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

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

3. Physical Assessment of Children

4. 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

5. Which time is suitable for physical examination?

6. For infant, should be made as often as necessary.

7. 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.

8. Preparation of the child for physical examination:

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

10. 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

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

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

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

14. 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.

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

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

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

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

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

20. 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.

21. Assessment points for heart auscultation
ICS = Intercostal space

22. 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.

23. 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. 

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

25. Hormonal influence on growth and development

26. 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.

27. 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