Foundation of Pediatric nursing

infant

0-12 months

Toddler

1-3 years

Preschooler

3-6 years

School-age

6-12 years

Adolescent 

11-20 years

Prevent/Minimize

stressors, pain & discomfort, sleep deprivation, inability to eat or drink, changes in elimination, parent child separation

Promote

family-centered care, treating the family as the patient, promote sense of control

Therapeutic communication

goal directed, focused and purposeful

Therapeutic play

provides emotional outlet or coping devices

Child education

helps child understand the reason for the hospitalization/procedures in developmentally appropriate ways

Parental education

engages parents as active participants in health care team

Preventing/Minimizing physical stressors

engage the child in identifying what would make them comfortable, use positions that are comfortable to the child, therapeutic hugging, distraction methods such as music, conversation

Distraction methods for younger children

have the child point toes inward and wiggle them, ask the child to squeeze your hand, encourage the child to count aloud, sing a song and have the child sing along, point out the pictures on the ceiling, have the child blow bubbles, play music appealing to the child

Psychological effects of hospitalization on children

Anxiety and fear related to the overall process,

Potential for bodily injury, physical harm, and pain

Separation from home, family, friends

-anger and guilt, separation anxiety, regression

-other types of defense mechanisms

Activities that help a child cope w/ hospitalization

Regression

returning to an earlier developmental stage, you see it in kids who are stressed or hospitalized. ex: potty trained kid might needs a diaper in a hospital

Methods to promote coping in children

deep breathing techniques, distraction techniques, imagery, providing opportunities for therapeutic play, music, provide age-appropriate education before events occur, provide support to siblings and other family members

Preparation for surgery or Hospitalization

provides reassurance and comfort to the child and allows them to know what will happen, must be geared to the child’s age and developmental level

Infant (delayed development)

may fail to develop a sense of trust and bonding

Toddler (delayed development)

may have difficulty developing autonomy

Preschooler (delayed development)

may have difficulty achieving sense of initiative

School-aged child (delayed development)

may have difficulty achieving industry

Adolescent (delayed development)

may have difficulty forming a sense of self-identity relative to peers

Behavioral indicators of pain in infants

facial expression, body movements, crying

Physiological indicators of pain in infants

Changes in heart rate, respiratory rate, blood pressure, oxygen saturation levels, vagal tone, palmar sweating, and plasma cortisol or catecholamine levels 

Pediatric pain assessment tools

wong baker, FACES pain rating scale, Oucher pain rating scale, poker chip tool, visual analog and numeric scales, adolescent pediatric pain tool. important to assess based on mental ability!

Absorption

the process by which a drug is taken up into the blood stream after administration by different routes.

Oral medications

affected by changes in gastric pH, slower gastric emptying

Intramuscular absorption

variability in muscle mass among children

Subcutaneous absorption

decreased perfusion may alter absorption

Topical absorption of medicaions

enhanced due to greater body surface area; the smaller you are the more body surface area you have, therefore important with this. Liodcaine will be absorbed faster

First pass metabolism

the infant’s liver can struggle to metabolism meds due to immature metabolism