Physical Assessment of a Child Patient

Compare the physical assessment of a child to that of an adult. In addition to describing the similar/different aspects of the physical assessment, explain how the nurse would offer instruction during the assessment, how communication would be adapted to offer explanations, and what strategies the nurse would use to encourage engagement. …..This is just a post not a formal paper. Thank You!

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Physical Assessment of a Child Patient

Introduction

When you’re an adult, it’s easy to ignore the needs of your child. But as a parent, it’s your job to know what signs indicate that your child is sick or injured. An experienced doctor can often spot physical problems simply by looking at a patient’s appearance and behavior. Here are some things you should look for when assessing a child:

Appearance

The appearance of a child can be an important indicator of their health, but it is also possible for a child to look sickly and unhealthy despite appearing well. This is because there are many different factors that influence how you perceive the health of others, such as:

Your own current physical state
The environment you’re in (for example, if it’s dark or noisy)
The time of day or night (children tend to have fewer energy reserves at these times)
What your senses are telling you (such as feeling pain or seeing blood)

Behavior

The physical exam of a child patient is primarily focused on the presence and absence of various conditions. It’s important to know what you’re looking for, so you can help your patient get the treatment they need.
Behavior is also an important part of the physical assessment process. You’ll want to pay close attention when evaluating behavior in children because it can tell you a lot about their health and well-being.

For example, if a child has difficulty speaking or behaving appropriately at school, this may signal some underlying problem that needs immediate attention from an expert like yourself (or even just another parent).

On the other hand, sometimes parents think that something’s wrong with their child when really there isn’t anything wrong at all–but rather than admitting this fact out loud when asked by doctors like yourself who care deeply about these kids’ futures!

Vital Signs

What are the vital signs?
How to take them?
What do they mean?
When should you take them?
Why are they important?

Head and Face

Head and Face
Check for symmetry. If the head does not appear symmetrical, ask about any recent changes in appearance or development, including new growths or deformities. Ask about facial expressions and how the child responds to painful procedures such as vaccination shots or blood draws. Make sure that you check for symmetry throughout your examination of this area: from nose to earlobe, from cheekbone down to chin line and from eye socket over a line straight through their skull (see Figure 1).
Look at hair distribution: Is it normal? Is there any balding? What color is it–is it blond with no highlights? Or are there black strands mixed in with brown tones? Do they have dark brown eyes or blue ones instead? Are they wearing glasses now that they weren’t before? What does their prescription look like –how much higher than 6/12 would you say that person’s reading ability was when compared against peers who don’t wear glasses at all?”

Eyes

The eyes are the first thing you should check for when examining a child. The following are redness, tearing and discharge; swelling or puffiness; any signs of trauma (an injury); pupils that do not respond to light; drowsiness/lethargy.

Nose and Mouth and Throat

Look for sores or bruises on the nose, mouth and throat.
Check for unusual odors in the nose and/or throat.
Listen for wheezing, stridor or other respiratory sounds from the lungs (lungs) that might indicate an asthma attack.
Feel the neck for swelling (tenderness), mass in the area of a lymph node or thyroid gland if it is enlarged.

Neck

The neck is a complex region of the body. It includes the head and shoulders, as well as all of your upper back and neck. The muscles of the neck are very important in keeping you safe during everyday activities like playing sports or driving your car.

The physical assessment should include:

Neck swelling, bruising or deformity
Range of motion – look for stiffness or pain with movement (especially when turning)
Signs or symptoms that may indicate injury (tenderness, pain)

Chest and Lungs

The chest and lungs are a common site for injuries in children. You will use your hands to examine the chest, feeling for symmetry, movement, tenderness and breath sounds. You should also check for adventitious noises such as crackles, whooshes or crepitations (noises caused by air moving through pockets). Finally, you should check tactile fremitus (a sound made by air moving over the surface of tissue) and percussion note (when you tap on various parts of their body with a soft mallet).

Heart and Neck Vessels

List the major arteries and veins of the neck.
What structures are assessed in the heart?
How do you assess a child patient’s heart?

Abdomen

Abdomen:

Check for distension. The abdomen should be firm, not distended or soft. A bloated feeling may indicate a perforated appendix, which is an emergency situation that requires immediate medical attention by your doctor.
Check for tenderness in the lower quadrants of your child’s abdomen (the area below their navel). Tenderness can indicate an inflamed appendix but also could be due to a growth spurt or pregnancy (which is often accompanied by abdominal discomfort). In some cases, this tenderness could indicate appendicitis; however, many times it does not require any treatment at all!

Genitalia, Rectum, and Inguinal Region

When evaluating the genitalia, rectum, and inguinal region of a patient it is important to remember that the size of the external genitalia may vary greatly depending on their stage of development. The external genitalia include:

Penis (or penis). This is made up of two structures: glans penis and corpus cavernosum. The glans consists of a head with a coronal ridge at its tip–this ridge contains blood vessels which supply blood to each erectile tissue layer within your penis when you get an erection. The corpus cavernosum surrounds these arteries like a tube inside your body; it contains smooth muscle tissue which helps to control erections.* Scrotum (or scrotal sac). This is located behind your lower abdomen but below both testicles.* Spermatic cord (or suspensory ligament). It connects your testicles to each other via their vas deferens ducts.* Internal Genitalia

Back, Spine, and Anus

The back, spine and anus are the most common areas that are examined in a physical assessment.
In children younger than 6 years old, any signs of pain when the child moves should be evaluated by your doctor.
Muscle spasms and weakness can occur with back pain because muscles around the spinal column contract or relax at different times to keep you from moving too far; however, these symptoms usually go away after treatment has begun.
Muscle atrophy is another sign that may indicate damage or disease within the body’s nervous system (that’s why it’s called “atrophy”). This means that some muscles have lost their ability to function normally–for example, if you were able to move before but not anymore then there might be something wrong with your nervous system!

Extremities – arms and legs. Upper extremities followed by lower extremities.

In your examination of the child’s extremities, look for signs of trauma. If there are no obvious injuries or fractures, then check for cyanosis, clubbing and edema. Also check capillary refill time (the time it takes for blood to travel back from the fingers to the heart) and pulses in both arms and legs.

The temperature should be taken rectally – if it is above 96 degrees Farenheit (35 degrees Celsius), then call 911 immediately because this can indicate serious problems with your child’s health!

Takeaway:

The takeaways from this exercise are:

You should be friendly, but not overly friendly.
It is important to establish a rapport with the child and their parents.

Conclusion

A physical assessment of a child is an important part of the medical examination. It enables you to identify the cause of illness and make appropriate treatment decisions. The information gathered during this process can help you diagnose and treat your patient quickly without unnecessary delays in obtaining medical care.

Nursing Worker

Physical Assessment of a Child Patient