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- Demonstrate clinical reasoning in conducting a child health assessment.
- Apply Erikson’s stages of child development to health assessment.
- Examine factors that increase the vulnerability of a child.
- Compare the physical assessment of a child to that of an adult.
The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 750-word paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:
Compare the physical assessments among school-aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child.
Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.
Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment.
You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
The physical assessment of school-aged children should entail a complete head-to-toe examination or comprehensive exam of each body system. The vital signs, height, weight, and mid-upper arm circumference is monitored for all ages (Chiocca, 2010). Blood pressure monitoring requires the use of a different cuff depending on the child’s age and mid-arm circumference. A vision test is performed with a Snellen’s chart, and the child should be assessed for strabismus, nystagmus and the range of eye movements (Chiocca, 2010). A dental exam should be done for all children; 6-8-year-olds should be assessed for the eruption of secondary teeth and shedding of primary teeth (Chiocca, 2010). Children aged 9-12 year are examined for dental cavities or delay in the growth of secondary teeth.
When assessing a school-aged child, I would modify the assessment approach by starting with the assessment of the body parts that require the child to cooperate (Press, 2015). For instance, if the child has respiratory symptoms, I will begin with assessing the nose, chest, lungs, and heart and finalize with the musculoskeletal system. Besides, painful procedures will be done last, and I will explain to the child the discomfort associated with the assessment or procedure and the time it will last before proceeding (Press, 2015). If the child had a complaint of pain in a specific body, I would examine the area last to avoid discomfort in the entire assessment. For the younger child aged 5-7 years, I will encourage the caregiver to be present or to hold them to promote cooperation (Press, 2015). Furthermore, I will ensure I screen the child during the examination and instruct the child to uncover only the part that is being examined and re-clothe it to avoid embarrassment and discomfort.
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.
Assessment is a significant component in the nursing practice in that it is required for planning and providing family and patient-centered care. However, when conducting the physical examination for children, it is important to consider the different techniques that are age appropriate. First, school-aged children tend to feel mature, but in the health care setting, it is significant to consider whether they want their parents around. A 5 years old child would want the parent around, but a 12 years old might decide that having the parent around is a limitation. The nurses can ask for the preference of the child. School going children also become conscious about their bodies, and thus, privacy becomes an [cmppp_restricted]issue to them (Drutz, 2008). It is thus important to have them wear a gown and some privacy to change into the gown. The head to toe method should be employed, and each step explained in an age-specific language. However, the child should also be allowed to provide information about their activities, diet and health.
Trevor is a 7 years old boy. For a child this age, he has the ability to use language, and his imagination and memory is heightened. Children this age also develop a sense of accomplishment and pride and portray this by taking pride in social activities, school work and sports. Trevor takes pride in social activities more so in video games. He never feels inferior and gets along well with other people. He can also understand the relationship between the future and the past and can express this relationship (Morin, 2019). The sense of morality of the child is based on personal relationships. He accepts the rules of the parents with the belief that this acceptance is significant for a positive relationship with them.
Based on Piaget theory of development, Trevor is in the preoperational stage of development. At this age, children are able to use language, imagination, as well as memory. They can easily express and understand the relationship between future and past events (Lourenço, 2016). When conducting a developmental assessment for Trevor, the first step would be to ask the parent about his overall physical and mental abilities. This is to identify if there are any lost abilities. The second step is to explain the assessment by the use of language and imagination. At his age, Trevor can use language and understand. When explaining, I would use imagination to create events that match the assessment process for the child to understand the significance of the assessment. The head to toe method should be employed to assess the physical aspects such as hearing and vision. A major strategy to gain cooperation is to give ownership in the process. This can be done by offering questions such as ‘what do you want to do next? The child needs to feel proud of the process and use their imagination to feel in control. To gain potential findings from the assessment, it is important to allow the child to air his historical view of his abilities. A 7 years old understand the relationship between future and past and with their ability to use language can be able to relay how they feel and what they want to feel in future (Bellman, Byrne & Sege, 2013). This can be used to assess their imagination and memory capabilities.
Bellman, M., Byrne, O., & Sege, R. (2013). Developmental assessment of children. Bmj, 346, e8687.
Drutz, J. E. (2008). The pediatric physical examination: General principles and standard measurements. Dosegljivo na: http://www. uptodate. com/contents/the-pediatric-physical–examination-heent, 2-150.
Lourenço, O. M. (2016). Developmental stages, Piagetian stages in particular: A critical review. New Ideas in Psychology, 40, 123-137.
Morin, A. (2019). The Developmental Milestones You Can Expect From Your 7-Year-Old. Retrieved from https://www.verywellfamily.com/7-year-old-developmental-milestones-620704 [/cmppp_restricted]
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.The Needs of a Child Aged 5-12 Years Old: Physical Assessment.
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The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 500-750-word paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:
1. Compare the physical assessments among school-aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child.The Needs of a Child Aged 5-12 Years Old: Physical Assessment.
2. Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.
3. Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.The Needs of a Child Aged 5-12 Years Old: Physical Assessment.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
Children in the 5-12 years age bracket are school-going children. They are in the developmental stage that is between preschoolers and adolescents. Physical examination or assessment is done on these children as well as the others in the other age groups and developmental stages for various reasons. It may be that they have been brought to a well-baby clinic, or that they are sick and are about to be admitted (Nurse Key, n.d.). Whatever the reason, it is essential to be aware of the child’s needs according to their age and developmental stage. This is what will inform the care panning for the child after getting the appropriate subjective and objective information from the assessment. This discussion examines the physical assessment of school-going children (5-12 years old), presents a case example, and looks at a developmental theory that may be used to explain the developmental assessment of a child.The Needs of a Child Aged 5-12 Years Old: Physical Assessment.
Physical Assessment Among School-Aged Children
Physical assessment among school-aged children is different from that of infants, toddlers, and preschoolers. This is because unlike these preceding developmental stages and age groups, the school-going child has begun to appreciate and understand reality as opposed to fantasy. According to theorist Jean Piaget, their thought processes at this developmental stage can be referred to as ‘concrete operations’. What this means is that school-aged children are able to think logically and comprehend the effect of an action or its consequences (Leifer, 2019). Their reasoning is more advanced since they have started interacting with other people in the outside world. Age 5-12 is also the time when the child is very eager to learn new things, accomplish tasks, and be appreciated. According to the developmental theorist Erik Erikson, the children at this age are in the ‘stage of industry,’ and this explains their industrious nature. (Leifer, 2019).The Needs of a Child Aged 5-12 Years Old: Physical Assessment. At this developmental stage, the child is able to give a proper and accurate account of their illness and this is why they should also be interviewed as well as the parent or guardian who brought them to be seen (Hairfield & McCormick, 2017). Modification of techniques to match the age and developmental stage of the child in this stage therefore involves equally questioning the child in addition to the parent/ guardian, asking the child questions they can answer (especially about school, their performance, and their friends), and examining the child as thoroughly as an adult since they can cooperate well during the procedure.The Needs of a Child Aged 5-12 Years Old: Physical Assessment.
A Case Example
Patient N.M. is a seven-year-old boy who was brought by his mother for a normal medical check-up at the wellness clinic. She is a child whose birth was normal and devoid of complications. Her birth weight was 3.25 kg with an Apgar score of 9. She received all the required immunizations and has only been admitted twice since birth for scalding and an allergic reaction to a medication. She is a child who is developing normally and achieving all the developmental milestones expected of her. These typical developmental stages or milestones of a child at this age include (CDC, 2020):
- Cognitive development
Can vividly describe thoughts and feelings, appreciates the thoughts and concerns of others, and demonstrates faster maturity in terms of mental skills.
- Social and emotional development
Craves for more acceptance by friends and other people, begins to exercise more independence, begins to appreciate more what friendship is, and starts to appreciate the abstract concept of existence.The Needs of a Child Aged 5-12 Years Old: Physical Assessment.
- Motor development
Has good motor coordination and is able to perform simple gymnastics.
Applying Jean Piaget’s Thoughts in the Developmental Assessment of a School-Age Child
Jean Piaget was the scholar who came up with the theory of cognitive development. This theory suggests that cognitive development in a child is a process that takes place gradually as the child interacts with its environment. The four stages of Piaget’s cognitive development model are (i) sensorimotor which starts from birth to 2 years, (ii) preoperational which is from one and a half years to age seven, (iii) concrete operational which is between ages 7 to eleven years, and (iv) formal operational which is from age 12 to 19 years (McLeod, 2018; Carey et al., 2015).The Needs of a Child Aged 5-12 Years Old: Physical Assessment.
Based on Piaget’s theory, this child would be developmentally assessed based on the concrete operational stage which is stage three in the above cognitive development theory. Given that this stage states that the child between 7-11 years old has developed operational thought or logical thinking, the developmental assessment will focus more on asking the child more pointed and specific questions that the mother may not answer with certainty. The strategy to gain cooperation during the assessment would be to ask the child about school, their friends, and what they like. Explanations would be offered through simple but logical explanations since the child already has developed logical thought processes. Potential findings for patient N.M. are expected to be normal, since the visit was a well child appointment.
Children undergo definite and specific developmental milestones that must be appreciated by the nurse to enable them understand the needs and problems of children of different ages. Among the developmental theorists is Jean Piaget who came up with the theory of cognitive development. Using this theory, one can apply its concepts to help in developmentally assessing any child, such as a 7 year-old falling under the school-age bracket of 7-12 year-olds.The Needs of a Child Aged 5-12 Years Old: Physical Assessment.