PEDIATRIC NURSING

PEDIATRIC NURSING

1. CHILD DEVELOPMENT

   • child development is an important aspect to consider when working with children. this will guide how you approach the child around their development stages
   • ADOLESENCE: want to be identified as their own individuals, approach and engage them directly, .acknowledging them my be the key to a therapeutic relationship
   • PLAY: allowd you to assess their fine motor skills etc
   • 'GUT FEELING" parents know their child better than anyone, so its good to go off what a parent says when they say something just isnt right
   • CHILDREN ARE ALL DIFFERENT: anatomically, physcially, ethnically, developmentally

2. NORMAL OBS: can vary from child to child and age

3. COMPLETE HEALTH SURVEY

   • health history
   • nutritional assesment
   • fam structure and function
   • througher physical exam
   • review of body systems
   • developmental assessment
   • birth history
   • birth route, complications etc

4. PEDIATRIC ASSESSMENT REQUIRES: expertise, sensitivity, clinical skills, communication, chid awareness

5. PARENTS KNOW THEIR CHILDREN BEST

6. ACROSS THE ROOM ASSESSMENT: a breif overall assessment prior to touching the child, direct observation

7. RESPIRATORY DIFFICULTIES

   • SIGNS:serial recessions, facial expressions, head bobbing, shoulders up, pursed lips, nasal flaring, increases RR, trachial tug, abdominal recession, inter & sub costal recession, tripod position, grunting
   • APPEARENCE: tone, consolability, speech, interactibility, look or gaze, cry
   • BREATHING: altered RR< nasal flaring, position of comfort, retraction, abnormal airway/resp sounds
   • CIRCULATION TO SKIN: pallor, cyanosis, rash, mottling, bleeding
   • CROUP SYNDROME: characterised by haoarsness, a resonant cough- barking- kids prone to dehydration.
     • NURSING MANAGEMENT: observe, minimal intervention, reassure parent, adrenaline if severe, hydration,
   • BRONCHOLITIS: acute viral infection. rare in children over 2. spread by hand to eye- nose or other mucosa membrane
     • TREATMENT:humidity, fluid, rest
       • REASONS TO ADMIT CHILD: tachypenic, low sats, chrnid cardio-resp disease HX, restless, poor fluid intake
         • NURSING CONSIDERATIONS: isolation, accurate obs, support, manage symptoms, eduication
   • ACUTE EPIGLOTITIS: serious obstructive inflammatory process that occurs in children 2-5 years- medical emergency.
     • PRESENTATION:fever, appears sicker, upright, mouth open, irritable, drooling
       • MANAGEMENT: assume serious, an emergency, intubation needed!! prevention with HIB vac. act quickly, observe child, monitor RR, HR, sats, suport fam, hydration, pain relief
   • RESP INFECTION SIGNS: fever, V&D, nasal block/discharge, anorexia, resp sounds, cough, sore throat

8. LEVEL OF CONSCIOUSNESS= AVPU

   • A= awake and alert
     • V=response to verbal stimulus
       • P+response to pain
         • U=completly unresponsive
   • EGHI
     • E=exposure and enviromental control
       • F= full set of vitals
         • G=give comfort mesures
           • H=head to toe assessment
             • I=inspect all surfaces

9. FEBRILE CONVULSIONS?SEIZURES

   • affects 4% of kids
   • 6months -3 years, x2 more likely in boyos
   • uncertain cause
   • temp exceeded 38.8
   • NURSING CONSIDERATIONS: stay alm, think safety, call for help, last lnger than 5 mins consult dr

10. DIAHRRHOEA AND VOMITING

    • may be viral or bacterial, infection control is vital! stool specim, dehydration?
    • THERAPEUTIC MANAGEMENT:assess fluid and electrolyts imbalance, rehydration, maintain fluid, adequate diet
    • NURSING MANAGEMENT: prevention/hygiene promotion, documentation, infection control, observation, communication, support eduication