Mosby's Pocket Guide to Pediatric Assessment - E-Book

Joyce K. Engel

Description

Mosby's Pocket Guide to Pediatric Assessment offers a concise but comprehensive approach to health assessment for the pediatric client. It begins with a general description of history taking and includes approaches to children at various ages, nutritional assessment, and measurement and evaluation of vital signs. Emphasis is on "how to" information, including how and what to assess in each body system. Psychosocial, anatomical, and physiological development variations are incorporated as appropriate, as well as normal and abnormal findings. Given the extensive information provided, this reference is ideal for a broad range of nurses and students dealing with pediatric patients.

• Concise, portable size makes this book very handy for use in clinical settings.
• Presents content in an outline format for clinical practicality.
• Includes both psychosocial and physical aspects of assessment within a developmental framework.
• Body system organization facilitates retrieval of information.
• Highlighted clinical alerts call attention to potentially serious findings.
• Up-to-date growth charts are provided for birth through age 18.

• Extensively revised to reflect trends in pediatric nursing, up-to-date techniques, and current literature.
• A new chapter on assessment of mental health addresses growing areas of concern including school phobia, ADHD, depression, suicide, anxiety, and schizophrenia.
• New tables provide quick reference to common childhood symptoms (i.e., fever, diarrhea, vomiting).
• Updated coverage of immunizations (U.S. and Canada) includes information regarding relevance and normal timing of immunizations as well as most current published tables.
• Nursing diagnoses have been updated throughout.

Informations

• Publié par: Mosby
• Date de parution: 09 mars 2006
• Nombre de lectures: 0
• EAN13: 9780323059732
• Langue: English
• Poids de l'ouvrage: 3 Mo

Extrait

Table of Contents

Cover Image
Reviewers
Preface
Chapter 1. Beginning the Assessment
Chapter 2. Dimensions of a History
Chapter 3. Family Assessment
Chapter 4. Home Visits and Assessments
Chapter 5. Physical Assessment
Chapter 6. Preparation for Examination
Chapter 7. Dimensions of Nutritional Assessment
Chapter 8. Body Temperature, Pulse, and Respirations
Chapter 9. Blood Pressure
Chapter 10. Integument
Chapter 11. Head and Neck
Chapter 12. Ears
Chapter 13. Eyes
Chapter 14. Face, Nose, and Oral Cavity
Chapter 15. Thorax and Lungs
Chapter 16. Cardiovascular System
Chapter 17. Abdomen
Chapter 18. Lymphatic System
Chapter 19. Reproductive System
Chapter 20. Musculoskeletal System
Chapter 21. Nervous System
Chapter 22. Development
Chapter 23. Assessment of Child Abuse
Chapter 24. Assessment of Mental Health
Chapter 25. Completing the Examination
Appendix A. Developmental Assessment
Appendix B. Growth Charts
Appendix C. Normal Laboratory Values
Appendix D. Immunization Schedules for Infants and Children
Appendix E. Sample Documentation of a Child Health History
Bibliography
Index



Reviewers
Sherry D. Ferki, RN, MSN (Adjunct Faculty)

Old Dominion University School of Nursing
College of the Albemarle, Portsmouth, Virginia
Mary Ann McClellan, ARNP, CPNP, MN, CFLE (Assistant Professor)

University of Oklahoma College of Nursing, Oklahoma City, Oklahoma
The author would also like to acknowledge consultants and reviewers who participated in previous editions of this book:
Barbara W. Berg, RN, PNP, MN (Head Nurse)

Rose Children's Center at Rose Medical Center, Denver, Colorado
Dena K. Cuyjet, RN, MS, CPNP (Pediatric Nurse Practitioner, Newborn Discharge Coordinator)

Kaiser Permanente San Francisco, San Francisco, California
Terry Fugate, RN, BSN (Formerly Adjunct and Associate Faculty)

Texas Tech University, Health Sciences Center, Lubbock, Texas
Sarah G. Fuller, RN, CPNP, PhD (Associate Professor)

College of Nursing, University of South Carolina, Columbia, South Carolina
Sandra L. Gardner, RN, MS, PNP (Director)

Professional Outreach Consultation, Aurora, Colorado
Marilyn B. Hartsell, RN, MSN (Coordinator)

Tri-Regional Education and Networking Development System, University of Delaware, Newark, Delaware
Karen Halvorson, RN, MN (Chief Patient Care Officer)

Highline Medical Center, Seattle, Washington
Christina Bergh Jackson, RN, CPNP, MSN (Pediatric Nurse Practitioner, Instructor)

Pennsylvania School of the Deaf, Philadelphia, Pennsylvania
Eastern College, St. Davids, Pennsylvania
Carol A. Kilmon, RN, MSN, PhD, CPNP (Assistant Professor)

The University of Texas Medical Branch, Galveston, Texas
Catherine F. Noonan, RN, MS, CPNP (Nurse Practitioner, Assistant Professor)

Children's Hospital
Nurse Education Department, Bunker Hill Community College, Boston, Massachusetts
Mary Ann Norton, RNC, PhD, CPNP (Associate Professor)

North Michigan University, Marquette, Michigan
Margaret C. Slota, RN, MN (Pediatrics Consultant)

Pittsburgh, Pennsylvania
Janet F. Sullivan, RN, C, PhD (Clinical Associate Professor)

Parent Child Health Nursing, State of New York Health Sciences Center, Stony Brook, New York



Preface
As in previous editions, the goal of Mosby's Pocket Guide to Pediatric Assessment is to present the complexities of assessing the health of children within a portable, usable, accessible, and practical format. The emphasis of the pocket guide on children 1 month to late adolescence assumes the influences of families, culture, genetics, and of the prenatal and neonatal periods.

Organization and Approach
This edition continues to set about the physical assessment of children through a systematic, body systems approach. This approach is replicated in the family assessment model, which strongly reflects its foundations in systems. The presentation of approaches to the home environment, culture, communication, development, abuse, and psychosocial and mental health places assessment of the child within a broader and holistic framework related to the health of children and families. Sections on assessment methodologies and findings are usually preceded by discussion of developmental variations that assist in rooting the process of assessment within the context of the child. Clinical alerts draw the attention of beginning and advanced nurses to significant findings and/or deviations from normal that might commonly be found in pediatric clients. Nursing diagnoses complete the assessment.

The New Edition
Since the fourth edition was written, we have been confronted with global concern about diseases such as SARS and avian flu. These infectious diseases, along with West Nile virus, while perhaps less devastating among children than adults, reflect the global challenges that infections present for the young. Infections, suicide, and unintentional injuries represent leading causes of death among children and adolescents. In recognition of this, the fifth edition provides up-to-date information and assessments associated with the new viral infections and with athletic and head injuries. It also offers a new chapter on assessment of mental health in children and adolescents, as well as incorporation of mental health findings throughout the text, including those associated with eating disorders.
Nearly every chapter includes revised or new content. Expanded assessment material on the common childhood symptoms of fever, vomiting, and diarrhea has been incorporated into charts, similar to those included in earlier editions on cough, headaches, and abdominal pain, with the goal of providing nurses with information that is quickly available in these areas that often crop up in everyday practice with children.

Continued Journeys
The expansion of knowledge and the causes of illness are reminders that health is dynamic and complex, just as are families and children. It is my hope that Mosby's Pocket Guide to Pediatric Assessment will provide a concise, practical guide to assist in making sound decisions that will in turn help families and children toward making sense of their experience and toward positive coping.
Joyce Engel




Chapter 1. Beginning the Assessment

This text focuses on health assessment of the child, beginning with the 1-month-old infant and ending with the teenager in late adolescence. Although the physical assessment process is broken down into evaluations of the various body systems, the nurse need not adopt a fragmented approach to physical assessment. In fact, physical assessment is continuous and occurs during the health interview, when the nurse is also able to observe the infant, child, or adolescent.
Assessment is facilitated for the child, parent (if present), and examiner if a rapport is established early. It might not be possible to erase all of a child's apprehension or discomfort, but creating an atmosphere of trust and communication can help make the assessment a more positive experience.

Guidelines for Communicating with Children

▪ Take time to become acquainted with the child and parents.

▪ Set up a physical environment that is appropriately warm, cheerful, and private. If possible, select an environment that is decorated in an age-appropriate manner; for example, adolescents might not appreciate Snow White pictures.

▪ Ask the parents how the child usually copes with new or stressful situations or what previous experiences the child has had with health care or caregivers. Knowing how the child might react enables the nurse to plan specific interventions to facilitate communication.

▪ Ask the parents what they have told the child about the health care encounter. The preparation children receive, especially males, is often inadequate or inappropriate. In such a case, more time might be necessary to prepare the child before beginning any aspect of the health assessment requiring active participation.

▪ Observe the child's behavior for clues to readiness. A child who is ready to participate in assessment will ask questions, make eye contact, describe past experiences, touch equipment, or detach willingly from the parent.

▪ Consider the child's developmental level and attention span, and use an imaginative approach when planning the examination.

▪ If a child is having difficulty accepting the assessment:

Talk to the parent, ignoring the child.

Compliment the child.

Play a game (such as peek-a-boo) or tell a story.

Use the third-person linguistic form: “Sometimes a guy can get really scared when his blood pressure is taken.”

Sequence the assessment from that causing least discomfort to that causing most discomfort.

Start from toe to head.

Undress the child gradually or allow the child to undress gradually.

Briefly perform the technique on the parent first.

▪ Encourage the child to ask questions during the assessment, but do not pressure to do so. This allows the child some control over the situation.

▪ Explain the assessment process in terms consistent with the child's developmental level.

▪ Use concrete terms rather than technical information, particularl