Nursing Health Assessment: School-Age & Adolescent

Front 1

Check Weight, Height, Vital Signs.
Note growth & development on growth chart.

Back 1

School-age children: grow 5 cm's yearly & gain 4 1/2 to 6 1/2 lbs yearly.

Front 2

General Health Survey:
Inspect overall appearance,
Noting: appropriate growth & development for child's age.

Back 2

Slender, loss of baby fat.
Detect any delays or premature maturation.
Note any obvious weight problems.

Front 3

Integumentary:
Inspect skin for lesions.

Back 3

Lesions, such as tinea capitis or (ringworm), needs treatment.

Front 4

Integumentary:
Inspect hair & scalp for lice.

Back 4

Pediculosis common among school-age children.

Front 5

HEENT
Head & Face:
Inspect head & face.

Back 5

Head size becomes more proportionate to body.

Front 6

Eyes:
Test visual acuity.

Back 6

Visual acuity 20/20 by age 6.
visual deficits warrant follow-up.

Front 7

Ears:
Test hearing with pure tone audiometer.

Back 7

Hearing deficits warrant follow-up.
Teach hazards of listening to loud music.

Front 8

Nose:
Inspect nasal septum & mucosa.

Back 8

Chronic rhinorrhea can result from allergic rhinitis. (Boggy, bluish-purple, or gray turbinates.)

Front 9

Mouth & Throat:
Inspect oral mucosa & pharynx.

Back 9

Tonsils are generally large.

Front 10

Mouth & Throat:
Inspect occlusion.

Back 10

Refer to Orthodontic if malocclusion is present.

Front 11

Mouth & Throat:
Inpect number of teeth.

Back 11

Secondary teeth being to erupt around age 6 (molars first)
Most secondary teeth have grown in by the time 12 year molars erupt.

Front 12

Neck:
Palpate the neck for lymph nodes.

Back 12

Enlarged lymph nodes may be associated with an infection or lymphoma.

Front 13

Respiratory:
Auscultate lungs.

Back 13

Children with exercise-induced asthma require bronchodilators befor activity.
Albuterol metered-dose inhaler is given 20 to 30 minutes before exercise.

Front 14

Cardiovascular:
Auscultate heart; note rate & rhythm.

Back 14

Children often have a sinus arrhythmia & a split second heart sound. Both the arrhythmia & the split second sound change with respiration. This is a normal variation.

Front 15

Gastrointestinal:
Inspect, auscultate, & palpate abdomen.

Back 15

Appendicitis is the most common illness during childhood that requires surgery.

Front 16

Genitourinary:
Inspect external genitalia.

Back 16

Precocious puberty-sexual development before age 8 in girls & age 9 in boys warrents follow-up evaluation.

Front 17

Musculoskeletal:
Inspect & palpate spinal curves. Test for spinal deformities.

Back 17

Scoliosis is the major variatin within the musculoskeletal system. Screening for scoliosis should be done in the preadolescent period, generally during the fifth & sixth grade. Any significant curvature should be referred for evaluation & follow-up.

Front 18

Musculoskeletal:
Test muscle strength.

Back 18

Strength doubles during school-age years.

Front 19

Neurologic:
Test balance, coordination, & accuracy of movements.

Back 19

During school-age years, the child's balance & coordination greatly improve with refinement of fine motor skills.