Podcast
Questions and Answers
What should be done when weighing a toddler?
What should be done when weighing a toddler?
At what age can children generally be weighed on a standing scale?
At what age can children generally be weighed on a standing scale?
What is considered an abnormal finding in weight assessment for a child?
What is considered an abnormal finding in weight assessment for a child?
When assessing a child's length or height, what equipment is appropriate?
When assessing a child's length or height, what equipment is appropriate?
Signup and view all the answers
What is the correct method for measuring the length of an infant on a length board?
What is the correct method for measuring the length of an infant on a length board?
Signup and view all the answers
Which of the following actions contributes to accurate weight measurement?
Which of the following actions contributes to accurate weight measurement?
Signup and view all the answers
To obtain an accurate weight measurement, how should you document the child's weight?
To obtain an accurate weight measurement, how should you document the child's weight?
Signup and view all the answers
How many measurers are required for accurately measuring the length of a child?
How many measurers are required for accurately measuring the length of a child?
Signup and view all the answers
What is the primary purpose of plotting findings on standard gender-specific growth charts?
What is the primary purpose of plotting findings on standard gender-specific growth charts?
Signup and view all the answers
Which method of temperature assessment is appropriate for children aged 6 months or older?
Which method of temperature assessment is appropriate for children aged 6 months or older?
Signup and view all the answers
Which of the following is a normal finding when assessing a child's body weight?
Which of the following is a normal finding when assessing a child's body weight?
Signup and view all the answers
What should a child or adolescent wear during weight assessment to ensure accurate measurement?
What should a child or adolescent wear during weight assessment to ensure accurate measurement?
Signup and view all the answers
What indicates poor growth in a child's height measurement?
What indicates poor growth in a child's height measurement?
Signup and view all the answers
What is a major factor to consider when assessing and documenting temperature for a preschooler?
What is a major factor to consider when assessing and documenting temperature for a preschooler?
Signup and view all the answers
Which measurement technique is typically used to assess the height of children in a clinical setting?
Which measurement technique is typically used to assess the height of children in a clinical setting?
Signup and view all the answers
What should be documented alongside temperature assessment for a comprehensive evaluation?
What should be documented alongside temperature assessment for a comprehensive evaluation?
Signup and view all the answers
What is the primary purpose of using a length board?
What is the primary purpose of using a length board?
Signup and view all the answers
What is the recommended practice for measuring a child's height?
What is the recommended practice for measuring a child's height?
Signup and view all the answers
What is the importance of plotting head circumference on a growth chart?
What is the importance of plotting head circumference on a growth chart?
Signup and view all the answers
When is it crucial to measure head circumference?
When is it crucial to measure head circumference?
Signup and view all the answers
Which thermometer type is typically recommended for children 3 years old or younger?
Which thermometer type is typically recommended for children 3 years old or younger?
Signup and view all the answers
At what age can a digital oral thermometer be used for temperature assessment?
At what age can a digital oral thermometer be used for temperature assessment?
Signup and view all the answers
What criterion should be met when measuring recumbent length for accuracy?
What criterion should be met when measuring recumbent length for accuracy?
Signup and view all the answers
What is noted during the measurement of a child's height?
What is noted during the measurement of a child's height?
Signup and view all the answers
Study Notes
Assessing the Child and Adolescent Health Assessment
- The assessment of a child or adolescent's health involves a family-centered approach
- A strong correlation exists between the health of the parents and child
- Building rapport with the child and parent is crucial before any assessment, establishing trust for future visits
- A calm and relaxed demeanor is critical for the child and the parent during assessment
- It's important to communicate with children at their eye level and using play
- Assessments should be tailored to the developmental level of the child
Developmental Principles
- Many events during childhood impact growth and development
- Development is directional (head to toe, midline to periphery) and sequential, though not always orderly
- Physical growth is governed by the maturing brain but development doesn't always follow a predictable pattern in every domain
- Cultural differences are essential to respect to develop trusting relationships, as these differences can affect communication
- Adapt the assessment based on the child's development
Child-Centered Care
- A family-centered approach to assessment is essential
- Establishing rapport with the child and parent creates trust and sets the tone for assessment
- A calm demeanor is important
- Active engagement and communication with children at eye-level using play is beneficial
- Use of age-appropriate language
Data Collection
- Gather information from various sources
- Observation is important
- Information sources involved include:
- Child
- Parent-child interaction
- Diagnostics
- Health history
- Physical exam
Diagnostics
- Urinalysis is a diagnostic tool
- Hematocrit measurement is a diagnostic procedure
- Blood lead levels are measured to detect lead poisoning
- Lipid screening is used to assess lipid levels
- Infectious diseases tests are also utilized, including tuberculosis and sexually transmitted infections (STIs)
- Tympanometry is another diagnostic procedure
Health History
- Important information for the visit may include well-child, school, sports physical, pre-operative, sick visit, or emergency situations
- Using the COLDSPA mnemonic to describe symptoms is important
- Observing the interaction between the child and parent/caregiver
- Gathering general health history, birth history, past medical history, family health history, psychosocial health history, sleep history, nutrition, and elimination details are included
- Pica is an eating disorder in children that may be considered abnormal in certain cultures
Health History (Specific Areas)
- Skin and nails
- Eyes and vision
- Ears
- Nose and sinuses
- Mouth, teeth, and throat
- Respiratory
- Female breast development (assessment with children without parents from age 11)
- Male breast development (gynecomastia resolves within 6-24 months)
- Cardiovascular (including congenital heart disease)
- Abdominal (including recurrent abdominal pain)
- Musculoskeletal (including limited ROM, pain, fractures, bone deformities)
Neurological Assessments
- Neurological issues are common: headaches (53%), difficulty walking, limited muscle strength/coordination, dizziness, fainting, and speech issues
- Concussion (TBI)
- Sluggish, hazy, or foggy mental state
Endocrine Assessments
- Assessing for type 1 diabetes (polyuria, polydipsia, polyphagia, extreme fatigue, blurry vision, slow healing cuts/bruises, weight loss)
- Identifying pituitary gland issues (growth pattern changes, delayed sexual maturation or precocious puberty)
Preliminary Steps
- Maintaining privacy for children who might feel vulnerable
- Using age-appropriate assessments, developmental approach for each child's age
Physical Examination
- Begin with less threatening, least intrusive procedures
- Explain the procedure and what to expect
- Utilize age-appropriate methods (diversions, involving parents for uncooperative children)
- Use developmental approaches tailored to different age groups during examination
- Emphasize procedures and equipment in ways that address developmental issues.
General Survey
- Purpose of general survey is to assess physical appearance, nutritional state, personality, interactions with caregivers, siblings, nurses, and healthcare providers
- Observe hygiene, clothing, overall development of motor/speech skills/coordination, behavior/interacting with others, attention span, ability to follow directions, eye contact, & personality
General Survey (Normal Findings)
- Good hygiene
- Seasonally appropriate clothing
- Posture appropriate for growth and development
- Clear speech, appropriate attention span for age
- Alert, cooperative
- Good eye contact
- Appropriate motor skills and coordination for age
- Positive social interactions
General Survey (Abnormal Findings)
- Poor hygiene, body odor
- Inappropriately clothed.
- Poor posture
- Decreased motor skills/coordination
- Limited eye contact
- Aggressive, negative, or uncooperative
Measurement (Specific Parameters)
- Weight: Plot findings on standard gender-specific growth charts
- Appropriate age/gender specific weight
- Length/Height: Plot findings on standard gender-specific growth charts. Appropriate height/length
Assessing Weight
- A child must be able to stand to use a standing scale; an alternative method is to weigh a child sitting or lying on the appropriate scale
Assessing Height
- Methods include using a length board or stadiometer to measure height. Length boards are used for children under 24 months or with difficulty standing; stadiometer is the proper equipment for measurement when children can stand
Head Circumference
- The head circumference should be measured during a physical exam within the first two years of life and plotted on the growth chart, along with height and weight
Assessing Temperature
- Various methods of measuring temperature
- Using appropriate method based on age, temporal, oral, rectal, tympanic, etc.
- Consider age and institutional policy
Assessing Heart Rate
- Equipment used includes watch or clock with second hand, and an age-appropriate stethoscope.
- Similar procedures to assessing adults are used to assess heart rate
Assessing Respiratory Rate
- Assess respiration rate and depth, rhythm, sounds, and effort with stethoscope
- Normal findings for various age groups are expected, and any abnormal findings are marked
Assessing Blood Pressure
- Assessing blood pressure with a non-invasive blood pressure device using an appropriate cuff
- Identify the right size cuff by using the child's upper arm or leg
Special Considerations
- Adjustments may need to be made to accommodate the child's developmental age, anxieties, and other circumstances
- Additional information is required from the child and parent for assessments.
- Visual acuity testing, appropriate tools to gather data from children and their parents are necessary for thorough assessments.
Assessing Pain
- Assess children's pain by using a validated, reliable, and age-appropriate tool
- Different age groups may require specific methods of assessing pain.
Inspecting/Palpating Skin
- Assess the skin for changes, rashes, lesions, and masses
- Examine skin color, odor, texture, temperature, moisture, turgor, and edema
Inspecting/Palpating Hair and Scalp
- Assess the hair for cleanliness, texture, thickness/distribution, color, any unusual hair, lesions, and infestations using gloves
Inspecting/Palpating Fingernails and Toenails
- Assess nails for smoothness, uniformity, angles, and capillary refill rates
- Assess for abnormal characteristics
Inspecting/Palpating the Head, Face, Mouth, and Neck:
- Assess the head and face for size, symmetry; examine shape of head, eyes, nose, mouth, and neck for any developmental abnormalities or deformities
- Assess fontanels, assess lymph nodes; evaluate specific areas and considerations based on age
- Assess the mouth, nose, throat, and neck for any abnormal qualities
Assessing Eyes
- Assess the eyes for any abnormalities using a penlight. Visual acuity testing methods must be tailored to the age of the child
Testing Visual Acuity
- Different methods are involved with various age groups in vision testing
- The goal is to measure the child's near and far vision.
Assessing Respiratory System
- Assess the respiratory system using an age-appropriate stethoscope
- Understand thoracic diameter ratio and costal angle differences based on age.
Assessing Cardiac System
- Assess the cardiac system in children similar to adults, but with age-specific considerations
Assessing Abdomen
- Evaluate presence of abnormal characteristics, using an age-appropriate stethoscope
- Assess abdominal prominence, any abnormality or characteristics; normal findings in different ages
Assessing Musculoskeletal System
- Assess bone and muscle conditions, including inspection, palpation, assessment of ROM, and assessing strength (specific consideration need to be made for spinal curvatures)
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
