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 Reply 1

Compare the physical assessment of a child to that of an adult. In addition to describing the similar/different aspects of the physical assessment, explain how the nurse would offer instruction during the assessment, how communication would be adapted to offer explanations, and what strategies the nurse would use to encourage engagement.

There is a numerous amount of developmental and physical diversities between infants, children, adolescents, adults and the aging adults. The time of substancial development and growth is when undergoing infancy, childhood, adolescence, and elder aging.

Ideally the information obtained through a nurses assessment consists of objective and subjective data. When obtaining this data for the adult patient it may be acquired by observation and asking the patient questions. When obtaining the proper assessment for pediatric patients, the information will be provided by the parent or caregiver, as well as for toddlers and some preschoolers who are still intimidated of strangers. Considering the age of the child this assessment may include questions regarding prenatal period, birth of the child, immunization history, and developmental milestones that have been achieved may be asked.

Many children that are school-aged will demonstrate eagerness to learn and understand cause and effect. Including data provided by the school-age child related to their care is welcomed by this specific age group. However, any medical decisions regarding the child’s care must be encountered with the child’s parent or caregiver not the child. One of the most essential nursing practices with this specific age group is to provide privacy due to the fact that these children are initially understanding their sexuality. An assessment by the nurse must be detailed and obtained through the methods of assessment by which include inspection, palpation, percussion, and auscultation generally performed the same way as in an adult.

It is essential to always keep in mind the level of education of the patient especially when communicating children therefore nurses must speak slowly, clearly and utilizing simple vocabulary. Such as a nurse may consider utilizing the word touch as opposed to palpate when caring for a five year old. Children in the ages of toddler and preschool ages may demonstrate impressive imagination therefore they may view machines as scary monsters. Therefore, nurses must provide an explanation of what is happening prior to the procedure including the physical examinations and encourage the child to express their concerns. It is also essential to praise and reward this age group because they are still developing and it praises positive behavior.

There are many helpful strategies that assist in engaging and assessing children and would include warming the hands and tools, such as the stethoscope, prior to placement on the child. It is also beneficial to Include the child in the assessment, position yourself on the level of the child to decrease fear, and utilize playing or games to attain the child’s cooperation.

References

Falkner, A. (2018). Age-Appropriate Approach to Pediatric Health Care Assessment. In Health assessment: Foundations for effective practice. Retrieved from https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter/2

Reply 2

Re: Topic 2 DQ 2

In assessment for both child and adult similarities are history taking, physical assessment and focusing on present illness. But you don’t take head circumference or motor skills assessment of an adult as you do for infant. In addition when you assess or discuss procedure to an adult, you can use logical explanation to help them to understand, can address everyone in room include family and visitors. With children entirely different, it is like learning another language. For example, history taking in pediatric musculoskeletal medium would be different as in adults. A young child history may be primarily from parent/ caregiver, consists of complain such as, my child is not right, stopped doing that or legs hurt. No, matter the age of child, effort should be made to ask simple age-appropriate questions. With adult you can directly take history or ask questions related to present complain.

It is important to modify assessment style when engaging with children and people. By using appropriate language, tone and be alert to non-verbal clues of discomfort, fear of embarrassment. Sometimes watching the child as they enter the room and play with toys could be the best way to gather information.

Building relationship with pediatric patients is very important for assessment. Try greeting the patient first then speak with parents. This communicates that they are important and builds trust. Being interactive is good strategy before jumping to lung assessment. For example, let the child look at your stethoscope, have them practice deep breaths before you put stethoscope in your ears. Listening to their parent’s lung first to show there are no “boos-boos” with assessment.

A skilled pediatric nurse understands the importance of connecting with the patients. Strategy use to encourage engagement is DOING YOUR HOMEWORK: like be in touch with what different age groups enjoy right now, like Watching bubble guppies, Dora or Barney? Being up to date on popular kid shows, tech, keep the conversation going. Another strategy is LET THEM HELP: pediatric patients are helper by nature. Let them help you get things for assessment, hold the band-aid or listen to your heart first.

Being a pediatric nurse is challenging, learn to be a kid again. This will help when communicating with pediatric patients and their parents.

Reference:

Angelina. W. (2018). Four major difference between pediatrics and adults’ nurses. Nurse. Org.

Fast. A ff. (2015). Pediatric nurse: A crash course in talking to kids.

Marianne. B. (2017). Pediatric health and physical assessment. Nurse labs.

Melissa. RN. (2014). 5 tips for communicating with pediatric patients. Nurse choice.