Pediatric Health Assessment

Pediatric Health Assessment

• Health assessment provides essential information for diagnosing client conditions and planning effective care for the client and family.

Pediatric Stages

• No specific information provided in the text.

Principles of Child Communication

• No specific information provided in the text.

Pediatric Systematic Assessment

• Any assessment involves collecting two kinds of data.
• Child history includes:
  • Demographic-biographical information (child's name, age, address/phone number, caregiver's name).
  • Current state of health (present history, e.g., fatigue, pain, weight gain or loss, activity tolerance, abilities or disability in communication, mobility, pain, etc.).
  • Type of onset (sudden, gradual), duration, and timing.
  • Predisposing factors, pain site and radiation, complaints characteristics (amount, consistency), severity, and frequency.
  • Investigation done and current state (feeding, urine and stool passing, activity, sleeping).

Review of Systems or Head-to-Toe Approach

• This approach is used to assess the child's systems.

Chief Complaint

• The chief complaint determines why the child was brought in for examination.
• It could be symptoms, signs, or abnormal laboratory test results.
• Start with open questions (e.g., "What's the main problem?", "How is he?").

Past History

• Provides background for the problem and any additional problems the child may have experienced.
• Includes acute or chronic conditions, surgical procedures, immunization, medication, hospitalization, prenatal, perinatal, and antenatal history.

Psychosocial Assessment

• Habits:
  • Sleep pattern (difficulty sleeping or excess sleep could indicate depression, drug reaction, or pain or discomfort from disease).
  • Eating habits (frequency and type of food intake; can reveal eating disorders, obesity, or malnutrition).
• Substance abuse:
  • Drugs, tobacco, or alcohol (current or past); determine frequency and amount or usage.
• Sexual activity:
  • Assess even in younger children (as young as age 8 or 9).

Nutritional Assessment

• Assessment involves physical examination, biochemical perspective, and dietary intake.
• Evaluate:
  • Nutrition habits and variety of food types.
  • Factors impacting food choices, fast-food choices, and economic barriers.
  • Adequacy of intake of nutrients from all food groups.
• Consider:
  • Economic assessment (financial deficit limiting ability to buy food).
  • Overweight (85–95% for body mass index [BMI]) on growth chart percentile.
  • Obesity (weight above 95th percentile for BMI); family eating habits play a large part in childhood obesity.

Clinical Examination

• Chart weight, height, and head circumference (for infants) on a growth chart.
• Calculate body mass index (BMI): Weight in kilograms divided by height in meters squared.
• Assess for:
  • Delay of development of secondary sex characteristics (breasts in girls, pubic hair, testes) indicating malnutrition or vitamin A and D deficit or excess.
  • Skin changes (loss of skin turgor, elasticity, or edema, swelling, or puffiness indicating dehydration or fluid overload).
  • Delayed wound healing (poor protein intake/malnutrition).
  • Flabby skin or stretch marks indicating malnutrition.