Assessment of Growth & Development of Children Human Growth and Development NUR 311 Lecture 2 Assessment of Growth & Development of Children

Physiological measurements. Physical examination. Outline: Growth measurements. Physiological measurements. Physical examination. Developmental screening.

Physical Assessment of Children

The 1st step in the assessment is complete history taking. Nurses perform physical assessments of infants and children in various settings the clinic, the hospital, the school and home. The physical examination may be part of a well-child assessment

Which time is suitable for physical examination?

For infant, should be made as often as necessary.

Schedule of follow up: Each month during the first year of life. Each 3 months during the 2nd & 3rd years. Each 6 months during the 4th &5th years. Yearly from the 6th years throughout life.

Preparation of the child for physical examination:

Conduct on parent's lap. Distraction. Infants Physical Examination Approach Developmental Stage Conduct on parent's lap. Distraction. Infants

Physical Examination Approach Developmental Stage Toddlers Distraction. Allow for touch/ holding of equipment. Choices when possible. Parent's lap. Try not to ask for permission Toddlers

Physical Examination Approach Developmental Stage Preschool Inform what you are going to do and how they can help. Praise for help and cooperation. Preschool

Physical Examination Approach Developmental Stage School Age Answer questions factually with age appropriate vocabulary. Explain use of equipment. School Age

Physical Examination Approach Developmental Stage Adolescent Ensure privacy. Examine without parent. Inform of each step of examination. Adolescent

History taking: Taking an accurate health history is the single most important component of physical examination. Complete or initial history data are gathered about the child from the time of conception to the child's current status.

Summary of Health History 1. Identifying information (Statistical information) Name Address Phone number Clinic number 2. Present concerns

3. Family profile Family characteristics Family history Family development Family interaction Support systems Culture

4. Child profile Past medical history Gestation Birth history Neonatal period Immunizations Laboratory tests Infectious diseases Operations/hospitalizations Accidents Allergies Current medications

Nutrition Sleep Elimination School Past utilization of health Care Special concerns of the adolescent 24 – hour history Review of systems

Length During the first two years of life, the child's length must be measured while the child is in the recumbent position.

Weight: The infant should be placed centrally on the scale and the older child should stand centrally on the platform. Head circumference Head circumference is measured until the child is 2 years old.

Assessment points for heart auscultation ICS = Intercostal space

Developmental Screening What is developmental screening? Is a procedure designed to identify children who should receive more intensive assessment or diagnosis, for potential developmental delays.

Developmental Screening Why is developmental screening important? Early identification and intervention for children with developmental delays is mandated Parents are interested in knowing more about their child’s development and pediatric practitioners need to be better prepared for this. 

Developmental Screening Who provides developmental screening services? Can be done by various professionals in healthcare, community, or school settings.

Hormonal influence on growth and development

Growth Hormone Secreted by the anterior portion of the pituitary gland The influence of growth hormone brings about an increase in the child’s height and weight, changes in skeletal proportions and head and face contours, dental development, and ossification of the long bones.

Thyroid Hormones (T3) and (T4) are the major thyroid hormones and are secreted by the thyroid gland. Thyroid hormones have a great influence on fetal and neonatal growth. In the absence of thyroid hormones during this period, there is a lack of brain growth