TECHNIQUES OF PHYSICAL EXAMINATION

BASED ON A CHILD’S AGE

AGE TECHNIQUES
Newborn Undress only the part being examined or use radiant heat warmer to conserve heat (be
certain all body parts as exposed during examination)

Examine heart and respiratory systems first before infant cries; then follow head-to-toe
procedure performing all manipulative procedures such as throat and eyes last.
Examine newborn with parents present, using these assessment time to teach them
about normal appearance and development
Infant As with newborns, begin examination with heart and respiratory assessment, and then
follow head-to-toe procedure, performing all manipulative procedures such as throat
and ears last. Begin examination while parent holds infant in arms or lap to calm the
child. Talk to the infant as proceed; infants calm to sound of your voice or the feeling
tone that you radiate as much as they do what you actually say. Positive feeling tone
(“this is like a game”) therefore often brings cooperation than strict, business like
approach. Infants older than 3 months like to handle tongue blades. They can be
distracted by brightly colored toys while you listen to their heart or lungs. They
cooperate best if parent holds them for major portion of examination. Offering a bottle
of water or pacifier may be necessary during heart assessment.

Toddler Allow toddler to handle equipment; include games, such as blowing out otoscope light,
to relax child. Ask parent to remove clothing or allow child to do it independently.

Use head-to-toe procedure; leave uncomfortable procedures such as throat and ear
examination for last.
Preschooler Use games such as “Simon says” to ease child’s fright. Ask child to undress; do not
remove underpants.

Preschoolers are extremely threatened by intrusive procedures. Thus, they are

frightened of examining instruments. Allow them to handle instruments before use.
Assure them that instruments do not hurt. Children up to school age often need to be
restrained for ear and throat examinations because they grow fearful about procedures
performed on a part of the body they cannot see (ears) or about a throat examination
that may be uncomfortable.
School-age Ask whether child wants parent present or not.
child
Proceed with head-to-toe assessment; leave genitalia for last.

Allow child to undress except for underpants; supply gown.

Explain equipments and reasons for procedures. Teach whys and hows of procedures.
Adolescent Ask if the adolescent wants parent or not.

Teach adolescent about good health care during examination. Comment on body parts
as examine them. “Your heart sounds good”, “Ears look fine” sometimes an
adolescent is so concerned with a part of her body (a supernumerary nipple, for
example) that she is unable to voice her concern. A comment such as, this is a
supernumerary (extra) nipple. Does it ever worry you that you have that?” may help the
adolescent to talk about what has been worrying for years.

Use head-to-toe procedure; leave genitalia for last.

Include health teaching on breast & testicular self-examination.

DR. CARL E. BALITA REVIEW CENTER TEL. NO. 735-4098/410-0250

 SUMMARY OF FREUD’S AND ERIKSON’S THEORIES OF
PERSONALITY DEVELOPMENT

FREUD’S STAGES OF CHILDHOOD ERIKSON’S STAGE OF CHILDHOOD

Psychosexual Stage Nursing Developmental Task Nursing
Implications Implications

Infant Oral stage: child Provide oral Developmental task is Provide a primary
explores the world by stimulation by giving to form a sense of care-giver. Provide
using mouth pacifiers; do not trust versus mistrust. experiences that add
especially the tongue. discourage Child learns to love to security, suchas
thumbsucking. and be loved. soft sounds and
Breastfeeding may touch. Provide visual
provide more stimulation for active
stimulation than child involvement.
formula-feeding
because it requires
the infant to expend
more energy.
Toddler Anal stage: Child Help children achieve Developmental task is Provide opportunities
learns to control bowel and bladder to form a sense of for decision making,
urination and control without undue autonomy versus such as offering
defecation. emphasis on its shame. Child learns to choices of clothes to
importance. If at all be independent and wear or toys to play
possible, continue make decisions for with. Praise for ability
bowel and bladder self. to make decisions
training while child is rather than judging
hospitalized. correctness of any
one decision.
Preschooler Phallic stage: Child Accept child’s sexual Developmental task is Provide opportunities
learns sexual identity interest, such as to form a sense of for exploring new
through awareness of fonding his or her own initiative versus guilt. places or activities
genital area. genitals, as a normal Child learns how to do involving water; clay
area of exploration. things (basic problem (for modeling); or
Help parents answer solving) and that finger paint.
child’s questions doing thing is
about birth or sexual desirable
differences
School-age Latent stage: Child’s Help the child have Developmental task is Provide opportunities
child personality positive experiences to form a sense of such as allowing child
development appears so his or her self- versus inferiority. to assemble supplies
to be non active or esteem continues to Child learns how to do for a dressing change
dormant. grow and the child things well (short projects
prepares for the finished completely),
conflicts of so that child feels
adolescent. rewarded for
accomplishment
Adolescent Genital stage: Provide opportunities Developmental task is Provide opportunities
Adolescent develops for the child to relate form a sense of for the adolescent to
sexual maturity and with opposite sex; identity versus role discuss feelings about
learns to establish allow child to confusion. Adolescent events important to
satisfactory verbalize feelings learns who he or she him or her. Offer
relationships with the about new is and what kind of support and praise for
opposite sex. relationships. person he or she will decision making.
be by adjusting to a
new body image;
seeking emancipation
from parents
choosing a vocation,
and determining a
value system

DR. CARL E. BALITA REVIEW CENTER TEL. NO. 735-4098/410-0250

DR. CARL E. BALITA REVIEW CENTER TEL. NO. 735-4098/410-0250