Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child
NRS 434 Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child
School-age children include those between the ages of 5 to 12 years, also referred to as middle childhood. The school-age child’s growth presents with gradual growth and development with notable differences in weight, height, and body build (Riley, Morrison & McEvoy, 2019). Besides, language skills continue to develop, and most behavior changes occur as they strive to find their place among their peers. In this regard, this paper will describe the physical assessment of school-aged children, including the typical developmental stages of a child 12-year-old child, and apply the Piaget theory to assess a school-age child developmentally.
Physical Assessments among School-Aged Children
Physical assessment of school-age children is similar in that the examiner applies the four techniques of inspection, palpation, percussion, and auscultation when conducting a head-to-toe exam. The examiner begins the physical exam by taking vital signs, including blood pressure, heart rate, respiration, and temperature (Riley et al., 2019). However, the blood pressure cuff differs based on the child’s age and size. The height and weight are taken and plotted against a growth graph to assess the child’s nutritional status. Additionally, the general appearance of the school-age child is documented, which includes the hygiene status, dressing, signs of neglect, and mannerism (Riley et al., 2019). The examiner also assesses the child for physical signs of abuse since school-aged children are vulnerable to abuse. Assessment of the reproductive system varies among school-aged children based on age. Children above ten years are assessed for secondary sexual characteristics, including breast growth and pubic hair, which is not the case for those below ten years (Riley et al., 2019). Physical assessments of school-age children also entail dental and vision screening to assess dental cavities and visual defects.
For a child aged 5-10 years, I would use a simple drape over their underpants or a colorful examination gown and cover the parts not being assessed to maintain privacy. Fr the younger child, I would conduct the exam in the caregiver’s presence to relieve anxiety and promote cooperation (Riley et al., 2019). However, examination of the older child would be performed in the caregiver’s absence to maintain privacy. Furthermore, I would start with the least distressful exam procedures and end with the most distressful and body parts associated with pain.
Typical Developmental Stages of a 12-Year-Old Child
A 12-year-old is characterized by numerous physical, cognitive, emotional, and social changes. Physical changes include the development of secondary sexual characteristics attributed to hormonal changes. Most males grow facial and pubic hair, and the voices deepen while most females grow pubic hair and breasts and start their menstruation (Sawyer et al., 2018). At 12 years, the child enjoys all physical activities and continues to improve their motor coordination. Cognitive changes include demonstrating an increased ability for complex thought and express feelings through talking (Sawyer et al., 2018). The child also develops a stronger sense of right and wrong. Emotional and social changes include expressing more concern about body image, looks, and clothes and experiencing more moodiness. Besides, 12-year-olds tend to focus on themselves, going back and forth between high expectations and lack of confidence (Sawyer et al., 2018). They also show more interest in and influence by peer group but express less affection toward parents and at times might seem rude or short-tempered.
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Applying Piaget Developmental Theory to Developmentally Assess the Child
The school-age child falls in the concrete operational stage of Piaget’s cognitive development. The stage is characterized by more logical and methodical manipulation of symbols (Babakr et al., 2019). The child is less egocentric and more aware of the outside world and events. They are also able to function on a higher level in their mental ability. I would developmentally assess a child using the Piaget theory by giving the child a fictional problem or scenario and asking them to solve it (Babakr et al., 2019). I will assess if the child can solve the problem without physically encountering it in the real world.
During the assessment, I would offer explanations using simple terms and language in line with the child’s cognitive developmental stage. I would also answer questions openly and in simple terms and ask the child questions to establish trust and promote cooperation (Riley et al., 2019). Besides, I will explain the assessment procedures to the child using simple terms before beginning the exam to promote cooperation and alleviate anxiety. I would also inform the child of the painful or distressing procedures to prepare them psychologically and increase their cooperation (Riley et al., 2019). After the assessment, I will explain to the child of the abnormal findings, possible causes for these findings, and any diagnostic procedures that will be required.
Conclusion
The physical assessment of the school-age child follows the head-to-toe approach and uses the basic examination techniques of inspection, palpation, percussion, and auscultation. The assessment should include taking vital signs, height and weight, general survey, dental and vision screening. Developmental stages of a 12-year-old include development of secondary sexual characteristics, increased cognitive capacity, and social and emotional changes. A school-aged child falls in the concrete operational stage in the Piaget theory and can be used to assess whether the child can function on a higher level in their mental ability.
References
Babakr, Z. H., Mohamedamin, P., & Kakamad, K. (2019). Piaget’s Cognitive Developmental Theory: Critical Review. Education Quarterly Reviews, 2(3), 517-524.
Riley, M., Morrison, L., & McEvoy, A. (2019). Health Maintenance in School-Aged Children: Part I. History, Physical Examination, Screening, and Immunizations. American family physician, 100(4), 213-218.
Sawyer, S. M., Azzopardi, P. S., Wickremarathne, D., & Patton, G. C. (2018). The age of adolescence. The Lancet Child & Adolescent Health, 2(3), 223-228. https://doi.org/10.1016/S2352-4642 (18)30022-1
Shadow Health: Interview and Focused Exam With Danny
Complete the Digital Experience. The estimated average time to complete this assignment each time is 1 hour and 30 minutes. Please note, this is an average time. Some students may need longer.
This clinical experience is a focused exam. Students must score at the level of “Proficiency” in the Shadow Health Digital Clinical Experience. Students have three opportunities to complete this assignment and score at the Proficiency level. Upon completion, submit the lab pass to the instructor in the classroom.
Students successfully scoring within the Proficiency level in the Digital Clinical Experience on the first attempt will earn a grade of 100 points; students successfully scoring at the Proficiency level on the second attempt will earn a grade of 90 points; and students successfully scoring at the Proficiency level on the third attempt will earn a grade of 80 points. Students who do not pass the performance-based assessment by scoring within the Proficiency level in three attempts will receive a failing grade (68 points).
This assessment will allow access to an Interview Guide to help students navigate their first digital experience. Subsequent assignments do not utilize an Interview Guide. Use this guide as needed to complete the assignment for this topic.
Please review the assignment in the Health Assessment Student Handbook in Shadow Health prior to beginning the assignment to become familiar with the expectations for successful completion.
If Proficiency is not achieved on the first attempt, it is recommended that you review your answers with the correct answers on the Experience Overview page. Review the report by clicking on each tab to the left titled Transcript, Subjective Data Collection, Objective Data Collection, Documentation, and SBAR to compare your work. Reviewing this overview and the course resources may help you improve your score.
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Developmental Assessment and the School-Aged Child
The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 500-750-word paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:
- Compare the physical assessments among school-aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child.
- Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.
- Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
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Topic 2 DQ 1: Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child
Child abuse and maltreatment is not limited to a particular age—it can occur in the infant, toddler, preschool, and school-age years. Choose one of the four age groups and outline the types of abuse most commonly seen among children of that age. Describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse. Discuss cultural variations of health practices that can be misidentified as child abuse. Describe the reporting mechanism in your state and nurse responsibilities related to the reporting of suspected child abuse.
Topic 2 DQ 2
Compare the physical assessment of a child to that of an adult. In addition to describing the similar/different aspects of the physical assessment, explain how the nurse would offer instruction during the assessment, how communication would be adapted to offer explanations, and what strategies the nurse would use to encourage engagement.
Re: Topic 2 DQ 1
The Center for Diseases and Control (CDC) defines abuse as “any act or series of acts of commission or omission by a parent or other caregiver (e.g. clergy, coach, teacher) that results in harm, potential for harm, or threat of harm to a child” ((Falkner, 2018, Chapter 2). The abuse can be physical, psychological/emotional, sexual or a combination of any of the three.
In school-age going children, a child may be sexually abused by a coach or teacher at school. Such cases happen within the school and the perpetrator is usually a trusted person. Sexual abuse of a child is any sexual act between an adult and a child, including penetration, intercourse, incest, rape, oral sex, and sodomy (“,” Child Abuse, p. 1). The effects of abuse are lifelong and require ongoing support and therapy. Some of the signs and symptoms to look out for are inappropriate interest in or knowledge of sexual acts, seductiveness, avoidance of things related to sexuality, or rejection of own genitals or body, either over compliance or excessive aggression and fear of a person (“Types of Child Abuse,” 2019, p. 1). Parents ought to pay attention to their children and be willing to be listeners. Other aspects to look at are delayed or inappropriate emotional development, loss of self-confidence or self-esteem, social withdrawal or loss of interest or enthusiasm, depression, desperately seeking affection, a decrease in school performance and possibly refusal to attend school. Other forms of abuse common in this age group include neglect and physical abuse.
Long term effects of child abuse include developmental problems, chronic physical or psychological effects, high-risk behaviors, and shortened lifespan. What is termed child abuse may vary between cultures and subcultures. Culture differences lead to cognitive blindness. Our reactions to differences in child rearing are not the only strong emotional response to cultural differences. This must be taken into consideration when handling issues of abuse. America is a country with so many different nationalities cannot be overlooked. What may be termed child abuse for a white man may be termed as discipline for an African man.
As nurses, our duty is to educate parents on the prevention of abuse and the signs and symptoms of abuse, so they can intervene quickly. Educate them on the importance of seeking counseling for the child and possibly themselves.
North Carolina General Statutes states that “any person or institution who has cause to suspect that any juvenile is abused, neglected, dependent or has died as a result of maltreatment, shall report the case of that juvenile to the director of the department of social services in the county where the juvenile resides or is found” (“G.S. 7B-301,” 2019, expression 1). The first step is to report to the county department of social services and they take it up from there.
References: Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child
Child Abuse. (Child Abuse). Retrieved from https://en.m.wikipedia.org
Falkner, A. (2018). Health Assessment Foundations for Effective Practice. Retrieved from https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter2
North Carolina General Statutes. (2019). Retrieved from https://www.ncga.state.nc.us/gascriots/statutes
Types of Child Abuse. (2019). Retrieved from https://www.healthyplace.com/abuse/child/abuse/information/types-of-child-abuse
Developmental Assessment and the School-Aged Child – Rubric
Comparison of Physical Assessment Among School-Aged Children
Criteria Description
Comparison of Physical Assessment Among School-Aged Children
Typical Assessment for a Child of a Specific Age
Criteria Description
Typical Assessment for a Child of a Specific Age
Developmental Assessment of a Child Using a Developmental Theory (Erickson, Piaget, Kohlberg)
Criteria Description
Developmental Assessment of a Child Using a Developmental Theory (Erickson, Piaget, Kohlberg)
Thesis Development and Purpose
Criteria Description
Thesis Development and Purpose
Argument Logic and Construction
Criteria Description
Argument Logic and Construction
4. 4: Good
4.9 points
Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introdu
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