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Health Assessment

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Information about Health Assessment
Education

Published on March 3, 2010

Author: anitarobins

Source: authorstream.com

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ASSESSMENT OF HEALTH IN CHILDREN : ASSESSMENT OF HEALTH IN CHILDREN Nirmala Roberts Paediatric Nursing HEALTH : 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 CHILD HEALTH : 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 pitfalls A healthy child will grow to be a healthy adult STAGES OF GROWTH IN CHILDREN : 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 WHY ASSESS HEALTH IN CHILDREN? : 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 METHODS OF HEALTH ASSESSMENT (For all age groups) : METHODS OF HEALTH ASSESSMENT (For all age groups) Dietary History H/O illness General examination Biochemical examination DIETARY HISTORY(0 – 5 yrs) : 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 HISTORY OF ILLNESS : 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 GENERAL EXAMINATION : GENERAL EXAMINATION General physical examination Nutritional anthropometry Neuromuscular control Assessment of tissue growth Bone age Dental age Biochemical & histological means Psychological tests GENERAL PHYSICAL EXAMINATION : 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 MEASUREMENT OF GROWTH : 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 SCHOOL AGE : SCHOOL AGE DIETARY HISTORY : 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 HISTORY OF ILLNESS : 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 GENERAL EXAMINATION : GENERAL EXAMINATION General physical examination Nutritional anthropometry Neuromuscular control Assessment of tissue growth Biochemical & histological means Psychological tests GENERAL PHYSICAL EXAMINATION : 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 MEASUREMENT OF GROWTH : 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 ADOLESCENCE : ADOLESCENCE DIETARY HISTORY : 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 HISTORY OF ILLNESS : 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 GENERAL EXAMINATION : GENERAL EXAMINATION General physical examination Nutritional anthropometry Neuromuscular control Assessment of tissue growth Biochemical & histological means Psychological tests GENERAL PHYSICAL EXAMINATION : 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 MEASUREMENT OF GROWTH : 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 BIOCHEMICAL EXAMINATION( For all age children) : BIOCHEMICAL EXAMINATION( For all age children) Blood – Hb%, PCV, S Protein Urine – RE Stool - RE PSYCHOLOGICAL EXAMINATION – INFANTS & TODDLERS : PSYCHOLOGICAL EXAMINATION – INFANTS & TODDLERS Compare against normal children Take ‘Corrected age’ for preterms Take note of disability or handicap PSYCHOLOGICAL EXAMINATION – PRESCHOOL AGE : 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 PSYCHOLOGICAL EXAMINATION –SCHOOL AGE & ADOLESCENCE : 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 PRE REQUISITE : 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 ThanQ : ThanQ

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