PEDIATRIC PHYSICAL EXAMINATION: an ILLUSTRATED HANDBOOK, SECOND EDITION ISBN: 978-0-323-10006-9 Copyright © 2014 by Mosby, an Imprint of Elsevier Inc
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Contents UNIT I Pediatric General 15 Male Genitalia, 213 Assessment Angel K. Chen 1 Approach to Care and Assessment of 16 Male and Female Breast, 232 Children and Adolescents, 1 Erica Bisgyer Monasterio; Naomi A. Karen G. Duderstadt Schapiro 2 Assessment Parameters, 9 17 Female Genitalia, 242 Karen G. Duderstadt Erica Bisgyer Monasterio; Naomi A. Schapiro 3 Developmental Surveillance and Screening, 24 18 Musculoskeletal System, 259 Abbey Alkon Karen G. Duderstadt; Naomi A. Schapiro 4 Comprehensive Information Gathering, 36 19 Neurological System, 288 Karen G. Duderstadt; Naomi A. Karen G. Duderstadt Shapiro UNIT Charting 5 Environmental Health History, 55 III Karen G. Duderstadt Pediatric Health Care Visits UNIT II Sy stem-Specific 20 Charting Pediatric Comprehensive Assessment and Symptom-Focused Health Care Visits, 311 6 Skin, 64 Karen G. Duderstadt Renee P. McLeod 7 Heart and Vascular System, 83 Appendices Elizabeth Tong; Patricia O’Brien A Gender- and Age-Specific Growth 8 Chest and Respiratory System, 102 Charts and Preterm Growth Concettina (Tina) Tolomeo Chart, 324 9 Head and Neck, 118 B Body Mass Index–for–Age Growth Karen G. Duderstadt Charts, 331 10 Lymphatic System, 130 C Modified Checklist for Autism in Karen G. Duderstadt Toddlers (M-CHAT), 333 11 Eyes, 140 D Pediatric Symptom Checklist, 335 Karen G. Duderstadt E Children with Special Health Care 12 Ears, 157 Needs (CSHCN) Screener, 336 Patricia Jackson Allen F Pediatric Environmental History, 338 13 Nose, Mouth, and Throat, 178 Patricia Jackson Allen G Sports Concussion Assessment Tool 2 (SCAT 2), 342 14 Abdomen and Rectum, 198 Victoria F. Keeton KAREN G. DUDERSTADT, PHD, RN, CPNP, PCNS Clinical Professor Department of Family Health Care Nursing School of Nursing University of California, San Francisco San Francisco, California; Children’s Health Center San Francisco General Hospital San Francisco, California 3251 Riverport Lane St. Louis, Missouri 63043 PEDIATRIC PHYSICAL EXAMINATION: AN ILLUSTRATED HANDBOOK, SECOND EDITION ISBN: 978-0-323-10006-9 Copyright © 2014 by Mosby, an imprint of Elsevier Inc. Copyright © 2006 by Mosby Inc. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods, they should be mindful of their own safety and the safety of others, including parties for whom they have a profes- sional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Library of Congress Cataloging-in-Publication Data Duderstadt, Karen. Pediatric physical examination : an illustrated handbook / Karen G. Duderstadt.—2nd ed. p. ; cm. Includes bibliographical references and index. ISBN 978-0-323-10006-9 (pbk. : alk. paper) I. Title. [DNLM: 1. Physical Examination—Handbooks. 2. Child. WS 39] RJ50 618.92’0075--dc23 2013012810 Executive Content Strategist: Lee Henderson Content Development Specialist: Jackie Twomey Publishing Services Manager: Jeff Patterson Project Manager: Tracey Schriefer Design Direction: Jessica Williams Top cover photo: Nurse Practitioner Pat Clinton performing an ear assessment. (Photo by Tim Schoon. Copyright © University of Iowa, 2002.) Right cover photo: Nurse Practitioner Julie Tsirambidis assessing an infant in Haiti. (Photo by Ted Stevens. Copyright © Ted Stevens, 2011.) Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 To all the students who have shaped me as a teacher and a mentor; To the children and families whom I have had the privilege of caring for and who have enriched my life; and To Chris, my constantly patient husband, who has supported my life’s work. Contributors Abbey Alkon, RN, PNP, PhD Comprehensive Information Gathering Professor Environmental Health History Department of Family Health Care Nursing Head and Neck School of Nursing Lymphatic System University of California, San Francisco Eyes San Francisco, California Musculoskeletal System Developmental Surveillance and Screening Neurological System Charting Pediatric Comprehensive and Patricia Jackson Allen, RN, MS, PNP-BC, FAAN Symptom-Focused Health Care Visits Professor, PNP Specialty Coordinator School of Nursing Victoria F. Keeton, MS, RN, CPNP, CNS Yale University Associate Clinical Professor New Haven, Connecticut Department of Family Health Care Nursing Ears School of Nursing Nose, Mouth, and Throat University of California, San Francisco San Francisco, California Angel K. Chen, RN, MSN, CPNP Abdomen and Rectum Associate Clinical Professor and Vice Chair Department of Family Health Care Nursing Renee P. McLeod, PhD, APRN, CPNP, FAANP School of Nursing Dean, Professor University of California, San Francisco Marybelle and S. Paul Musco School San Francisco, California; of Nursing and Health Professions Pediatric Urology Nurse Practitioner Brandman University Children’s Health Center Irvine, California San Francisco General Hospital Skin San Francisco, California Male Genitalia Erica Bisgyer Monasterio, MN, FNP-BC Clinical Professor Karen G. Duderstadt, PhD, RN, CPNP, PCNS Director, Family Nurse Practitioner Program Clinical Professor Department of Family Health Care Nursing Department of Family Health Care Nursing School of Nursing, School of Nursing Clinical Professor University of California, San Francisco Division of Adolescent and Young Adult San Francisco, California; Medicine Children’s Health Center Department of Pediatrics San Francisco General Hospital University of California, San Francisco San Francisco, California San Francisco, California Approach to Care and Assessment Male and Female Breast of Children and Adolescents Female Genitalia Assessment Parameters iv Contributors v Patricia O’Brien, MSN, CPNP-AC Concettina (Tina) Tolomeo, DNP, APRN, Nurse Practitioner FNP-BC, AE-C Department of Nursing/Patient Services, Nurse Practitioner Cardiovascular Program Director of Program Development and Boston Children’s Hospital Operations Boston, Massachusetts Yale School of Medicine Heart and Vascular System New Haven, Connecticut Chest and Respiratory System Naomi A. Schapiro, PhD, RN, CPNP Clinical Professor Elizabeth Tong, MS, RN, PNP, FAHA, FAAN Department of Family Health Care Nursing Clinical Nurse Specialist and Research School of Nursing; Coordinator (Retired) Project Director Pediatric Cardiology; UCSF Elev8 Healthy Students & Families Clinical Professor (Emeritus) University of California, San Francisco School of Nursing San Francisco, California University of California, San Francisco Comprehensive Information Gathering San Francisco, California Musculoskeletal System Heart and Vascular System Male and Female Breast Female Genitalia Reviewers Sameeya Ahmed-Winston, RN, MSN, CPNP, Nancy McLoone, RN, MS, CPNP CPHON Assistant Professor, Pediatric Nurse Pediatric Nurse Practitioner Practitioner Children’s National Medical Center Mankato Clinic Washington, District of Columbia Minnesota State University Mankato, Minnesota Deanne Buschbach, RN, MSN, NNP, PNP NNP and NP Team Leader for the Intensive Jessica Pech, APN, CPNP Care Nursery Ann & Robert H. Lurie Children’s Hospital of Duke University Medical Center Chicago Durham, North Carolina Chicago, Illinois Annette Carley, RN, MS, NNP-BC, PNP-BC Susan Rice, PhD, RN, CPNP, CNS Clinical Professor Professor School of Nursing University of Toledo University of California, San Francisco Toledo, Ohio San Francisco, California Caroline A. Rich, RN, MSN, CPNP, AC/PC Margaret-Ann Carno, PhD, MBA, CPNP, Pediatric Nurse Practitioner DABSM, FAAN Helen DeVos Children’s Hospital Associate Professor of Clinical Nursing and Wayne State University Pediatrics Grand Rapids, Michigan School of Nursing University of Rochester Cheryl Rodgers, PhD, RN, CPNP, CPON Rochester, New York Instructor, Pediatric Nurse