Compare the physical assessments among school–aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child
The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 500-750-word paper, examine the needs of a school–aged child between the ages of 5 and 12 years old and discuss the following:
1. Compare the physical assessments among school–aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child.
2. Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.
3. Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment.
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Expert Answer and Explanation
Physical Assessment of Children in Pediatrics
In nursing, the overall assessment is vital because it provides nurse with information on how they can care for a specific patient. Generally, nurses conduct a patient assessment in three levels (Harris et al., 2016). The first stage is the admission assessment. Here, nurses assess the patient the moment he or she visits the hospital.
The second assessment is shift assessment, where the nurse can determine how the admitted patient is fairing. The third assessment is focused examination (Wong Vega et al., 2019). Here, the nursing will assess the patients’ body function by focusing on the possible diseases ailing the patients. In the admission assessment, several sub-assessments can be done to the patient.
They include physical assessment, patient history, vital signs, and general appearance. Different patients require different physical assessment depending on their age and stages of development. In this paper, the needs of a school-aged child between the ages of 5 and 12 years are examined.
Modifying Assessment Techniques in Children
When assessing school-aged children, the nurse should consider the kids’ age before choosing assessment methods. Also, the nurse should behave in a way that shows respect to the kids’ cultural values, gender, personal preferences, and age. Hockenberry and Wilson (2018) mention that, the nurse should introduce himself or herself to the kids’ before starting the physical assessment to create a friendly and conducive environment for the process.
Also, when assessing school-aged children, nurses should use systematic approach often and flexible enough to accommodate the children’s behaviors. Further, the nurse should examine the child’s least intrusive areas first before moving on to more intrusive places (Beltramini et al., 2019). The least intrusive areas include arms and hands while sensitive sites are mouth, nose, and ears.
The nurse should use more comfortable assessment techniques when conducting a physical assessment of children. The assessment techniques that can be used to perform a physical evaluation of children include observation and palpation. Observation technique is the use of hearing, vision, and smell to examine a patient. Here, the nurse will observe the movement, breathing, odors, and sound.
When the nurse suspects any strange action during observation, he or she will move to palpation. Palpation can be used to determine the body part that is paining the kids. Assessment techniques will be modified based on the kids’ reactions to the previous methods.
Developmental Stages of Children in Adolescent
DD is a 12 years old girl. According to Bibace and Walsh (2015), adolescent starts at the age of 12, and thus DD is in the adolescent stage of development. DD exhibits physical, psychological, and cognitive signs which shows that she is in an early adolescent stage. At this stage, the child’s sexual and adrenal glands have developed.
Also, when examining her reproductive system, the nurse found that she has mature ovaries and uterus though she has not yet started her periods. Her hips have broadened, and breasts have increased in size and shape. Also, her height has increased. Currently, she is about 4.8 fit. In terms of cognitive development, she has developed more complex cognitive skills. She thinks more abstractly.
When asked why she believes that there is God, she answered that God is there because evil exists. She said that the presence of sin means that there are God and Satan. Also, she can write an abstract composition about her teacher and explain her views more clearly. She also feels for other people. When walking inside the hospital, she saw a wounded man and felt for him. In terms of psychological development, DD is struggling to understand her role in society.
She told the nurse that when she grows up, she wants to treat and care for people. Also, she said that she wanted to be like her mother. In other words, DD is in the identity vs confusion stage of psychosocial development theory.
Using Theories to Assess DD Developmentally
Nurses can use development theories in assessing children. The arguments that will be used to evaluate DD are cognitive theory by Piaget and psychosocial theory by Erickson. The nurse will use cognitive theory to appeal to the thinking abilities of the kid while Erickson’s approach will be used on her psychological feelings.
The nurse will start a conversation with the kid by asking her who would she want to be, where she studies, which grade is in, her favorite food, and many more to make her cooperate during the assessment process. The nurse will use simple terms and language to explain to the kid why she is being assessed. Medical terms are discouraged here because the kid’s mind has not yet developed to understand the terms.
Also, when offering the explanations, the nurse will be required to encourage the kid and tell her that everything will be fine. In addition, the nurse should make the kid feel that she is in control. However, when reporting potential findings, the nurse will first talk to the kid’s parents or guardian because the child might not be psychologically prepared to handle any bad news about her health.
In conclusion, when assessing patients, nurses should consider their age. When the patients are kids, the nurse should apply friendly tone, respect the child’s opinions, and start by examining the kid’s less-sensitive areas. DD is in adolescent stage based on her age and physical, mental, and psychological development. Piaget and Erickson’s theories would be applied when examining DD.
References
Beltramini, A., Galinski, M., Chabernaud, J. L., Almenar, R. R., Tsapis, M., Goddet, N. S., … & Fournier-Charrière, E. (2019). Pain assessment in children younger than 8 years in out-of-hospital emergency medicine: reliability and validity of EVENDOL score. Pediatric emergency care, 35(2), 125-131.
Bibace, R., & Walsh, M. E. (2015). Children’s conceptions of illness. Particulars and Universals in Clinical and Developmental Psychology: Critical Reflections A book honoring Roger Bibace, 65.
Harris, J., Ramelet, A. S., van Dijk, M., Pokorna, P., Wielenga, J., Tume, L., … & Ista, E. (2016). Clinical recommendations for pain, sedation, withdrawal and delirium assessment in critically ill infants and children: an ESPNIC position statement for healthcare professionals. Intensive care medicine, 42(6), 972-986.
Hockenberry, M. J., & Wilson, D. (2018). Wong’s nursing care of infants and children-E-book. Elsevier Health Sciences.
Wong Vega, M., Beer, S., Juarez, M., & Srivaths, P. R. (2019). Malnutrition Risk in Hospitalized Children: A Descriptive Study of Malnutrition‐Related Characteristics and Development of a Pilot Pediatric Risk‐Assessment Tool. Nutrition in Clinical Practice, 34(3), 406-413.
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Nursing assessment of school age child
Assessing a school-age child’s health is important for identifying potential health issues, as well as monitoring their overall well-being. Here are some key areas to consider when conducting a nursing assessment of a school-age child:
- Health history: Collect a comprehensive health history, including any previous medical conditions, surgeries, hospitalizations, and allergies. Also, ask about family medical history, as some conditions may be hereditary.
- Vital signs: Measure the child’s height, weight, and blood pressure. Observe their breathing and respiratory rate, as well as heart rate.
- Physical examination: Conduct a head-to-toe physical examination, assessing the child’s eyes, ears, nose, throat, chest, abdomen, extremities, skin, and neurological status. Pay attention to any signs of distress or discomfort, such as abnormal breathing, fever, or rashes.
- Developmental assessment: Evaluate the child’s cognitive, social, and emotional development. Assess their speech, language, and fine and gross motor skills. Ask about their academic performance and social interactions.
- Nutritional assessment: Ask about the child’s diet, including their typical meals, snacking habits, and dietary preferences. Assess their body mass index (BMI) and ask about any recent changes in weight.
- Behavioral and mental health assessment: Assess the child’s mental health and behavior, including any signs of anxiety, depression, or behavioral problems. Ask about their sleep habits and screen time.
- Environmental assessment: Consider the child’s living environment, including their access to healthcare, food security, and exposure to environmental toxins.
Overall, a comprehensive nursing assessment of a school-age child should be holistic and include all aspects of the child’s physical, mental, and emotional well-being. This information can help identify potential health problems and guide appropriate interventions and treatment.
Compare the physical assessment of a child to that of an adult
There are several differences between the physical assessment of a child and that of an adult due to differences in anatomy, physiology, and developmental stages. Here are some of the key differences:
- Age and size: Children are generally smaller in size than adults and may require different equipment for physical assessment. For example, a child’s blood pressure cuff and stethoscope will be smaller than those used for an adult.
- Developmental stages: Children’s bodies undergo rapid changes during their developmental stages, which can impact the assessment. For example, a newborn’s head will be measured as part of their assessment, while an adult’s head circumference is not typically measured. Additionally, a child’s developmental stage can impact the types of questions that are asked and the types of tests that are performed.
- Vital signs: Children’s vital signs can vary greatly from adults. For example, a newborn’s normal heart rate can range from 100 to 160 beats per minute, while an adult’s is typically around 60 to 100 beats per minute. Children’s respiratory rates and blood pressure can also be different than adults.
- Positioning: Children may require different positions for assessment, such as lying on their side or sitting in a parent’s lap, depending on their age and level of comfort.
- Assessment techniques: Children may require different techniques for assessment, such as using a pacifier during an oral examination, or having a parent hold their hands during a blood draw to provide comfort and support.
Physical assessment of a child requires special attention to their developmental stage, size, and comfort level. Nurses and healthcare providers must adapt their assessment techniques and equipment to meet the unique needs of the child, in order to provide the most accurate and effective care.