Class notes
BSNC 5000 Peds
- Course
- BSNC 5000 (BSNC5000)
- Institution
- British Columbia Institute Of Technology (BCIT )
Modules 1-5 of Peds, all you need
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MODULE 1,
,- 0-1 (infancy): tell us their needs by crying, growing, working on achieving their milestones, stranger
anxiety therefore build trust w/caregiver
- 1-5: intense activity/discovery, motor skills, physical develop. Language, social, role standards, self control,
aware independence/dependence, self-concept, parallel play, curiosity, imaginary play
- 5-12: physical/sexual maturity, mental social skills, early moral development, critical period on self-
concept, abstract play, modesty/integrity
- 12-18 (adolescence): transitional period onset of puberty, entry to adult world, biological/personality
maturity, physical/emotional turmoil, redefine self-concept, internalize values, focus on individuality not
group, giving them privacy/integrity, language is more laymen terms but can be more advanced, peer
pressure, hormones, emotional volatility
- INFANCY is the period that has rapid physical, cognitive, and social development (most crucial period for
development).
- Adolescence (12-18) is the most unstable and challenging for development of personal identity.
- KNOW the differences of how an infant compares to an Adult
- Kids are NOT mini adults!
Pediatric Ax
• Initial assessment (Pediatric assessment triangle)
• Primary survey (ABCDE with VS)
• Secondary survey (focused Hx/Ax)
• SAMPLE (s&s, allergies, meds, pass med Hx, last oral intake, events surrounding illness/injury THEN do we
need to report?)
• DO PAT triangle first, GCS (ask parent), then focused assessments, then VS, BP last to be effected from
illness, Speech/cry, What they are looking at
• WOB: Nasal flaring, position, tripod position for asthma, tracheal tug, rate of breathing,
• Circulation: mottled on extremities, pale, lips/fingertips cyanosis, moisture
• infants decompensate fast, children have more compensatory mechanisms for a long period and then when
something happens then it is drastric drop and change in LOC
• Atraumatic care during Ax: address caregiver first depends on growth/development stages, tone/voice is
calm, bringing toys, for 2 yr old put on show/ipad, bubbles
• Be honest, tell them if something is gonna hurt, consent to touch/remove clothing
SCENARIOS
Charlie (5 year old)
• Coughing, green nasal discharge, lethargic, anorexia (not eating). Subcostal, intercostal, and
suprasternal in drawing.
- RESULTS: URTI resp, neurological/cardiovascular Ax, IN/OUTs increased WOB sputum,
tachycardic/RR, diminished/wheezing air entry, smaller airways so harder to clear airways, crackles in
lungs
Frankie (8 year old)
• 5 day history of nausea, vomiting and explosive bloody diarrhea. Unable to keep anything down for
36hrs. Significantly lethargic, dark circles under eyes.
- RESULTS: GI upset, Focused GI/GU/Hydration/Perfusion, F/E imbalance, abd pain, malnourished,
increased HR, decreased urine output, hx of recent travel, neuro Ax, bacterial
infection/gastroenteritis/food poisoning
Morgan (20 month old)
• Spent the day with a babysitter. Caretakers notice later that day a goose egg bruise on Morgan’s
forehead that is quite swollen. There are abrasions on both knees and not wanting to use their left arm.
, - RESULTS: Injury to head/fracture, trauma, Pain Ax, mobility, neurological, neurovascular Ax, crying
flacc scale, cardiovasc/Resp Ax
Morbidity VS Mortality
- Morbidity: Instance of illness/injury/disease, low birth weight, poverty, homelessness. Children at highest risk
of injury under age of 5, SIDS, suicide MH, injury, obesity
- Mortality: preventable injuries, at-home injuries, co-sleeping, playgrounds/cars, drowning (2cm water enough
to drown baby)/suffocation), helmets, burns
- CAUSES/FACTORS for both: Education, Income, supportive environment, access to healthcare, parental age,
bullying,
Themes for Health Promotion:
• Injury prevention
• Client education
• Behavior prevention
• Disease prevention
• Physical development
• Psychosocial development
SUMMARY
• Children are vulnerable population, and the risk for adverse health outcomes is highly dependent on age,
level of development, and support systems.
• Age-appropriate interaction with pediatric clients is imperative to establishing effective nurse-client
relationships. Play is a must. Ensure privacy and confidentiality.
• Children have unique anatomical and physiological differences, which are essential to know to provide the
competent pediatric nursing care
• The five major developmental periods are prenatal, infancy, early childhood, middle childhood, and
adolescence
• Growth and development are affected by physiological factors, heredity, gender, disease, physical
environment, nutrition and interpersonal relationship.
• The pediatric assessment triangle is foundation of pediatric assessment
• The roles and responsibilities of pediatric nurse are diverse and must support child and their family.
• Know Erikson + Piaget theories
MODULE 2
• Describe parental authority and its relationship to informed consent for a child.
• Discuss the impact of the phrase “mature minor” and how it applies to medical consent.
- FCC (fam-centered care) has the intention to increase parent and client participation, partnership approach to
health-care decision making, considers needs of all family members not just child
- FCC put into practice by making families partners in decision making, make sure their present, Translation
language services, open flexible scheduling, more external resources, mutual planning and care, use eval tools
- Atraumatic Care: Use of interventions that eliminate or minimize psychological and physical distress or
trauma that is experienced by children and their families in the health care system, prevent/minimize
separation of child from family, promote sense of control in pt, prevent/minimize pain/injury
- Concerns over extent and nature of parental involvement
- Nurses must learn to navigate complex legal considerations within pediatrics that is in the best interest of the
child
- Homie with an extra Chromy = downsydnrome
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