This document provides information on concepts of child care, including principles of child health nursing, rights of children, and differences between adult and child nursing. Specifically, it outlines six principles of child health nursing, such as respecting a child's need to regress in stressful situations. It also describes the rights of children according to the UN Declaration of the Rights of the Child, including rights to protection, provision of needs, and participation. Finally, it details several anatomical, physiological and psychological differences between adults and children that are important for nursing care.

1. UNIT 1. CONCEPTS OF CHILD
CARE
1. Principles of Child Health Nursing
2. Rights of children
3. Difference between adult and child
nursing
August 12,
2020
1
Ms.Anju George, Associate Professor,
SGCON

2. Principles Of Child Health
Nursing
August 12, 2020 2
Ms.Anju George, Associate Professor,
SGCON

3. 1.Respect the child’s need to regress & help him to
accept dependence on others if he resists this.
• Whenever a new situation or a stressful situation arises a
child cannot adjust with the situation and he will
regress, i.e., he will go back to the previous stage of
development.
• Eg: -
August 12, 2020
Ms.Anju George, Associate Professor,
SGCON
3

4. 2.Have an awareness of the child’s need for help in reconquering the
negative counterpart of the core problem in the stages of development
to which he has regressed.
• In each stage of child’s developmental task there is a positive and negative
counterpart.
• When the child faces a stressful situation he regress to the previous stage of
development, once the situation resolves he needs to be helped to overcome
the negative counterpart and attain the positive one.
• Eg:-
August 12, 2020
Ms.Anju George, Associate Professor,
SGCON
4

5. 3.Protect the child-family inter -relationships
• The family is the most important
part in a child’s life, especially the
mother. Hence the nurse needs to
provide a family centered care
while caring for a child.
• Eg:-
August 12, 2020
Ms.Anju George, Associate Professor,
SGCON 5

6. 4.Awareness of the feelings of others and readiness to
respond to them so as to strengthen their resources to
cope up with stress.
• When a child gets hospitalized emotional support is needed to
the child and mother. The mother provides emotional support to
the child, the mother too requires emotional support which the
nurse must understand and provide.
• Eg:-
August 12, 2020
Ms.Anju George, Associate Professor,
SGCON
6

7. 5.Children can tolerate discomfort if they are prepared
for it, comprehend its real purpose and are
adequately prepared.
August 12, 2020
Ms.Anju George, Associate Professor,
SGCON
7
• The child should be explained and prepared according to
their level of understanding on the purpose of
hospitalization which will gain their cooperation in various
procedures.
• Eg:-

8. 6.Tochild, play is not time out from daily living, but rather
an essential part of it that enables him grow & mature
through the various stages of the development.
• Play is essential for the growth and development of a child. It enables
him to explore his surroundings and himself.
• Eg :-
August 12, 2020
Ms.Anju George, Associate Professor,
SGCON
8

9. RIGHTS OF CHILDREN
August 12, 2020
Ms.Anju George, Associate Professor,
SGCON
9

10. DECLARATION OF THE RIGHTS OF THE
CHILD.
• In 1959 20th November the United Nations
General Assembly adopted Declaration of the
Rights of Child whose provisions are,
• Protection rights
• Provision rights
• Participation rights
August 12, 2020 10
Ms.Anju George, Associate Professor,
SGCON

11. DECLARATION OF THE RIGHTS OF THE
CHILD.
• Protection rights:- against maltreatment neglect
& all forms of exploitation.
August 12, 2020 11
Ms.Anju George, Associate Professor,
SGCON

12. DECLARATION OF THE RIGHTS OF THE
CHILD.
• Provision rights:- right to food, health care,
education and benefit from social security.
August 12, 2020 12
Ms.Anju George, Associate Professor,
SGCON

13. DECLARATION OF THE RIGHTS OF THE
CHILD.
• Participation rights: right to act in certain
circumstances and the right to be involved in
decision making.
August 12, 2020 13
Ms.Anju George, Associate Professor,
SGCON

14. INDIAN CONSTITUTION
• Article 24---prohibits employment of children in
factories under age 14.
• Article 39---prevents abuse of children of tender age.
• Article 45---provides for free and compulsory
education ---till they complete age 14 yrs.
August 12, 2020 14
Ms.Anju George, Associate Professor,
SGCON

15. UNITED NATIONS DECLARATION OF THE
RIGHTS OF THE CHILD
1. Right to develop in an atmosphere of affection and security, and wherever
possible, in the care and under the responsibility of his/her parents.
2. Right to enjoy the benefits of social security, including nutrition, housing and
medical care.
3. Right to free education.
4. Right to full opportunity for play and recreation.
5. Right to a name and nationality.
6. Right to special care, if handicapped.
August 12, 2020
Ms.Anju George, Associate Professor,
SGCON
15

16. Contn…
7. Right to be among the first to service protection and relief in times of disaster.
8. Right to learn to be a useful member of society and to develop in a healthy
and normal manner and in conditions of freedom and dignity.
9. Right to be brought up in spirit of understanding, tolerance, friendship
among the people, peace and universal brotherhood.
10. Right to enjoy these rights, regardless of race, color, sex, religion, national or
social origin.
August 12, 2020
Ms.Anju George, Associate Professor,
SGCON
16

17. DIFFERENCE BETWEEN ADULT AND
CHILD
August 12, 2020 17
Ms.Anju George, Associate Professor,
SGCON

18. • Children and adults differ physically and
mentally.
• As a nurses it is necessary to learn the
differences to deliver the care accordingly.
Introduction
August 12, 2020 18
Ms.Anju George, Associate Professor,
SGCON

19. • Anatomical differences
• Physiological differences
• Psychological differences
CLASSIFICATION of differences
:
August 12, 2020 19
Ms.Anju George, Associate Professor,
SGCON

20. 1. SIZE
• Greater size and weight of the newborn’s head as
compared to the body’s length and weight.
• This along with the immature motor development
makes handling of baby different from older children.
• Thus the usage of various sized equipments in
pediatric wards.
ANATOMICAL DIFFERENCES
August 12, 2020 20
Ms.Anju George, Associate Professor,
SGCON

21. 2. SKULL
• Sutures in the skull of newborn are not united.
• Fontanels are not closed.
• Shape of the head and chest can be altered by constant
pressure from lying in one position.
3. EYES
No tears in early infancy- due to poor functional
development of lacrimal gland.
August 12, 2020 21
Ms.Anju George, Associate Professor,
SGCON

22. 4. NOSE
• Nasal and oral airway passages are relatively small making the baby
more prone to airway obstruction.
• Nose breathers till 6 months of age. (breathing difficulty in respiratory
infections).
5.ORAL CAVITY
• Infants tongue is large and the oral cavity is small making the baby
prone to develop airway obstruction.
August 12, 2020 22
Ms.Anju George, Associate Professor,
SGCON

23. 6. EUSTACHIAN TUBE
• It is short and straight in children (10 degree in
children and 40 degree in adults).
• Sore throat extends to otitis media because of
the closeness of eustachian tube to throat.
August 12, 2020 23
Ms.Anju George, Associate Professor,
SGCON

24. 7. TRACHEA
• Short and narrow trachea under 5 years - susceptible to
foreign body aspiration.
8. STOMACH
• In children cardiac sphincter of the stomach is relaxed.
• Hence vomiting is so frequent, hence proper positioning
of the child during feed is so important.
August 12, 2020 24
Ms.Anju George, Associate Professor,
SGCON

25. PHYSIOLOGICAL DIFFERENCES
1. BASAL METABOLIC RATE:
• BMR rate is high in newborn.
• This is due to the rapid energy consumption, secondary to
the rapid cell growth and increased requirement for heat
production.
• Higher BMI will lead to increased oxygen consumption and
calorie requirement.
August 12, 2020 25
Ms.Anju George, Associate Professor,
SGCON

26. 2. TEMPERATURE REGULATION
 Poor thermo regulation is due to immaturity of the
hypothalamus, immaturity of controlling and effector
mechanisms and large surface area compared to the weight of
the baby.
 Shivering and sweating mechanisms are absent in newborn.
 The mechanism of heat production in newborn baby is by non
shivering thermogenesis which utilizes the brown adipose tissue
(present only for newborns).
August 12, 2020 26
Ms.Anju George, Associate Professor,
SGCON

27. August 12, 2020
Ms.Anju George, Associate Professor,
SGCON
27
3. FLUIDS AND ELECTROLYTES
– Approximately 75-80% of the body weight is composed
of body water in newborn whereas only 60% of the body
weight is composed of body water in adults.
4. CARDIO VASCULAR SYSTEM
 Change from fetal to normal circulation.
 Heart rate is more in children.
 Newborn – 140-160 beats/ min.

28. August 12, 2020
Ms.Anju George, Associate Professor,
SGCON
28
5. HEMATOLOGICAL SYSTEM
– The RBCs are large in infants.
– The lifespan of RBC in adult is 120 days; whereas in
newborn its 2/3rd of adult time.
– The blood value in newborn is 85ml/kg body weight;
whereas in adult its 60-70ml/kg

29. August 12, 2020
Ms.Anju George, Associate Professor,
SGCON
29
6. GASTROINTESTINAL SYSTEM
– The cardiac sphincter of stomach is relaxed.
– The liver is immature .
– Iron reserve is less. It is only sufficient to meet the demands till 6 months
hence the child need iron supplements
7. RESPIRATORY SYSTEM
– Respiratory rate is rapid .
– Alveolar surface area and the weight of the lungs are 20 times more than that
of the adult.

30. 8. URINARY SYSTEM
Concentration of urine in newborn is 800 mOsmol /L where as in adult
it is 1400 mOsmol/l.
GFR and tubular functions are lower in neonates than adult because of
low blood supply to kidney, smaller pore size and less filtration power
across nephron .
 GFR- 38 ml/ min (neonate)
 GFR- 125 ml/min (adult)
August 12, 2020 30
Ms.Anju George, Associate Professor,
SGCON

31. 9. ALIMENTARY TRACT
– Water absorption is poor – faeces of the child is watery.
– Dehydration leads to circulatory failure within 24 hours if
treatment is inadequate.
10. INTEGUMENTARY SYSTEM
– Sebaceous glands are large.
– The hair of the neonate is fine and silky.
August 12, 2020 31
Ms.Anju George, Associate Professor,
SGCON

32. 11. CENTRAL NERVOUS SYSTEM
 Myelination of nerve endings is incomplete.
 90% of brain growth takes place by 2 years of age.
 Nerve endings in the retina (rods and cones) are not
fully developed. Thus the images are blurred and
colorless for few weeks.
August 12, 2020 32
Ms.Anju George, Associate Professor,
SGCON

33. PSYCHOLOGICAL DIFFERENCES
• Fear , escape and avoid strangers till 5 years of age. Explore the
environment.
• INFANCY- more bonding with parents. Separation anxiety is very
common.
• TODDLERS – Negativistic behaviors.
• PRE SCHOOLER- short attention span, easily distractible , better
comprehension
• SCHOOLER – improved attention
• ADOLESCENTS- Identity of peer, confusion.August 12, 2020 33
Ms.Anju George, Associate Professor,
SGCON

34. August 12, 2020 34
Ms.Anju George, Associate Professor,
SGCON