic of infants' breathing is true?

They are primarily thoracic breathers

Infants are obligate nose breathers (correct)

Their breath duration is equal for inspiration and expiration

Infants breathe using only their abdominal muscles

How is the posterior fontanel shaped and when does it close?

Triangular shaped, closes between 6-8 weeks (correct)

Oval shaped, remains open indefinitely

Diamond shaped, closes by 18 months

Circular shaped, closes by 12 months

What finding is normal in newborns during examination for acrocyanosis?

Cyanosis on palms and soles when cold Signup and view all the answers

What does a positive Barlow test indicate when assessing for congenital hip dysplasia?

Hip dislocates upon manipulation Signup and view all the answers

Which test assesses for scoliosis in children?

Adam's Bend Forward Test Signup and view all the answers

During an otoscopic exam of a child under 3 years, how should the auricle be positioned?

Down and back Signup and view all the answers

What is indicated by uneven skin folds in a prone infant when tested for congenital hip dysplasia?

Positive unequal skin folds Signup and view all the answers

What respiratory pattern is typically observed in newborns?

Quiet, rapid, and shallow breathing Signup and view all the answers

What is the significance of a Trendelenburg sign test?

Assessing hip abductor strength Signup and view all the answers

What is the appropriate method to measure the heart rate in children under 7 years old?

Listen to the apical pulse over the PMI Signup and view all the answers

What indicates a right to left shunt when measuring oxygen saturation in infants?

Difference of 2% SpO2 Signup and view all the answers

At what age should blood pressure measurements routinely begin in pediatric patients?

At 3 years old Signup and view all the answers

What is the normal temperature range for children?

97.5-99 ℉ Signup and view all the answers

What is a common physical finding in pyloric stenosis?

A firm mass that resembles an olive Signup and view all the answers

How do respirations change as children age?

Respiration rates decrease Signup and view all the answers

Which of the following statements best describes central cyanosis in infants?

Cyanosis of the central parts like face and torso Signup and view all the answers

What is a characteristic presentation of intussusception in infants?

Sudden onset inconsolable crying and red jelly stools Signup and view all the answers

What does the appropriate cuff size for taking blood pressure in children refer to?

40% of the arm circumference Signup and view all the answers

Which condition does not typically require surgical intervention?

Diastasis recti Signup and view all the answers

Study Notes

Vital Sign Changes

Temperature: Normal range is 97.5-99°F (36.6-37.2°C).
- Measured via axillary or oral methods; axillary requires positioning the thermometer well into the axilla.
Heart Rate: Decreases with age; apical pulse is advisable for neonates, infants, and children with cardiac issues.
- Listen for one minute; warm stethoscope before placement over the point of maximal impulse (PMI).
Respirations: Decrease with age; rapid in children, diaphragmatic in those under 7, and thoracic in older children.
- Monitor rise and fall of chest/abdomen for one minute; auscultation can help differentiate from heart rate.
Blood Pressure: Increases with age, measured in children over 3.
- Cuff should take 40% of arm circumference; length should cover 80-100% of the arm circumference.
Oxygen Saturation: Normal in children greater than 95%, measured differently in infants.
- Significant differences (greater than 2%) between pre-ductal (right hand) and post-ductal (foot) suggest shunting.

Tanner Stages

Not elaborated but key in assessing sexual maturity in children.

Abnormal Pediatric Findings

Pyloric Stenosis: Thickening of pylorus causing projectile, nonbilious vomiting in infants.
- Palpable firm mass in upper abdomen.
Intussusception: Life-threatening folding of intestine impacting digestion.
- Signs include sudden inconsolable crying, knee-draw to chest, bilious vomiting, and red jelly stools.
Umbilical Hernia: Abdominal wall failure to close; typically self-resolving without surgery.
Diastasis Recti: Weakness between rectus abdominal muscles due to increased intra-abdominal pressure.
Central Cyanosis: Cyanosis in central body parts indicates low blood oxygen, always abnormal in newborns.
- Acrocyanosis is normal in newborns, manifesting as cyanosis in hands and feet.

Fontanels

Anterior Fontanel: Diamond-shaped, flat, closes by 18 months; bulging or depressed indicates abnormalities.
Posterior Fontanel: Smaller, triangular, closes at 6-8 weeks.

Otoscopic Exam Differences

In children over 3, pull auricle up and back; under 3, pull down and back due to ear canal curvature.

Breathing Differences

Infants are nasal breathers; under 7 are diaphragmatic; over 7 are thoracic breathers.

Congenital Hip Dysplasia Tests

Ortolani Test: Detects dislocated hip; a 'clunk' indicates positive.
Barlow Test: Attempts to dislocate hip; positive if hip can be dislocated.
Galeazzi Sign: Check knee level with legs flexed; unequal knees suggest dysplasia.
Unequal Skin Folds: Assessed in prone position; difference indicates potential dysplasia.

Scoliosis Testing

Adam's Bend Forward Test: Evaluates spinal curvature; a degree of 7 or more warrants further investigation.
Trendelenburg Sign: Pelvis tilting indicates weakness of hip abductors or dysplasia.

Infant Chest and Breathing

Infants have a barrel chest and a 1:1 A/P to transverse diameter ratio.
Chest circumference is less than head circumference until 1 year.
Breathing patterns include longer inspirations and irregular rates; tachypnea is the first sign of distress.
Wheezing during respiration highlights airway obstruction; inspiratory indicates high obstruction.

Reflexes

Babinski Reflex: Dorsiflexion of great toe with fanning occurs in newborns; disappears by 12-18 months.
Moro Reflex: Startle response with arms spread; disappears by 4 months.

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Description

Test your knowledge on how vital signs change with age in pediatrics. This quiz covers proper techniques for measuring temperature, heart rate, and understanding what normal values are. Perfect for medical students and healthcare professionals!