Physical Assessment

Physical Assessment

  • Anthropometric Measurements
    • Height, weight, and circumference
      • Weigh the child, taking two measurements and averaging them
    • Calculate BMI
      • equation.pdf
    • BMI under the 5th percentile indicated the child is underweight
    • BMI over the 85th percentile correlates with overweight
    • Measure the infant’s head circumference (up to age 2 to 3 years)
  • Examination techniques
    • Inspection
      • Purposeful observation of the child’s physical features and behaviors during the entire physical examination
      • Physical feature characteristics include size, shape, color, movement, position, and location.
      • Adequate lighting is essential
      • Detection of odors is also a part of inspection
    • Palpation
      • Use of touch to identify characteristics of the skin, internal organs, and masses.
      • Characteristics include texture, moistness, tenderness, temperature, position, shape, consistency, and mobility of masses and organs
      • The palmar surface of the fingers and the fingertips pads are used for determining position, size, consistency, and masses
      • The ulnar surface of the hand is best for detecting vibrations
    • Auscultation
      • Listening to sounds produced by the airway, lungs, stomach, heart, and blood vessels to identify their characteristics
      • Auscultation is usually performed with a stethoscope to enhance the sounds heard in the chest and abdomen
      • Speech is also assessed during auscultation
    • Percussion
      • Striking the surface of the body, either directly or indirectly, to set up vibrations that reveal the density of underlying tissues and borders of internal organs in the chest and abdomen
      • As the density of the tissue increases, the percussion tone become quieter
      • The tone over air is the loudest, and the tone over solid areas is soft
  • Physiological and growth measurements
    • Temperature by age
Expected Level Recommended Routes
3 Months 37.5° C (99.5° F)
  • Axillary
  • Rectal (if exact measurement necessary)
6 Months
1 Year 37.7° C (99.9° F)
3 Years 37.2° C (99.0° F)
  • Axillary
  • Tympanic
5 Years 37.0° C (98.6° F)
  • Oral (if child cooperative)
  • Rectal (if exact measurement necessary)
7 Years 36.8° C (98.2° F)
  • Oral
  • Axillary
  • Tympanic
9 Years 36.7° C (98.1° F)
11 Years
13 Years 36.6° C (97.9° F)

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