The document discusses the care of hospitalized children. It emphasizes that children require specialized pediatric care due to anatomical, physiological, immunological, psychosocial and cognitive differences compared to adults. The hospital environment can impact children in various ways depending on their developmental stage. Nursing care aims to minimize stressors like separation from parents, loss of control, and pain/injury through measures like parental involvement, developmentally-appropriate activities, and clear communication. The goal is to help children benefit from hospitalization and cope with the experience in a healthy manner.
TRENDS IN PEDIATRICS AND PEDIATRIC NURSING
Pediatric regarded as the medical science which enables an anticipated newborn to grow into a healthy adult, useful to the society
Role of Child Health Nurse in caring of Hospital ChildAlka Singh
Subject : Child Health Nursing. Topic : Role Of Child Health Nurse In Child care at Hospital, Nursing Diagnosis, Various Measures to make hospital Child Friendly, Nurses Role in Care Of Toddlers, Infants, School Children, Adolescent.
TRENDS IN PEDIATRICS AND PEDIATRIC NURSING
Pediatric regarded as the medical science which enables an anticipated newborn to grow into a healthy adult, useful to the society
Role of Child Health Nurse in caring of Hospital ChildAlka Singh
Subject : Child Health Nursing. Topic : Role Of Child Health Nurse In Child care at Hospital, Nursing Diagnosis, Various Measures to make hospital Child Friendly, Nurses Role in Care Of Toddlers, Infants, School Children, Adolescent.
HOSPITALIZATION: Effect on children and their parentsShivani Thakur
The experience of hospitalization in children can be considered as a process of effort for returning to health and, on the whole, the regaining of the individual's status in the world.
Nurse can ease this process by showing the importance of experience and feelings of individuals at the time of hospitalization and help people to adapt themselves to their new surroundings.
Terminal illness and death during childhoodNEHA MALIK
A terminally ill child is a child who has no expectation of a cure for his or her disease or illness. this study material will help the medical professionals to learn more about caring for a terminally ill child.
YOUTUBE CHANNEL LINK :- https://www.youtube.com/results?search_query=medic+o+mania
Current principles, practices and trends in pediatricGnana Jyothi
Evolution of pediatrics, Pediatrics in India, Evolution of Pediatric Nursing in relationship to Child health, Historical background on the care of the child, Factors influencing the care of the child.........
HOSPITALIZATION: Effect on children and their parentsShivani Thakur
The experience of hospitalization in children can be considered as a process of effort for returning to health and, on the whole, the regaining of the individual's status in the world.
Nurse can ease this process by showing the importance of experience and feelings of individuals at the time of hospitalization and help people to adapt themselves to their new surroundings.
Terminal illness and death during childhoodNEHA MALIK
A terminally ill child is a child who has no expectation of a cure for his or her disease or illness. this study material will help the medical professionals to learn more about caring for a terminally ill child.
YOUTUBE CHANNEL LINK :- https://www.youtube.com/results?search_query=medic+o+mania
Current principles, practices and trends in pediatricGnana Jyothi
Evolution of pediatrics, Pediatrics in India, Evolution of Pediatric Nursing in relationship to Child health, Historical background on the care of the child, Factors influencing the care of the child.........
Stressor and effect of hospitaliztion on child and familymanishasammal
INTRODUCTION
It is a stressful experience for both children and their family. Hospitalization leads to interruption of child’s active growth and development. The child is removed from daily routine loss of contact with siblings, relatives and pers.
DEFINITION
A stressor is any event or stimulus that causes an individual to experience stress.
“Barbara kozier”
Stress is the pressure experienced by a person in response to life demands. Selye
At the end of unit 2, the students will be able to:
Appreciate the differences between children and adult
Describe the hospital environment for a sick child
Explain the impact of hospitalization on child
Discuss the grief and bereavement
Outline the role of a child health nurse
Explain the principles of pre- and post-operative care for children
Perform pain assessment in children
Enhancing pediatric care: A comprehensive presentation on hospitalized child ...Rachel Masih
This PowerPoint presentation provides a thorough overview of strategies and protocols for managing hospitalized child, aiming to improve pediatric care and enhance the overall well-being of young patients.
Objective: At the end of this unit, the students will be able to:
Describe internationally accepted rights of child
Discuss national policies, legislation and agencies related to child welfare
Explain National Health Programs related to child health
Enumerate changing trends in child health
Outline child morbidity and mortality
Describe the ethics in Pediatric Nursing
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
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Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
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Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
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According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
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This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
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Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...
Hospitalized child
1. Care of Hospitalized Child
Dr.Smriti Arora
Professor, Amity College of Nursing
Gurgaon
smritiamit@msn.com
2. Introduction
Children are not small adults.
– Anatomical , physiological- BSA, HR, soft bones,
nerves, fontaneles
– Immunological
– Psychosocial- communicate, dependent on parent
– Cognitive – egocentric, magical thinking
They require specialized pediatric care from
practiced professionals
3.
4. Introduction
The children’s reaction to illness,
perception to illness, body images are
of different at different age group.
Therefore they need special attention
during each stage to help them for
appropriate growth and development.
5. Quality care to hospitalized child
Structure
Process
Child Friendly
6. Measures to make hospital environment
friendly for children:
Provide good illumination
Keep floors clear of fluid or objects that might
contribute to floors
Use nonskid surfaces in washrooms
Familiar with the area-specific fire plan
Secure all windows, blinds and curtain cords.
Keep plants away as they harbor gram negative
bacteria and molds that may affect
immunocompromised children.
7.
8. Measures to make hospital
environment friendly for children:
Electrical equipment should be in good working
order. It should be used only by personnel familiar
with its use and kept away from children.
Furniture should be checked for safety. Infants,
young children, and those who are weak, paralyzed,
agitated, confused, sedated or cognitively impaired
should never be left unattended on treatment tables,
weighing scales or in treatment areas.
Prevent fall from the beds, and cribs by raising the
side rails.
9.
10. Measures to make hospital
environment friendly for children:
Asses the safety of toys. Toys should be appropriate
to the child’s age, condition, and treatment.
Setting limits is essential, and children should know
where they are permitted to go and what they are
supposed to do.
Ensure safe transportation for children within or
outside the unit.
11. A child friendly environment
should have:
facilities, equipment and medications tailored
to fit the needs of children.
bright colors, themed décor and plenty of
areas and opportunities to play
13. Impact of hospitalization on
child
Child:
– Child’s developmental age
– Coping mechanisms
Parents
– Presence of the mother, preparation of the mother, support
of the child by the mother
– parental values
– and socioeconomic status
14. Impact of hospitalization on
child
Hospital
– The hospital environment is generally
considered to be threatening to school-age
children.
– length of hospitalization, nature and degree
of illness, type of procedure, and method of
preparation for the hospital experience.
15. Children with chronic illness have identified
stressors related to
– the anticipation of surgical procedures, lengthy
and involved medical treatments,
– inadequate information about procedures,
– and disruption of daily routines
(Coyne, 2006; Hildenbrand, Clawson, Alderfer,
& Marsac, 2011; Kazak et al., 2005)
18. Separation anxiety
1. Phase of protest
Children react aggressively to separation.
Refuse attention of anyone
cry and scream for their parents, inconsolable.
Continuously search for their parents, cling to parent
when they reach, and avoid or reject contact with
anyone else.
Toddlers verbally and physically attack strangers,
attempt to escape from the area to find parents.
These manifestations may last from hours to days
and ceasing only with physical exhaustion.
19. Separation anxiety
2. Phase of despair
During this phase crying stops and depression is
evident.
Child is less active and shows no interest in food or
play.
He looks sad, lonely, isolated and apathetic.
Child may regress to earlier behavior like thumb
sucking, bed wetting, or use of a pacifier.
Child’s physical condition may further deteriorate
from refusal to eat, drink or move.
Others usually misinterpret this phase for child’s
cooperation, and adjustment to his hospitalization.
20. Separation anxiety
3. Phase of detachment
Child appears to have finally adjusted to
the loss.
Starts showing more interest in the
surroundings, plays with others and
seems to form new relationships.
21. Loss of control
Children perceive a great amount of control
according to their age group. New situations like
hospitalization decrease the amount of control a child
feels.
This feeling of loss of control causes a threat and can
affect childrens’ coping skills.
So the nurses must have an insight into the type of
environment conducive to child’s optimum growth.
The major areas of loss of control - physical
restriction, altered routine, and dependency; varies
according to different age groups.
22. Loss of control
Infants
Infants attempt to control their environment through
emotional expressions, such as crying or smiling.
According to Erikson, infants develop a ‘trust’ while
overcoming a sense of ‘mistrust’.
Infants trust that their feeding, comfort, stimulation,
and caring needs will be met. So the care that the
infant receives matters. The trust acquired in infancy
provides the foundation for all succeeding phases.
Inconsistent care and making changes in the infant’s
daily routine may lead to mistrust and loss of control.
23. Loss of control
Toddlers
Erikson- the developmental task of toddlerhood is
acquiring a sense of autonomy while overcoming a sense
of doubt and shame.
Their behaviors range from motor skills, play,
interpersonal relationships, ADL and communication.
When their pleasures are not met and they perceive
hospital routine and caregivers as obstacles, they react
with negativism and temper tantrums.
Toddlers rely on the consistency and familiarity of daily
rituals to provide a measure of stability and control in their
life.
Their rituals include eating, sleeping, bathing, toileting,
and play.
24. Loss of control
Toddlers
When this daily routine is disrupted by hospitalization
their principle reaction is ‘regression’.
Rigid schedules, altered caregiving activities,
unfamiliar surroundings, separation from parents, and
medical procedures decrease the toddler’s control
over their world.
Prolonged loss of autonomy may result in passive
withdrawal from interpersonal relationships and
regression in all areas of development.
25. Loss of control
Preschoolers
Preschoolers experience loss of control when
they are physically restrained, routines are
altered, and when they feel enforced
dependency.
They take their hospitalization as a
punishment for their wrongdoings.
26. Loss of control
School-age children
School age children are movers and
shakers.
They control their self-care and typically are
highly social.
They like being involved, and most fill their
days with activities.
Illness can change all these patterns. Friends
are very important to this age group.
27. Loss of control
Adolescents
Control is very important to this age group. Understanding this
issue is key when caring for adolescents.
Adolescents are unsure if they want their family with them or
not.
Some enjoy the freedom. Ideally, the peer group will support
the ill friend. They want to hear from their friends frequently.
Giving the adolescent some control avoids endless power
struggles.
Control issues can cause a major conflict between adolescents
and parents.
Parents often feel like ping-pong balls as they are bounced back
and forth by a child who wants help one and rejects it the next.
28. Bodily injury and pain
When a child enters into a hospital he is most
concerned about pain and bodily injury.
When children experience pain they become
reluctant to enter the hospital.
Children in different age groups react
differently to pain.
29. Bodily injury and pain
Infants
Infants may express pain by assuming certain
positions, such as squirming, writhing, jerking.
Some infants may cry loudly after the procedure,
where as others are easily calmed by a gentle hug.
Research has found that infants have stored
memories acute pain, experiences and react in
subsequent painful events with heightened
behavioral responses to pain.
Older infants react intensely with physical resistance
and uncooperativeness.
30. Bodily injury and pain
Toddlers
The older the child, the more elaborate/intense is the
protest. The child cries, cling to the parent, kick, and
generally create a scene. Parents need to
understand that this behavior is a sign of healthy
parent-child attachment.
The toddler may resist bedtime and eating, temper
tantrums, regression (esp. with toileting and eating).
By the end of the toddler period a child is able to
locate their pain but not able to describe the intensity
of pain.
31. Bodily injury and pain
Preschoolers
Have fear of injury and pain. They react with verbally
abusing their attackers. Here nurses need to
understand that this is just an expected normal
behavior from a preschooler. Sometimes they may try
to avoid the event by stating some excuses.eg –“ I
have to go to bathroom”.
The preschooler fears mutilation.The child who has
surgery experiences increased fear.
Also afraid of intrusive procedures, and because of
their literal interpretation of words, they often imagine
treatments to be much worse than they are.
Imagination can go wild during illness.
32. Bodily injury and pain
Preschoolers
This age child has attained a good deal of independence in self-
care and they expect to maintain their independence in the
hospital.
Like the toddler, a preschooler likes familiar routines and rituals
and may show some regression if not allowed to maintain some
areas of control.
Preschooler may believe that the illness occurred because of
some personal deed or thought or perhaps just because the
child touched something or someone.
This can lead to feelings of guilt, shame and increased stress at
a time when the child has to cope with several other stressors.
33. Bodily injury and pain
School-age children
Able to describe their pain with words. Most of the time they
demand explanation of procedures from the caregivers.
Be aware of nonverbal clues- a serious facial expression, a half
hearted reply of “ I am fine ”, silence, lack of activity, or social
isolation, as signs of the need for help.
Older children may be more concerned with missing school and
the fear that their friends will forget them.
School aged children are more relaxed about having a physical
examination or having the eyes or an ear examined but are
uncomfortable with any type of genital examination.
They want to know the reason for the procedures and ask
relevant questions about their illness. They can relate actions to
becoming ill like not wearing a coat or eating nutritiously may
cause illness.
34. Bodily injury and pain
Adolescents
Body image is paramount during adolescence.
Because of the development of secondary sexual
characteristics, adolescents are concerned about
privacy.
They may react to pain with much self control but
they will not tolerate lack of privacy during
procedures.
They tend to observe all the procedures you
demonstrate on them.
35. Bodily injury and pain
Adolescents
One has to look for the physical indications, such as
limited movement, excessive quiet or irritability, as
adolescents may not disclose their level of pain to
others : appearance to this age is crucial.
Therefore illness or injury that changes their
perception of themselves can have a major impact.
37. Infant (trust versus mistrust)
Encourage parent to visit / rooming in.
Encourage parents to participate in care,
Teach parents procedures they are capable
of doing.
Discuss arrangements for care of other family
at home.
Try to simulate home routine.
Assign same nurse.
38. Infant (trust versus mistrust)
Allow parents to be present during
procedures and comfort afterwards.
Keep frightening objects away from view.
Provide swaddling, soft talking to soothe.
Play close attention to light and sound
stimulation
39. Toddler (autonomy versus
shame and doubt)
Encourage parent to room in and if have to leave,
leave when awake and leave something of meaning
with child for support.
Provide warmth and support.
Explain to parent the stage child is in.
Bring infants security object -- favorite toy, blanket.
Set limits, give choices on simple decisions.
40. Toddler (autonomy versus
shame and doubt)
Teach parents that child may regress, may
promote potty chair if child is trained.
Promote ritualistic behavior for bedtime.
Teach parents about hazards (crib, chair,
toys, equipment). Be sure to supervise when
out of crib.
41. Preschooler ( initiative versus
guilt )
Acknowledge child’s fears regarding hospitalization.
Orient to the hospital, spend time with child to build
trust.
Encourage presence of parent if possible and
encourage to participate in care.
Provide comfort and support.
Assess his likes and dislikes among food items. Give
small portions.
Make environment comfortable and accept messes.
Encourage intake of fluids with games.
42. Preschooler ( initiative versus
guilt )
Provide consistent environment.
Reinforce coping behavior.
Provide with as much mobility as possible.
Provide play and diversional activities.
Avoid intrusive procedures as much as
possible.
Assess child’s perception by asking to draw a
picture and tell about it.
43. School age ( industry versus
inferiority)
Ascertain what child knows.
Clarify using scientific terminology and how body
functions.
Direct questions more to the child when teaching
them (help master over feelings of inferiority).
Use audiovisuals, pictures, body outlines.
Suggest ways of maintaining control (i.e.: deep
breathing relaxation).
Gain cooperation.
Give positive feedback.
44. School age ( industry versus
inferiority)
Include in decision-making (time to do it,
preferred site).
Encourage active participation (removing
dressings).
Plan child’s day if possible with child’s input.
Maintain clear and consistent limits.
Allow for privacy.
45. Adolescent ( identity versus identity
diffusion/role confusion )
Assess knowledge.
Encourage questioning regarding fears, or risks.
Involve in decision-making.
Ask if child wants parent there. Make as few of restrictions
as possible.
Suggest ways of maintaining control.
Accept regression to more childish ways of coping.
Give positive reinforcement.
Provide privacy for care.
Encourage to perform normal grooming.
Allow favorite food to be brought in if not on a special diet.
46. Care of hospitalized child includes:
Prepare for hospitalization
Prevent or minimize separation
Minimize loss of control
Prevent minimize bodily injury
Allow for regression
Provide pain management ( Atraumatic care)
47. Care of hospitalized child
includes:
Provide for developmentally appropriate
play activities
Maximize potential benefit of
hospitalization
48. Play therapy – to reduce stress &
anxiety
Great for socialisation, motor skills, and intellectual
development. In hospital, playing with children can
also create understanding and serve as a distraction,
as well as help in:
Building rapport and providing a positive experience
Encouraging development and independence
Relieving stress and boredom
Helping to prepare for procedures
Normalising the environment
Breeding familiarity with hospital equipment
Providing opportunities to talk and listen
49. Research suggests that children facing surgery feel
upset, angry and depressed when they are not
provided with sufficient information (Coyne, 2006).
They have also expressed feelings of anxiety and
worry related to the treatment process (Carney et al.,
2003).
50. Preoperative management
Elicit history, review previous medical records, interview
the parent and child.
Perform focused preoperative assessment, do physical
examination.
Psychological preparation: pre-admission educational
programmes reduce the stress of admission for parents
and children. Educate the caregiver about the surgery,
encourage questioning.
Give age appropriate explanation to the child about
surgery.
Toys and a relaxed atmosphere are essential.
Avoid separating the child from the parent.
51. Preoperative management
Drape child in gown, cap and mask.
Ensure anaesthetic check up is done.
Premedication: anxiolytics like midazolam for
the particularly anxious child, anticholinergics
and antibiotics. Topical local anaesthetic
creams - Emla for painless cannulation.
Apply identification band.
Inform parents where to wait and where will
the child be shifted after surgery.
52. Preoperative management
Recognize the need for blood transfusion.
Fasting guidelines: clear written instructions
about the period of preoperative fasting
should be issued and the importance of
compliance stressed (prevents aspiration).
Ensure that all the investigations are done
and reports attached in the file.
Ensure consent is obtained from caregivers
for surgery.
53. Postoperative management
Ensure airway is patent. Perform oral, ET or TT suctioning
as required.
Change position 2 hourly.
Administer oxygen. Monitor ABG values.
Maintain fluid and electrolyte balance, administer IV fluids
at correct drop rate, maintain intake output chart. Monitor
serum electrolyte values. Notify physician if abnormal.
Follow standard precautions while performing any
procedure to avoid infections
Monitor and record vitals.
Keep the child NPO until advised which depends on the
type of surgery done. Usually oral feeds are started once
the peristalsis returns.
55. Postoperative management
Monitor for complications like nausea, vomiting,
bleeding, delayed micturition, unsteady gait etc.
Give postoperative health education to the caregivers
related to the surgery e.g. breathing exercises,
advice about ambulation, colostomy care etc.
Advise for follow up at regular intervals.
56. Making a hospital stay happier
Being honest, open communication, trusting
relationship
Promote the positives. Praise the child for their
efforts and encourage their progress, verbally and
with rewards.
Reward them with a favourite toy or book.
Anxiety- Practice some relaxation techniques, like
focusing on breathing to calm down or releasing
stress by squeezing a ball. Distract child by talking
through what is happening, or divert their attention
with a conversation, favourite story or activity
57. Summary
Stressors – separation anxiety, loss of
control , body injury
Child friendly environment