Pediatric physical assessment in children

physical assessment in children

1. PEDIATRIC PHYSICAL ASSESSMENT-2 Devangi N Sharma F.Y M.SC (N)

2. ASSESSMENT

3. PRE-PREPARATION FOR ASSESSMENT

4. EXAMINATION ROOM Outpatient settings Room must be warm ,well-lighted and comfortable.  Avoid use of yellow/blue color curtains

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

6. 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

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

8. METHODS OF ASSESSMENT

9. INSPECTION

10. 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.

11. PALPATION A method of feeling the body part(size ,shape, firmness, consistency & location) using the hands (palm and fingers)

12. HEAD TO TOE ASSESSMENT

13. VITAL PARAMETERS Temperature Arterial pulse Respiration Blood pressure Capillary refill time Hydration Oxygen saturation

14. GENERAL MARKERS OF DISEASE   Pallor Icterus Cyanosis Clubbing Lymphadenopathy Edema Jugular venous pressure

15. PALLOR

16. ICTERUS

17. CYANOSIS

18. CLUBBING

19. LYMPHADENOPATHY

20. JUGULAR VENOUS PRESSURE

21. EDEMA

22. COMPONENTS OF HEAD TO TOE EXAMINATION

23.   Cranium Face Eyes Ears Nose Mouth and oral cavity Neck Hands ,feet and limbs Chest Abdomen Skin and nails Genitalia

24. NECK Position, lymph nodes, masses, fistulas, clefts Range of Motion (ROM) Check clavicle in newborn Head control in infant Trachea & thyroid in midline Carotid arteries (bruits) Meningeal irritation  

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

26. FLIP BOOK

27. CHEST Assessment of the chest is done by: Inspection Palpation Percussion Auscultation

28. Chest Percussion

29. Chest Auscultation

30. ABDOMEN

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

32. VIDEO

33. ???

34. 1. Which of the following method is used to assess the shape, size and location of body part? Palpation Auscultation Percussion Inspection

35. In older children icterus is diagnosed when serum bilirubin level increases above………….. 5mg/dl 3mg/dl 2mg/dl None of the above

36. 3 Clubbing develops in …………….. grades. 4 2 3 5

37. 4 Splint hand and foot syndrome is termed as …………. Syndactyl Polydactyl Ecrodactyl Both a & b

38. 5 Umbilical hernia- ballon shaped umbilicus commonly found in……………years of age. less than 4 years less than 2 years more than 2 years more than 4 years  

39. THANK YOU