Physical examination of under five childrens

under five

1. PHYSICAL EXAMINATION OF UNDER-FIVE CHILDRENS MS. KALYANI R. SAUDAGAR

2. INTRODUCTION Under five assessment in necessary for decision concerning provision of appropriate health services to the children. Children are susceptible to get many health problems. Most of the disease are easily preventable. Children under year of age require special health care. PURPOSE To assess the health status of children To know the existing health problem among children To assess the growth and development of children To provide health education to their parents To treat the diseases if any

3. ARTICLES REQUIRED WEIGHING MACHINE:- To record weight INCH TAPE :- To measure height SNELLENS CHART SHAKIR TAPE :- To measure MAUC, bangle 4 cm radius INFANT METER :- To measure the length of infant NUTRITION CUPS FLASH CARDS AND POSTERS

4. STEPS IN UNDER FIVE ASSESSMENT Take hand washing articles from the bag Wash hand thoroughly with soap and water Allow hands to dry in the air Get the paper bag ready Take out the articles from the bag such as inch tape, shakir tape, nutrition cup, bangles 4cm radius Explain the procedure the parent or the group Weight the infant using the weight balance or Barscale weighing machine or path weighing machine Remove the shirt of the child Weight the individual and record

5. For height and length:- Place the scale and measuring rod in a well lighted or well ventilated area Hold the head and heal form and read the measure Check the scale for accuracy Remove extra clothing or shoes otherwise weight will vary Record it accurately Use infant meter if childs age is below 2 yrs Place the infant on the board, hold head and feet in a straight line and record the measurement where the tape is fixed on the board If the child is more than 2 years instruct the child to stand with his feet together with his back to measure, arms and hand down, head erect and eyes straight Tell the height and weight of the child to the parents Chest and head circumference can be measured Anthro-pometry should be entered in health card

6. CLINICAL EXAMINATION OF THE CHHILD Screen the child from head to foot Screen the child in the following order(and find out the abnormalities if any) VITAL SIGNS Temperature : Heart rate : Respiratory rate : Blood pressure : Weight : height/weight :

7. General appearance of the child: Body position: Posture: Evidence of pain: Crying: Hygiene: Nutritional status: Mental alertness: Behaviour :

8. Head and neck : examine head for shape and size, fontanelle , sutures, hair color and texture, presence of infection or any lesion, dandruff, webbing of neck, enlarged of thyroid or neck swelling etc. Face : examine the face for expression ,asymmetry, paralysis, nose bride, size of maxillla and mandible, tenderness over sinus. Eyes : observe eyes for infection, periorbital edema, photophobia, distance between the eye, distribution of eyebrows, xeropthalmia and vision. Ears : examine the ear for the shape size position discharge hearing ability. Nose : examine the nose for patency, discharge, bleeding, deviated septum, foreign body Mouth and throat : examine the color of lips, lesion, cleft lip or palate, number of teeth, evidence of dental caries, gum bleeding, swelling and lesion of baccal mucosa, tongue and pharynx tonsilitis . Chest : observe the size, shape and symmetry of chest, pigeon chest, condition of breast and nipple, breath sound, heart sound etc. Abdomen : examine for size and shape, distension, scar, condition of umbilical cord in neonate, hernia. Limbs : examine for any deformity, asymmetry, bow legs, knock-knees, edema, limitation of the joints, paralysis, clubbing of finger, number of fingers. Spine and back : sign of abdominal spine, curvature, hair, spine-bifida, neck stiffness. Genitalia : male genitalia assess for urethral opening and its abnormalities hypospadias , epispadias , phimosis , hydrocele , hernia, underscended testes, size of penis. Anus and rectum : observe for patency of anus, presence of fistula, perianal erythema . Behaviour pattern : irritable, depressed, apathetic, excited, aggressive. Abdominal signs and symptoms: examine for presence of cough and cold, bleeding, vomiting, loose motion, lack of hygiene, oliguria , anaemia , edema, wound, ulcer etc. Inform the parent about the condition of the child. Record the finding in the individual health card Refer the child if needed Give health talks according to the felt heads of the child