Pediatric Nursing PowerPoint PDF

Welcome to NR 328 Pediatrics Family Centered Care Recognition that the family is the constant in a child's life Family should be considered and involved in care Atraumatic Care The overriding goal in providing atraumatic care is First, do no harm Health Promotion= health and wellness Anticipatory gu...

Welcome to NR 328 Pediatrics Family Centered Care Recognition that the family is the constant in a child's life Family should be considered and involved in care Atraumatic Care The overriding goal in providing atraumatic care is First, do no harm Health Promotion= health and wellness Anticipatory guidance= educating the parents about safety, injury prevention, Congenital anomalies is #1 cause of death amongst this age group. This Photo by Unknown Author is licensed under CC BY Anxiety is decreased Provides a sense of control Pain management improves Benefits of Atraumatic Care Recovery times decrease Families’ confidence increase Problem-solving skills are improved Communication improves Health care costs decrease Resources used more effectively Atraumatic Care, Treatment Room A Child Life Specialist can help a child before/during/after procedure. Informed Consent vInformed consent vs assent vRequirements for obtaining informed consent vEligibility for giving informed consent vCompetent vInformed vVoluntary vEmancipated minor/Mature minor vTreatment without parental consent vSexually transmitted infections vMental health services vAlcohol and drug dependency vPregnancy vContraceptive advice vLife sustaining emergencies (covered under EMTALA) Infant HR RR 140-160 30-60 SBP 70-90 Toddler 80-130 20-30 70-100 80-120 20-30 80-110 School-Aged 70-110 20-30 80-120 Adolescent 55-105 12-20 80-120 Pediatric Vital Signs Preschooler Growth and Development Infant NR 328 This Photo by Unknown Author is licensed under CC BY-NC-ND Definition of an Infant Infant 1 month to 1 year Erikson Developmental Theories Trust versus Mistrust Trust is created when infant’s needs are consistently met Mistrust can occur when needs are not consistently met Piaget Sensorimotor Uses senses and motor skills to learn about the world Developmental Changes qIncrease in physical size qWt. 5-7 oz per week qDouble birth weight by 5 months qTriple birth weight by 1 year qLinear Growth Pattern qLength increases by 50% in first year qFontanel closure qSequential maturation qAssess for Failure to Thrive (FTT) Gross and Fine Motor Development CEPHALOCAUDAL PROXIMODISTAL Motor Milestones Gross Motor Fine Motor 1m Head lag 1m Grasp reflex/hands closed 2m Lift head off mattress 2 m Grasp reflex fading 3m Lift head and shoulders 3m Hands open 4m Can hold head up 5m Plays with toes 5m Roll front to back 6m Holds bottle 6m Roll back to front 7m Transfer objects hand to hand 7m Tripod sit 8m Sit unsupported 9m Pull to standing position 10m Move from prone to sitting 11m Cruises 12m Walks with one hand held 8m Early pincer grasp 9m Dominant hand evident 10m Grasp rattle by handle 11m Neat pincer grasp 12m Tries to build 2 block tower Language Milestones v1m Cries to get needs met v2m Begins to coo v10m Says mama/dada v11m Imitates speech and animal sounds v12m Says 3-5 words Social Milestones 1m May cry up to 4h/day 2 m Social smile 3m Turns head to locate sound 4m-5m Laugh and squeal, separation anxiety begins 6m Stranger anxiety begins 8m – Know the difference between family and strangers 9m-10m Understand no, object permanence, wave bye –bye, play peak a boo 12m Follow simple commands Solitary play Nutrition qNutrition—breast milk is best for first 6 months of life qNutrients qReadily and easily digestible qNo need for water qIntroduction of solid foods q4-6 months qRice cereal, vegetables, fruit, and lastly meat qIntroduce 1 new food at a time( over a 3-5 day time frame) qJuice after 6 months-limited qIron added by 6 months qWeaning from breast or bottle around 1 year qSwitch to cows milk at 1 year qTransition to table food by 1yr qAssess for Failure to Thrive if growth pattern not linear Pain in infant Crying Thrashing, rigidity Kicking Drawing up legs Grimacing Eyebrows furrowed Eyes tightly closed Safe Sleeping and SIDS Prevention Sleep pattern develops around 3-4 months SIDS Prevention Back to sleep Firm mattress No pillows/toys/blankets Cool environment No co-sleeping Pacifier use No secondhand smoke Concerns Colic Teething- symptoms/management Abuse- coping strategies Stimulation and play Aspiration, suffocation, falls Baby proofing the house (poisoning) Leading Cause of death – congenital anomalies Health Promotion Preserve Preserve the infant”s trust Encourage Encourage the caregivers to “room in” to facilitate caregiver-child attachment. Maintain Maintain normal routines and rituals when possible. Allow Allow choices, when possible, to facilitate feelings of control with the child's caregiver. Growth and Development of the Toddler 1- 3yrs old 3 NR328 Physical Growth of the Toddler u Height and weight u increase steadily but in a step like pattern in spurts u Quadruple birth weight by 2 ½ years u Average weight gain is 4 to 6 lbs per year Height increases an average of 3 inches per year. u Anterior Fontanel closes by 18 months. u Big head, pot belly, sway back u Gross motor-still very clumsy This Photo by Unknown Author is licensed under CC BY-NC-ND Erikson Developmental Theories Autonomy v/s Shame and Doubt Separates from parent, seeks to achieve autonomy Negativism abounds in frustration from not being successful Piaget Pre-operational Only think of one concept at a time Can’t use logic Gross/Fine Motor Development 15 months 18 months u Walk without help u Run but falls a lot u Creep up stairs u Throw a ball overhand u Uses a cup well u Manages spoon well Gross/Fine Motor Development 24 months u Walk up and down stairs 2 feet on a step u Runs well u Kick a ball 30 months u Stands on one foot briefly u Jump from step or chair u Holds crayon with fingers u Draws horizontal and vertical lines u Begins to draw circles Speech Development u Receptive language development: the ability to understand what is being said or asked u NO is favorite word u Echolalia: repetition of words and phrases without understanding u Points and gestures to communicate u Appx 300 words by age 2 years u Knows first and last name by 30 months Emotional and Social Development of a Toddler u Focus is Separation u u Seeing oneself as separate from the parent Provide a simple routine and maintain it when possible u Negativism is common and normal u Egocentrism u Temper tantrums u May rely on a security item u u Ritualism is common and normal Regression is common with illness and hospitalization u May display aggressive behaviors Parallel Play Safety Promotion for Toddler Provide Provide a childproof environment Prevent Prevent falls Use Use a safe car seat in back of car. Provide Provide a safe home environment. Avoid Avoid exposure to tobacco smoke Prevent Prevent suffocation Prevent Prevent poisoning Prevent Prevent drowning Prevent Prevent burns Nutrition for Toddler u Offer finger foods u Introduce child size spoon/fork u Limit milk to 2-3 cups/day u Minimize distractions during mealtime u Establish a family routine u picky eaters u Limit snacks u Do not turn mealtime into a battle Prepare them immediately before a procedure Use simple language Avoid terms with figurative meaning Communication Toddlers use limited verbal communication Don’t expect a response every time Use play to convey information Get physically down to their level Pain Assessment u Signs a Toddler is in Pain u Crying u Thrashing u Withdrawal from stimulus u Noncooperation u Clinging u May anticipate pain