To examine the abdomen of a ticklish child, the clinician can: ...

[Redwolflake15]

To examine the abdomen of a ticklish child, the clinician can:
 
  A. Leave the abdomen examination for last
  B. Use the child's smaller hand under your own to palpate the belly
  C. Distract the child by handing them a doll or toy
  D. B and C

Question 2

What assessment technique should be used to assist in the diagnosis of otitis media in a child?
 
  A. Cotton tip applicator to gather sample for culture
  B. Curettage removal of cerumen
  C. Pneumatic otoscopy
  D. Hearing evaluation

[fdliggud]

Answer to Question 1

ANS: D
To aid in the abdominal assessment of a ticklish child, have the child lie with knees bent or use the child's smaller hand under your own to palpate the belly. It is also helpful to engage the child in conversation to provide distraction from what you are doing.

Answer to Question 2

ANS: C
The otoscopic examination is described in detail in Chapter 6 (Ear, Nose, Mouth, and Throat). The otoscopic examination should be saved for last in infants and young children because of the distress it often causes. To examine the inner ear in an infant or young child, pull the pinna down and out. For examination in an older child, pull up and back as you would with an adult. As with adults, the tympanic membrane (TM) should be mobile and intact and should appear thin, smooth, and pearly gray with bright light reflexes. The mobility of the TM should be assessed by pneumatic otoscopy if a diagnosis of acute otitis media is expected. Although crying will cause erythema of the TMs, the light reflexes and mobility should remain intact. Diagnosis of acute otitis media should not be based solely on a reddened TM. Also observe for bubbles or an obvious fluid level line behind the TM, which indicates middle ear effusion.

[Redwolflake15]

TYSM

[ryhom]

Excellent