Transcript PEDIATRIC NURSING Caring For Children and Their Families

PEDIATRIC NURSING
Caring For Children and
Their Families
MODULE 1
What is Pediatric
Nursing?
• Caring for children and families
• Promoting health and wellness
through several roles
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Care provider
Educator
Research
Advocate
- Manager of care
- Collaborator
Nursing Process
• Foundation for all nursing
– Assessment
– Nursing diagnosis
– Planning
– Implementation/interventions
– Evaluation
See page 31, Box 2-3
Special Competencies
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Medication dosage calculation
Pediatric-specific skills
Neonatal, infant and child resuscitation
Play therapy
Family-centered care
Developmentally appropriate care and
communication
Peds Nursing Issues
• Safety of culture and environment
• Access to healthcare
• Divorce, abuse, drug use- exposure in
home
• Lack of prenatal care and appropriate
screenings
• Violence and bullying in school
• Injury and accidents
• Nutrition and obesity rates; eating
disorders
• Peer pressure, drug and alcohol use
• Sexual activity and rates of STD and teen
pregnancy
• Mental health
• Child abuse and neglect
Care Settings
• Acute care- hospital setting
• Critical care hospital unit
• Specialty clinics for children with special
needs
• Public health department
• School
• Home health and hospice care
• Primary care facilities
Definition of Family
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Family is who they say they are
Biological
Legal
Emotional
Two or more persons
Nuclear, alternative, adoptive,
foster, and group
Growth and Development
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Growth vs Development
Piaget-cognitive
Freud-psychosexual
Erikson-psychosocial
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Table 4-1 pages 56-57
• Kohlberg- moral (won’t focus on)
Communication
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Techniques
Verbal
Nonverbal
Active listening
Play
Purpose??
Stages of G & D
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Infant
Toddlers
Preschoolers
School age
Adolescent
Emotional Factors
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Separation anxiety
Stranger anxiety
Tantrums
Depression
Self image
Insecurity
Safety/Accident
Prevention
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Environmental
Equipment
Medication
Anticipatory guidance
Risk factors
Pain Management
• Nonpharmacologic
• Pharmacologic
– Non-opioid
– Opioid
Anatomic Differences
• Respiratory
– Small, short, narrow airways
– Obligatory nose breathers
– Immature respiratory system
• Skin
– Larger body surface area
– Increase fluid loss
– Problems with temp regulation
• Cardiac
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Increased heart rate
Congenital anomalies
Decreased blood pressure
Increased oxygen demand
Increased metabolic demand
• Renal
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Immature, not effective for filtration
Can’t concentrate urine
Small changes=big consequences
Differing lab values by age group
Small bladder capacity
Prevent UTI
1-2mL/kg/hr
• GI
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Feces changes based on diet and age
Dietary inclusions
Allergies
Congenital disorders
• Neuro
– Primitive reflexes
– Replaced slowly with gross and fine
motor movement
– Cephalocaudal; proximodistal
– Dependent on nutrition and function of
other body systems
• Immune
– Need acquired immunity in infancy
• 3-4 months of age
– Immunizations
– Immature immune system, not adequate
until early childhood
• Musculoskeletal
– Spurts and lulls
– Mastery of motor skills is influenced by
environment and stimulation
– Highly individualized
– 2-4-6-8-10/12 concept
G&D Templates
• http://www.atitesting.com