Cedarville university NSG 3030 Pediatric Physical Assessment Module

Although the approach to and the techniques of physical assessment of children (infants, children
and adolescents) are often the same as used in adults, there are significant differences. The 
purpose of this module is to highlight those differences without repeating the aspects that are 
similar in both children and adults. 
Please use your pediatric Hockenberry textbook to assist you in completing the pediatric 
assessment module ( Hockenberry, 9th edition pp. 139 – 180 and 10th edition, chapter 4). 
PHYSICAL ASSESSMENT SEQUENCE
Describe how the sequence of the physical assessment in infants and toddlers differs from the 
usual head to toe approach used for preschoolers up through adults.
Smaller children are more easily stressed out by examinations of private areas and by 
instruments used for the examination, so in order to do a physical examination of infants and 
toddlers, nurses must first begin with procedures that are comfortable. From this, nurses will 
build trusting relationships with the parents and children so that the children will trust them to do
parts of the assessment that are more uncomfortable later.
GROWTH MEAUSREMENTS
What are the procedures for measuring: 
Recumbent length: (used to measure children up to 24/36 months of age) have the infant 
lay on their back, position the head in midline, put the legs together and fully extend them. 
Measure the length from head to toe with a measuring board or with paper on a surface and a 
writing utensil held at 90 degrees. 
Height: taken with the child standing upright and with their back to a wall. Have them 
remove their shoes and hold their head in midline position. Measure to nearest mm or 1/8 inch. 
Head circumference: measure at the head’s greatest circumference – above the eyebrows 
slightly and at the pinna of the ears and around the occipital prominence at the back of the skull. 
Measure more than once because there can be variances at different locations. Use a paper or 
metal tape. Plot all measurements on growth charts at line corresponding to age. 
According to the CDC growth chart, a child is considered: