Appendix H. Child and Adolescent Health Assessment and Intervention Guide
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1 Appendix H Child and Adolescent Health Assessment and Intervention Guide Description: This assessment guide is intended to assist the community health nurse to assess the health status of children. The nurse identifies nursing diagnoses and plans, implements, and evaluates nursing interventions to promote child health and to resolve existing health problems. The assessment component of the tool is based on the epidemiologic perspective of the six dimensions of health. Appropriate populations: Children from birth to adolescence. Data sources and data collection strategies: Information regarding the child s health history may be obtained in interviews with parents or other knowledgeable caretakers or from older children themselves. Other sources of information include observations by the nurse and the findings of the physical examination and screening tests. Development may be assessed using a variety of age-appropriate developmental assessment tools (e.g., the Denver II for children from birth to 6 years of age). Parents may also be asked to complete a nutrition diary to provide information on child nutrition. Use of information: Information obtained with the assessment tool is used to derive both problem-focused and wellness diagnoses. Emphasis is given to using assessment data to design interventions for promoting health and preventing illness as well as resolving existing problems. Special consideration should be given to providing parents with anticipatory guidance concerning their children s development.
2 2 APPENDIX H CHILD AND ADOLESCENT HEALTH ASSESSMENT AND INTERVENTION GUIDE Name: Phone: Address: Guardian: Relationship to child/adolescent: Assessment Biophysical Considerations Maturation and Aging/Genetic Inheritance Age: Date of birth: Gender: Race/ethnic group: Birth weight and length: Pattern of growth (compared with norms and previous pattern): Accomplishment of developmental milestones (DDST or other appropriate test): Parental knowledge of child development and its implications: Significant family health history (include genogram): Physiologic Function Significant events during pregnancy: Congenital defects: Current acute or chronic illnesses (describe problem, status, treatment, if any): Current signs or symptoms of physical health problems: Areas of physical disability or limitation of function: Significant past illnesses, injuries, hospitalizations (what, when, outcomes): Review of Systems Head (headache [how often, quality, treatment outcome], syncope, trauma): Eyes (vision problems, burning eyes, glasses, last eye exam, blocked tear duct, discharge, tearing, itching): Ears (difficulty hearing, discharge, earache, frequent otitis): Mouth and throat (sore throat, lesions, toothache, caries, last dental visit): Respiratory system ( frequent colds, nosebleeds, cough, pneumonia, asthma, shortness of breath, sinusitis, hay fever):
3 Child and Adolescent Health Assessment and Intervention Guide 3 Cardiovascular system (heart problems, hypertension, chest pain, cyanosis [especially when crying], shortness of breath, murmurs, edema): Gastrointestinal system (nausea, vomiting, diarrhea, constipation, flatulence, abdominal pain, loss of appetite, weight loss or gain, rectal pain or bleeding, quality of stool, frequency): Urinary tract (dysuria, urinary frequency, urgency, nocturia, difficulty voiding, urinary retention, CVA pain, odor, strength of urinary stream, number of wet diapers in infant): Reproductive system (vaginal or penile discharge, development of secondary sex characteristics, menarche, wet dreams, extent of sex education, extent of sexual activity, age at sexual debut, history of STD): Musculoskeletal system (joint pain; swelling; tremor; history of trauma; history of fracture, sprain or strain; muscle weakness): Integumentary system (eczema, diaper rash, lesions [describe character, locale, color], changes in skin color, itching, hair loss, discoloration or pitting of nails, clubbing of nails, birthmarks, swollen glands, piercings): Hematopoietic system (anemia, bleeding tendencies, bruising easily, transfusions [when, why]): Immunization status (up-to-date for age): Physical Examination Height, weight, head and chest circumference: Vital signs (T, P, R, B/P): General appearance (posture, gait, deformities, hygiene): Skin (diaper rash, eczema, acne, milia, bruises, burns, hygiene, tattoos): Head and neck (lymph nodes, face): Eyes (ability to focus and follow objects): Ears (ability to localize sound): Nose and sinuses: Mouth and throat (monilial patches, number of teeth, dental hygiene, caries):
4 4 APPENDIX H Chest: Breast examination (newborn engorgement, precocious puberty, normal breast development, gynecomastia): Heart (murmurs, split heart sounds): Lungs: Abdomen: Genitalia (undescended testes, vaginal tears, discharge, imperforate anus, secondary sex characteristics): Musculoskeletal system (symmetry of extremities, spina bifida, scoliosis, congenital hip dislocation, muscle strength): Nervous system (cranial nerves, DTRs, temperature, kinesthetic sense, newborn reflexes): Screening test results (PKU, T4, hematocrit, sickle cell, serum lead, TB, urinalysis as appropriate): Psychological Considerations Reactivity patterns and parental responses: Parental expectations (appropriateness): Discipline (type, consistency, appropriateness): Parental coping skills: Parent child interactions: Self-image: Emotional state or mood (usual, recent changes): Evidence of abuse or neglect: Recent experience of significant loss (death, divorce, move): Suicide ideation: Level of social or parental pressure to perform:
5 Child and Adolescent Health Assessment and Intervention Guide 5 Physical Environmental Considerations Where does the client live? Is there adequate space and privacy in the home? Are safety hazards present in the home? (See Home Safety Inventory in the Community Assessment Reference Guide) Extent of age-appropriate child-proofing of home: Presence of weapons in the home: Are there pets in the home? (What kind? How many? Inside or outside?) What is the neighborhood like? (safety, pollutants, etc.) What pollutants are present in the environment? What health effects do they have? (secondhand smoke): Sociocultural Considerations Education (grade, performance): Interaction with peers: Interaction with others: Cultural childrearing attitudes/practices: Language spoken in the home: Intergenerational conflict: Childcare outside the home (where, by whom, adequacy): Parental employment and effects on child/adolescent: Employment of adolescent (type, hours, health effects): Behavioral Considerations Consumption Patterns Infant (formula, breast, amount, formula preparation, feeding and burping techniques): Other age groups (well-balanced diet, amount of junk food, food allergies): Parental knowledge of nutrition needs: Exposure to drugs/alcohol/tobacco smoke: Use of alcohol/tobacco/other drugs:
6 6 APPENDIX H Rest and Exercise Sleep patterns: Type and amount of exercise: Use of safety precautions, equipment: Other Sexual activity ( frequency, use of contraceptives, condoms, sexual practices/orientation): Use of seat belts, other safety devices: Extent of safety education: Cultural practice of FGM: Chronic disease self-care (need, knowledge, efficacy): Risk-taking behavior: Health System Considerations Use of primary prevention services (general and dental): Source of illness care: Parental knowledge of illness care and need for medical assistance: Availability of needed health care services: Use of available health care services: Financing of health care services (insurance, adequacy): Barriers to health care services: (For guidelines related to nursing diagnoses, planning, implementation, and evaluation of interventions for children and adolescents, use pages 7 8 of Appendix F.)
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