Download - Health Assessment
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ASSESSMENT OF HEALTH IN CHILDREN
Nirmala RobertsPaediatric Nursing
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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
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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
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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
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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
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METHODS OF HEALTH ASSESSMENT (For all age groups)
Dietary History H/O illness General examination Biochemical examination
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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
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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
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GENERAL EXAMINATION
General physical examination Nutritional anthropometry Neuromuscular control Assessment of tissue growth Bone age Dental age Biochemical & histological means Psychological tests
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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
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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
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SCHOOL AGE
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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
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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
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GENERAL EXAMINATION
General physical examination Nutritional anthropometry Neuromuscular control Assessment of tissue growth Biochemical & histological means Psychological tests
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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
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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
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ADOLESCENCE
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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
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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
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GENERAL EXAMINATION
General physical examination Nutritional anthropometry Neuromuscular control Assessment of tissue growth Biochemical & histological means Psychological tests
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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
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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
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BIOCHEMICAL EXAMINATION( For all age children)
• Blood – Hb%, PCV, S Protein
• Urine – RE
• Stool - RE
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PSYCHOLOGICAL EXAMINATION – INFANTS & TODDLERS
Compare against normal children Take ‘Corrected age’ for preterms Take note of disability or handicap
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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
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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
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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
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