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Health Assessment

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Health Assessment

Health Assessment


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  • 1. ASSESSMENT OF HEALTH IN CHILDREN By: Dave Jay S. Manriquez RN. Pediatric Nursing
  • 2. 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
  • 3. 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
  • 4. 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
  • 5. 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
  • 6. METHODS OF HEALTH ASSESSMENT (For all age groups)
    • Dietary History
    • H/O illness
    • General examination
    • Biochemical examination
  • 7. 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
  • 8. 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
  • 9. GENERAL EXAMINATION
    • General physical examination
    • Nutritional anthropometry
    • Neuromuscular control
    • Assessment of tissue growth
    • Bone age
    • Dental age
    • Biochemical & histological means
    • Psychological tests
  • 10. 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
  • 11. 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
  • 12. SCHOOL AGE
  • 13. 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
  • 14. 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
  • 15. GENERAL EXAMINATION
    • General physical examination
    • Nutritional anthropometry
    • Neuromuscular control
    • Assessment of tissue growth
    • Biochemical & histological means
    • Psychological tests
  • 16. 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
  • 17. 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
  • 18. ADOLESCENCE
  • 19. 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
  • 20. 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
  • 21. GENERAL EXAMINATION
    • General physical examination
    • Nutritional anthropometry
    • Neuromuscular control
    • Assessment of tissue growth
    • Biochemical & histological means
    • Psychological tests
  • 22. 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
  • 23. 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
  • 24. BIOCHEMICAL EXAMINATION ( For all age children)
    • Blood – Hb%, PCV, S Protein
    • Urine – RE
    • Stool - RE
  • 25. PSYCHOLOGICAL EXAMINATION – INFANTS & TODDLERS
    • Compare against normal children
    • Take ‘Corrected age’ for preterms
    • Take note of disability or handicap
  • 26. 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
  • 27. 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
  • 28. 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
  • 29.