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NR 328 PEDS STUDY GUIDE 1 CHAPTER 1: PERSPECTIVES OF PEDIATRIC NURSING $18.45   Add to cart

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NR 328 PEDS STUDY GUIDE 1 CHAPTER 1: PERSPECTIVES OF PEDIATRIC NURSING

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NR 328 PEDS STUDY GUIDE 1 CHAPTER 1: PERSPECTIVES OF PEDIATRIC NURSING Health Care for Children • Healthy People 2020 o Framework for identifying essential components for child health promotion programs o Designed to prevent future health problems in children o Goal to increase quality and...

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  • May 15, 2022
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  • 2021/2022
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NR 328 PEDS STUDY GUIDE 1
CHAPTER 1: PERSPECTIVES OF PEDIATRIC NURSING
Health Care for Children
 Healthy People 2020
o Framework for identifying essential components for child health promotion programs
o Designed to prevent future health problems in children
o Goal to increase quality and length of healthy life and eliminate health disparities
 Substance abuse
 Dental caries---single most common chronic disease of childhood
o Begins practicing dental hygiene beginning w/ the first tooth eruption; drinking fluoridated water, including bottled
water; and instituting early dental preventive care
 Violence
 Mental health disorders
Child Health Promotion
 Provides opportunities to reduce differences in current health status among members of different groups and ensure equal
opportunities and resources to enable all children to achieve their fullest health potential
 “Bright Futures”---book on kind of what to expect in the upcoming months or years –also provides family support, physical
activity, healthy weight, dental carries
o Really hits hard on safety!
Case Study
 A group of nursing students have been asked to participate in a pediatric health fair. They will talk to participants about
health care for children. The nursing students know that the health fair will include both parents and children of all ages.
Leading Health Indicators (Healthy People 2020)
1) Physical inactivity
2) Overweight and obesity (#1 nutritional problem in children)
o Greater than the 95th percentile---child is considered obese
3) Tobacco use
4) Substance abuse
5) Responsible sexual behavior
6) Mental health
7) Injury and violence
8) Environmental quality
9) Immunization
10) Access to health care
Development
 Developmental processes are unique to each stage of development:
o Infant
o Toddler
o Early Childhood
o Adolescence
 Continuous screening and assessment are essential for early intervention when problems are found.
Nutrition in Infancy
 Breast-feeding is BEST
o Human milk is the preferred form of nutrition for all infants
o Provides
 Micronutrients
 Immunologic properties
 Enzymes that enhance digestion and absorption
Nutrition in Childhood
 Lifelong eating habits established by age 3
 Parent teaching
 Eating preferences and attitudes related to food are established by:
o Family influences
o Culture

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,  Homelessness and low income associated with lack of resources to provide children with adequate, nutritious meals.
Case Study (Cont.)
 When talking to parents about childhood obesity and type 2 diabetes, which topics should the nursing students discuss with
the parents? Select all that apply.
a) Obesity in children and adolescents is defined as a body mass index at or greater than the 95th percentile for
youth of the same age and gender.
b) Easy access to television and video games has increased the incidence of obesity.
c) Lack of physical exercise contributes to obesity.
d) The importance of allowing children to choose their favorite foods every day, including sweets such as dessert.
e) The importance of maintaining a normal body weight.
f) Overweight youth have increased risk for not only type 2 diabetes, but also high blood pressure and
dyslipidemia.
Dental Care
 Dental caries are preventable
o Dental hygiene beginning with first tooth eruption
o Role of fluoridated water
o Early dental preventive care
o Parent and child teaching
Case Study (Cont.)
 The single most common chronic disease of childhood is?
a) Arthritis
Cancer
b) Dental caries
c) Diabetes
Immunizations: Role of Nurse
 Review individual immunization records at every clinic visit
 Avoid missing opportunities to vaccinate
 Encourage parents to keep immunizations current (U.S. Department of Health and Human Services, 2009)
 Keep up with changes in immunization schedules, recommendations, and research related to childhood vaccines
 www.cdc.gov/vaccines
 HPV--- usually given at 11 yrs of age
o Girls pass out from HPV vaccine—less likely to happen if given at a younger age (9yrs)
Childhood Health Problems
 Obesity and Type 2 Diabetes, p. 3
 Childhood Injuries, p. 3
 Violence, p. 6
 Mental Health Problems, p. 6
Case Study (Cont.)
 When talking to parents about pedestrian accidents, the nursing students know that the top reasons involving children are
related to motor vehicle–related deaths. Most of these accidents will occur in which areas? Select all that apply.
a) Driveways
b) Freeways
c) Intersections
d) Midblock
e) Parking lots
Mortality statistics refer to the number of individuals who have died over a specific period
 Infant Mortality
o Death in first year of life per 1000 live births***
o 6 lives per 1000 live births (in 2011)
 neonatal mortality (<28 days of life)
 low birth weight (less than 2500g---5lbsish)
 postneonatal mortality (28 days to 11 months)
o the lower the birth weight, the higher the mortality
o First 4 causes ( accounted for about half of all deaths of infants under 1 year of age)
1) Congenital anomalies
2) Disorders r/t short gestation and unspecified LBW
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, 3) SIDS
4) Newborn affected by maternal complications of pregnancy
 Childhood Mortality
o Usually presented per 100,000 population
o Ages 5-14 –have the lowest rate of death
 Usually do to accidental injuries
o Sharp rise is really seen after the age of 14----driving, adolescence, think they are invincible
Morbidity statistics show the prevalence of specific illness in the population at a particular time
 Prevalence of a specific illness in a population
 Childhood morbidity
 Statistics generally rates per 1000 population
 Difficult to define
o May denote acute illness, chronic disease, or disability
 Resp. infections
 Diarrhea
 Common cold--- chief illness of childhood****
Childhood Morbidity
 Acute illness: symptoms severe enough to limit activity or require medical attention
 Respiratory illness = approximately 50% of all acute conditions
 Infections and parasitic disease = 11%
 Injuries = 15%
 Leading cause of death from unintentional injuries in children= motor vehicle injuries
o Leading cause of death in children older than 1 year of age
 Drowning and burns are among the top 3 causes of death for boys and girls throughout childhood
 Intentional poisoning, associated w/ drug and alcohol abuse and suicide attempt, is the second leading cause of death in
adolescent females and the 3rd leading cause in adolescent males
The “New Morbidity”
 AKA Pediatric Social Illness
o Behavior, social, and educational problems
o Psychosocial factors
 Poverty, violence, aggression, noncompliance, school failure, and adjustment to parental separation and
divorce
o Mental health issues
Philosophy of Care (from American Nurses Association, 2010):
 Protection, promotion, and optimization of health and abilities
 Prevention of illness and injury
 Alleviation of suffering through the diagnosis and treatment of human response
 Advocacy in the care of individuals, families, and populations
Family-Centered Care: Two Basic Concepts
 Enabling
o Current abilities and competencies
o Acquire new abilities and competencies as needed
o Means we are giving the parents the tools they need to take care of their child
 Ex: baby admitted d/t FTT---give the parents the skills they need in order to be successful in taking care of
that child
 Empowerment
o Interaction that allows the family to maintain or acquire a sense of control
o Behaviors that foster family’s strengths, abilities, and actions
o Giving the family the voice that they need---allow the parent to let their voice be heard. Empower the care givers
so they are able to recognize & pay attention to own gut instincts and act on them
Case Study (Cont.)
 The nurse makes sure that the family maintains a sense of control over their lives while their child is in the hospital when
the nurse provides family-centered care and positively acknowledges their strength and helping behaviors. What concept
would this nurse’s actions demonstrate?
a) Nonmaleficenceobligation to minimize or prevent harm
b) Empowerment
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, c) Atraumatic care eliminate or minimize distress (psychological/ physical)
d) Enabling
Atraumatic Care
 Eliminate or minimize distress
o Psychologic
 Anxiety, fear, anger, disappointment, sadness, shame, or guilt
o Physical
 Sleeplessness and immobilization to disturbances from sensory stimuli such as pain, temperature
extremes, loud noises, bright lights, or darkness
Goals of Atraumatic Care
 Prevent or minimize separation from the family
 Promote sense of control
 Prevent or minimize bodily injury and pain
 Examples
o Foster the parent-child relationship
o Prepare child before any treatment or procedure
o Control pain
o Allow privacy
o Provide play activities for expression of fear and aggression
o Providing choices to children
o Respecting cultural differences
Role of the Pediatric Nurse
 Therapeutic Relationship
 Family Advocacy and Caring
 Disease Prevention and Health Promotion
 Health Teaching
 Injury Prevention injuries kill or disable more children over 1 year old than all childhood diseases combined
 Support and Counseling
 Coordination and Collaboration
 Ethical Decision Making
Ethical Decision Making
 Ethical dilemmas = competing moral considerations
 Competing moral values may include
o Autonomy patients right to be self-governing
o Nonmaleficence minimize or prevent harm (do no harm)
o Beneficence promote the patients well-being (do
good)
o Justice concept of fairness
 Determine the most beneficial or least harmful action within
the framework of
o Societal mores
o Professional practice standards
o The law
o Institutional rules
o Family’s value system and religious traditions
o Nurse’s personal values
Evidence-Based Practice
 Based on valid, important, and applicable patient-reported,
nurse-observed, and research-derived information
 Combines knowledge with clinical experience and intuition
 Provides a rational approach to decision making that
facilitates best practice

GRADE Criteria for EBP
 Evaluates the quality of research articles used to develop
practice guidelines
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