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PEDS EXAM 1 2024/2025 NOTES - PEDIATRIC NURSING BC COLLEGE
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PEDS EXAM 1 2024/2025 NOTES - PEDIATRIC NURSING BC COLLEGE
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lOMoARcPSD|15963292PEDS EXAM 1 2024/2025 NOTES -
PEDIATRIC NURSING BC COLLEGE
, lOMoARcPSD|15963292
Lecture 1:
• Role of the nurse
Provider: for patient and family (family centered care), meet the needs of the child
depending on developmental level, culture, age, family involvement.
Educator: teach the child on their level and the parent. DO NOT teach during trauma
because it won’t stick, assess how they learn best so you can provide it to them, so
they have the best chance of understanding what they’re teaching. Establish rapport
and encourage participation. Don’t be in a hurry to interrupt them
Advocate: be aware of the patient and family needs and give them info needed to
make the decision for care of child (respect decision even if you don’t agree). Be active
on comities that promote health. Ensure needs are being met and that care plan meets
the needs, cultures, and beliefs of patient and family.
Case Manager: have the best outcome while having continuity of care and keeping cost
down. Matching health care resources to patients’ condition and links child and fam
• Healthy People
o Goals and objectives with 10-year targets striving to improve the health of all of us
o Guide health promotion and disease prevention
o Improve the health of all in the US
o Goal 1: attain high quality longer lives free of disease, disability, injury and
premature death
o Goal 2: achieve health equity, eliminate disparities, and improve health of all groups
o Goal 3: create social and physical environments that promote good health for all
o Goal 4: promote quality of life, healthy development, and healthy behaviors across
all life stages
• Healthcare financing
o 1965- Medicaid of social security act enabled pregnant woman and children to
have healthcare
o CHIP: serves uninsured children up to age 19 years to provide health insurance for
children when their family’s income is too high to qualify for Medicaid but inadequate
to pay for private insurance coverage. ***program administered by the states but
follows federal guidelines (funded by both) 10 million children enrolled.
(3.6children in CHIP/Medicaid in FL)
• Medicaid is largest form of insurance in US
• PT. Protection/ ACA: eligible for health ins (low co pay based on income) and
bridges gap between low income for private and high income for Medicaid
• WIC: federal grants given to states for nutrition education, food, referrals
for pregnant women, breastfeeding, children at age 5 to be at nutritional
risk Health screening, nutrition, breast feed counsel,
(ex: infant cereal, peanut butter, whole wheat bread, diary, fruit/veggies)
• Practice act, accountable for our actions so we have to do CEU’s
• Legal Issues
o Informed consent: need to be signed for child for an invasive procedure or
participation in research. If one parent has custody; either sign unless its stipulated on
the custody to only one, then they can only give consent
, lOMoARcPSD|15963292
o Child participation: minors can provide consent independently if:
▪ pregnant, or a parent
▪ emancipated (self-supporting under 18 years of age)
▪ mature minor may give independent consent to receive or refuse treatment
for limited conditions (14-18)
o Child vs Parent: ex: blood transfusion (Jehovah witness), suspected neglect
o Confidentiality: HIPAA
• Ethic issues
o Beneficence: obligation to promote well-being of child/family
o Autonomy: right to self-determination and respect their refusal/consent
o Non-maleficence: reduce risk of harm
o Justice: treat all w same respect (like VIP vs poverty child)
o Ethics committee can get involved if parents and HCP can’t decide on treatment,
even court can become involved.
▪ Organ transplant concern: requires that team recognized issues between
children and adults.
CHAPTER 2: PFCC
• Patient family centered care: mutually beneficial partnership develops between family, nurse
and other health care professionals (includes respect and trust, open collaboration, being on
the same page with everyone, consider different cultures, beliefs, and backgrounds)
-Anxiety is decreased when parent is present during procedures
-Parents are now recognized as part of children care
• Promoting PFCC: use words like “working together, guidelines, welcome” INSTEAD OF
“policies, allowed, not permitted”. Maintain mutual respect and trust
-take CULTURAL BELIEFS into consideration
-ASSESS the parent’s strength in managing ongoing responsibilities before adding more.
-Parental roles
o Assisting in the design and evaluation of programs and systems
o Assessing a healthcare setting for its family-centered policies and care practices, as
well as its cultural appropriateness
o Participating in the renovation or construction of healthcare facilities
o Recommending changes that will ultimately improve the quality of care
o Educating health professionals about working effectively with families as partners in
the child’s care
• Family Composition
o Nuclear family: child lives w both biological parents
o Blended family: two parents w biological children from a previous marriage who
marry or cohabit (step people)
o Extended family: one parent/couple shares expenses as well as household/child
responsibilities with grandparents, sibling of parent, or other relatives (live w
grandma)
• FMLA: eligible employee takes unpaid job protected leave for 12weeks in a 12month period w
job protected and benefits/insurances still active
, lOMoARcPSD|15963292
o Can be used in adoption and foster homes, newborns, illness of self, spouse, or child
• Head start: program that will meet all children’s needs from birth-5 years of age and must
be culturally responsive to communities they serve
o Early leaning (readiness for school), health (developmental screens, oral and mental
health support), family well-being (to support housing, education, and financial
security)
o Early head start program (until 3 years of age- “Zero to Three”)
o Provides services to more than 1 million children per year.
Chapter 3: Culture
• Culture is based on values and beliefs which you learn as you grow up.
• Giger: (transcultural nursing) transcultural assessment model where the client is the center
of care and culturally unique.
o Based on six phenomena: communication, space, social organization,
time, environmental control, biological variation
o Creating right environment to support healing (providing space, giving time to
respond, eye contact patterns)
o GIGER THE GUIDER
• Leininger: nurse will know and understand diff cultures and provide meaningful care to
CHILD while valuing their culture beliefs
o Culture care diversity and universality and its components include values,
beliefs, political, legal, economic, educational, religious and philosophical
factors.
o “Sunrise enabler” is a guide that can be used to examine a variety of influences on care.
o LENINGER THE ENABLER
• Purnell: 12 concepts to assess pt so you can promote culturally centered care
o Model for cultural competence important components of the individual, family,
and community
o PURNELL 12
• Specter: health is balance of physical, mental, and spiritual aspects in outside world
o Illness occurs because of imbalance of one or all parts of the person (mind, body, spirit)
o “HEALTH traditions model” reflects balance of the person and is predicated on the
concept of holistic health/describes practices used to maintain, protect, and
restore health.
o SPECTOR THE SKEPTIC
• Race, ethnicity, stereotyping, prejudice, and bias
o Assimilation: adopting/incorporating characteristics of the new culture within
one’s practices
o Acculturation: modifying one’s culture to fit within the new or dominant culture
• Culturally sensitive practices
o Family roles: who has authority in the house, who is patriarch/matriarch dependent
on cultural influence
o Communication: verbal (spoken/written), nonverbal, health literacy (no medical jargon)
o Time: diff culture diff value on time
▪ Cultures in the past begin care w lengthy descriptions of health care
treatment with little interest in learning methods of adapting
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