When it comes to a physical assessment of a child versus adult, there will be many things the same and many things different. When performing an assessment, nurses receive subjective and objective data. From infancy to toddlers and preschoolers to school-aged children to adolescents and adulthood, vital signs will vary for objective data.
Average range of vital signs for a preschoolers can be SBP 95-110, DBP 60-75, HR 65-110, RR 20-25, (Rudd & Kocisko, 2014). For adults, average range of vital signs can be SBP less than 120, DBP less than 80, HR 60-100, RR 12-20, (JohnsHopkinsMedicine, 2019). When taking blood pressure on a child, the nurse may ask what arm the child wants to be used to involve them in the care. For more objective data, when it comes to performing the physical assessment, most things should be the same.
Breath sounds should all clear in all lobes, child or adult. S1 and S2 should be noted with no adventitious sounds for both child and adult. Both child and adult should should have regular bowel movements and urine output appropriate for their ages. Systems within the body should have no defects or abnormalities. For subjective data, for adults the information will come from them with understanding and little explanations of the questions.
For children, most of the time the adults will know the answers and the nurse can receive information from them. When questioning the child, it may be a little more complicated and depends on the child. When it comes to explaining and offering instructions during the assessment, adults can be spoken to logically. Depending on the age, the explaining of the assessment shall vary. If the child is school-aged, they may be cooperative in the care. Nurses should talk directly to the child and provide rationales with their actions. For child, strategies to use to encourage engagement for children may be smiling and being friendly to earn their trust.
For younger children, I learned that using items such as puppets, and first performing the procedure on them may make the experience less scary for the child. Nurses should be aware of the developmental theories by Erikson, Piaget, and Kohlberg when learning about children, (Rudd & Kocisko, 2014).
JohnsHopkinsMedicine. (2019). Vital signs (body temperature, pulse rate, respiration rate, blood pressure). Retrieved from https://www.hopkinsmedicine.org/healthlibrary/conditions/cardiovascular_diseases/vital_signs_body_temperature_pulse_rate
Rudd, K. & Kocisko, D.M. (2014). Pediatric nursing: The critical components of nursing care. Philadelphia, F.A. Davis Company.
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