Because pediatric patients are at high risk for illness and rapid deterioration, always give them special consideration. Be aware of:
- appropriate vital sign ranges
- growth and development issues, including expected height and weight
- duration of the complaint
- hydration status
- immunization status
- allergies
- current medications
- identity of the primary caregiver.
Patients older than age 75 are also at increased risk for rapid deterioration. They may also have concurrent medical conditions that can alter assessment findings. Don't assume that abnormal assessment findings are due to aging. Remember that elderly patients may experience:
- decreased cardiac reserve
- depressed sense of pain
- diminished protective airway mechanisms
- decreased resistance to infection
- decreased temperature regulation
- diminished short-term memory.
When communicating with a non–English-speaking patient through a translator, be sure to:
- speak in a normal tone
- speak directly to the patient, not the interpreter
- avoid using complicated medical terminology.
Additionally, observe the patient's nonverbal communication style for eye contact, expressiveness, and ability to understand common signs. Determine the patient's spatial comfort level, particularly in light of his conversation proximity to others and body movement.