Pediatric Nursing Notes

Pediatric Nursing Overview

  • Involves nursing care for children from birth to adolescence.
  • Encompasses clinical and psychological aspects of nursing.

Classification of Infants

Weight

  • LBW: Low-birth-weight (< 2500 g)
  • VLBW: Very-low-birth-weight (< 1500 g)
  • ELBW: Extremely low-birth-weight (< 1000 g)
  • AGA: Appropriate-for-gestational-age (10th-90th percentile)
  • SGA: Small-for-gestational-age (< 10th percentile)
  • LGA: Large-for-gestational-age (> 90th percentile)
  • IUGR: Intrauterine growth restriction (commonly referred to SGA).

Gestational Age

  • Premature: Born < 37 weeks gestation
  • Full term: 38-42 weeks gestation
  • Post term: > 42 weeks gestation

Problems Related to Dysmaturity

Prematurity

  • Born before 37 weeks, weighing < 2500 g.
  • High risk for complications like RDS due to lack of surfactants.
  • Assessment focuses on physical development and neurological status.

Postmature Infants

  • Born beyond 42 weeks.
  • Physical symptoms: cracked skin, excessive hair, poor glucose regulation risk.

Complications of Prematurity

  • Anemia of Prematurity: Normochromic, normocytic anemia due to immature hematopoietic system.
  • Kernicterus: Indirect bilirubin causing brain damage; treated with phototherapy.
  • Patent Ductus Arteriosus (PDA): Management includes fluid therapy and Indomethacin.
  • IVH: Intraventricular hemorrhage due to fragile capillaries.

Nursing Diagnoses for Premature Infants

  • Ineffective Breathing Pattern
  • Ineffective Thermoregulation
  • Imbalance Nutrition: Less than Body Requirement
  • Risk for Impaired Parent-Infant Attachment

Common Respiratory Issues

Respiratory Distress Syndrome

  • Caused by surfactant deficiency; characterized by low oxygen exchange and respiratory acidosis.
  • Symptoms: tachypnea, cyanosis, nasal flaring, grunting.

Meconium Aspiration Syndrome

  • Due to fetal distress, causing respiratory distress post-birth.

Hyperbilirubinemia

  • Jaundice from bilirubin accumulation; may be physiologic or pathologic.
  • Pathologic causes include Rh/ABO incompatibility.
  • Management: phototherapy, IVIG, and possible exchange transfusion.

Hematologic Disorders

  • Sickle Cell Anemia: Pain crises, increased risk of infections; management focused on pain relief and hydration.
  • Thalassemia: Requires regular transfusions and management of iron overload.

Congenital Heart Defects

  • Cyanotic vs. Acyanotic defects; management varies from surgical correction to supportive care.
  • Common defects: ASD, VSD, Tetralogy of Fallot, coarctation of the aorta.

Nursing Responsibilities

  • Monitor vital signs and promote growth and development.
  • Provide emotional support to families and ensure infection control.
  • Educate parents on conditions and care procedures.

Growth and Development

  • Important to provide age-appropriate activities and monitor developmental milestones.
  • Encourage positive parent-infant interactions for bonding.