ASSESSMENT OF THE

SCHOOLER

SUBMITTED TO, SUBMITTED BY,

Mr. Ram Holambe Mr. Abhishek Raut
M.Sc. Pediatrics 3rd Year B.B.Sc Nursing
V.I.O.N., Parli-V V.I.O.N., Parli-V
SUBMITTED ON
 ASSESSMENT OF THE SCHOOLER
SCHOOLER PERIOD : 6-12 years of age

DEFINITION OF SCHOOLER ASSESSMENT

A schooler assessment is a systematic review of the body systems, structures and growth and development of a schooler or between 6 to
12 years of age to identify normal or deviation from normal.

OBJECTIVES SCHOOLER ASSESSMENT

GENERAL OBJECTIVE:

At the end of assessment students will acquire knowledge regarding systematic review of the body systems, structures and growth and
development of the schooler, they will develop considerable attitude towards identification of normal or deviation from normal of schooler and
they will also develop the required skill in the accurate assessment of schooler in the clinical practice.

SPECIFIC OBJECTIVES:

1. Assess the normal growth and development of the normal healthy schooler.
2. Detect in early period any abnormal condition like delayed milestones, mental retardation etc.
3. Evaluate schooler with developmental, chromosomal and neurological disorders.
4. Identify deformity and treatable diagnosis.
5. Formulate screening tool for early primary prevention.
6. Plan nursing care
7. Provide health education to parents
DEMOGRAPHIC DATA

1. Name of the Informant : Mr. Komal Chate

2. Relation with the Child : Mother
3. Name of Child : Mr. Karan Mahadev Chate
4. Age : 08 years Date of Admission:
5. Sex : Male Reg No.
6. Birth Weight : 3300 gm Date of Birth : 08/01/2013
7. Hospital/Ward : Diagnosis :
8. Religion : Hindu
9. Name of Mother : Mrs. Komal Mahadev Chate
10. Antenatal History : Mother had taken vaccination and attended 5 antenatal visits during the antenatal period.
She has taken adequate nutrition and folic acid, multivitamin supplements and calcium supplements
11. Birth History : Mother has delivered a full term baby by vaginal delivery on 08/01/2013 at 6:00 am, a male child of
birth weight 3300 gm.
12. Any Problem : no any problem.
13. Socio-economic Background: The child and his family belong to middle class. They have annual income of rs 7 lakh .
14. Chief Complaints : no any chief complaints
 PHYSICAL EXAMINATION

SR.
NO CHARACTERISTIC NORMAL ABNORMAL PATIENT FINDINGS REMARK
.
Looks ill acutely/ chronically Abnormal
1 Overall health Looks healthy Looks unhealthy

2 Nourishment Well nourished Well nourished

Under/over nourished
3 Body build Normal Thin/ obese Normal
4 Consciousness Conscious unconscious Conscious
Inattentive/drowsy/anxious/
5 Alertness Alert Alert
worried/depressed
Oriented to time, place,
Oriented to time, place, person N
6 Orientation Disoriented/confused person
O
Difficult/unusual voice/pitch-faster or R
7 Speech Clear, fluent Clear, fluent M
slow/slurred/ paces/pauses
Dressed properly and A
8 Dress Dressed properly and neatly Improperly dressed/untidy L
neatly
9 Personal hygiene Well maintained & clean Not maintained & unclean Well maintained & clean
Posture, gait, Upright, smooth
10 Upright, smooth rhythmic gait Gait stooped
position rhythmic gait
11 Body curves Normal Lordosis/ kyphosis/scoliosis Normal
12 Vital signs
Body
Euthermia (98.60F) Hypo/hyperthermia Hyperthermia (1000F) Abnormal
temperature
Pulse As per age & sex Deviation from normal 87 beats/min Normal
 Respiration As per age & sex Deviation from normal 23 breaths/min Normal
B.P As per age & sex Deviation from normal 95/65 mm Hg Normal
13 Skin
Color Pink Pallor/jaundice/cyanosis/flushing Pink
Vascularity Visible vein Varicose vein Visible vein
Pigmentation No pigmentation Scar/edema/birth marks No pigmentation N
Moisture Dry Moist/clammy Dry O
Temperature Warm Hot, cool Warm R
Texture Soft , regular Rough Soft , regular M
Turgor Elastic and mobile Loss of elasticity Elastic and mobile A
Lesions Absent Present Absent L
Edema Absent Present Absent
Hair
Appropriate as per age Inappropriate as per age Appropriate as per age
distribution
14 Nails N
Condition Smooth Brittle/ soft/rough Smooth O
Color Pink Blue/white Pink R
Capillary M
Within 3 sec More than 3 sec Within 3 sec
Refilling A
L
Clubbing No clubbing Clubbing No clubbing
Disproportionate to body size and Appropriate to body
15 Skull Appropriate to body shape & size
shape shape & size
Scalp No lesions/tenderness Lesions/ tenderness No lesions/tenderness Normal
Pediculosis /unclean/ Clean, black in color ,
Hair Clean, black in color
dandruff/infections long
16 Face Pink Pale/flushed/puffiness/fatigue/pain/fear Pink Normal
 / anxiety
Mobile & easy
Facial movement Mobile & easy movements Asymmetric & difficult Normal
movements
17 Eyes
Eye brow Present Absent Present Normal
Eye position Straight Intrusion/extrusion/squint Straight Normal
Eye lashes Normal Infection/sty Normal
Eye ball Normal Sunken /protruded Normal
Conjunctiva Clear, pink Redness, haemorrhage,yellowish Clear, pink
Normal
Clear/smooth/shiny/trans
Cornea Clear/smooth/shiny/transparent Cloudy
parent
Lens Normal Infection Normal
Eye movements Paired eye movements Uncoordinated eye movements Paired eye movements Normal
Pupil unequal, irregular in shape, non
Pupils PERRLA PERRLA Normal
reactive to light, do not accommodate
18 Ear
Auricle Present Absent Present
Outer pinna Symmetric Deformity/tenderness/swelling Symmetric
Impacted cerumen/discharge/ foreign brown earwax in right
Canal Yellow brown earwax, no lesion Normal
bodies/ mass /redness/swelling ear , no lesion
Tympanic
Intact Perforation/ abnormal color/ Intact
Membrane
19 Nose
External nose Straight Deviation in shape, size Straight
Nasal septum Straight Deviation Straight
Normal
Nostrils Not tender/swollen Tender/swollen Not tender/swollen
Frontal- Not tender/swollen Tender/swollen Not tender/swollen
 Maxillary sinuses
20 Mouth
Asymmetrical/dry/fissures/scar/ crusts/ Moist, pink without
Lips Moist, pink without crusts Normal
blue/ angular stomatitis crusts
Abnormal
color/coating/swelling/lesions/deviatio Moist/pink/midline/symm
Moist/pink/midline/symmetric/mob
Tongue n from etric/mobile/without
ile/without lesions
midline/enlargement/ulceration/protrusi lesions, white coated
on/paralysis
Odor of mouth No odor Foul smelling No odor
Bleeding/ swelling/pus/ inflammation/
Gums Pink, no lesion Pink, no lesion
discoloration/ lesions/ ulcer
Buccal mucosa Discoloration/ulcer/masses Normal N
Teeth (Number, Discoloration/ dental caries/ Disease free, firmly O
Disease free, firmly placed, 32 R
Arrangement, malocclusion/plague/missing or loose placed, 32 teeth,
teeth, symmetric M
general condition) teeth/deformities symmetric
Uvula (look for A
Symmetric, visible but L
Symmetry when patien Symmetric, visible but not enlarged Enlarged, white spots/appears swollen
not enlarged
)
Smooth/ moist/pink/gag reflex Dry, red, grayish membrane, absent Smooth/ moist/pink/gag
Pharynx
present gag reflex reflex present
Abnormal voice- hoarse, extremely
Voice Effortless speech high or low pitched/speaking requires Effortless speech
effort
Sense of taste Able to identify taste Unable to identify taste Able to identify taste
21 Neck
Movements Flexion, extension, rotation Movements restricted/painful Flexion, extension,
 rotation
Lymph nodes Not palpable Palpable/enlarged Not palpable
Not observable except in thin Enlarged, observable nodules, Not observable except in N
Thyroid
person tenderness thin person O
Not distended-in sitting R
External jugular Not distended-in sitting position position M
Marked distension with bulging
vein Distended-in supine position Distended-in supine A
position L
Present ,equal, normal regular Diminished, absent ,abnormally Present ,equal, normal
Carotid arteries
pulsation forceful pulsations regular pulsation
22 CHEST:
Respiratory system Normal
Chest movement Normal Pneumonia No effort, or use of
Effort No effort, or use of accessory Abnormal sounds- wheezing, crackles, accessory muscles
normal
Chest retraction muscles strider etc. Not present
Breath sounds Not present Chest retraction present Normal breath sound S1
Heart sounds Normal breath sound Murmurs congenital heart disease etc. & S2 heard,
S1 & S2 heard,
23 ABDOMEN-
Distension: No Abdominal distention No N
Abdominal girth: Normal Ascitis Normal O
Palpable mass: No mass palpable Organomagaly No mass palpable R
Bowel sounds: Normal peristaltic movements Liver palpable (hepatomegaly) Normal peristaltic M
Enlargement or movements A
tenderness of organs L

Spinal curvature deformity, tenderness,

24 Spine Normal curvature Normal curvature Normal
stiffness over spinous process
25 Male Genitalia
Distribution of pubic
Distribution of pubic hair; clean, no
hair; clean, no masses,
masses, scar, lesions, erosion, odor, Abnormal distribution of pubic hair;
scar, lesions, erosion,
External genitals tenderness, swelling , testis well unclean, masses, scar, lesions, erosion, Normal
odor, tenderness, swelling
distended, no any epi or odor, tenderness, swelling
, testis well distended, no
hypospadias
any epi or hypospadias
Inflammation, scar, fissure,
hemorrhoids, masses, tenderness, fetal
Skin darker ,no masses, moist, no Skin darker ,no masses,
26 Rectum compaction, nodules Normal
hair moist, no hair

Reflexes
Superficial reflex
 Plantar
28 Present Absent Present Normal
 Abdominal
 Cremasteric
 Anal
Deep tendon reflex
 Bicep
 Triceps
Present Absent Present Normal
 Supinator
 Knee jerk
 Ankle
 ASSESSMENT OF GROWTH AND DEVELOPMENT OF THE SCHOOLER

SR. AGE CHARACTERISTI PARTICULA NORMAL PATIENT FINDINGS REMARK

NO. (YRS) C RS
10 PHYSICAL &
1. years BIOLOGIC
DEVELOPMENT
Weight: Approx 22-32 kg (48-70 lb). Has gained 3.8 Wt- 37.6 kg SLIGHTLY
kg (7 lb) yearly Expected weight : LESS
40kg
Height Approx 121.5-136.5 cm (47.5-53.5 in). 140cm NORMAL
Gains 1.13 cm (2.5 in) yearly.
Pulse 85 ± 10 beats/min 87 beats/min
Respiration 20 ± 3 /min 23 breaths/min
Blood pressure 102/60 ± 16/10 mm of Hg. 95/65mmHg
2. 10 MOTOR SKILL
years DEVELOPMENT

Gross motor skill  Participates in organized sports like Performed bicycles NORMAL
development baseball, football Participate in foot ball
 Throws a ball skillfully overhand and running, throws ball
underhand and catch skill
10 Fine motor  Can Use both hands independently Use both hand NORMAL
years Development  Draw a person with 18-20 parts independently , He
 Has increased smoothness and doing all activity
speed in fine motor control without help
 Prints fluently, cursive writing Increased speed in
 improved. writing , playing
games and running
3 10 SENSORY Visual acuity: 20/20 Normal NORMAL
years DEVELOPMENT
4 10 PSYCHOSOCIAL Sense of
years DEVELOPMENT industry VS
(Erik Erikson) Sense of
inferiority
 Hero worship Self identity NORMAL
 Considers peer opinion Trust more on friends
more Important than Helping in work
parents Take care of younger
 Enjoys running around brother
 Helping when mother is busy Fear about any thing
 Relationships with siblings is reasonable
improved Understanding about
 Has fears that are reasonable not more mix with
 Aware of appropriate sexual boys.
Role
5 10 PSYCHO-SEXUAL Latency stage  Associates with peer of same sex Mix with same age NORMAL
years (Sigmund Freud)  Develop social skills, values boy.
6 10 COGNITIVE  Thinking and Reasoning Thinking appropriate NORMAL
years DEVELOPMENT  They can think of present, such as need for study
(Jean Piaget) past &future They think about
 Able to classify objects in future e. g. study hard
more complex manner for better marks
 Able to arrange objects ,impact of television
according to their size and on eyes
relationship to other things Able to arrange object
 according to
ascending or
descending order
7 10 MORAL  Respect for rules laid down Respect for parents NORMAL
years DEVELOPMENT by parents and others adult and also others – by
(Jean Piaget & in authority calling respectful
Lawrence word e.g. adult person
Kohlberg ) Aunty or uncle ,
teacher
8 10 SPIRITUAL  Does understand instruction and Understand NORMAL
years DEVELOPMENT recognize idols instruction ,and also
(James. W. wants to idols
Fowler)
9 10 LANGUAGE
years DEVELOPMENT
Receptive  Follows suggestions better Better commands, NORMAL
than commands give suggestion,
Expressive  Begin to use shorter and Express thoughts by NORMAL
compact sentences using small sentences
10 10 SELF CARE  Fully independent in bathing, All routine care done NORMAL
years ACTIVITIES dressing, grooming, feeding etc independently
11 10 DEVELOPMENTAL  Decrease dependence on family Independently doing NORMAL
years TASK  Participation in games & works activity , need
with other guidance,
 Able to reason communication skill
 Communicates with others with other is
realistically developed
 Active & cooperative participant Active participate in
 in the family social activity like
 Giving & receiving affection to any function Giving
& from family and friends & receiving
 Socially acceptable behavior affection to & from
 Learns how to handle strong family and friends
feelings and impulses Normal social
 Is able to adjust with changing behavior
body image &self concept
 Develops a positive attitude
towards his own and others
social, racial, economic &
religious groups
12 10 PLAY
years STIMULATION
 Prefers companionship in play Plays outdoor games NORMAL
 Likes to compete like tennis, kho-kho,
Kabbadi, and indoor
games like Chess
13 10 NUTRITIONAL  80 cal/kg body wt Daily NORMAL
years REQUIREMENT 50% — carbohydrate Breakfast 1 roti or
35% — fat 50gm poha or upma
15%— protein Lunch 1 roti with baji
Recommended dietary allowances by Evening 100ml tea
ICMR in 2009 with chapti-1
Age Body Energy Protein Dinner- chpati 1 with
years wt. Kg Kcal gm bhaji , rice with dal
10 34.6kg 1780 64 100gm
years Some times fruit
Eat all vegetable but
not eat nonveg food
14 10 BEHAVIORAL  Truancy, stealing, pica, eating, No any behavioral NORMAL
years PROBLEM sleeping disorder, Attention deficit problem
hyperactivity etc.
15 10 IMMUNIZATION
years
AGE Immunization All vaccination till NORMAL
0 At birth BCG, OPV0 date is completed
6 weeks DTP1,OPV1, HEP-B 1ST
10 weeks DTP2, OPV2, HEP-B 2ND
14 weeks DTP3, OPV3 HEP-B 3RD
9 month Measles, VIT-A 1ST (2 IU)
every 6 monthly,1 lac IU,
total 9 doses
18-24 month DTP+OPV+ Hepatitis B
(1st Booster Dose)
5 years DT B2
10 year TT
NEEDS OF THE CHILD

- Adequate nutrition
- Appropriate treatment of pneumonia.
- Protection from infection and allergic agents
- Prevention of infection in the ward
- Maintenance of personal hygiene
- Immunization
- Growth monitoring
 SUMMARY

I have taken a male schooler child for assessment. I have informed the father regarding assessment and did the assessment of the child. There
is no any abnormality is found in the child and he is normal. The child’s needs have been identified and told to the father to take appropriate
care of the child.

CONCLUSION

From this assessment I have assessed all the growth and development characteristics of the schooler and came to know how to differentiate
between the normal and abnormal characteristics of the schooler child at various stages of age. In this case I found that the child has all normal
characteristics and there is no any abnormality detected. I have assessed the needs of the child and given health education to the father regarding
the care of child.

BIBLIOGRAPHY

1. David Wilson, “Wong’s Essentials of Pediatric Nursing”, 8th Edition(2009), Elsevier Publications, Noida, UP.
2. Manoj Yadav, “Child Health Nursing”, 1st edition, S Vikas & Company (Medical Publishers), Jalandhar.
3. Datta Parul, “Pediatric Nursing”, 4th edition, Jaypee brothers Publishers, New Delhi.