Comprehensive physical assessment of
a child (exam 1)
Bronchovesicular sounds medium-pitched quite sounds expected when auscultating over the mainstem
bronchus
Bruit Pulsing, blowing sound produced by turbulent bld flow
Crepitation crunching sounds under skin due to air
Kyphosis forward curve of. thoracic spine (hunch back)
Orthopneic position Body position to ease breathing; often lean forward, use arms for support and lift
chest to increase breathing
Pallor paleness, absent skin color
Pericardial friction rub scratching or squeaking sound heard over precordium and indiciates inflamm of
pericardial lining
Scoliosis "S" shaped spine
Tactile fremitus vibration felt by hand on chest when speaking
Thrill palpable vibration caused by turbulent bld flow
Vesicular sounds soft, fine, breeze, low pitched heard over peripheral lung tissue
,B.P cuff -length of bladder at least 80% circumference
- 40% with of bladder
Otoscope 2mm for peds and 4mm for adults
Tongue depressors feel around oral cavity. and do a sensitivity test with popsicle stick. Break in half and
poke with sharp and dull so they can tell the difference
Exam (assessment) considerations -Engage parent
-Organize examination
-Involve child
-Steady pace
-Be honest
Exam considerations (infants) -forms of communication are nonverbal, rocking, patting or holding
-let them see parents at all times
Exam considerations (toddlers) -concrete thinkers, take everything literally
Exam considerations (Preschoolers) Bascially like toddlers but are better. Make up cool situations like
hero games. you can starrt to use proper terminology. Like rewards
Exam considerations (school-age children) concrete thinks but more sophisticated. sensitive to
embarrassment. Will listen to what you say
, Exam considerations (Adolescents) understand their prior experiences with healthcare
-monosyallbic responses
- to all responses (nonverbal, ect)
-determine comprehensive reading level
-get parents out of room so they can share
Weight Newborns: round to the nearest 0.5oz
Toddler/Preschoolers: might need to remove clothes but may not have privacy so just take off jacket
and hat
School-age children/adolescents: use upright scale to measure adolescents height. Be aware of eating
disorders (anorexia nervosa, buliimia nervosa)
Head Circumference Head should be measured at birth and at 36mo.
-place tape measure on widest part of head (slightly above eyebrows)
-head increases in size up to 2cm/month in the first 6mo.
Temperature checks -Rectally for children older than 3mo
Newborns/Infants
- rectal temp 0.6in depth
-refererence range core temp is (36.5-37.6)
(97.7-99.7) and for newborns 37-37.5 (98.6-99.5)
a child (exam 1)
Bronchovesicular sounds medium-pitched quite sounds expected when auscultating over the mainstem
bronchus
Bruit Pulsing, blowing sound produced by turbulent bld flow
Crepitation crunching sounds under skin due to air
Kyphosis forward curve of. thoracic spine (hunch back)
Orthopneic position Body position to ease breathing; often lean forward, use arms for support and lift
chest to increase breathing
Pallor paleness, absent skin color
Pericardial friction rub scratching or squeaking sound heard over precordium and indiciates inflamm of
pericardial lining
Scoliosis "S" shaped spine
Tactile fremitus vibration felt by hand on chest when speaking
Thrill palpable vibration caused by turbulent bld flow
Vesicular sounds soft, fine, breeze, low pitched heard over peripheral lung tissue
,B.P cuff -length of bladder at least 80% circumference
- 40% with of bladder
Otoscope 2mm for peds and 4mm for adults
Tongue depressors feel around oral cavity. and do a sensitivity test with popsicle stick. Break in half and
poke with sharp and dull so they can tell the difference
Exam (assessment) considerations -Engage parent
-Organize examination
-Involve child
-Steady pace
-Be honest
Exam considerations (infants) -forms of communication are nonverbal, rocking, patting or holding
-let them see parents at all times
Exam considerations (toddlers) -concrete thinkers, take everything literally
Exam considerations (Preschoolers) Bascially like toddlers but are better. Make up cool situations like
hero games. you can starrt to use proper terminology. Like rewards
Exam considerations (school-age children) concrete thinks but more sophisticated. sensitive to
embarrassment. Will listen to what you say
, Exam considerations (Adolescents) understand their prior experiences with healthcare
-monosyallbic responses
- to all responses (nonverbal, ect)
-determine comprehensive reading level
-get parents out of room so they can share
Weight Newborns: round to the nearest 0.5oz
Toddler/Preschoolers: might need to remove clothes but may not have privacy so just take off jacket
and hat
School-age children/adolescents: use upright scale to measure adolescents height. Be aware of eating
disorders (anorexia nervosa, buliimia nervosa)
Head Circumference Head should be measured at birth and at 36mo.
-place tape measure on widest part of head (slightly above eyebrows)
-head increases in size up to 2cm/month in the first 6mo.
Temperature checks -Rectally for children older than 3mo
Newborns/Infants
- rectal temp 0.6in depth
-refererence range core temp is (36.5-37.6)
(97.7-99.7) and for newborns 37-37.5 (98.6-99.5)
