Pediatric Assessment Overview

Overview

This lecture covers the essential components of pediatric assessment, including health history, vital signs, physical growth measurements, and appropriate pain assessment tools for different pediatric age groups.

Pediatric Assessment Components

• Conduct a general survey of the child’s appearance, hygiene, and clothing.
• Obtain health history by interviewing caregivers, including family, personal, and birth history details.
• Ask about birth history (prematurity, NICU stay, birth trauma) as it impacts assessment.
• Review immunization status, noting any missed or delayed vaccines.
• The order for vital signs in infants: respirations first (before touching), then apical heart rate, blood pressure if indicated, and temperature last.
• Use age-appropriate pain assessment scales.
• Measure length (lying down for infants), height (standing for older children), weight, and head circumference (for younger children).
• Assess developmental milestones: fine/gross motor skills, language, cognitive, social, and psychosocial development.

Growth and Trends

• Record anthropometric data (length/height, weight, head circumference) and plot on appropriate growth charts by gender, disease, or ethnicity.
• Focus on percentile trends, not single numbers; significant changes up or down may indicate issues.
• Investigate further if a child is under the 5th percentile or over the 95th percentile.

Pediatric Vital Signs

• Normal temperature: 97.4–99.6°F (36.3–37.6°C) for both infants and children.
• Infant pulse: 100–160 bpm (beats per minute); children: 70–120 bpm.
• Infant respirations: 30–60 breaths/min; children: 20–30 breaths/min.
• Infant blood pressure: systolic 65–90, diastolic 45–65 mmHg; child blood pressure: systolic 90–110, diastolic 55–75 mmHg.
• Children have faster pulse and respirations, but lower blood pressure than adults.

Pediatric Pain Assessment

• Use the CRIES scale for neonates (preterm and full-term newborns).
• Use FLACC scale (Face, Legs, Activity, Cry, Consolability) for ages 2 months to 7 years.
• Use FACES scale (drawings) for ages 3 years and up.
• Use Oucher scale for ages 3 to 13 years.
• Use the numeric pain scale (0–10) for children 8 years and older, but best for those with abstract thinking (usually older children).

Key Terms & Definitions

• Anthropometric data — Physical measurements of the body (height/length, weight, head circumference).
• Percentile — A statistical value representing how a child’s measurements compare with peers.
• FLACC scale — Behavioral pain assessment for young children, based on five criteria.
• CRIES scale — Pain assessment tool for neonates.
• FACES scale — Visual pain assessment tool using facial expressions.

Action Items / Next Steps

• Review normal pediatric vital sign ranges for different ages.
• Practice selecting the appropriate pain scale for various pediatric age groups.
• Complete any related quiz questions or readings on pediatric assessment and pain measurement tools.