NURS210 Pediatrics Assessment Tips
Infancy
(Birth – 6 months)
Infancy
(6 – 12 months)
Toddler
(1yr – 3yr)
Preschool
(3yr-6yr)
School-age
(6yr-12yr)
Adolescent
(12yr and up)
Commun
-ication
- Nonverbal
(cooing, smiling,
crying)
- Responds to
nonverbal
behavior
(rocking,
cuddled, softness
in voice)
- Nonverbal (cooing,
smiling, crying)
- Responds to
nonverbal
behavior (rocking,
cuddled, softness
in voice)
- Between/blend of
infancy and preschooler
- May not explain much
related to fear but
act/explain right prior
to event
- Egocentric (relation
to themselves)
- Not concerned with
others’ feelings (say
to them ‘this is what
you will feel’)
- Interpret literally
(the word ‘time’,
coughing your head
off, sticky fingers)
- Based on
previous
experience
rather than what
they currently
see
- Ask a lot of
questions, want
a lot of
explanation and
reasoning
(‘why’)
-
- Fluctuates
between child and
adult in
communication
and thought
processes
- Privacy and
confidentiality are
huge at this age
- May seek security
more familiar with
childhood
Develop-
mental
Approach
- Keep parent
present
- Encourage
comfort and
distraction
- Observe mood,
general activity,
responsiveness to
handling
- Talk/move infant
- Flexible order of
exam, take
advantage of
infant being sleep
or quiet and do
heart/lungs/
abdomen sounds
- Most disruptive
task comes last
(hips)
- Examine on
parents’ lap
- Encourage comfort
& distraction
- Observe mood,
general activity,
responsiveness to
handling
- Begin with
feet/hands due to
development of
separation anxiety
- Take advantage
when infant
asleep,
quiet to auscultate
heart, lungs, and
abdomen
- Examine on parents’ lap
- Allow time to warm up
- May have stranger
anxiety
- Demonstrate use of
medical equipment
- Inform the child what
you are doing; avoid
asking for permission,
they will likely say ‘no’
- Start with feet and
work up
- Examine ears, eyes,
and mouth last
- Allow choices when
appropriate
- Neurological/musculosk
eletal assessment can
be done when they are
playing/walking around
room
- May separate from
parent easily/may
need to examine in
parents lap
- Mostly cooperative,
use distraction
- Allow child to touch
medical equipment
prior to use
- Flexible order of
exam, may be able
to proceed head to
toe
- Give simple
explanations
- Offer choices
- Cooperative,
helpful
- Head-to-toe
sequence
- Protect modesty
- Offer choices
- Explain what
you are doing,
when you are
doing it, why
you are doing it
(teaching
opportunity)
- Private place to
change into gown
- Head-to-toe
sequence
- Protect modesty
- Perform in private
unless adolescent
requests parent
present
- May need
chaperone
- Provide
reassurance of
normal
development and
further
expectations
