PEDS | peds nursing today

atraumatic care

- by method focused on minimizing physical and psychological trauma

- prevents fear of health care and post-traumatic stress

how should atraumatic care be implemented for toddlers/preschoolers?

give brief info right before the procedure

how should atraumatic care be implemented for school-age?

explain proceudres on the day they happen

how should atraumatic care be implemented for older children?

inform days/weeks in advance

technqiues for providing atraumatic care?

avoid/reduce: painful procedures, physical distress, restrains, invasive procedures, lying about pain

implement: family-centered care, distraction, feeling control, honesty, topical anesthetics (EMLA cream before IVs), comfort positions (parent's lap), skin to skin and sucrose for infants

comfort positions for blood draws

side sitting

back to tummy

tummy to tummy

on the table with support

how should information be shared to promote family-centered care?

non-judgemental and in small doses

what is the #1 cause of child death?

unintentional injuries (car accidents, drowning, poisoning, falls, suffocation, firearms)

responsibilities of primary care clinic

- preventative care and common illnesses

- physicals, height/weight/head circum, vitals, milestone screenings, immunizations and meds, and teaching

responsibilities of peds specialty daycare facilities

- for medically fragile or complex children whose parents work.

- close ongoing monitoring, early identification of complications, coordination of therapies (PT, OT, speech), support adherence to treatment plans

responsibilities of peds ER

- for acute and life-threatening conditions in children

- recognize abnormal pediatric vitals, draw blood, start IVs, administer medications and blood products, interpret lab results, manage emergencies and life-threatening conditions quickly

responsibilities of a school nurse

- first aid

- ensure up-to-date immunizations and educate on immunization importance

- manage outbreaks of contagious diseases

- administer routine medications and vaccinations

- screen for: health challenges, chronic illness management (e.g., diabetes, asthma), mental health concerns, social determinants of health

responsibilities of specialty hospitals

- chronic or terminal pediatric conditions (cancer, complex cardiac issues, orthopedic needs, etc.)

- inpatient care, special certifications (ie. chemotherapy), bloodwork, daily assessments in response to therapy, specialty medications, extensive education for child and parents

what is anticipatory guidance?

educating parents and caregivers about what to expect in the next phase of development

moral distress vs. moral injury

- when the nurse knows the right thing to do but either personal or institutional factors make it difficult to do the right thing

- emerges from severe moral distress/repeated trauma that leads to emotional trauma, disengagement, burnout, and internal dissonance

characteristics of authoritarian parenting + outcomes

- strict rules, limited output, high discipline, low trust

- fear driven behavior, low self estreem, aggression

characteristics of authoritative parenting + outcomes

- clear rules, open communication, emotional support

- confidence, emotional regulation, high self esteem

characteristics of permissive parenting + outcomes

- nuturing but few rules, child-led

- impulsivity, poor self regulation, moderate social skills

characteristics of neglectful parenting + outcomes

- uninvolved, low support, minimal interaction

- self-sufficiency, emotional dysregulation, academic and social issues

key points for addressing religion in the healthcare setting

- never assume based on perceived religion

- open-ended questions

- collaborate with chaplains/support services

cultural awareness

self-reflection on values/biases and cknowledge impact of biases on care

cultural knowledge

learn cultural beliefs, disease incidence, treatment efficacy

cultural skills

gather culturally relevant data and integrate into care

cultural humility

lifelong commitment to empathy, openness, and seeing value in

others.

primary vs. secondary vs. tertiary prevention

primary: prevent disease & risk reduction (ie. childhood immunizations)

secondary: early detection of disease (ie. screenings)

tertiary: prevent progression of disease (ie. rehabilitation after burns)

education tips for co-parenting success

- parenting plan all agree on

- clear boundaries.

- allow children to share emotions and listen carefully

- open communication

- resolve conflict in private.

- show empathy to coparents and unconditional love to children

recommended screen time for children

no screen time for children until they are 18 to 24 months of age, and from then until age 5, a maximum of 1 hour per day is recommended

ways to prevent bullying

teach:

- how to identify bullying

- how to stand up to bullies

- how to report

- how to be a role model for the child

encourage:

- participation in activities they enjoy

- open communication

indicators of human trafficking

- delayed medical care

- signs of physical, emotional, or sexual abuse

- appearance of neglect or malnourishment

- avoidance of eye contact and closed body language

- inconsistencies in the client's history or story of illness

- parents who do not let clients speak for themselves

- unusual tattoos or evidence of branding

- controlling parent who refuses to leave client

- presence of infectious disease or sexually transmitted disease