By Ellen M. Chiocca MSN CPNP APN RNC-NIC
Complicated Pediatric overview offers a close and complete method of acquiring the historical past and actual exam of kids, start via formative years. The textbook ways the well-being evaluate of the pediatric shopper through the use of a physique platforms framework within the context of developmental and cultural facets of kid evaluate. as well as actual overview, emphasis is put on put on the child’s psychosocial well-being, with chapters on communique, relations overview, psychological health and wellbeing evaluation and evaluate of abuse and overlook. future health upkeep and well being is additionally emphasised, with separate chapters on pediatric healthiness supervision, nutrients and safeguard.
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Extra info for Advanced Pediatric Assessment
In addition, each child must be viewed within the context of his or her family, culture, and social situation (see Chapter 3 for a discussion of the communication skills needed to work with children and families). OBTAINING THE PEDIATRIC HEALTH HISTORY The reason for the child’s visit dictates the type of history that the health care provider obtains (see Chapter 6). For example, interval histories require only injury- or C HA P T E R 1 A s s e s s m e n t o f He alth an d I lln e s s in Ch ildre n: An Over view • 15 illness-specific data.
Oxygen consumption also increases in coldstressed neonate because it is needed to metabolize brown fat Sweating and vasodilation mechanisms not fully developed; peripheral vasodilation is inefficient because of incomplete myelination Birth until age 2 years Infants do not flush to release body heat with increased body temperature or fever; body does not cool as fast, making child prone to febrile seizures Metabolic rate higher than in adults Birth through adolescence Need more oxygen than adult to support rapid body growth, work of breathing; metabolic rate increases during fever or illness; have difficulty maintaining homeostasis during illness; young children prone to hypoxia and dehydration; have high heart rates; have high caloric and fluid requirements to support active metabolism; certain drugs metabolized faster in children than adults Proportion of fat to lean body mass increases with age (Conroy, 2003) Birth until age 12 years Distribution of fat-soluble drugs limited in children; a drug’s lipid or water solubility affects the dose for the infant or child CLINICAL IMPLICATIONS (continued) 1 4 • S e c t i o n 1 GR O W T H AN D DEV ELO PM ENT TABLE 1-1 Anatomic and Physiologic Differences in Infants, Children, and Adolescents (Continued) BODY SYSTEM Endocrine System ANATOMIC/PHYSIOLOGIC DIFFERENCES AGE-GROUP AFFECTED Not fully mature until adolescence with hormonal and physical changes that occur in puberty Birth to adolescence Affects bone growth, thyroid function, adrenal cortex, and secretion of sex hormones Thelarche normally takes place between 8 to 13 years; pubarche between 8 and 14 years; menarche about 2 years after thelarche School-aged children; adolescents Affects physical examination; provider should be aware of precocious or delayed puberty; gynecomastia in adolescent boys may be because of pubertal changes, obesity, or the use of marijuana or anabolic steroids.
In 1995, Chess and Thomas published their work regarding the effect of temperament, in which they explain how children, as young as infants, have innate tendencies to react to their environment in certain ways. The temperamental characteristics and C H A P T E R 2 A s s e s s m e n t o f Ch ild De ve lo p m e n t and Behavior • 21 TABLE 2-1 Developmental Theorists AGE AND DEVELOPMENTAL STAGE ERIKSON (PSYCHOSOCIAL DEVELOPMENT) PIAGET (COGNITIVE DEVELOPMENT) FREUD (PSYCHOSEXUAL DEVELOPMENT) KOHLBERG (MORAL DEVELOPMENT) GILLIGAN (MORAL DEVELOPMENT) Infant (birth to 1 year) Trust vs.
Advanced Pediatric Assessment by Ellen M. Chiocca MSN CPNP APN RNC-NIC