Assessments part 1 peds

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Questions and Answers

During a pediatric assessment, under what circumstance is it essential to use extreme caution when obtaining a rectal temperature?

  • Due to the risk of perforation or increased risk of infection. (correct)
  • When the child is uncooperative.
  • When the child has a history of gastrointestinal issues.
  • When a precise core temperature is needed, such as in cases of suspected sepsis.

What is the primary reason for auscultating the apical heart rate for a full minute in pediatric patients?

  • To calm the infant.
  • To detect murmurs more accurately.
  • To identify any irregularities or variations in the heart rhythm. (correct)
  • To assess for heart failure.

Which of the following considerations is most crucial when selecting a blood pressure cuff for a child?

  • The child's age.
  • The child's arm circumference (diameter and width). (correct)
  • The availability of the cuff size in the clinic.
  • The preference of the healthcare provider.

A nurse is preparing to assess a toddler. Which approach best combines assessment with the child's developmental needs?

<p>Using play to complete vital signs and allow the child to handle equipment. (D)</p> Signup and view all the answers

A young child is brought in with respiratory distress. During auscultation, the nurse hears high-pitched whistling sounds. What is the most likely term to use when documenting this finding?

<p>Wheezing (C)</p> Signup and view all the answers

Which of the following is the primary focus when modifying a head-to-toe assessment for a child?

<p>Accommodating the child’s developmental needs. (B)</p> Signup and view all the answers

When communicating with children, which strategy is most appropriate to avoid information overload?

<p>Monitoring the child's non-verbal cues such as silence and fidgeting. (C)</p> Signup and view all the answers

What is most important when providing care to adolescents during an assessment?

<p>Spending time together, encouraging expression of ideas, and respecting their views. (A)</p> Signup and view all the answers

Which of the following is a key principle in pediatric nursing?

<p>Understanding and appreciating the differences between children and adults. (A)</p> Signup and view all the answers

During the assessment of school-aged children, which strategy is vital for fostering trust and cooperation?

<p>Explaining the procedures and equipment to the child. (C)</p> Signup and view all the answers

Which of the following vital sign changes would a nurse expect to see in a child experiencing stress or fever?

<p>Increased heart rate (D)</p> Signup and view all the answers

When assessing an infant, which sequence should the nurse prioritize to ensure accuracy and minimize distress?

<p>Begin with auscultation of the heart, lungs, and abdomen, followed by traumatic procedures. (A)</p> Signup and view all the answers

A nurse is performing a respiratory assessment on an infant. What is normal to observe?

<p>Abdominal or diaphragmatic respiratory movements. (D)</p> Signup and view all the answers

What is an effective approach to have a child take deep breaths in order to increase the assessment quality of breath sounds?

<p>Have the child blow a pinwheel, party horn, or pretend to blow out a flashlight. (D)</p> Signup and view all the answers

What is the shape of an infant's chest?

<p>Circular. (D)</p> Signup and view all the answers

When should resting vitals be taken during a toddler examination?

<p>Before undressing. (D)</p> Signup and view all the answers

When collecting a pediatric health history, which element focuses on the structure, function, and relationships within the child's family?

<p>Social assessment. (A)</p> Signup and view all the answers

Auscultating breath sounds is a component of which system review during a pediatric assessment?

<p>Respiratory. (B)</p> Signup and view all the answers

During T-I-C-L-S, what does 'C' stand for?

<p>Consolability. (D)</p> Signup and view all the answers

When performing a general assessment on a pediatric patient, what should the nurse do?

<p>Assess the child visually first. (A)</p> Signup and view all the answers

Flashcards

What is 'T' in TICLS?

Assessing the patient's movement, resistance, and muscle tone.

What is 'I' in TICLS?

Evaluating the patient's alertness and awareness.

What is 'C' in TICLS?

Determining if the patient can be consoled or comforted by the caregiver.

What is 'L' in TICLS?

Checking if the patient's eyes follow movement or if they have a vacant stare.

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What is 'S' in TICLS?

Assessing if the patient's speech or cry is strong and spontaneous, or weak, muffled or hoarse.

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Heart Rate Considerations

Auscultate apical heart rate for one full minute.

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Pediatric Health History

Includes biographical data, chief complaint, present illness, past history, family history, nutritional assessment, social assessment, and home/community environment assessment.

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Blood pressure measurement

Blood pressure can be measured manually or electronically; appropriate cuff size (diameter and width) is crucial; limb size varies in children.

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Respiratory rate

Count for a full 60 seconds, chest rise can be used in adolescents, rate decreases with age, increases with fever or stress.

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Temperature routes

Oral, axilla, rectal, and tympanic.

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Adolescent Assessment

Adolescents need privacy, explanation, and respect.

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Preschool Assessment

In preschool, use play, allow touch, make it comfy.

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Infant Assessment

Assess visually, auscultate, then complete traumatic procedures last.

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Peds Nursing

Children are children, not smaller adults; maintain professional boundaries; involve family.

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Communication

Be honest, let child talk, lower speaking volume, and listen.

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Normal Breath Sounds

Vesicular breath sounds are heard over the lung surface, inspiration is louder than expiration.

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Abnormal Breath Sounds

Adventitious breath sounds are caused by inflammation, fluid, or obstructed airways.

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Infant Respiratory

Infants have a barrel chest shape and abdominal breathing.

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Study Notes

Research Methods

  • Primary and secondary methods are used in research
  • Surveys can be completed in person, online, or via telephone to gather quantitative or qualitative data
  • Interviews are useful to collect detailed qualitative insights from an individual
  • Focus groups are a form of qualitative research where a group of people are asked about their perceptions, opinions, beliefs, and attitudes towards a product, service, concept, advertisement, idea, or packaging
  • Observations are used to collect data on naturally occurring behavior in its usual context
  • Experiments involve manipulating one variable to determine if it causes changes in another variable
  • Literature reviews give an overview of what has been studied, published, and written on a specific topic
  • Data analysis is a process of inspecting, cleansing, transforming, and modeling data with the goal of discovering useful information, informing conclusions, and supporting decision-making
  • Online research refers to collecting information from the internet for research purposes

Sampling Methods

  • Probability sampling techniques involve random selection
  • Simple random sampling gives each member of the population an equal chance of being selected
  • Stratified random sampling divides the population into subgroups and then randomly samples from each group
  • Cluster random sampling divides the population into clusters, randomly selects some clusters, and then samples all members within the selected clusters
  • Systematic random sampling selects every nth member from a list
  • Non-probability sampling techniques do not involve random selection
  • Convenience sampling selects participants that are easily accessible
  • Quota sampling sets quotas for each category of participant
  • Purposive sampling is when the researcher uses their own judgment to select participants
  • Snowball sampling is when existing study subjects recruit future subjects from among their acquaintances

Data Analysis

  • Quantitative data analysis involves numerical or statistical analysis to quantify the data and make generalizations
  • Statistical analysis is a component of data analytics
  • Regression analysis is a set of statistical methods used for the estimation of relationships between a dependent variable and one or more independent variables
  • Hypothesis testing is a statistical method that is used in making statistical decisions using experimental data
  • Qualitative data analysis involves interpreting non-numerical data, such as text, audio, and video
  • Content analysis is a research technique used to make replicable and valid inferences by interpreting and coding textual material
  • Thematic analysis is used for identifying, analyzing, and interpreting patterns of meaning ("themes") within qualitative data
  • Narrative analysis uses stories and personal accounts researched or told by an individual

Static Electricity: Charging

  • Static electricity involves the accumulation of electric charge on the surface of a material
  • Materials can become charged through friction, induction or contact
  • Friction occurs when materials rub together, electrons are transferred
  • Gaining electrons results in a negative charge
  • Losing electrons results in a positive charge
  • An electric field is created around a charged object
  • The field's strength is greatest nearest the charged object
  • Electric field lines point from positive to negative charges
  • Induction occurs when a charged object brings a charge in another object without contact
  • A positive object attracts negative charges
  • A negative object repels negative charges
  • Earthing is connecting a charged object to the earth to allow charge flow
  • Earthing removes excess charge

Static Electricity: Dangers

  • Fuel flowing through pipes generates charge via friction
  • This can cause sparks that could ignite the fuel
  • Pipelines are earthed to prevent charge build-up
  • Rain clouds become charged from friction between ice particles and air
  • Negative cloud bottoms induce positive charges on the ground
  • When the charge is high enough lightning strikes
  • Aircraft flying through air experience friction charging
  • Aircraft static can interfere with communication equipment
  • Static dischargers on wings remove excess charge

Static Electricity: Uses

  • Electrostatic precipitators filter dust and smoke in chimneys
  • Dust particles gain a negative charge passing through a grid
  • Charged particles stick to positive plates
  • Plates shaken to remove collected dust
  • Photocopiers use static electricity to copy documents
  • The drum receives a positive charge
  • The image projects onto the drum and reduces charge
  • Toner (black powder) gets a negative charge and sticks to positive drum areas
  • The paper receives positive charge and toner is transferred
  • Toner is fused by heat
  • Spray painting
  • The object receives a negative charge
  • The paint receives a positive charge
  • Paint is attracted to the object

Static Electricity: Equations

  • Key equations are used to quantify static electricity phenomena
  • The electrical charge equation is $Q = l*t$
  • Q is the charge measured in Coulombs (C)
  • I is the current measured in Amperes (A)
  • t is time measured in seconds (s)
  • Electric field equations is $E = \frac{kQ}{r^2}$
  • E is the electric field strength measured in Newtons per Coulomb (N/C)
  • k is Coulomb's constant (8.99 x 10^9 Nm^2C^{-2})
  • Q is the charge measured in Coulombs (C)
  • r is the distance from the charge measured in meters (m)
  • $F = \frac{kQq}{r^2}$ is used to calculate electrostatic force (N)
  • Here, Q and q are quantities of charge (C)
  • r is the distance measures between charges (m)

Measuring CPU Performance

  • The importance of CPU performance metrics, performance counters, and the perf tool in analyzing CPU performance
  • You can improve your understanding how a CPU's microarchitecture affects performance

CPU Performance Metrics

  • Clock Rate: Measures how fast a CPU executes instructions, in Hertz (Hz)
  • a higher clock rate means better performance but this is only one factor among others
  • Instructions Per Cycle (IPC): The average number of instructions a CPU executes in a single clock cycle
  • Higher IPC indicates a more efficient CPU architecture
  • Cache Miss Rate: the percentage of times the CPU needs to access main memory because required data isn't in the cache
  • Higher cache miss rates significantly degrade performance

Performance Counters

  • Special-purpose registers in modern CPUs that count hardware events
  • Measure instructions executed, clock cycles, and cache misses
  • Provide detailed information about CPU performance to identify bottlenecks
  • Key counters include cycles for the number of clock cycles
  • instructions for the number of instructions executed
  • cache-references for the number of cache accesses made
  • cache-misses for the number of cache misses

Perf Tool

  • perf is a command-line tool in Linux used for performance analysis
  • Allows monitoring performance counters
  • Enables profiling code and tracing system events and optimizing CPU performance
  • Three basic perfcommands include:
  • perf stat: Reports performance counter statistics for a given command
  • perf record: Records performance counter data for a given command
  • perf report: Analyzes performance counter data recorded by perf record

Motion and Force: Forces

  • Types of forces
  • Contact
  • Normal force ($\vec{N}$) is perpendicular to the surface of contact
  • Tension force ($\vec{T}$) is transmitted through a string, rope, cable, or wire when it is pulled tight by forces acting from opposite ends
  • Friction force ($\vec{f}$) opposes motion (static and kinetic)
  • Applied force ($\vec{F}_{app}$) is a force that is applied to an object by a person or another object
  • Field
  • Gravity ($\vec{F}_{g}$) is the universal force of attraction between all matter
  • Electric force ($\vec{F}_{e}$) is the attraction or repulsion between charged particles
  • Magnetic force ($\vec{F}_{m}$) is the force exerted on magnets and moving charges

Motion and Force: Combining Forces

  • Forces are vectors.
  • Use vector addition to find net force.
  • The net or resultant force is $\vec{F}{net} = \vec{F}{1} + \vec{F}_{2} +...$

Motion and Force: Newton's Laws

  • Newton's First Law: "Law of Inertia"- an object will remain in a state of rest or constant velocity unless acted upon by a net external force, $\vec{v} = constant$
  • Newton's Second Law $\vec{F}_{net} = m\vec{a}$
  • Newton's Third Law "Action-Reaction"- If object 1 and object 2 interact, the force exerted by object 1 on object 2 is equal in magnitude and opposite in direction to the force exerted by object 2 on object 1, $\vec{F}{12} = -\vec{F}{21}$

Motion and Force: Inertia and Mass

  • Inertia is an object's tendency to resist velocity changes
  • Mass measures an object's resistance to velocity changes
  • Mass is a scalar quantity
  • Mass is an intrinsic property of an object
  • Mass is not weight
  • Kilogram (kg) is the SI unit for mass

Motion and Force: Other Forces

  • Gravitational Force (Weight), $F_{g} = mg$
  • g = 9.8 m/s^2 on Earth
  • Weight isn't intrinsic
  • Location determines weight (location determines g)
  • Weight is a force
  • Mass and weight are separate
  • Normal Force is a contact force exerted by a surface
  • The normal force is perpendicular to the surface
  • The normal force isn't always the object's weight

Motion and Force: Free Body Diagrams

  • To create free body diagrams:
  • Draw a diagram of the object(s) of interest.
  • Draw forces acting on the object.
  • Only forces acting on the object
  • Indicate force magnitudes and directions.
  • Resolve forces into components.
  • Apply Newton's Second Law in component form.
  • $\sum F_{x} = ma_{x}$
  • $\sum F_{y} = ma_{y}$

Detecting Phony News Stories

  • Phony news deceives and misleads
  • Can slant public opinion and agendas
  • Uses sensational, dubious, or manufactured headlines
  • Investigate the reporting source to ensure it is known and reputable
  • Read past the fabricated headlines and sensational claims, to properly understand it
  • Check the credibility and expertise of the author
  • Consider supporting evidence, facts, sources, and links
  • Verify publication date for relevancy
  • Critical thought and contemplation are useful
  • Check reputable fact-checkers
  • Never share and always report

Relational Algebra: Introduction

  • Relational algebra is a foundational query language
  • Serves as basis for relational database management systems (RDBMS)
  • Key characteristics
  • Formal: Based on strong math foundations like set theory
  • Procedural: Describes how to assess a query

Relational Algebra: Key Components

  • Relations are sets of tuples (rows) sharing a stricture (attributes)- like tables
  • Relation Schema specifies a relation's name, attribute names, and data types
  • Example: Etudiant(nom: string, age: integer, adresse: string)
  • Relation Instance is a set of tuples that adhere to the relation schema
  • Example includes a table with name, age, and address columns

Relational Algebra: Basic Operators

  • Core set of functions used to manipulate and retrieve data from relations
  • Includes Selection, Projection, Union, Set Difference, Cartesian Product, and Rename

The Selection Operator

  • The symbol for Selection is $\sigma$
  • Selection identifies tuples within a relation that meet a given predicate
  • It uses the syntax, $\sigma_{predicat}(relation)$
  • The Predicate is a conditional expression consisting of logical (\land, \lor, \lnot) and comparative operators (=, $\neq$, , $\le$, $\ge$).
  • The example $\sigma_{age > 20}(Etudiant)$ shows the selection of students older than 20

The Projection Operator

  • Projects identifies specific attributes from a relation and includes the symbol $\Pi$
  • It uses the syntax $\Pi_{attribut1, attribut2,...}(relation)$
  • The result will contain the specified attributes from the relation
  • Duplicates are removed
  • The example $\Pi_{nom, age}(Etudiant)$ fetches student names and ages together

Set Operators

  • The UNION operator is a set operator, its symbol is $\cup$
  • It combines tuples from two relations while removing duplicates
  • Requires that both relations have the same schema
  • The Intersection operator helps to find common tuples of two relations
  • The SET DIFFERENCE finds differing pairs of relations, using the symbol '-' It requires that both relations have the same schema
  • Returns tuples present exclusively in the first relations

Cartesian Product Operator

  • Cartesian Product is symbolized by $\times$
  • Allows combinations of tuples from two relations
  • Returns all possible pairings between the two
  • Does not require schema compatibility
  • Is rarely used directly
  • Renaming Relations requires symbol $\rho$ and enables renaming relation or attribute names
  • Facilitates self-joins and multiple uses of the same relation in an expression
  • Renames, example $\rho_{Eleve}(Etudiant)$ helps by renaming "Etudiant" into "Eleve"

Division And Join

  • Join joins related tuples from multiple relations
  • Connects based on a join condition predicate
  • Division finds tuples in relation 1 that relate exclusively to all tuples in relation 2
  • Less frequently used, but helpful for specific needs

Jointure and Intersection

  • The JOIN operator ($\Join$), is to combine tuples from two (or more) relations based on related attributes
  • Uses Syntax: $relation1 \Join_{predicat} relation2$
  • "predicat" is a join state comparing attributes between 2 relations
  • Join operations can be expressed through Cartesian products and selections
  • Different kinds of JOINS exist and include Natural, Equi, Outer

Phony News Social Media

  • It is important to refrain from sharing phony news stories
  • This should be reported on social platforms
  • Consider the impact of each piece, and look to help prevent dissemination

Radiation from Matter for Radiative Transfer

  • All matter radiates when T > 0K
  • Its spectrum depends on the temperature and emittance quality
  • Radiation comes as a photon (packet form) or electromagnetic waveform (wave form)

Radiative Transfer Basic Quantities

  • Solid Angle $$\Omega = A/r^2$$
  • A is the area
  • r the radius and the units are in Steradians (sr)
  • Flux $$F = \frac{dW}{dt dA}$$
  • dW is energy and dt the timing. The units are in $W m^{-2}$
  • Specific Intensity $$I = \frac{dW}{dt dA d\Omega \cos\theta d\nu}$$
  • I is independent to distance in vacuum
  • Where $dW$ is energy, $dt$ the timing. $dA$ area. $d\Omega$ solid angle, $d\nu$ the frequency and the units in $W m^{-2} sr^{-1} Hz^{-1}$
  • Mean Density $$J = \frac{1}{4\pi} \int I d\Omega$$
  • For isotropic is $J=I$ and the units $W m^{-2} sr^{-1} Hz^{-1}$
  • Energy density $$u = \frac{1}{c} \int I d\Omega = \frac{4\pi}{c} J$$
  • Measured in $J m^{-3}$
  • Radiation $$P = \frac{1}{c} \int I \cos^2\theta d\Omega$$
  • For isotropic the radiation pressure is $P = u/3$ and the units in $N_m^{-2}$

Radiative Transfer Blackbody

  • Blackbody radiation will absorb radiation to emit radiation and is determined according to temperature.
  • Planck Function $$B_\nu(T) = \frac{2h\nu^3}{c^2} \frac{1}{e^{h\nu/kT} - 1}$$
  • h is Planck's constant
  • c speed of light, k Boltzmann's constant, $\nu$ is frequency, $T$ the temperature
  • Wien's $$\lambda_{max} = \frac{b}{T}$$
  • $b \approx 2.9 \times 10^{-3} m \cdot K$
  • Stefan-Boltzmann $$F = \sigma T^4$$
  • $\sigma \approx 5.67 \times 10^{-8} W m^{-2} K^{-4}$ Stefan-Boltzmann constant.

Radiative Transfer Equation

$$\frac{dI}{ds} = -\alpha I + j$$

  • I is the intensity, s is the distance, $\alpha$ is the absorption. j is the emission
  • Optical Depth $$d\tau = \alpha ds$$ $$\tau = \int \alpha ds$$
  • Rewritten $$\frac{dI}{d\tau} = -I + S$$
  • For constant $S$ $$I(\tau) = I(0)e^{-\tau} + S(1 - e^{-\tau})$$ $$I(\tau) = I(0)e^{-\tau} + B_\nu(T)(1 - e^{-\tau})$$

Understanding Exposure: What is Exposure?

  • Exposure is how light or dark an image is.
  • Images happen when camera sensors/films are exposed to light.
  • The quantity of light is based on:
  • Aperture = the Lens opening size
  • Shutter Speed = How long the sensor is exposed to light
  • ISO = How well the sensor can detect light
  • These three controls can affect exposure and is named the “Exposure Triangle.”

Understanding Exposure: Why is exposure so important?

  • Correctly exposing an image is important because it determines how much detail is captured.
  • Images that underexposed too dark lead to no details Images that are overexposed are too bright and will also lack detail Meter Settings
  • Meter camera setting
    • A tool to assist correct exposure that reviews the metrics
  • “Sunny 16” rule: a quick good starting point for a great exposure
    • On sunny days the aperture should be closed (f / 16), and your shutter speed should be the reciprocal = 1/ ISO
    • ISO 200 = 1 / 200, this is a starting point and adjustments may be needed.

Understanding Exposure: Other settings

  • Exposure adjustments by hand can help in troublesome photos
    • scenes with bright and low brights
    • "+/-" symbol typically denotes exposure compensation
  • Histograms:
    • graphs/exposure of visual data and image exposure
  • "well exposed graph" and great data should be in center, underexposed is to the left and overexposed is to the right.

Understanding Exposure: ISO, Aperture and Shutter Speed

ISO: This is for sensor sensitivity.

  • Low ISO = Less sensitive, but less noise
  • High ISO = Higher sensitivity, but also image noise
  • when should this be adjusted? when the aperture and shutter are “desired settings/goals”, make appropriate changes from there.
    • typical: 100-200 @Sunny, 400-800 indoor, and 1600-3200 when low lighting. Aperture is for lens opening
  • The opening is the opening in the lens and will allow data through to the sensor. -f-stops is the measure here
  • lower f-stop = large opening, more lighting, less depth vs higher f-spot = smaller opening, less, and large DoF. Aperture and Depth of Field relation is defined by
  • depth of field is the goal, Shutter Speed is a sensor with light for data
  • Seconds/part of seconds is the quantity here.
    • high shutter speed =less light but more capture low shutter speed=more lights but blurred objects and images

Rules of Inference

  • Rules guide for valid arguments. and derive a conclusion from premises.
  • Basic rule
  • Modus Ponens, with $P \rightarrow Q$, then P, meaning Q.
  • Modus Tollens, with $P \rightarrow Q$, then $\neg Q$ means $\neg P$..
  • Hypothetical Syllogism, with $P \rightarrow Q$ and $Q \rightarrow R$ means $P \rightarrow R$
  • Disjunctive Syllogism with $P \lor Q$ and $\neg P$ with Q
  • Premise rules for addition, simplification, and conjunction

Rules of Inference: Testing

  • Formal proof
  • Using If it rains, then the ground is wet, AND If the ground is wet it is slippery. Meaning, if it Rains, then ground slippery
  • Proof:
  • $L \rightarrow M$ (Premise)
  • $M \rightarrow R$ (Premise)
  • $L \rightarrow R$ with reasoning

Rules of Inference: Key Notations

  • $L$: It is raining
  • $M$: The ground is wet
  • $R$: The ground is slippery

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