Most times “Sick” will hit you over the head when you see a child from across the room or as you stand in the doorway. Other times it is less obvious and a good way to determine if the child is ill and how ill is to compare your assessment findings to normal.
Activity: What is the child’s level of activity during play with others or alone like compared to normal?
Bathroom: When was the child’s last bathroom activity or soiled diaper? Is the frequency and volume as expected?
Consolable: Are parents or caregivers able to console the child with quiet talk, soothing touch, and or distraction?
Drinking: Is the child drinking normal volume and at a normal rate? Sips, when a child normally gulps, might indicate airway swelling, discomfort, or irritation.
Eating: Is the child eating normal amounts and at regular times?
Fever: Does the child have a fever? Review this tip on infant rectal temperature assessment.
ABCDEF … I couldn’t keep the list going, but here are a few other things to consider.
Pain and Discomfort
Look for non-verbal clues about pain which might include eye rubbing, hair pulling, or other self-soothing behaviors. For a verbal child ask about where the pain is located, what it feels like, and use the faces pain assessment scale. For an adolescent use the OPQRST pain assessment questions.
Have the parents administering any medications? What, when and how much? And importantly what was the child’s response.
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