Pediatric physical assessment in children

PEDIATRIC PHYSICAL ASSESSMENT-2

Devangi N Sharma F.Y M.SC (N)

PREPREPARATIONFOR ASSESSMENT

• - - EXAMINATION ROOM• - EQUIPMENTS• - POSITION • - NURSE PREPARATION

METHODS OF ASSESSMENT

• -INSPECTION• -PALPATION• -PERCUSSION• -AUSCULTATION

HEAD TO TOEASSESSMENT

• -VITAL PARAMETERS

• -GENERAL MARKERS OF

• DISEASE

• -DETAILED EXAMINATION

ASSESSMENT

PRE-PREPARATION FOR ASSESSMENT

EXAMINATION ROOM

Outpatient settings Room must be

warm ,well-lighted and comfortable.

 Avoid use of yellow/blue color curtains

EQUIPMENTS• Stethoscope• Torch Light• Fiber Glass• Measuring tape(inches)• Weighing machine• Spatula• Sphygmomanometer• Clinical thermometer• Red ring & blocks(for developmental

assessment)

POSITION• Children between 3mnths – 1year should

be allowed to sit in mother’s lap• 1year-3 years should be in the standard

required position on examination table

NURSE PREPARATION• Informed Consent• Hand Washing• Warming of hands • Communication Skills• Avoid white apron • Small handy toys• Privacy• Eye to Eye contact

METHODS OF ASSESSMENT

INSPECTION

PERCUSSION• Tapping on surface

to determine the underlying structure.

• Done with the middle finger of one hand tapping on the middle finger of the other hand using a wrist action.

PALPATION• A method of

feeling the body part(size ,shape, firmness, consistency & location) using the hands (palm and fingers)

HEAD TO TOE ASSESSMENT

VITAL PARAMETERSTemperatureArterial pulseRespirationBlood pressureCapillary refill timeHydrationOxygen saturation

GENERAL MARKERS OF DISEASE 

PallorIcterusCyanosisClubbingLymphadenopathyEdemaJugular venous pressure

PALLOR

ICTERUS

CYANOSIS

CLUBBING

LYMPHADENOPATHY

JUGULAR VENOUS PRESSURE

EDEMA

COMPONENTS OF HEAD TO TOE EXAMINATION

CraniumFaceEyesEarsNoseMouth and oral cavityNeckHands ,feet and limbsChest Abdomen Skin and nails Genitalia

NECKPosition, lymph nodes, masses, fistulas,

cleftsRange of Motion (ROM)Check clavicle in newbornHead control in infantTrachea & thyroid in midlineCarotid arteries (bruits)Meningeal irritation

EXTREMITIES UPPER & LOWER EXTREMITIES• Handedness• Size and Shape• Color• Bones and Joints• Rash• Nails• Involuntary Movements

FLIP BOOK

CHEST• Assessment of the chest is done by:

1. Inspection2. Palpation3. Percussion4. Auscultation

Chest Percussion

Chest Auscultation

ABDOMEN

Assess for …• Shape and Size• Abdominal movements• Umbilicus• Skin scars• Superficial veins• Visible peristalsis• Pulsations• Groins and scrotum

VIDEO

???

1.Which of the following method is used to assess the shape, size and location of body part?

a) Palpationb) Auscultationc) Percussion d) Inspection

2 In older children icterus is diagnosed when serum bilirubin level increases above…………..

a) 5mg/dlb) 3mg/dlc) 2mg/dld) None of the above

3 Clubbing develops in …………….. grades.a) 4b) 2c) 3d) 5

4 Splint hand and foot syndrome is termed as ………….

a) Syndactylb) Polydactylc) Ecrodactyld) Both a & b

5 Umbilical hernia-ballon shaped umbilicus commonly found in……………years of age.a) less than 4 yearsb) less than 2 yearsc) more than 2 yearsd) more than 4 years

THANK YOU