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N331 - Lecture 2 Growth & Development

Is under5thpercentile over95thpercentile physiologic

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Unformatted text preview: T: PHYSICAL ASSESSMENT: CHILDREN APPROACH IS CRITICAL Growth Measurement Physiologic Measurement General Appearance Organ Systems GROWTH MEASUREMENT GROWTH MEASUREMENT Growth Chart – Length/Height – Weight – 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 & Moist Condition Smooth Hydration Dry and flaky Soft Skin Skin HEAD HEAD Size and Shape Fontanels – Posterior closes by 2 months – Anterior closes by 12­18 months HEAD Ears 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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