Child & Adolescent Health: Nursing Care

• Provides information about specialist nursing care regarding child and adolescent health, covering family centered care, illness impact, and specific conditions like meningitis, seizures, and asthma.

Family-Centered Care (FCC)

• Provider and family are mutually respected partners.
• FCC acknowledges that the family is the one constant in a child's life.
• Key traits include recognizing strengths, respecting diversity, and exchanging unbiased information.
• Aims to manage distress, promote self-care, maintain health, and foster growth alongside developmental milestones.
• Application involves incorporating FCC concepts into policy and ensuring accessible services across settings.
• Collaboration between providers and family is essential for positive outcomes.

Family Dynamics

• Family theories describe family responses to internal and external events.
• A blended family includes children from previous relationships coming together as one unit.
• A binuclear family is a post-divorce family divided into two households.
• Parenting styles range from authoritarian to indifferent, each affecting child development differently.
• Strengths provide support during change, including traits like optimism and assets like finances.
• Cultural beliefs influence family goals, roles, and childbearing practices.

Cultural Competence

• Communication and language skills affect understanding and compliance with treatment.
• Promoting cultural competence involves assessing cultural influences, incorporating health beliefs, and increasing plan compliance.

Healthcare Plans

• Family-centered care plans should help assess family needs, strengths, and resources.
• Consider how a child's condition influences family functioning.

Impact of Illness and Hospitalization

• Infants are aware of separation from parents around 6 months.
• Toddlers may view illness as punishment.
• School-age children have a more realistic understanding of illness.
• Adolescents understand the complexity of illness and worry about body image.
• Common effects on all children encompass fear, loss of control, and separation anxiety.
• Stages of separation anxiety include protest, despair, and detachment.
• Separation can cause withdrawal, fear, anxiety, and loss of control.

Nursing Management

• Encourage parental presence and adhere to routines wherever possible.
• For toddlers, allow parental holding in the examinations.
• Be sure to incorporate choices and explain all procedures to the patient and the family.
• For school-age children, encourage parental participation.
• For teens, include the individual in the plan of care.
• Family stress increases with hospitalization and family processes are altered.
• Assess family roles, knowledge, and support systems.

Stress Minimisation

• Family presence, parental involvement, and child life programs also help minimize stress.
• Maximizing control through choices and encouraging independence are key.
• Provide developmentally appropriate interventions, assess family strengths, and encourage participation.
• Establish therapeutic relationship and empower family.
• Prepare child and family with education and clear goals to provide care.

Neurological Alterations: Meningitis

• Meningitis is the inflammation of membranes covering the brain and spinal cord, often caused by infection. Bacterial meningitis involves symptoms like fever, lethargy, and nuchal rigidity.
• Viral has milder symptoms compared to bacterial meningitis often.
• Bacterial requires a lumbar puncture to diagnose and determine the infection spread.

Neurological Alterations: Encephalitis

• Encephalitis is an inflammation of the brain itself, caused by viruses, bacteria, or parasites.

Physical Assessment

• Opisthotonic position manifests as severe hyperextension.
• Kernig and Brudzinski signs are indicators of meningeal irritation.

Seizure Disorders

• Seizures are sudden disruptions in brain function due to excessive neuronal discharges.
• Etiology includes genetics, trauma, infections, and metabolic imbalances.

Seizure Types

• Partial seizures originate on one side of the hemispheres.
• Generalized seizures affect both hemispheres.

Clinical Manifestations

• Factors to consider include alterations of consciousness, motor and sensory functions, or involuntary actions/autonomisms.

Seizure Assessment

• You need to assess the aura present or the absence of.
• Time the start and stop is essential.
• Evaluate for triggers, tonic/clonic, and postictal state.
• Diagnostic testing includes EEG in order to check the rhythm of the brain.

Status Epilepticus And Meds

• Prolonged seizures need prompt treatment.
• The main priority goal is to maintain the airway.
• Next administer prescribed meds while monitoring vitals.
• Dilantin must be diluted with 0.9% saline and administered slowly.
• After the episode, make sure to turn to the side to avoid aspiration.

Seizure Management

• Prevent injury by padding side rails, and nothing should be forced in the mouth.
• Educate the child and family on self-care management, triggers, medication adherence, safety, and emotional support.

Febrile Seizures

• Febrile seizures happen because of a spike in temperature.
• These usually occur in children aged 6 months to 3 years.

Cerebral Palsy (CP)

• Caused by damage to the brain impacting muscular function.
• Characterized by lack of it, muscle stiffness/tightness and involuntary movement.
• Therapy includes multidisciplinary approaches, mobility devices, and medications.
• Play therapy can be incorporated to stimulate movement and coordination via engagement.

Muscular Dystrophies (MD)

• Early signs consists if weakness, that can develop to respiratory or heart failure.
• Classified by muscle groups affected, age of onset, rate of progression, and inheritance pattern.
• The Most Common Type in Children that being Duchenne's form.

Spine Alterations

• These affect motor neurons, categorized by age of onset.
• Werdnig-Hoffman causes degeneration anterior horn cells & wasting of muscles.
• Palliative care should aim at maximizing quality of life.

Electrolyte disorders

• Can happen from an infection.
• The body is prone to electrolyte imbalances from the imbalance of output and intake.
• Determine presence of illness, symptoms, measure output and assess characteristics of excretion/vomit/dehydration.

Diarrhea

• Presents when there is an inflammation of the lining of the stomach and small/large intestine.
• The loose stools may indicate a virus depending on the severity of the frequency of the stool.
• Determine the presence of infections in families.
• Check their kidney or heart history.

Clinical Manifestations

• Diarrhea is indicated watery stools are more frequent.
• Vomiting if predominating may be a sign of any gastroesophageal reflux.
• Make sure to measure the dysaria.
• All of these signs all affect abdominal pain. • Maintain good skin condition. • Be sure to eliminate the risk of infection. • Promote health literacy and infection control strategies

General Guidelines

• Use caution: Body surface area (BSA) is used to calculate some chemotherapy dosages for children. • There is a fine line between treatment/toxic levels. • You must learn to assist the child with dealing with a cancer diagnosis. • Supportive- minimize further health complications.

Neoplastic Diseases

• These are most common for liquid- blood, soft tumors, tissue and solid. • Be sure to recognize key features that would impede the child's health, such as a fever- or red flags. • Take measures in addressing them with antibiotics as much as possible. • Monitor input and output and prevent electrolyte alterations.

Anemia

• Anemia is more common among certain populations.
• It can affect learning in school.
• Iron replacement increases absorption.

G6DP Deficiency

• This enzyme causes damage to blood cells leading to hemolysis.
• Triggers include being exposed to fava beans.

Sickle cell

• Diagnise and treat according to the disease parameters.
• Maintain healthy habits in self-care.
• If stroke indicates medical crisis.

Hemophilia

• This is a type of genetic lack of clotting.
• Characterized by excessive bruising.
• Therapy comes with regular intervals with the coagulation replacements.
• It Is common for the child to present with affected joints.

Idiopathic

• Usually happens after a viral infection.
• Characterized by easy bruising and mucosal bleeding.

Asthma

• Asthma it has many variables, but is usually caused by hypersensitivity.
• Main symptoms are wheezing and shortness of breath.
• It is crucial to assess all triggers in the surrounding enviromment.
• Steroids may be adminstered- however, be sure to do so very slowly. • This is the most essential teaching.
• Monitor responses to treatment, because they will be lifelong issues.
• Education Is key here.
• Also, develop a support system in place.