414 Peds exam 1 (weeks 1-4)

Basic Understandings

-Children are not little adults
-They come in a package
-- Include family
-Care is in context of development

Health Triangle

-Family (appropriate support), community(access to care and available resources), and culture (health beliefs)
-every child NEEDS health promotion (diet and exercise)
-Health maintenance (disease and injury prevention)
-Not as common, but also includes ac


-"Content Competence"
-Family Orientation
--Care for family, not just the individual
-Knowledge of legal, ethical, political issues
-Proficiency in safety and injury prevention
--know every age and stage of development
-Provision of excepti

How much of the population is under 18


Children in poverty

-22% are near poor
-19% are poor
-poverty is the #1 risk for a childs health

Health care needs of children

-Mortality decline
-Injury most common cause of death after 1st year
--can be prevented most of the time
--lots of teaching opportunities at each stage of development
-Children with special health care needs
-Points of transitions
--children who are now 1

Scope and standards of pediatric clinical nursing

-Pediatric nursing is the protection, promotion and optimization of health and abilities for children of newborn age through young adulthood.
-Prevention of illness and injury
-Alleviation of suffering
-Advocacy in the care of children and families

Standards of practice

-Collection of data
-Analysis of the assessment data
-Identification of outcomes
-Development of a plan of care
-Implementation of plan
-Health Teaching and Health Promotion
-Advanced Practice Roles

Examples of standard practice

-Involves child and family in holistic data collection
-Derives diagnosis appropriate to growth and development, culture, age, family
-Derives outcomes relative to families capabilities and resources
-Provides plan that includes continuity of care

Direct Care in peds

Developmentally appropriate
Culturally sensitive
In partnership with family
Holistic across all dimensions
Increasingly specialized
clinics, hospitals, etc

education in peds

Health promotion and prevention
Health maintenance
Self care
Management of a health condition

child advocacy in peds

Know family's needs, strengths, resources
Understand policies and resources in agency
Safeguard for care/protect from injury
Protect child/family from unethical, illegal, or incompetent care
Understand and act at community level for population needs of ch

case management in peds

Transition between and among settings
Promotes self care
Quality of services
Effective utilization of services
Continuity of Care

research in peds

Maintain evidence based practice
Evaluate and critique current research
Recommend areas for research
Participate in research studies
Conduct research

Understanding Norms for age

Newborn up to 1 month
Infant 1 month to 1 year
Toddler 1-3 years
Preschooler 3-6 years
School aged 6-12 years
Adolescent 12 +

Whats different (child vs adult)

Vital signs
Assessment techniques
Fluid volume
Lab values
Intellectual development
Anatomy and physiology
Response to pharmaceuticals....... And on... and on.....

Peds hx

Educational needs
Behavior patterns
Communicable disease
Potential Exposure to Hazardous Agents
Diet/Nutrition/Family Eating Patterns
Sexual history
Substance abuse

important safety considerations

Medication errors:
-Multiple steps in calculation -Misplaced decimal points
-Different concentrations of medications
-Off label usages/no FDA approval
-Child can't report side effects
-Family errors

Examples of legal considerations

-Informed consent
-Assent (if doctor deems cognitively developed enough, child can start to consent)
-Parental rights

Age of consent in WA

Mental health- 13
drug, alcohol abuse (outpatient)- 13
HIV, STD testing- 14
chemical dependency treatment (residential)-18
abortion and birth control- any age in which child can give informed consent

ethical considerations

-Withdrawal of treatment
-Organ transplant
-Inconsistency between parent and child interests