PHysical assessment

[deanikins211]

We will have our case presentation. Im appointed to the physical assessment and review of systems of a school aged child.

format is like this:

System Objective Problem identified.

please help me . My pediatric book is not complete from head to toe.

[Daytonite, BSN, RN]

there is direction on head-to-toe assessment on this sticky thread in nursing student assistance forum:

• https://allnurses.com/forums/f205/health-assessment-resources-techniques-forms-145091.html - health assessment resources, techniques, and forms - information on head-to-toe assessments are on posts #5, #11 and #13

also

• http://www-personal.umich.edu/~samt/503/resources/pediatric_health_hx.doc - these are questions to ask for the history taking part of the pediatric history and physical.
  
• http://www.yalepediatrics.org/education/medstudentedu.html
  • http://www.comsep.org/educationalresources/multimediateaching.htm - click on the "pediatric physical examination" link. you need a windows media player to view the 19-minute video

  [*]http://www.columbia.edu/itc/hs/medical/clerkships/peds/student_information/reference_materials/pe_video.html - same video of a pediatric physical exam as above - need a real player to view

your assessment should focus on the particular signs and symptoms of the condition the patient has. also bring in assessment of the child's stage of development and whether or not they are performing tasks appropriate to their developmental level.

have you seen the guidelines that i am always posting for assessment activities? that's what you should be doing for this part of the presentation. the basic difference between a pediatric person and an adult is their age and their behavior.

1. assessment (collect data from medical record, do a physical assessment of the patient, assess adl's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
   • a physical assessment of the patient
     
   • assessment of the patient's ability and any assistance they need to accomplish their adls (activities of daily living) with the disease
     
   • data collected from the medical record (information in the doctor's history and physical, information in the doctor's progress notes, test result information, notes by ancillary healthcare providers such as physical therapists and dietitians
     
   • knowing the pathophysiology, signs/symptoms, usual tests ordered, and medical treatment for the medical disease or condition that the patient has. this includes knowing about any medical procedures that have been performed on the patient, their expected consequences during the healing phase, and potential complications. if this information is not known, then you need to research and find it.