On completion of this chapter the reader will be able to: • Identify communication strategies for interviewing parents. • Formulate guidelines for using an interpreter. • Identify communication strategies for communicating with children of different age groups. • Describe four communication techniques that are useful with children. • State the components of a complete health history. • List three areas that are evaluated as part of nutritional assessment. • Prepare a child for a physical examination based on his or her developmental needs. • Perform a comprehensive physical examination in a sequence appropriate to the child’s age. • Recognize expected normal findings for children at various ages. • Record the physical examination according to the head-to-toe format. evolve.elsevier.com/wong/essentials Animations—Abdominal Anatomy; Cranial Nerves; Organ Systems 3-D Tour Case Studies—Communicating with Adolescents; Pediatric Assessment Nurses are increasingly responsible for assessing children’s symptoms and applying clinical judgment for further medical care (triage) via telephone report. Most often, health problems are assessed and prioritized according to urgency, and nurses provide treatment via telephone services. A well-designed telephone triage program is essential for safe, prompt, and consistent-quality health care (Beaulieu and Humphreys, 2008; Marklund, Ström, Månsson, and others, 2007). Telephone triage is more than “just a phone call” because a child’s life is a high price to pay for poorly managed or incompetent telephone assessment skills. Typically, guidelines for telephone triage include asking screening questions; determining when to immediately refer to emergency medical services (dial 911); and determining when to refer to same-day appointments, appointments in 24 to 72 hours, appointments in 4 days or more, or home care (Box 6-1). Successful outcomes are based on the consistency and accuracy of the information provided. Telephone triage care management has increased access to high-quality health care services and empowered parents to participate in their children’s medical care. Consequently, patient satisfaction has significantly improved. Unnecessary emergency department and clinic visits have decreased, saving medical costs and time (with less absence from work) for families in need of health care. Empathy is the capacity to understand what another person is experiencing from within that person’s frame of reference; it is often described as the ability to put oneself in another’s shoes. The essence of empathic interaction is accurate understanding of another’s feelings (Mathiasen, 2006). Empathy differs from sympathy, which is having feelings or emotions similar to those of another person, rather than understanding those feelings (Mathiasen, 2006). Everything is direct and concrete to small children. They are unable to work with abstractions and interpret words literally. Analogies escape them because they are unable to separate fact from fantasy. For example, they attach literal meaning to such common phrases as “two-faced,” “sticky fingers,” and “coughing your head off.” Children who are told they will get “a little stick in the arm” may not be able to envision an injection (Fig. 6-3). Therefore, avoid using a phrase that might be misinterpreted by a small child (see Table 22-1).
Communication and Physical Assessment of the Child
Guidelines for Communication and Interviewing
Telephone Triage and Counseling
Communicating with Families
Communicating with Parents
Being Empathic
Communicating with Children
Communication Related to Development of Thought Processes
Early Childhood
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Communication and Physical Assessment of the Child
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