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In: Nursing

Growth and development template for data collection technique (Physical finding to report for and older adult)

Growth and development template for data collection technique (Physical finding to report for and older adult)

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Expert Solution

Q: growth and development data collection.

Ans: basic template for growth and development data collection

Bio- graphic data

name of client :

age:

sex:

date of admission ;

time of admission ;

I.P No:

Unit:

Address;

provisional diagnosis;

cheif complaints;

present history of illness;

past history of illness;

BIRTH HISTORY

Antenatal history;-

1. Position of the baby;

2. presentation ;

3. Antenatal checkup:

Intranatal history;-

Postnatal history;-

APGAR SCORE TABLE

Criteria 0 1 2
Respiration Absent slow, regular good, crying
Heart rate Absent slow, below 100bpm more then 100bpm
Muscle tone flaccid some flexion of extremities active body movement
Reflex response no response grimace cry
Skin colour blue, pale

body pink

extrimitie blue

Completely pink

Total score

no depression : 7- 10

mild depression : 4-6

severe depression : 0-3
Reflexes;-

Physical assessment

1. temp-

2. Pulse-

3. resp-

Anthropometric measurement

1. Height

2. weight

3. Head circumference

4. mid- arm circumference

Head to toe examination

Head:

eyes;

nose;

ears;

mouth;

neck;

chest;

abdomen;

genitalia;

back;

extrimities;

History of family illness;-


family pedigree ;-

Dietary history;-

Rest and sleep;-

economic history ;

Growth and development ;

According to book and Clie

Book picture client picture

1. Growth

2. development


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