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School Screening

In: Other Topics

Submitted By theartist1974
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Several standard and basic techniques were used during the physical assessment of elementary students. To start, the patients were informed of the procedures in very basic terms that were understood. Height was assessed using a measuring device marked in inches. To assess accurate height, the patient must stand straight with feet close together. Weight was measured using scales marked in ounces and pounds. The BMI was determined using the data collected from height and weight. Hearing was assessed using headphones and a device that sends tones at variable decibels and hertz. If the patient wore hearing aids during screening, it was noted. Hearing was screened at 1000, 2000, and 4000 Hz beginning with 20 db. Vision was screened using two charts from a distance of 20 feet. The first chart was the Snellen letter chart and the consisted of only pictures. If the patient wore corrective lenses during screening, it was noted . Also, scoliosis was screened for by examining the patients spine while changing posture. Upon screening the results were taken and compared to find if the patient was within normal limits for the appropriate age range. Abnormal findings occur if the following apply: vision is greater than 20/30 in either eye, or a difference of two lines between both eyes; hearing is greater or equal two 30 db in either ear; the spine is curved; and weight is charted in the 85th percentile or above. Also these findings are slightly altered by gender. Deficits in any category assessed can pose a great risk on the patient. Because hearing and vision are both sensory functions the following nursing diagnosis applies: risk for injury related to disturbed sensory perception and self care deficit related to disturbed sensory perception. Since height, weight, and BMI are related the following nursing diagnosis applies: risk for disproportionate growth and imbalanced nutrition related to “more” or “less” than body requirements. Scoliosis can lead to impaired physical mobility related to musculoskeletal impairment. If abnormal results are found, proper referrals need to be completed promptly. First the parents or guardians must be contacted . Depending on what assessment is abnormal, the following specialists need to be contacted: optometrist or ophthalmologist, ear nose and throat specialist or otolaryngologist, pediatrician, nutritionist, and physical therapist. It is crucial to the patient to seek appropriate care immediately. All data acquired needs to be recorded for each patient along with the date and patients age. Such data include the vision for each eye and both eyes including presence of corrective lenses; hearing for both ears, noting presence of hearing aids; height; weight; BMI; and detection of scoliosis. The height and weight, along with the BMI is graphed to determine the percentile for age group. All findings whether normal or abnormal need to be recorded along with any referral notes. An article discussing vision screening suggests that it is not completed enough for children to benefit. It suggests that it is due to the time consuming methods that have been implemented. A study was conducted using a noncyclolpegic autorefactor to perform eye exams on preschoolers. This study resulted in more accurate results and within less time. This method compensates for others with disabilities that may be overlooked using the standard method of examination. The article emphasizes the utilization of time. Because this method requires less time, it is more likely to be used. According to the article, several school districts have invested in this machine to share among surrounding schools. It is implied that if children are screened as often as needed, the pre-existing problems may be corrected in a more timely manner resulting in a reduction of the problem; which in turn, leads to a more normal functioning life.
Bibliography
Clarke, N., Shacks, J., Kerr, A., Bottrell, C., Poulsen, M., Yin, L. (2008). Use of a noncycloplegic autorefractor to perform vision screening in preschools. The Journal of School Nursing, 24(3), 158-163.

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