Health & Physical Assessment in Nursing First Edition

1. Health & Physical Assessment in NursingFirst Edition Donita D’AmicoandColleen Barbarito Chapter 25 Assessment of Infants, Children, and Adolescents

2. LEARNING OBJECTIVE ONE

3. LEARNING OBJECTIVE ONE • Child and Adult Variations • Integument • Head, eyes, ears, nose, and throat • Vital signs • Respiratory • Cardiovascular

4. LEARNING OBJECTIVE ONE • Child and Adult Variations • Breasts • Abdomen • Genitourinary and reproductive • Musculoskeletal • Neurologic

5. LEARNING OBJECTIVE ONE • Physical Variants in the Integument System • Increased risk of heat and water loss • Decreased heat tolerance • Presence of milia, lanugo, salmon patches, Mongolian spots, acrocyanosis, and vernix caseosa

6. LEARNING OBJECTIVE ONE • Physical Variants in the Head, Eyes, Ears, Nose, and Throat • Presence of fontanels and cranial sutures, caput succedaneum, cephalohematomas, and head disproportionate to body • Growth of lymph tissue • Smaller sinuses

7. LEARNING OBJECTIVE ONE • Physical Variants in the Head, Eyes, Ears, Nose, and Throat • Smaller external ear canals with shorter, straighter eustachian tubes • Teeth eruption and loss of primary teeth • Shorter neck and nonpalpable thyroid gland • Decreased visual acuity until age seven

8. LEARNING OBJECTIVE ONE • Physical Variants in the Vital Signs • Irregular breathing patterns • Age-dependent blood pressures

9. LEARNING OBJECTIVE ONE • Physical Variants in the Respiratory System • Thinner chest wall • Louder and harsher breath sounds • Abdominal breathing • Pliant airways • Increased oxygen needs

10. LEARNING OBJECTIVE ONE • Physical Variants in the Cardiovascular System • Closure of ductus venosus, ductus arteriosus, and foramen ovale • Sinus arrhythmias • Louder heart sounds • Physiological S2 split with inspiration • Functional murmurs

11. LEARNING OBJECTIVE ONE • Physical Variants in the Breasts • Inverted nipples • Breast discharge • Thelarche • Gynecomastia

12. LEARNING OBJECTIVE ONE • Physical Variants in the Abdomen • Presence/removal of umbilical cord • Palpable liver edge

13. LEARNING OBJECTIVE ONE • Physical Variants in the Genitourinary and Reproductive Systems • Smaller bladder capacities • Development of sphincter control • Genital growth • Infant vaginal discharge as a result of maternal hormones

14. LEARNING OBJECTIVE ONE • Physical Variants in the Musculoskeletal System • Ossification of skeletal bones • Bone growth

15. LEARNING OBJECTIVE ONE • Physical Variants in the Neurologic System • Growth of myelin sheath • Presence of primitive reflexes • Development of gross and fine motor skills • Need for increased sleep

16. LEARNING OBJECTIVE TWO

17. LEARNING OBJECTIVE TWO • Physical Assessment of Infants and Children • Techniques • Inspection • Palpation • Auscultation

18. LEARNING OBJECTIVE TWO • Specific Areas of Infant’s and Children’s Assessment • Growth and development • Skin, hair, and nails • Head and neck • Eyes and vision • Ears and hearing • Nose and sinuses • Mouth and throat

19. LEARNING OBJECTIVE TWO • Specific Areas of Infant’s and Children’s Assessment • Chest and lungs • Cardiovascular system • Abdomen • Genitourinary system • Musculoskeletal system • Neurological system

20. LEARNING OBJECTIVE TWO • Growth and Development • Measurement of height, weight, and head circumference (on children under age two) • Vital signs

21. LEARNING OBJECTIVE TWO • Integument System • Inspection of the skin for the presence of lesions, birthmarks, or discolorations • Inspection of the hair and nails for texture, distribution, and moisture

22. LEARNING OBJECTIVE TWO • Head and Neck • Inspection and palpation of the skull for deformities • Palpation of the lymph nodes

23. LEARNING OBJECTIVE TWO • Eyes and Vision • Inspection of the inner and outer structures for symmetry, position, movement, and appearance • Measurement of visual acuity

24. LEARNING OBJECTIVE TWO • Ears and Hearing • Inspection of the structures • Evaluation of hearing

25. LEARNING OBJECTIVE TWO • Nose and Sinuses • Inspection of the structures

26. LEARNING OBJECTIVE TWO • Mouth and Throat • Inspection of the structures

27. LEARNING OBJECTIVE TWO • Chest and Lungs • Inspection of the chest • Auscultation of lung fields

28. LEARNING OBJECTIVE TWO • Cardiovascular System • Inspection for cyanosis, chest pulsations, and PMI • Palpation of pulses • Auscultation of heart sounds

29. LEARNING OBJECTIVE TWO • Abdomen • Inspection, auscultation, and palpation of the structures

30. LEARNING OBJECTIVE TWO • Genitourinary System • Inspection and palpation of the structures

31. LEARNING OBJECTIVE TWO • Musculoskeletal System • Observation of gait and movements • Inspection of the upper and lower extremities, hips, and spine

32. LEARNING OBJECTIVE TWO • Neurological System • Evaluation of mental status • Evaluation of reflexes • Evaluation of cranial nerves • Evaluation of coordination, sensation, and movement

33. LEARNING OBJECTIVE THREE

34. LEARNING OBJECTIVE THREE • Child Compliance and Safety During Physical Assessment • Protection of modesty and privacy

35. LEARNING OBJECTIVE THREE • Nursing Approaches • Caring, supportive, yet firm • Play should be incorporated into nursing procedures

36. LEARNING OBJECTIVE THREE • Head - to - Toe Approach • May not work with young children • Threatening parts of the examination should be performed last

37. LEARNING OBJECTIVE FOUR

38. LEARNING OBJECTIVE FOUR • Health Assessment of Children • Physical, cognitive, and emotional development

39. LEARNING OBJECTIVE FOUR • Scoliosis Treatments • Strengthening • Stretching • Bracing • Surgery

40. LEARNING OBJECTIVE FOUR • Understandings of Health and Illness • Understanding of health risks • Relate illness to bad thoughts or behaviors

41. LEARNING OBJECTIVE FOUR • Approaches with Children • Caring, supportive, firm • Play and nursing procedures • Painful procedures

42. LEARNING OBJECTIVE FOUR • Parents and Stress

43. LEARNING OBJECTIVE FIVE

44. LEARNING OBJECTIVE FIVE • Focus Areas for Infant and Child Health Outlined in Healthy People 2010 • Fetal and infant deaths • Child deaths • Adolescent deaths

45. LEARNING OBJECTIVE FIVE • Key Objectives for Fetal and Infant Deaths • Reduce the number of fetal and infant deaths, including all deaths, neonatal deaths, postneonatal deaths, deaths related to birth defects, deaths related to congenital heart defects, and deaths caused by SIDS

46. LEARNING OBJECTIVE FIVE • Key Objectives for Child Deaths • Reduce the numbers of deaths in children between the ages of one and nine

47. LEARNING OBJECTIVE FIVE • Key Objectives for Adolescent Deaths • Reduce the number of preventable deaths in adolescents ages 10 through 19

48. LEARNING OBJECTIVE SIX

49. LEARNING OBJECTIVE SIX • Critical Thinking and the Nursing Process