Touch is a powerful communication tool, especially for the infant who
calms when cuddled or patted, or a parent who is distraught about a
child’s condition.Culture alertBe aware of cultural variation in physical contact, particularly
across genders, which might be considered inappropriate or taboo.Provide an interpreter or use technology to assist in translation of ques-
tions and of responses voiced in native tongue.
Remember that nonverbal communication is as important as verbal.
Smiling and maintaining a pleasant facial expression reduces client and
parent anxiety.
Attitude is also important in establishing a trust relationship with client
and parents. Maintaining a nonjudgmental manner will help the child/
parent feel comfortable and provide truthful information to the nurse.Nursing History
Discuss or have parent complete a form containing the following information
to provide contact data and clarify relationships to child:
Demographic-biographical information (child name, age, address/phone
number, caregiver name, relationship to child, etc.).
Current state of health (i.e., fatigue, pain, weight gain or loss, activity tol-
erance, abilities or disability in communication, mobility, pain, etc.).
Review of systems or head-to-toe approach should be used.
Chief complaint:Current symptoms determine why the child was
brought in for examination.
Past history provides background for the problem and any additional
problems that the child may have experienced. This assessment should
include acute or chronic conditions as well as surgical procedures.Assessment
Psychosocial Assessment
Habits: Sleep pattern, that is, difficulty sleeping or excess sleep could
indicate depression, drug reaction, or pain or discomfort from disease.
Eating habits: Frequency and type of food intake; can reveal eating dis-
orders, obesity, or malnutrition (failure to thrive in infant population)
possibly due to poverty or could reveal abuse or neglect.
Substance abuse: Drugs, tobacco, or alcohol (current or past); determine
frequency and amount or usage.
Sexual activity: Do not limit assessment to older adolescents because a
child as young as age 8 or 9 may be sexually active.2(^34) Pediatric Nursing Demystified