paediatric nursing summarized notes, Lecture notes of Nursing

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BY MISS KINYUA

Course outline

 Definition  Principles of paediatric nursing  Review of the normal growth and developmental milestones in childhood  Effects of illness and hospitalisation on children: biological, physical, social, psychological

 Streptococcal sore throat  Rheumatic heart diseases  Meningococcal meningitis  Neonatal tetanus  Juvenile diabetes mellitus  Malignancy in children: wilm’s tumour, retinoblastoma

Congenital abnormalities:  CVS: tetralogy of fallot, atrial ventricular defect, ventral septal defect, patent ductus arteriosus, aortic aneurism.  Musculoskeletal: talipes  Alimentary system: cleft palate/lip, oesophageal atresia, esophageal fistulae, pyloric stenosis, hirschsprung’s disease, imperforate anus, gastrochiasis

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 Anaemia  Malnutrition  Asthma  Burkitts lymphoma  Leukaemia

INTRODUCTION

 Pediatric is concerned with health of infants, children, & adolescents.  It includes the five stages of development according to erik erickson. Thus, infancy, toddler, preschool, school and adolescent.  It focuses on their growth & development to ensure they are given the opportunities to achieve their full potential as adults.  The young are most vulnerable or disadvantaged in society hence need special attention. Children are individuals, not little adults who must be seen as part of the family.

The child in the context of the

family

 No other factor in a child’s life has a greater influence than the family, which is the first and the most important socializing agent in one’s life.  Successful socialization is the process by which children acquire beliefs, values and behaviours deemed significant in the society, this is a function of parenting and other familial interactions.  Their well-being is inextricably linked to the families, communities & the society they live.  Many familial factors have impact on children. Divorce, family size, absent fathers, working mothers, sibling position, and sex.

Legal and ethical issues of

paediatrics

 Nurses are confronted by difficult ethical/ legal decisions especially for nurses taking care of children in critical care conditions e.g. Does one resuscitate a child or not? Hence the need to understand some legal/ ethical guidelines that can resolve these dilemmas.  Different governments have different legal laws and regulations. Though children have right to informed consent, usually, it’s the legal guardian or parents who take the consent .children are said to “assent” i.e. Paediatric client has been informed about the procedure and is willing to permit it being performed. However, assent is not legally required but important for child’s cooperation.

Refusal of medical care by parent/caregiver  Usually, this occurs if health care conflicts parent’s religious beliefs. Parents may refuse to act to the best interest of the child. In such cases, the government may make legal decision of the child.  The theory of parens patrie is applied. This is a legal rule allowing government to make decision in place of parents when they are unable or unwilling e.g. To provide for the best interest of the child.

Perspective on pediatric nursing

1. Family centered care:  paediatric care involves care of children and their entire family.  Family centered care considers family contributions and involvement in the plan and delivery of child care

2. Atraumatic care:  care that minimizes or eliminates physical or psychological distress for children and other families in the health care environment.  Many interventions are traumatic, stressful; painful hence the nurse should recognize them and provide care that minimizes them.

Principles for the basis for atraumatic care  Identify stress for child and family  Minimize separation of child and care givers  Minimize or prevent pain Examples of atraumatic interventions include: prepare child/family before every procedure especially surgery e.g. Allow the child to play with equipment, visit the hospital prior to the surgery and reassurance ; involve caregivers to support the child; control pain by administering analgesics freely and provide social support to the family.

Advanced practice roles  nurse practitioner,  clinical nurse specialist  care manager

Nurse, child and family

communication

Nurses need to use effective communication skills in every interaction to:  enhance cooperation of family and  ensure interventions are likely to be optional because of good rapport.