physical assessment in children

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

2. PREPREPARATION
FOR ASSESSMENT
• - - EXAMINATION ROOM
• - EQUIPMENTS
• - POSITION
• - NURSE PREPARATION
METHODS OF
ASSESSMENT
• -INSPECTION
• -PALPATION
• -PERCUSSION
• -AUSCULTATION
HEAD TO TOE
ASSESSMENT
• -VITAL PARAMETERS
• -GENERAL MARKERS OF
• DISEASE
• -DETAILED EXAMINATION
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.

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

14. HEAD TO TOE
ASSESSMENT

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

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

17. PALLOR

18. ICTERUS

19. CYANOSIS

20. CLUBBING

21. LYMPHADENOPATHY

22. JUGULAR VENOUS PRESSURE

23. EDEMA

24. COMPONENTS OF
HEAD TO TOE
EXAMINATION

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

26. 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

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

29. FLIP BOOK

30. CHEST
• Assessment of the chest is done by:
1. Inspection
2. Palpation
3. Percussion
4. Auscultation

31. Chest Percussion

33. Chest Auscultation

35. ABDOMEN

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

37. VIDEO

39. 1.Which of the following method is used to
assess the shape, size and location of body
part?
a) Palpation
b) Auscultation
c) Percussion
d) Inspection

40. 2 In older children icterus is diagnosed when
serum bilirubin level increases
above…………..
a) 5mg/dl
b) 3mg/dl
c) 2mg/dl
d) None of the above

41. 3 Clubbing develops in …………….. grades.
a) 4
b) 2
c) 3
d) 5

42. 4 Splint hand and foot syndrome is termed as
………….
a) Syndactyl
b) Polydactyl
c) Ecrodactyl
d) Both a & b

43. 5 Umbilical hernia-ballon shaped umbilicus
commonly found in……………years of age.
a) less than 4 years
b) less than 2 years
c) more than 2 years
d) more than 4 years

44. THANK YOU