Pediatric Nursing Demystified

Physical Examination

A systematic approach to the physical examination, proceeding from head to

toe, is the best method of fully assessing a client. For infants and toddlers,

however, intrusive procedures such as ear, eye, nose, and mouth examinations

should be done last to keep the child calm for as long as possible during the

physical examination. Use play as much as possible to encourage coopera-

tion (e.g., “Where is your belly?” when palpating stomach). Allow child to

handle equipment when appropriate (stethoscope). Normal findings for exam-

ination of most systems are similar across the age span, but some distinctions

are noted at certain developmental stages.

General

Overall appearance reveals cleanliness, well nourished, clothes well fit-

ting, stature appropriate for age, posture straight, no signs of pain

(frown/grimace).

Behavior and personality, interactions with parents and nurse, tempera-

ment(behavioral style: calm or not). Note: If child is agitated, some

assessments will need to be deferred until more cooperative and calm to

minimize distress.

Skin Integrity (absence of lesions, drainage, etc.)

Color:Pallor(pale appearance) or cyanosis(bluish tint) could indicate

poor circulation or oxygenation; flushing could indicate increased blood

flow to skin due to infection.

(^38) Pediatric Nursing Demystified

1. When performing a family assessment, it is important to consider the ____
   and the ____ of the child’s family.
   Answer:


2. When performing physical assessments on young children and infants, intrusive pro-
   cedures must be completed first to ensure the accuracy of the assessment.
   True/False?
   Answer:


3. Mark, age 4, has a hearing deficit. Why would the nurse need to speak with the social
   worker about services to support Mark and his family?
   Answer:

✔ ROUTINE CHECKUP 1