Health Assessment
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Transcript of Health Assessment
ASSESSMENT OF HEALTH IN CHILDREN
By: Dave Jay S. Manriquez RN.Pediatric Nursing
HEALTH
A state of complete physical, mental and social well being, and not merely the absence of disease or infirmity (WHO 1947)
Not a condition, but an adjustment Not a state, but a process The process helps us to adapt not only to our
physical, but also to our social environments
CHILD HEALTH
Closely related to her growth & development Directly proportional to the growth &
development Is the responsibility of every adult Needs to be assessed frequently to avoid
pitfallsA healthy child will grow to be a healthy adult
STAGES OF GROWTH IN CHILDREN
Infancy – Birth to 12 months Neonate – 0–28 days Infancy – 1–12 months
Early childhood – 1–6 yrs Toddler – 1–3 yrs Preschooler – 3-6 yrs
Middle Childhood ( School age) – 6–12 yrs Late Childhood – 11–19 yrs
Pre pubertal – 10-13 yrs Adolescence – 13-18 yrs
WHY ASSESS HEALTH IN CHILDREN?
Peculiarities of the child – Dependent, poor communication skills, and low immunity
Ensure normal health Provide timely guidance for optimal health Detect abnormal states and correct them Educate parents on ways to ensure good
health
METHODS OF HEALTH ASSESSMENT (For all age groups)
Dietary History H/O illness General examination Biochemical examination
DIETARY HISTORY(0 – 5 yrs)
Nature of diet Staple food Appetite Breast feeding, weaning, feeding problems Vitamin/ mineral supplements Food allergy/ fads Birth weight, recent weight loss Veg garden/ poultry/ cattle
HISTORY OF ILLNESS
Infections Infestations Immunization status – For all VPDs Personal hygienic habits Emotional health Social health Access to civic amenities
Potable water Waste disposal Medical facilities
GENERAL EXAMINATION
General physical examination Nutritional anthropometry Neuromuscular control Assessment of tissue growth Bone age Dental age Biochemical & histological means Psychological tests
GENERAL PHYSICAL EXAMINATION
General condition Appearance, activity, stature Face – Appearance, eyes, lips, oral cavity Glands & lymph nodes Skin – colour, hydration, rashes, edema
Systemic – CVS, Resp, Congenital anomalies Others -
Sleep Play Bowel & bladder function
MEASUREMENT OF GROWTH
• Weight – Infant weighing scale (manual/ electronic), Salter spring machine, Bathroom scale
• Length – Infantometer, Stadiometer• MAC – Tape measure, Bangle, Shakir’s tape• OFC – Tape measure • Chest circumference – Tape measure• BMI - Wt/ Ht2 • Skin fold thickness – Harpenden/ Best skin calipers• Dental development • Neuromuscular control – Milestones, motor skills
SCHOOL AGE
DIETARY HISTORY
Nature of diet – NV/PV, Fads, preferences, fast foods, snacking, beverages
Staple food, lunch box Appetite – Lack of interest Food allergy Recent weight loss Veg garden/ poultry/ cattle
HISTORY OF ILLNESS
Infections Infestations Immunization status – TT, HBV, BCG Personal hygienic habits Emotional health Social health Access to civic amenities
Potable water Waste disposal Medical facilities
GENERAL EXAMINATION
General physical examination Nutritional anthropometry Neuromuscular control Assessment of tissue growth Biochemical & histological means Psychological tests
GENERAL PHYSICAL EXAMINATION
General condition Appearance, activity, stature Face – Appearance, eyes, lips, oral cavity Glands & lymph nodes Skin – colour, hydration, rashes, edema
Systemic – CVS, Resp, Genito urinary Others -
Sleep Play Bowel & bladder function
MEASUREMENT OF GROWTH
• Weight – Bathroom scale• Length – Stadiometer• Chest circumference – Tape measure• BMI - Wt/ Ht2 • Skin fold thickness – Harpenden/ Best skin
calipers• Neuromuscular control – Motor skills
ADOLESCENCE
DIETARY HISTORY
Nature of diet – NV/PV, Fads, preferences, fast foods, snacking, beverages
Staple food Appetite – Anorexia Nervosa, obesity Food allergy Recent weight loss Veg garden/ poultry/ cattle
HISTORY OF ILLNESS
Infections Infestations Immunization status – TT, HBV, BCG Gynaecological health Urological health Personal hygienic habits Emotional health Social health Access to civic amenities
potable water Waste disposal Medical facilities
GENERAL EXAMINATION
General physical examination Nutritional anthropometry Neuromuscular control Assessment of tissue growth Biochemical & histological means Psychological tests
GENERAL PHYSICAL EXAMINATION
General condition Appearance, activity, stature Face – Appearance, eyes, lips, oral cavity Glands & lymph nodes Skin – colour, hydration, rashes, edema, pricks
Systemic – CVS, Resp, Genito urinary Others -
Sleep Play Bowel & bladder function
MEASUREMENT OF GROWTH
• Weight – Bathroom scale• Length – Stadiometer• Chest circumference – Tape measure• BMI - Wt/ Ht2 • Skin fold thickness – Harpenden/ Best skin
calipers• Neuromuscular control – Motor skills
BIOCHEMICAL EXAMINATION( For all age children)
• Blood – Hb%, PCV, S Protein
• Urine – RE
• Stool - RE
PSYCHOLOGICAL EXAMINATION – INFANTS & TODDLERS
Compare against normal children Take ‘Corrected age’ for preterms Take note of disability or handicap
PSYCHOLOGICAL EXAMINATION – PRESCHOOL AGE
Adaptive behaviour - Play, climbing, speech, feeding
Vision – Posture, walking, play, manipulation with toys
Performance – understanding matching color, concentration, visual acuity
Comprehension of language – Body parts, pictures, commands
PSYCHOLOGICAL EXAMINATION –SCHOOL AGE & ADOLESCENCE
Application, concentration, organizational skills -Three ‘R’s, drawing
Vision, hearing IQ tests
Stanford Binet Intelligence Scale Wechsler Intelligence Scale Goodenough ‘Draw a Man’ test Denver Development Screening Test
PRE REQUISITE
• Venue – Congenial environment - Good lighting, pictures, posters - Good sleep, food, warmth - Good IPR, ‘relaxed’, ‘stories’ - Ensure presence of parents• Articles – Weighing scale, Stadiometer, Tape
measure, books, paper, pencil, crayons, toys - NCHS chart - Growth chart