Hair and scalp Hair should be evenly distributed, smooth, and strong Manifestations of nutritional deficiencies include hair that is stringy, dull, brittle, and dry Hair

General Appearance Appears undistressed, clean, well-kept, and without body odors Muscle tone: Erect head posture is expected in infants after 4 months of age Make

Pulse Rate Grading of Pulses Grade Description 0 Not palpable +1 Difficult to palpate, thready, weak, easily obliterated with pressure +2 Difficult to palpate, may

Temperature measurement in pediatrics Ask the Question PICOT Question: In infants and children, what is the most accurate method for measuring temperature in febrile children?

Physical Assessment Anthropometric Measurements Height, weight, and circumference Weigh the child, taking two measurements and averaging them Calculate BMI BMI under the 5th percentile indicated

Performing Pediatric Physical Examination Perform the examination in an appropriate, nonthreatening area: Have room well-lit and decorated with neutral colors. Have room temperature comfortably warm.

Sequence of examination Infant Before able to sit alone — supine or prone, preferably in parent’s lap; before 4 to 6 months, can place on

Clinical Assessment of Nutritional Status Evidence of Adequate Nutrition Evidence of Deficient or Excessive Nutrition Deficiency or Excess General Growth Normal weight gain, growth velocity,

Nutrition Dietary intake Dietary Reference Intakes (DRI) are a set of four evidence-based nutrient reference values that provide quantitative estimates of nutrient intakes for use

Review of systems   Constitutional:  Overall state of health, fatigue, recent or unexplained weight gain or loss (period for either), contributing factors (change of diet,

Pediatrics Health History Identifying information Name Address Telephone Birth date and place Race or ethnic group Sex Religion Date of interview Informant (most likely the

Blocks to communication Communication Barriers (Nurse) Socializing Giving unrestricted and sometimes unsought advice Offering premature or inappropriate reassurance Giving over-ready encouragement Defending a situation or