1)Compare and contrast identified similarities as well as differences in expected assessment across the childhood age groups.
As a child moves from being a toddler through preschool to school-aged, they are faced with many challenges to overcome. Development growth, which is subject to the child’s environment and sphere of influential people and pressures in their lives, is directly shaped and guided by their family’s culture, religion and value/belief system.
The differences are seen in how each developmental phase interacts and responds within each health assessment pattern. The toddler and preschool child need more structure and routine, whether it’s brushing their teeth, eating or bedtime rituals. School-aged children take the values and learned behaviors of being a toddler and build upon them as they move toward building their own self-concept and sense of identity. There are similarities as the children strive for autonomy and the ability to express themselves verbally. As the child continues to learn, they will develop an understanding of good behaviors and bad behaviors.
Summarize how a nurse would handle physical assessments, examinations, education, and communication differently with children versus adults. Consider spirituality and cultural differences in your answer.
When the nurse is caring for a child, the nurse must remember that they are essentially caring for two patients, the child and the parent (Jarvis, 2012). For a nurse, the assessment, examination and interaction with a child patient offer its own set of challenges and require a different approach from that of an adult. When dealing the toddler and preschooler, the nurse should interact with the caregiver, giving the child the opportunity to see the nurse’s interaction with their caregiver. This allows the child to see that the caregiver has accepted and trusts the nurse. For the toddler and the preschooler, the parent will be providing most, if not all of the health history. With the pre-school-aged population, they may be the sole source of important data to the history (Jarvis, 2012).
The nurse should interview the child and caregiver together, and they should be present at all exams. With children of each stage of development, the nurse must be cognizant of verbal and non-verbal cues provided by the child. The nurse should be mindful that there could be cultural and/or spiritual considerations to take into account, like when undressing a child of the opposite sex. The nurse needs to ensure that the caregiver and the child feel comfortable with and during the interview, assessment, examination and educational/patient teaching phases of the visit. Strategies that the nurse might incorporate include awareness of the various developmental stages that children go through. When performing a physical assessment of a child the nurse should be at eye level. When talking to the child and explaining concepts the nurse should use simple language that they child can understand. The nurse should allow the child to hold instruments, like a stethoscope, during the physical exam to help them feel like they are involved in their own care. Sharing reading materials or media to look at can help divert their attention away from the nurse.