Unformatted text preview: T: PHYSICAL ASSESSMENT: CHILDREN APPROACH IS CRITICAL Growth Measurement
Organ Systems GROWTH MEASUREMENT
GROWTH MEASUREMENT Growth Chart – Length/Height
– Head circumference Take note when pt. is: Under 5th percentile Over 95th percentile PHYSIOLOGIC PHYSIOLOGIC MEASUREMENTS Respirations, pulse, BP, temp
– Respiration for 1 minute
– Pulse = Apical pulse for 1 minute
– B/P = Dinamap, 2/3 to 3/4 of upper arm
– Temperature Oral, Axillary, Tympanic Evidence Alert: Evidence Alert: Tympanic Temperature Temp measured in 106 infants in ED by tympanic, axilla, rectal. Results: Tympanic closer to rectal than axillary, whether febrile or not.
Tympanic measurements had a sensitivity of 76% whereas axillary had a sensitivity of only 24%. CONCLUSION: Tympanic thermometry is more accurate than electronic axillary thermometer. ElRahdi , A. & Patel, S. (2006). An evaluation of tympanic thermometry in a paediatric emergency department. Emergency Medicine Journal , 23(1): 401. No two babies are alike! GENERAL APPEARANCE GENERAL Overall physical appearance such as nutritional state, hydration status, behavior…
Your general impression? SKIN
SKIN Color, temperature, moisture, turgor
Typical assessment findings: – Skin is warm and dry. Good skin turgor, no lesions.
– Skin is rough and dry with scaling patches over chest and arms. Skin
Skin Color Markings Pink
Smooth Hydration Dry and flaky
HEAD Size and Shape Fontanels – Posterior closes by 2 months
– Anterior closes by 1218 months HEAD Ears
• Check ear position
• Young children are at risk for otitis media because
the eustachian tubes are shorter and more horizontal.
•Pull back and down to examime...
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