Paediatric Nursing Skills for Australian Nurses

Introduction

Nurses working with children and families need to develop skills to assess the child, and these skills need to be underpinned by knowledge of child growth and development, and their normal parameters. To develop an appropriate plan of care for the child, the paediatric nurse requires a foundational knowledge of physical assessment techniques and the ability to analyse and interpret assessment findings as normal or abnormal, and then to respond appropriately with further focused assessment or referral to other members of the multidisciplinary team.

In this chapter, you will be introduced to principles and techniques for conducting a physical assessment of the child. The first section will focus on understanding growth, nutrition and development, and will highlight the important differences in physical examination techniques used in different age groups.

While this chapter focuses on physical assessment, it is important to note that psychosocial assessment also comprises a central part of assessment of the child, as does family assessment. (For further reading regarding psychosocial development see Fraser et al., 2017, and to learn more about family assessment see Patane & Forster, 2017.)

The importance of assessment

Understanding assessment

Assessment is the collation of subjective and objective data to inform an overall picture of the health status of the child. Together with comprehensive history-taking, eliciting parental concerns and ongoing monitoring, the physical assessment informs effective clinical decision-making (Fergusson, 2009).

Assessment is not performed as an isolated task, but should be ongoing and dynamic. A physical assessment of the child will provide a snapshot of their health status at a particular point in time. Ongoing assessment, through continued monitoring, enables the paediatric nurse to observe and analyse trends against expected norms to identify any deviations and take appropriate action (Broom, 2007).