NUR 600 Discussion 12.1 Pediatric Physical Exams

Sample Answer

A newborn physical exam varies from an adult physical exam in that the newborn exam begins within 24 hours of birth. They are evaluated to establish the overall condition, which includes any developmental concerns, gestational development, and congenital problems.

Furthermore, the data acquired from a newborn examination differs greatly from that gained from an adult examination. An infant, for example, has a higher average heart rate and respiratory rate than an adult.

An infant’s heart rate typically ranges from 115 to 140 beats per minute, with average respirations per minute ranging from 30-68 (Lomax, 2021). Adults have a heart rate of 60-100 beats per minute and a breathing rate of 12-20 breaths per minute.

Before commencing the test, the examiner should make certain that the infant’s needs are met. This implies that the newborn should be well-fed, dry, and rested to reduce the risk of a fussy infant who will not allow the examiner to do their test (Lomax, 2021).

In contrast, while there may be possibilities to satisfy these requirements in the adult examination, it is not a priority to accomplish a successful physical exam. Making an examination game for a school-age youngster might be beneficial. This not only engages the youngster but also puts them at ease, reducing the painful experience of a physical examination (Figg, 2021).

Allowing a school-age child to inspect your stethoscope and equipment before using them, for example, helps the youngster realize that these items will not harm them and piques their interest. A successful adult examination, on the other hand, will not necessitate the use of such tactics.

One frequent and one unusual pediatric patient diagnosis concerns the eyes. Strabismus is a prevalent clinical condition in pediatric patients that refers to the misalignment of the eyes. Strabismus happens when the eyes do not line up properly and point in opposite directions.

One eye can be directed straight ahead, while the other can be directed inside, outward, up, or down. Moreover, the misalignment might shift from one eye to the other. The direction in which the eyes concentrate is controlled by six separate eye muscles. Misalignment can occur when one or more of the muscles fails to work properly.

A growing misalignment might have an impact on eyesight. This is typical in newborns up to 6 months old and is considered transitory and a natural aspect of development (Goolsby & Grubbs, 2019). Retinoblastoma, on the other hand, is an eye malignancy. It all starts with the retina, which is a layer of nerve cells that lines the back of the eye.

The retina’s nerve cells change in size and quantity, eventually producing a tumor. Cancer cells spread uncontrolled throughout the eyeball. They can also spread to other regions of the body, including the brain and spine. Despite being one of the most frequent eye tumors in children, retinoblastoma is the least common ocular condition that children confront (Goolsby & Grubbs, 2019).

A physical inspection of the eyes, numerous diagnostic examinations, and a genetic history would be used to differentiate between strabismus and retinoblastoma. Although both disorders present with eyes that appear to be facing in opposite directions, the retinoblastoma patient has a white pupil upon light testing (Goolsby & Grubbs, 2019).

The color of the retina is unaffected in strabismus children. Moreover, ultrasound (US), MRI, and bone scans are commonly used to establish a diagnosis of retinoblastoma since these tests disclose the presence of a tumor, the degree of tumor dissemination, and whether or not therapy is effective.

There are no detailed examinations for strabismus because it is often a transitory problem that resolves after six months of age. Finally, a genetic test that reveals the existence of an RB1 gene mutation typically suggests bilateral retinoblastoma.

This group frequently has more than one tumor that forms within the eyes, a disease known as multifocal retinoblastoma. Strabismus is also a hereditary disorder, with up to 30% of children having a family relative who suffers from the same issue (Figg, 2021).

Unfortunately, no research or proof has been found to determine the gene that causes strabismus. It is normally a treatable issue as the infant develops and their eye muscles improve.

References

• Figg, B. (2021). National Eye Institute. Journal of Consumer Health on the Internet, 25(2), 187–195. https //doi.org/10.1080/15398285.2021.1911158
  Goolsby, M. J., & Grubbs, L. (2019). Advanced assessment Interpreting findings and formulating differential diagnoses (4th ed.). F.A. Davis Company.
  Lomax, A. (2021). Examination Of The Newborn an evidence-based guide. (3rd ed.). Wiley-Blackwell.