VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
1 nega Pediatrics-Introduction-1.ppt
1. Larson & Farber, Elementary Statistics: Picturing the World, 3e 1
1
Nursing Health Assessment
2. 6/25/2023 2
NEGA TEZERA (BSC, N, MSC, N)
UNIVERSTY OF GONDAR
COLLEGE OF MEDICINE AND HEALTH SCIENCE
DEPARTMENT OF NURSING
Pediatrics Nursing and Child Health
Care
For Bsc nursing student
3. Larson & Farber, Elementary Statistics: Picturing the World, 3e 3
Unit one: Introduction
Outline
Overview of pediatric Nursing
Definition of pediatric Nursing
Current trends in child health care
The nurse’s role in child care
Modern concepts of pediatric nursing care
Overview of pediatric health assessment
Common pediatric nursing procedures
6/25/2023 3
4. Larson & Farber, Elementary Statistics: Picturing the World, 3e 4
Objectives
At the end of this session the students will be able
to:
define pediatric nursing
describe the modern concepts of pediatric nursing
care
explain the basics of pediatric health assessment
differentiate normal and abnormal V/S values
identify common pediatric nursing procedures
6/25/2023 4
5. Larson & Farber, Elementary Statistics: Picturing the World, 3e 5
Overview of pediatric nursing
Relatively new medical speciality (1800s)
In the earlier times:
Epidemics were common
Many children died during infancy/childhood
Families were large (compensation)
Children were cared by families or neighbours
Children were not considered important
6/25/2023 5
6. Larson & Farber, Elementary Statistics: Picturing the World, 3e 6
Overview ...
•Hospitalized children were cared as adults
•Unsanitary conditions
•Mortality rates were commonly 50% to 100%
6/25/2023 6
7. Larson & Farber, Elementary Statistics: Picturing the World, 3e 7
Overview ...
After world war I:
•A period of strict asepsis
•Babies were placed in individual cubicles
•No one was allowed to pick up children
•No toys
•Infant mortality rates continued
6/25/2023 7
8. Larson & Farber, Elementary Statistics: Picturing the World, 3e 8
Overview ...
1970s to 1980s
•Hospital regulations changed slowly
•Isolation practices relaxed
•Nurses used play as therapeutic tool
•Children visited playroom
6/25/2023 8
9. Larson & Farber, Elementary Statistics: Picturing the World, 3e 9
Factors influence the health and
illness patterns of a child
6/25/2023 9
External Factors
Internal Factors
10. Larson & Farber, Elementary Statistics: Picturing the World, 3e 10
Pediatric Nursing is:
A parent-nurse partnership
Nurse’s goals are: to promote a therapeutic
relationship between parent and child
Accomplished by family-centered care
To promote continued growth and development
6/25/2023 10
11. Larson & Farber, Elementary Statistics: Picturing the World, 3e 11
Pediatric Nursing ....
is the art and science of giving nursing care to
children from birth through adolescent with
emphasis on the physical growth, mental,
emotional and psycho-social development
6/25/2023 11
12. Larson & Farber, Elementary Statistics: Picturing the World, 3e 12
Current trends in child health care
Family-centred care
Regionalized care
6/25/2023 12
13. Larson & Farber, Elementary Statistics: Picturing the World, 3e 13
Are children considered as little adult?
Point out the difference between adult and
child ?
(think-pair-share)
6/25/2023 13
14. Larson & Farber, Elementary Statistics: Picturing the World, 3e 14
Anatomical difference
Immaturity and inadequate ossification
Suture and skull are not united
Infant tongue is large
Nasal and oral air way passage are relatively
small
No tears in early infancy
15. Larson & Farber, Elementary Statistics: Picturing the World, 3e 15
Eustachian tube is short and straight in children
Trachea is short and narrow under 5 years
children
Children cardiac sphincter of stomach is relaxed
16. Larson & Farber, Elementary Statistics: Picturing the World, 3e 16
Physiological difference
Poor thermoregulation is attributed to
immaturity of Hypothalamus
Shivering and sweating mechanism are
absent in newborn
GFR and tubular function are lower in
neonate.
17. Larson & Farber, Elementary Statistics: Picturing the World, 3e 17
Psychological differences
Fear, escape and avoid stranger till 5 years
of age
Explore the environment
Infancy: more bonding with parents
separation anxiety is very common
Toddler: Negativistic behavior
18. Larson & Farber, Elementary Statistics: Picturing the World, 3e 18
Why pediatrics ... ?
1. The health problems of children differ from those
adults in many ways
2. Children’s response to an illness is influenced
by age
3. Managements of childhood illness are
significantly different from an adult
4. Children need special care since they are among
the most vulnerable groups
6/25/2023 18
19. Larson & Farber, Elementary Statistics: Picturing the World, 3e 19
Modern concepts of child care
Previously the emphasis was on the care of the ill
child as an individual
Current emphasis:
Prevention of illnesses and accidents
Holistic nursing care
Independent practice
Interdisciplinary approach
6/25/2023 19
20. Larson & Farber, Elementary Statistics: Picturing the World, 3e 20
Tips for pediatric nursing care
1- Critical observation
2- Honesty and truthfulness
3- Love to work with children
4- Family-centered care
5- Nurse-parent relationship
6- Parent & child education
7- Each family is unique
6/25/2023 20
21. Larson & Farber, Elementary Statistics: Picturing the World, 3e 21
Overview of Pediatric Health Assessment
Contents of Pediatric History
1. Personal details
2. C/C
3. HPI
4. Past medical History
21
22. Larson & Farber, Elementary Statistics: Picturing the World, 3e 22
...pediatric history
5. Family history
6. Immunization history
7. Nutritional history
8. Developmental history
9. Review of systems
6/25/2023 22
23. Larson & Farber, Elementary Statistics: Picturing the World, 3e 23
Personal details
Date and time of interview
Name of patient
Address
Age
Sex
Historian
6/25/2023 23
24. Larson & Farber, Elementary Statistics: Picturing the World, 3e 24
Chief Complaint (C/C)
The main complaint that has brought the patient
to seek for medical help
In the words of the patient
√e.g., yellowish discoloration of the eyes
Symptom + Duration
√e.g., cough of three days
6/25/2023 24
25. Larson & Farber, Elementary Statistics: Picturing the World, 3e 25
History of present illness
The details should include
Chronology of symptoms
-Mode of onset (insidious, sudden)
-Elaboration of symptoms and relevant questions
about positive and negative statements (help for
differential dx)
-Aggravating and relieving factors
6/25/2023 25
26. Larson & Farber, Elementary Statistics: Picturing the World, 3e 26
For pain ask about:
Onset
Location
Quality (mild, moderate, severe)
Severity
Alleviating and aggravating factors
Radiation
Associated symptoms
6/25/2023 26
27. Larson & Farber, Elementary Statistics: Picturing the World, 3e 27
For fever ask about:
Pattern (intermittent, remittent, continuous or
relapsing)
√Tertian: a 3 day pattern; peaks every other day
at a gap of 48 hours. E.g. P. vivax
√Quartan: a 4 days pattern; peaking every 3rd
day. E.g. P. malaria
Associated symptoms (coryza, skin rash,
urinary symptoms)
6/25/2023 27
28. Larson & Farber, Elementary Statistics: Picturing the World, 3e 28
For cough ask about:
Character (hacking, brassy, barking or paroxysmal)
Associated symptoms (stridor, whoop)
Characterize sputum (color, amount, and odor)
Dyspnea (indicates cardiac problem), if present
grade it
6/25/2023 28
29. Larson & Farber, Elementary Statistics: Picturing the World, 3e 29
For diarrhea ask about:
Duration
Frequency
Consistency of the stool
Associated symptoms
6/25/2023 29
30. Larson & Farber, Elementary Statistics: Picturing the World, 3e 30
Past medical history
Includes prenatal, labor, delivery, neonatal,
infancy, and childhood events
Recorded in chronological order with diagnosis and
outcome
6/25/2023 30
31. Larson & Farber, Elementary Statistics: Picturing the World, 3e 31
Past ....
Childhood illnesses should be specifically asked
(measles, pertussis, mumps, chicken pox etc;
surgical conditions and medications, allergies)
6/25/2023 31
32. Larson & Farber, Elementary Statistics: Picturing the World, 3e 32
Family history
Social history
√General demographic and socio-economic
information (housing, income, water supply, family
size, waste disposal, etc)
6/25/2023 32
33. Larson & Farber, Elementary Statistics: Picturing the World, 3e 33
Family ...
Medical history
√Possible familial (diabetes, bronchial asthma) and
hereditary diseases (Hemophilia, thalasemia)
√Clustering of disease in family (scabies, infectious
hepatitis, cholera, etc)
6/25/2023 33
34. Larson & Farber, Elementary Statistics: Picturing the World, 3e 34
Immunization history
Ask:
When the vaccine was given
The route of administration
For the immunization card (when applicable)
6/25/2023 34
35. Larson & Farber, Elementary Statistics: Picturing the World, 3e 35
Nutritional history
Type of food
Amount
Frequency of feeding
Share of the same plate with older siblings?
Food hygiene
6/25/2023 35
36. Larson & Farber, Elementary Statistics: Picturing the World, 3e 36
Nutritional ...
For infants
Duration of exclusive breast feeding
Duration of breast feeding
Initiation of complementary feeds
Types of complementary feeds
Exposure of sunlight
6/25/2023 36
37. Larson & Farber, Elementary Statistics: Picturing the World, 3e 37
Developmental history
One of the cardinal manifestations of diseases and
deprivation in children is psychomotor
developmental delay
Developmental milestones are used to assess the
past progress of the child
6/25/2023 37
38. Larson & Farber, Elementary Statistics: Picturing the World, 3e 38
Developmental ...
The questions should address:
Gross motor: control of head, trunk and extremities
Fine motor: the development of fingers’ movements
6/25/2023 38
39. Larson & Farber, Elementary Statistics: Picturing the World, 3e 39
Developmental ...
Language development: production of sound, single
or combination of words, gestures, facial
expressions and understanding of others
Personal and social: sleeping habits, identification
of objects and persons, ability to play with others,
manipulation of objects, etc.
6/25/2023 39
40. Larson & Farber, Elementary Statistics: Picturing the World, 3e 40
Pediatric Physical Examination
The aim is the same as adults but the
approach is different
Both the techniques and interpretations
vary according to the age of the patient
Examination of infants under the age of 6
months is much easier than the older ones
6/25/2023 40
41. Larson & Farber, Elementary Statistics: Picturing the World, 3e 41
Physical ...
Be opportunistic in examining a child!
6/25/2023 41
43. Larson & Farber, Elementary Statistics: Picturing the World, 3e 43
V/S: Temperature
Normal body temperature: 36.5oC to 37.5oC (97.7-
99.5oF)
Hyperthermia: >37.5oC
Hypothermia: <36.5oC
Mild hypothermia: 36-36.4oC
Moderate hypothermia: 32-35.9oC
Severe hypothermia: <32oC
6/25/2023 43
44. Larson & Farber, Elementary Statistics: Picturing the World, 3e 44
The nursing process
1. Assessment
2. Nursing diagnosis
3. Planning
4. Intervention
5. Evaluation
6/25/2023 44
45. Larson & Farber, Elementary Statistics: Picturing the World, 3e 45
Common pediatric nursing procedures
Medication administration
NG-tube insertion and feeding
Oxygen administration
Resuscitation
Administering enema
Tracheostomy care
6/25/2023 45
46. Larson & Farber, Elementary Statistics: Picturing the World, 3e 46
...pediatric procedures
Blood transfusion
Specimen collection
Iv cannulation , etc ...
6/25/2023 46
47. Larson & Farber, Elementary Statistics: Picturing the World, 3e 47
Assignment-1 (Non-graded)
Read and take short note about common
pediatric nursing procedures by considering
the following points when appropriate.
Indications
Contraindications
precautions
Steps with its rationale
Differences from the adult
6/25/2023 47
48. Larson & Farber, Elementary Statistics: Picturing the World, 3e 48
Thank you so much!
6/25/2023 48
Editor's Notes
Children are vital to the nation’s present and its future. In recent years, there has been an increased focus on issues that affect children
and on improving their health. Children have begun to be recognized not only for who they are today but for their future roles in creating families, powering the workforce, and making Ethiopia democracy work
The phrase “regionalization of health care” suggests the development of a structured system of care “to improve patient outcomes by directing patients to facilities with optimal capabilities for a given type of illness or injury.”1 The development of a regionalized system is typically driven by economic factors, such as the infeasibility of all hospitals to maintain the equipment and personnel to treat specific medical conditions,2 or by interhospital variations in patient
outcomes within a geographic region.
The philosophy is grounded on several
principles that revolve around the central idea that the family is the constant in a
child’s life (Neal et al., 2007). Nurses must work with the family to develop the
best plan of care for a child. Parents are experts in their child’s care and know
more about their child then we can ever learn through assessments or charts.
The family is also the child’s main source of support providing stability in what
can be an otherwise traumatic period in a child’s life. The presence of the family
during health related procedures can significantly reduce both the child’s and
parent’s anxiety (Neff, 2003) Decreased anxiety from the patient and family
decreases the stress on healthcare workers, positively affecting their ability to
Poor functional development of lacrimal gland
T=susciptable to foreign body aspiration
C=frequent vomiting is expected & appropriate positioning is important
Low blood supply to kidney, smaller pore size, less filtration power across nepheron
Continuous Fever.The temperature remains above normal throughout the day and does not fluctuate more than 1 degree Celsius in 24 hours. This type of fever occurs in lobar pneumonia, typhoid, urinary tract infection, infective endocarditis, brucellosis, typhus etc.
Remittent FeverThe temperature remains above normal throughout the day and fluctuates more than 2 degree Celsius in 24 hours. This type of fever is usually seen patients of typhoid infection and infective endocarditis. This type of fever is most common in practice.
a short, weak repeating cough, often caused by irritation of the larynx by a postnasal drip. It can also result from side effects of angiotensin-converting enzyme inhibitor therapy and smoking.
(of sound) harsh, strident, or resembling the sound of a brass instrument