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 –Care provider - Manager of care –Educator - Collaborator –Research –Advocate

Nursing Process Foundation for all nursing –Assessment –Nursing diagnosis –Planning –Implementation/interventions –Evaluation See page 31, Box 2-3

Special Competencies 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 Family is who they say they are Biological Legal Emotional Two or more persons Nuclear, alternative, adoptive, foster, and group

Growth and Development Growth vs Development Piaget-cognitive Freud-psychosexual Erikson-psychosocial Table 4-1 pages Kohlberg- moral (won’t focus on)

Communication Techniques Verbal Nonverbal Active listening Play Purpose??

Stages of G & D Infant Toddlers Preschoolers School age Adolescent

Emotional Factors Separation anxiety Stranger anxiety Tantrums Depression Self image Insecurity

Safety/Accident Prevention 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 –Increased heart rate –Congenital anomalies –Decreased blood pressure –Increased oxygen demand –Increased metabolic demand

Renal –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 –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 – /12 concept

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