Describe principles of family-centered and developmentally appropriate care with the pediatric population (Ch. 2).
Discuss principles of safety, cultural sensitivity, and advocacy in the pediatric setting (Ch. 2).
Describe the nurse’s role in communicating with children and families, including barriers and communication during emergency care (Ch. 3).
Identify strategies for promoting cross-cultural communication (Ch. 4).
Discuss considerations for newborns, infants, toddlers, preschoolers, school-age children, and adolescents related to growth and development, safety, and health challenges (Ch. 7-10).
Describe pathophysiology, clinical presentation, and nursing care of pediatric clients with health alterations (varied).
Recognize congenital and cardiac anomalies and priority nursing actions (OB book, Ch. 17).
Family-Centered Care
Families are central to children's well-being; family can be defined in various ways.
Family-Centered Strategies:
Involve parents in care decisions.
Adapt schedules to fit family routines.
Implement quiet time to enhance patient comfort.
Provide amenities for families, such as fridges and microwaves.
Ensure privacy for families.
Establish family resource centers and learning councils.
Benefits of Family-Centered Care
Enhances learning and decreases stress.
Increases adherence to care plans and reduces medical errors.
Improves sleep/nutrition and increases satisfaction for patients and families.
Developmentally Appropriate Care
Children respond differently to pain than adults, including the ability to describe and localize pain.
Use appropriate pain scales (e.g., NPASS, NIPS, FLACC, Faces).
Safety in the Pediatric Setting
Adhere to National Patient Safety Goals (NPSGs):
Use two patient identifiers, implement security tags.
Reduce patient falls and ensure medication safety.
Cultural Sensitivity and Advocacy
Cultural sensitivity involves understanding patients' cultural beliefs and ensuring safe accommodations.
Advocacy includes prevention, detection, and management of child maltreatment.
Communicating with Children
Nurse’s Role:
Introduce yourself and ensure privacy in communication.
Use play and visual aids in assessments.
Recognize communication barriers, especially during emergencies.
Childhood Development Stages
Growth and Development Principles:
Individualized and influenced by various factors.
Patterns of Growth:
Cephalocaudal (head to tail) and proximodistal (center to periphery).
Infants (0-1 Year)
Regular growth metrics:
Weight: Gain 5-7 ounces/week; double by 6 months.
Height: Increase 1 inch/month for first 6 months.
Fine and Gross Motor Development:
Voluntary grasp: 4-5 months.
Sit unsupported: 8-9 months, walk alone: 12-15 months.
Language Development:
First communication is crying, social smile at 2-3 months.
Nutrition:
Breast-feed exclusively for the first 4 months; introduce solids after 5-6 months.
Toddlers (1-3 Years)
Physical Growth:
Birth weight quadruples by 2.5 years; growth is step-like.
Motor Skills:
Uses a fork at 3; by age 2, can build a tower of 6 blocks.
Language:
Vocabulary up to 50 words by 18 months, 1,100 words by age 3.
Preschoolers (3-5 Years)
Physical Growth:
Height increases by 2-3 inches/year.
Cognitive Development:
Understand time and tends to negotiate problem-solving.
Safety:
Focus on injury prevention strategies, including supervision and safe environments.
School-Age (6-12 Years)
Physical Growth:
Height increases by 2 inches/year, weight by 2-3 kg/year.
Safety:
Motor vehicle crashes are leading causes of injury.
Adolescents (13-18 Years)
Physical Growth:
Significant growth spurt correlating with sexual maturation.
Psychosocial Development:
Significant reliance on peers; struggle between independence and parental authority.
Safety Concerns:
High-risk behaviors, including substance use and risk of injury from vehicles or firearms.
Pediatric Medication Administration
Safety protocols for medication administration across different age groups to prevent errors.
Respiratory Disorders
Bronchiolitis and RSV:
Monitor respiratory status, hydrate, and educate caregivers on symptoms.
Asthma:
Chronic inflammation managed through avoidance of triggers and medications.
Cardiovascular Disorders
Kawasaki Disease:
Monitor for fever and symptoms; administer IV immunoglobulin.
Congenital Cardiac Defects:
Recognize symptoms like fatigue and failure to thrive.
Neurologic Disorders
Hydrocephalus:
Monitor ICP; provide shunt care.
Cerebral Palsy:
Early intervention and support are vital.
Genetic and Hematologic Disorders
Conditions like Trisomy 21 requiring supportive care and monitoring for associated health issues.