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Pediatric Patients

Adonis K. Lomibao11/30/11

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Objectives

Understand the Phychosocial and Physical needs of different age groups.

Identify age-specific nursing care for each group.

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Family

When a child is sick, whole family affected. Different types of parents:

-Biological parent- birth or genetic

-Adoptive parent-legally assume responsibility

-Stepparent- assumes role through marriage Legal custody- person with right to consent Legal guardian has legal custody Family-the household unit in which the chilld lives.

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Pediatric Units

Separated in 2 ways:

-by age groups

-by type of patient Infancy(0-1) Toddler(1-3) Preschooler(3-6) Schoolage(6-12) Adolescent(12-18)

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Developmental Tasks

Each age group has a certain developmental level.

Each level has physical and psychologiocal tasks that the average child in age group can perform.

Understanding tasks make it easier to encourage develoment

Regress- go backward

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Erikson's Stages

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Caring for infants (Birth-1)

Double birth-length Triple birth-weight Mastery over gross motor behavior starting with

head and moving down. Head control, rolling over, sitting up, crawling,

walking Achievement of skills=Developmental milestone

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Infants

Psychosocial developmental task=TRUST. Build trust by responding to needs such as

crying, changing, feeding, etc. Consistency is important Fear of strangers begin at 6-7 months

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Infants

Communication is difficult because needs can't be told.

Age-appropriate toys helps in development.i.e. Colorful mobiles, rattles, and mirrors.

It is important for siblings to visit infant, esp. toddlers and preschoolers

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Routine Procedures

Hold the infant properly (Figure 50-4) Organize care so infant can digest food and

sleep after feedings. Avoid movement to prevent emesis.

It is important to take vitals,measure weight, and change crib linens.

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Vital Signs

Heart rate: 120-160 Respirations: 30-60 Systolic BP: 74-100 Diastolic BP: 50-70

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Feeding

Feeding satisfies hunger and sucking needs. Provide infant with opportunity to suck Always hold infant when feeding or not. Always hold the bottle when feeding Never leave the baby with bottle propped up. During and following feeding, infant should be

burped.

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Breastfeeding

Direct woman to a place of privacy and comfort. Responsible for weighing the infant before and

after. When returned to crib, place on back or on

side.

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Collecting a Urine Specimen

To collect from infants or toddlers that isn't potty-trained, an adhesive pediatric collection bag is used.

The urine is then placed into a specimen cup for collection.

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Restraints

Generally not restrained to obtain an order to restrain an infant or child.

Restraints are used to protect the child from injury or others.

Should be freed at least every 2 hours. Never tie restraints to a crib side or bed rail.

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PCT Tasks/Responsibilities

Maintain safe environment. Monitor vital signs. Routine care.i.e. Feeding & bathing. Collect & test specimens Etc. (p. 894)

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Childhood Obesity

More than 10% of preschool children are overweight.

2005-9 million children over 6 are obese. Diseases being seen in children include Type 2

diabetes, sleep apnia, hypertension, etc. p.895 80% of overweight adolescents become

overweight adults.

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Caring for Toddlers (1-3)

The age when a child is trying to be independent & in control.

Increases in motor coordination, more verbal, curiosity.

Developmental task is AUTONOMY (independent action).

Allow for independence, avoid situational struggles,allow toddler to do own activities.

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Toddlers Cont.

Do not scold the toddler for accidents. Stress that the illness is not the child or

anyone's fault. Allow children to handle equipment you will

use. Try to follow the child's usual schedule for

eating,naps, toileting, etc.

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Play

Toddlers love to play,but have short attention spans.

Keep toddler amused with

-Finger painting

-moving toy cars or trucks

-coloring

-reading of stories

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PCT Tasks/Responsibilities

Maintain a safe environment. Monitor vital signs. Supervise & assist with routine care. Collect & test specimens. Provide & assist with opportunities for play Provide warmth, security, & affection. Promote independence with choices.

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School-age children

Developmental tasks-trying to achieve sense of accomplishment.

Increase control over environment and independence.

School-age child is better able to handle stress of illness.

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School-age cont.

Left security of home and into the school-system.

Developing relationships with other children. May respond to peer separation more than

parent separation. Keep a roommate with same age. Take active interest in health & acquiring

knowledge.

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Activities & Nursing care

Allow time for doing schoolwork & visiting friends & patients.

Provide explanations using proper body part names, drawings, and books.

Encourage socialization with other children in same age group.

Provide time for schoolwork & tutors.

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Caring for the Adolescent

Transition from childhood to adulthood. Major health problems are related to accidents,

sports injuries, or to chronic and/or permanent disablilities.

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Psychosocial Development

Care is difficult b/c adolescent is

-developing an identity & increasingly independent.

-Issues with authority figures.

-Usually uncooperative. Friends are the most important people

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Nursing Care

Orient to rules and hospital unit Assist with body hygiene Provide simple explanations Promote independence Encourage socialization