discussion réponse 2

There are similarities and differences in doing a physical assessment between an adult and child.  Doing a head-to-toe between an adult and a child is similar in many ways except that the nurse should take into account changes related to puberty and developmental issues related with adolescence (Falkner, A., 2020).  The nurse should explain to the patient the normalcy of those physical development.  During this time there will also be an influx of hormonal changes, making the patient develop curiosity towards sex as a whole (Curtis, 2015).  It will be the duty for the nurse to provide education for this too.  The more information they get the more likely they will make an informed decision about their bodies (Falkner, A., 2020).  In any assessment wether adult or child, the nurse should always practice standard precautions to protect both the nurse and the patient.  The rationale for this is to prevent exchange of blood and bodily fluids and the use of hand hygiene, personal protective equipments and disinfecting potentially contaminated equipment and surface (Nelson, L., 2020).  Before any physical assessment the nurse should prepare the things she will be using.  Although the list of equipment for both adult and child are basically similar, there will be some differences.  For example, the pediatric client may need a neonatal, infant, or pediatric blood pressure cuff.  The techniques used to assess the vital signs also vary among the age group (Registered Nursing, 2020).  During assessment, the nurse should also be aware of developmental milestones for children.  The nurse should reassure parents or caregivers that there are variances, although any extended delay in achieving the milestones should be reported to the pediatrician (Falkner, A., 2020).  

 Children are dependent upon adults for their welfare, Teaching and communication should involve the parents and caregivers for a family-centered care.  Often direct communication and recommendation to other community sources provides the best advice (Falkner, A., 2020).  Knowledge of Erikson’s psychosocial stage of development is essential for the nurse to be able to make a working plan on how to assess and communicate with the child depending on the child’s stage of development (Falkner, A., 2020).  The initial encounger with the nurse is the best opportunity to build trust with the nurse.  Use of open-ended questions will provide information and build upon that trust (Falkner, A., 2020).  The nurse should include the children in the communication.  Using of understandable vocabulary and avoiding medical jargons, active listening, being aware of verbal and non-verbal cues and be culturally aware of the child and family’s needs (Burks, J., 2016).  Providing anticipatory guidance and a walkthrough on what you will be doing will usually gain cooperation.  If the procedure will cause discomfort be honest.  Tell them how long the assessment will last (Burks, J., 2016).  Use of age-appropriate toys and questions will foster cooperation and communication.  Showing interest to the child and what the child has to say should be encouraged.  Mke the child feel important.  This will help the child feel comfortable and establish rapport (Belleza, M., 2017).      When dealing with teenagers, the nurse should be aware that they need to be treated with respect.  The nurse should communicate with them with privacy, away from their parents or siblings.  This will allow the teenager to provide answers pertaining to sexuality, drugs and alcohol use, and other topics they might not feel comfortable discussing when others are around (Falkner, A., 2020).  

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