Health Assessment

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Focused Health Assessment Lola Lewis-Walker University of Phoenix NUR/420: Health Assessment Gina Robinson, MSN, RN, CLNC December 18, 2006 Focused Health Assessment Trauma one Pediatric Emergency Department! Trauma one Pediatric Emergency Department responding over! Rescue Unit 29 transporting a 12 year-old boy, named Mike, hit by a car while riding his bicycle. This is a hit and run accident, but other motorists called a rescue unit. The child was not wearing a helmet. Facial bleeding is under control, but he suffered facial and head trauma. There appeared to be no facture of the extremities. Presently he is awake and semi-alert. Vitals signs: BP 120/56, Pulse 120, Oxygen…show more content…
In the book clinical manual of emergency pediatrics the Cain and Gershel state "spinal cord injury is sometimes overlooked during the initial evaluation of the severe brain injury patient" (Crain & Gershel, 2004. p.642). The head in humans is connected to the neck bone, therefore injury to the cervical spine should be ruled out. To evaluate this, ask the child if any numbness or tingling in any body part or does it feel like pins or needles. The toes or sole of the feet should be touched to detect sensation then ask "can you feel your toes being touched." "Paresthesia is an abnormal sensation" says Jarvis (2002. p.670).The goal is to detect any spinal cord injury. If there are any indications of a suspected traumatic brain injury a CAT scan of the brain should be done as long as no spinal injury is detected. The nurse should continually be alert to the signs and symptoms of increases in intracranial pressure, such as restlessness, nausea and vomiting, altered mental status, and changes in vital signs. Monitor closely for seizure activity. The child that was riding a bicycle and was struck by a vehicle is more prone to injuries to the head, spine and the abdomen. According to Cook, Schweer, Shebesta, Kaaren& Falcone "The flexible skeletal structure in young children may allow traumatic forces to extend to deeper structures, creating injury without fracture." (Society of trauma Nurses, 2006. p 58) The child's chest should be examined for any broken ribs, tenderness or
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