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
Competence
-"Content Competence"
-Communication
-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
22.2%
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
-Coordination
-Health Teaching and Health Promotion
-Advanced Practice Roles
-Evaluation
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
-Provid
Direct Care in peds
Developmentally appropriate
Culturally sensitive
In partnership with family
Holistic across all dimensions
Multidisciplinary
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
Birth
G&D
Illness/surgery
Educational needs
Behavior patterns
Communicable disease
Allergies
Potential Exposure to Hazardous Agents
Diet/Nutrition/Family Eating Patterns
Immunizations
Sexual history
Substance abuse
Pain
School
Elimination
Sleep
Strengths
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)
-Confidentiality
-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
-DNR
-Organ transplant
-Inconsistency between parent and child interests