Nursing 101 PEDIATRIC PHYSICAL ASSESSMENT
Many assessments for the child are similar to those for the adult. Techniques for approaching the
pediatric patient vary from one age group to the next. A basic principle is building a trusting
relationship; this can be done in a variety of ways.
1. Explain what will be done prior to each portion of the assessment and answer questions
honestly.
2. Praise the client for positive behaviors (e.g. for example, cooperating during assessment
of the middle ear).Portraying a caring attitude will greatly influence both the patient’s
and the caregiver’s sense of trust.
3. Show respect for the patient as an individual and allow expression of feelings
(whimpering, crying).
EQUIEPMENT:
1. SCALE
2. Appropriate-sized blood pressure cuff
3. Snellen and Tumbling E charts
4. Allen cards
5. Color vision chart
6. Ophthalmoscope
7. Otoscope, speculum (2.5-4mm), pneumatic attachment
8. Pediatric stethoscope
9. Growth chart
10. Peanut butter or chocolate
11. Small bell
12. Brightly colored object
13. Denver II materials
14. Clean gloves
15. Disposable centimeter tape measure
VITAL SIGNS:
• Temperature
• Respiratory rate
• Physical growth (use the same scale at each visit, if possible, to prevent variations in
serial weight checks).
• Blood pressures (never use the phrase “blood pressure”, say instead “I am going to hud
your arm with this cuff”).
• Weight and height
,Nursing 101 PEDIATRIC PHYSICAL ASSESSMENT
Assessment of the Integumentary System
Skin: A. Inspection
1. Observe the color of the body, 1. These areas are prominent locations for
especially at the tip of the nose, the detecting cyanosis or jaundice.
external ear, the lips, the hands, and
the feet.
2. Observe the skin for lesions, noting the 2. Lesions can be localized, regionalized,
anatomic location. or generalized. They can involve
*ABCDE Mnemonic for evaluating exposed areas or skin folds.
skin lesions
A (Asymmetric): Is the lesion
asymmetric?
B (Borders): are the borders of the
lesion irregular?
C (Color): Is the color of the lesion
uneven, irregular, or multicolored?
D (Diameter): Has the lesion’s
diameter changed recently?
E (Elevation): Has the lesion become
elevated?
B. Palpation
1. Use the finger pad to palpate the skin. To note the quality, thickness and
Palpate with finger pads in different suppleness. (e. g. Use the finger pads to walk
areas. The technique of palpating the up the abdomen and touch the nose). Skin of
skin of a younger child can be the pediatric patient is normally smooth and
accomplished by playing games. soft. Milia, plugged sebaceous glands,
present as small, white papules in the
newborn.
2. Temperature: palpate with back of hand, Temperature should be uniform within
noting uniformity of warmth normal range.
3. Palpate dependent areas (sacrum, feet, -degree of pitting edema reflects the depth of
and ankles) for mobility by applying indentation in centimeters or inch: mild-0 to ¼
pressure with fingers, noting degree of inch, moderate-1/2 inch, severe-3/4 to 1 inch.
indention. Edema is usually graded from trace to 3+ or 4+
pitting. Trace is a slight indention that
disappears in a short time. Grade 3+ or 4+,
depending on the scale, is deep pitting does not
disappear readily.
Hair: Inspection/palpation
1. Quality, distribution, pattern of hair To note thick, evenly distributed hair.
loss if any over the scalp. Thin, brittle hair occurs with
hypothyroidism.
2. Texture and oiliness Normally resilient hair is silky.
3. Amount of body hair. The amount of body hair varies, hair should be
free from infestation.
Head: Inspection
, Nursing 101 PEDIATRIC PHYSICAL ASSESSMENT
may pulsate with
Many assessments for the child are similar to those for the adult. Techniques for approaching the
pediatric patient vary from one age group to the next. A basic principle is building a trusting
relationship; this can be done in a variety of ways.
1. Explain what will be done prior to each portion of the assessment and answer questions
honestly.
2. Praise the client for positive behaviors (e.g. for example, cooperating during assessment
of the middle ear).Portraying a caring attitude will greatly influence both the patient’s
and the caregiver’s sense of trust.
3. Show respect for the patient as an individual and allow expression of feelings
(whimpering, crying).
EQUIEPMENT:
1. SCALE
2. Appropriate-sized blood pressure cuff
3. Snellen and Tumbling E charts
4. Allen cards
5. Color vision chart
6. Ophthalmoscope
7. Otoscope, speculum (2.5-4mm), pneumatic attachment
8. Pediatric stethoscope
9. Growth chart
10. Peanut butter or chocolate
11. Small bell
12. Brightly colored object
13. Denver II materials
14. Clean gloves
15. Disposable centimeter tape measure
VITAL SIGNS:
• Temperature
• Respiratory rate
• Physical growth (use the same scale at each visit, if possible, to prevent variations in
serial weight checks).
• Blood pressures (never use the phrase “blood pressure”, say instead “I am going to hud
your arm with this cuff”).
• Weight and height
,Nursing 101 PEDIATRIC PHYSICAL ASSESSMENT
Assessment of the Integumentary System
Skin: A. Inspection
1. Observe the color of the body, 1. These areas are prominent locations for
especially at the tip of the nose, the detecting cyanosis or jaundice.
external ear, the lips, the hands, and
the feet.
2. Observe the skin for lesions, noting the 2. Lesions can be localized, regionalized,
anatomic location. or generalized. They can involve
*ABCDE Mnemonic for evaluating exposed areas or skin folds.
skin lesions
A (Asymmetric): Is the lesion
asymmetric?
B (Borders): are the borders of the
lesion irregular?
C (Color): Is the color of the lesion
uneven, irregular, or multicolored?
D (Diameter): Has the lesion’s
diameter changed recently?
E (Elevation): Has the lesion become
elevated?
B. Palpation
1. Use the finger pad to palpate the skin. To note the quality, thickness and
Palpate with finger pads in different suppleness. (e. g. Use the finger pads to walk
areas. The technique of palpating the up the abdomen and touch the nose). Skin of
skin of a younger child can be the pediatric patient is normally smooth and
accomplished by playing games. soft. Milia, plugged sebaceous glands,
present as small, white papules in the
newborn.
2. Temperature: palpate with back of hand, Temperature should be uniform within
noting uniformity of warmth normal range.
3. Palpate dependent areas (sacrum, feet, -degree of pitting edema reflects the depth of
and ankles) for mobility by applying indentation in centimeters or inch: mild-0 to ¼
pressure with fingers, noting degree of inch, moderate-1/2 inch, severe-3/4 to 1 inch.
indention. Edema is usually graded from trace to 3+ or 4+
pitting. Trace is a slight indention that
disappears in a short time. Grade 3+ or 4+,
depending on the scale, is deep pitting does not
disappear readily.
Hair: Inspection/palpation
1. Quality, distribution, pattern of hair To note thick, evenly distributed hair.
loss if any over the scalp. Thin, brittle hair occurs with
hypothyroidism.
2. Texture and oiliness Normally resilient hair is silky.
3. Amount of body hair. The amount of body hair varies, hair should be
free from infestation.
Head: Inspection
, Nursing 101 PEDIATRIC PHYSICAL ASSESSMENT
may pulsate with
