Chapter 32 Health Assessment of Children

Question 1

Physical Examination

Answer 1

Newborn
Place to Perform Exam: Lie on exam table or in caregiver’s lap
Exam Direction: Running dialog w/caregiver, explain steps along the way

Infant
Place to Perform Exam: In caregiver’s lap or on exam table w/caregiver right beside the infant
Exam Direction: Explain each step to caregiver, address child by name, invasive parts last

Toddler
Place to Perform Exam: Freedom of movement if possible.
- May stand between caregiver’s legs or sit on lap.
Exam Direction: Introduce self to caregiver and child.
- Explain most steps to child
- Allow child to handle instruments.
- Invasive last

Preschooler
Place to Perform Exam: May be willing to sit on exam table with caregiver close by.
Exam Direction: Allow child to decide order of exam; explain what instruments do and let child try them.
- Speak to caregiver before and after exam

School Age
Place to Perform Exam: Sitting on exam table where they have eye contact with caregiver
Exam Direction: Include child in all parts of the exam.
- Use Head-to-toe approach with genital exam last.
- Speak to caregiver before and after

Early Teen
Place to Perform Exam: Some may be willing to have caregiver wait outside exam room.
Exam Direction: Speak to child using mature language; appeal to their desire for self-care. Head-to-toe. Genital exam last

Late Teen
Place to Perform Exam: Explain to caregiver that teen needs privacy and ask them to wait outside room
Exam Direction: Explain confidentiality to caregiver and teen; allow time talking with them together and separately. Head to toe. Genital exam last.