How to do a pediatric physical exam
Other platforms explain it with text and video. In Making Synapses you practice it on the patient.
With children, order and approach matter more than in adults. Observe first, touch later, and save the ears and throat for last.
Step by step
Observe first
Color, breathing, activity and interaction while the child sits with the parent. [1]
Build trust
Talk to the child, show the instruments, let them touch the stethoscope. [1]
Quiet parts first
Listen to the heart and lungs while the child is calm. [1]
Then the rest
Abdomen, skin, limbs, neuro; on the parent's lap if needed. [1]
Ears and throat last
They are the most upsetting. [1]
Growth and development
Plot growth and check milestones. [2]
Explain
Share findings with the parent and the child at their level. [3]
Common errors
- Starting with the throat.
- Separating a young child from the parent.
- Missing breathing effort at the start.
Practice it in Making Synapses
In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
Making Synapses cases that train this skill
- Anaphylaxis in a child
- Sickle cell pain crisis
- Child with diarrhea and dehydration
- Suspected child abuse
- BRUE in an infant
- Bronchiolitis in an infant
69 Making Synapses cases train this skill: open the case library
Sources
- OpenStax, Clinical Nursing Skills (reference)
- NCCPA PANCE Content Blueprint
- AAMC Core Entrustable Professional Activities (Core EPAs)
- Stanford Medicine 25 (bedside exam)
- Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Facts and steps also follow NCCPA PANCE Content Blueprint; Stanford Medicine 25 (bedside exam). Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.