Clinical Assessment of a Child with Pneumonia

CLINICAL SCENARIOS 1
Clinical Assessment of a Child with Pneumonia
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CLINICAL SCENARIOS 2
Assessment
Respiratory problems are very common among children and the symptoms are unique
to the age bracket. The respiratory distress in children arises as the infant’s lungs develop and
adapt to the environment. The child should be carefully assessed for an obstruction in the
airway, the breathing rate and heart rate.
The nurse should look at the symmetry of the child’s chest expansion. The nurse will
look for the presence lip cyanosis. Since the child is trying very hard to breathe, he will use
his accessory muscles while breathing. The nurse should also look at central trachea for an
unequal pressure within the chest cavity. During the assessment, nurses should check if the
airway is patent, if there is a foreign body in the airway and if the child is drooling. The
child’s normal conditions should be noted first before the abnormal changes are monitored
(Gallacher, et al., 2016). This helps in planning for the child’s medication.
The nurse should use the butterfly procedure to find the specific symmetry of the
chest expansion during the assessment. The nurse will then try to find out if there is presence
of any subcutaneous emphysema by checking if there is any tenderness around.
The nurse should then listen carefully for a wheezing or gasping sound. Children
trivet whenever they have a difficulty in breathing therefore the nurse should leave the child
if he/she decides to extend the neck (Abbie, 2015). The extension of the neck opens the
child’s airway.
The immediate examinations in the assessment of a child with respiratory distress
should be oximetry of the pulse, a radiograph of the chest and blood tests (Arterial blood gas,
the blood culture and a full blood count). A chest radiograph is predominantly useful for
finding out the core cause. It is also very necessary to monitor the RR and oxygen saturation.
Normal oximetry pulse of a child less than 5 years should be 95 – 100%.Lower airway
infections are prevalent among children with consistent respiratory problems (Proesmans,
2016). Systematic clinical evaluation of the child is the most imperative aspect of perfectly
diagnosing the core respiratory condition.
Jasper is breathing very hard and has a breathing rate of 48 breaths per minute,
temperature of 39.1 degrees Celsius; his heart rate is 142 beats per minute and a blood
pressure of 95/60 mmHg. Jasper has had rhinorrhoea, low grade fever and cough in the past
four days. Jasper’s blood pressure is normal; however, the temperature exceeds the normal
range of 36.5 – 37 degrees Celsius; the heart rate exceeds the normal range of 60 – 110; and
the respiratory rate exceeds the range of 20-25 in a four year old child (Kliegman & Stanton,