Study Notes on Health Promotion for the Infant, Child, and Adolescent

Foundations and Adult Health Nursing

Chapter 30: Health Promotion for the Infant, Child, and Adolescent

  • Source: Mosby, Inc., an imprint of Elsevier Inc. (© 2023, 2015)

Healthy People 2030

  • Definition: A comprehensive national program with 10-year health goals for all Americans.
  • Core Objectives: 358 measurable public health objectives with evidence-based interventions and 10-year targets.
  • Vision: To promote a society where all individuals achieve their full health potential across their lifespan.
  • Overall Health and Well-Being Measures: 8 broad outcome measures intended to assess the Healthy People 2030 vision.
  • Leading Health Indicators: A subset of 23 high-priority objectives selected to drive health improvement.
  • Developmental Objectives: Focus on public health issues with interventions lacking reliable data.
  • Research Objectives: Address public health issues not associated with evidence-based interventions.

Access to Health Services

  • Issue: Millions of children in the United States are uninsured.
  • Responsibilities of Health Care Providers: Improve healthcare access to mitigate delays in diagnosis and treatment.
  • Common Barriers to Access:
      - Lack of Primary Care Providers (PCPs).
      - Cultural and spiritual differences.
      - Language barriers.
      - Discrimination.
      - Concerns about confidentiality.

Nutrition, Physical Activity & Obesity

  • Physical Activity:
      - Essential for healthy growth and development among children and adolescents.
      - 80% of adolescents do not meet recommended physical activity levels.
      - Regular physical activity lowers adult death rates and reduces risks for:
        - Heart disease.
        - High blood pressure.
        - Diabetes mellitus.
        - Colon cancer.
      - Strategies to promote activity include education for parents, teachers, schools, and daycare providers.

  • Overweight and Obesity:
      - Statistics: 19.3% of American children are classified as overweight.
      - Contributing Factors:
        - Lack of physical activity.
        - Increased consumption of fast foods.
        - Economic pressures from working mothers.
        - Poverty.
      - Treatment includes low carbohydrate and low fat diets, coupled with increased physical activity.

  • Poor Eating Habits:
      - Issues stem from time constraints, particularly in households with two working parents.
      - Major caloric sources for children aged 2-17:
        - Grain-based desserts.
        - Yeast breads.
        - Pizza.
      - Recommended milk for children under 2: whole milk or 2% milk.
      - Importance of 60 minutes of daily physical activity.

Tobacco Use

  • Significance: Cigarette smoking identified as the most preventable cause of death.

  • Concerns Related to Tobacco:
      - Includes smokeless tobacco, cigar smoking, and exposure to secondhand smoke.

  • Health Risks: Increased risk of cancers (mouth, throat, stomach) and respiratory diseases (asthma, bronchitis) in children due to exposure to environmental tobacco smoke.

  • Teen Smoking Behaviors:
      - Influenced by peer approval, accessibility of tobacco products, low self-esteem, and advertising.
      - Secondhand smoke concerns: harmful smoke trapped in fabrics and furnishings.

Substance Abuse

  • Social Problems Associated: Includes domestic violence, STIs, teen pregnancy, school failure, motor vehicle accidents, and increased healthcare costs.
  • Trends in Adolescent Substance Use: Current experimentation with marijuana, cocaine, crack, heroin, LSD, inhalants, methamphetamines, ecstasy, and misused prescription drugs.

Communication and Education on Substance Abuse

  • Importance of Parental Involvement:
      - Parents should discuss risks of substance abuse proactively with children and educate themselves on signs of potential drug use.

Media Consumption: TV, Video Games, and Internet

  • Screen Time Statistics: Children watch over 3 hours/day of TV; teens exceed 7 hours on cell phones daily.

  • Implications:
      - Reduces time for reading and homework.
      - Presence of TV in bedrooms correlates with higher obesity risk.

  • Influence of TV on Development:
      - Exposure to violence on TV can lead to aggressive behavior, decreased sensitivity, increased fearfulness, and sleep disturbances (nightmares, obsessive thoughts).

  • Video Games:
      - Concerns include sleeplessness and triggers for epileptic seizures yet can enhance hand-eye coordination and social interaction in active games (e.g., Just Dance, Boxing, Wii Fit).

Social Media Usage among Teens

  • Over 80% of teens use social media, averaging 3 hours/day.
  • Concerns with Social Media:
      - Cyberbullying, online harassment, privacy violations, sexting, and Facebook depression.

Responsible Sexual Behavior

  • Trends: Young people are delaying sexual activity, with an average age of 17.
  • Major Risks of Irresponsible Behavior: Unintended pregnancies, STIs, HIV, and AIDS.
  • Recommendations:
      - Abstinence is the only 100% effective method for preventing STDs and unintended pregnancies, while proper condom use has an 80% effectiveness rate.

Mental Health

  • Healthy People 2030 Initiatives:
      - Focus on reducing adolescent suicide attempts and improving access to mental health treatment.

  • Challenges in Teenage Years: A critical period for fitting in, belonging, and influencing mental health, often leading to depression and anxiety associated with cell phone usage.

  • Holistic Treatment: Pediatric nurses should treat the mental health and physical health of patients as equally important.

  • Common Mental Health Issues: Include depression, suicide ideation, eating disorders, and substance abuse.

Injury and Violence

  • Common Injuries: Include motor vehicle accidents, accidental poisonings, suffocation, drowning, falls, aspiration of foreign bodies, and burns.
  • Recent Concerns: Premeditated shootings among adolescents are on the rise. Goals focus on reducing pediatric deaths from motor vehicle accidents and homicides.

Car Safety Guidelines

  • Recommendations for safe car seating:
      - Infant and toddlers should be rear-facing until age 2 or until they exceed size recommendations.
      - For older toddlers, transition to forward-facing seats and booster seats as needed until they reach 4'9" or between ages 8-12.
      - Reinforce the importance of appropriate seat belt use.

Bullying

  • Definition: Repeated aggressive behavior (verbal, physical, social, psychological).

  • Statistics: 28% of students in grades 6-12 report being bullied.

  • At-risk Children: Those perceived as different, anxious, or not fitting in with peers are more likely to be bullied.

  • Predisposing Factors for Bullying: Aggressive behavior, low parental involvement, negative self-perception, positive view of violence, and social circles composed of bullies.

Environmental Quality

  • Health Concerns: Include exposure to environmental tobacco smoke, ozone standards, and lead-based paint.
  • Risks for Children: Particularly affected are children under 6 years, as they often explore their environment and may ingest lead chips or dust.

Immunization

  • Benefits: Immunizations prevent many infectious diseases; more than 70% of children in the U.S. receive complete vaccination.
  • Barriers to Vaccination: Include a lack of insurance, funding, transportation, education on vaccination importance, and personal/cultural beliefs.

Vaccine-Preventable Diseases

  • Types of Diseases and Vaccines:
      - Measles: MMR vaccine protects against measles.
      - Chickenpox: Varicella vaccine protects against chickenpox.
      - Diphtheria: DTaP vaccine protects against diphtheria.
  • Common Symptoms and Complications: Each disease carries different symptoms and potential complications that emphasize the necessity for vaccination.

Dental Health

  • Development: Baby teeth emerge around six months after birth; insufficient fluoride increases tooth decay risk.
  • Prevention Strategies:
      - Avoid prolonged nighttime bottle use with sugary liquids.
      - Schedule regular dental checkups during school-age years.

Injury Prevention Strategies

  • Education: Teach parents the importance of preventing accidents based on child's developmental stages:
      - Infants: Focus on falls and suffocation.
      - Toddlers: Emphasize water safety, poison prevention, and fire safety.
      - School-aged: Address bicycle, car, and skating safety.

Poisoning Prevention

  • Common Source: Ingestion of harmful substances, particularly in children under 5.
  • Prevention Tips:
      - Do not refer to medicines as candy.
      - Store poisonous substances in locked cabinets.

Aspiration Prevention

  • Risks: Younger children are at high risk of asphyxiation from aspirated objects, with common hazards including small foods or toys.

Burn Injury Prevention

  • Safety Measures: Set water heaters to no higher than 120°F, keep hot items out of reach, and teach older children safe cooking practices; practice fire drills and maintain smoke detectors.

Conclusion

  • This comprehensive overview encapsulates strategies for promoting health and preventing injuries among infants, children, and adolescents recognizing the essential role of health education, nutrition, physical activity, and comprehensive healthcare services.