Hospitalized Child

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  1. Infant: understanding of health
    • -6 months old aware of themselves
    • -unaware of effects of illness
    • -anxious when approached by strangers
  2. Toddler/Preschooler: understanding of health
    • -understand illness but not cause
    • -know germs but not how they spread
    • -names and locations of body parts (limited)
    • -internal organs and functions vague
    • -view illness as punishment, or magical
    • -events that happen prior to illness maybe associated with the illness
  3. School-Aged Child: Understanding of Health
    • -understand how germs are spread
    • -more understanding of disease and how body organs function
    • -body parts and function is maturing
  4. Adloescent: Understanding health
    • -aware of physiliogic, psychologic, and behavioral causes of illness and injury
    • -understand that disease may involve causes and effects and that multiple organs and body parts may be involved
    • -symptoms r/t certain organ functions
    • -concerned w appearance and perceive an illness in terms of its effect on their body image
  5. what are some significant stressors for hospitalized children
    • -seperation from parents
    • -loss of self-control, autonomy, privacy
    • -painful/invasive procedures
    • -fear of bodily  injury and disfigurement
  6. Infant: Stressors
    • -seperation anxiety
    • -stranger anxiety
    • -painful procedures
    • -immobilization
    • -sleep deprivation, sensory overload
  7. Toddler: stressors
    • -separation anxiety
    • -loss of self control
    • - immobilization
    • -painful procedures
    • -bodily injury, multilation
    • -fear of dark
  8. Preschooler: stressors
    • -separation anxiety, abondonement
    • -loss of self -control
    • -bodily injury, multilaiton
    • -painful procedures
    • -fear of dark and monsters
  9. School-Aged Child: stressors
    • -loss of control
    • -loss of privacy
    • -bodily injury
    • -separation from family and friends
    • -painful procedures
    • -fear of death
  10. Adolescents: stressors
    • -loss of control
    • -fear of altered body image
    • -disfigurement, disability, death
    • -spearation from pear group
    • -loss of privacy
  11. What are some nursing managements to reduce stressors of children
    • -encourage parental prescence
    • -adhere to childs routine
    • -use topical anesthetis or preprocedural sedation
    • -quiet enviroment and decrease stimuli
    • -allow parents to hold in lap
    • -allow choices
    • -explain all procedures
    • -allow night-light
    • -encourage peer interaction via internet, phone
    • -include in plan of care
    • -encourage discussion of fears and anxieties
    • -ask if want parental involvement
  12. Protest stage of separation anxiety
    • -screaming
    • -crying
    • -clinging to parents
    • -resisit other adults attemps of comfort
  13. Despair stage of spearation anxiety
    • -sadness
    • -quiet, "settled in"
    • -withdrawl or compliant behavior
    • -crying when parents return
  14. Denial stage of separation anxiety
    • -lack of protest when parents leave
    • -appearace of being happy and content w everyone
    • -shows interest in surroundings
    • -close relationships not established
  15. Needs frequently identified by parents of hospitalized children include:
    • -reg. info about their child's condition, prognosis, tx
    • -healp, encouragement, and support formt he nursing staff
    • -a trusting, confidential relationship with the nursing staff
  16. what is the PICU
    • Pediatric Intensive Care Unit
    • -provides specialized care to infants and children, including children with life threatening conditions requiring advanced support and continuous monitoring
  17. psychological preparation for procedure
    • -know purpose of procedure
    • -expirienced procedure before? Good/bad
    • -What does the child think will happen
    • -is procedure painful
    • -what techniques does child use to gian control in challenging situations
    • -will the parents or other caregiver be present to provide support
  18. Physical Preparation for procedure
    • -performed in a tx room to promote sense of security
    • -perform quickly and efficiently
    • -praise child after procedure
  19. Oral medication administration to children
    • -children under 5 cannot swallow pills
    • -use 1 spoonful of food or 1-2ml fluid for crushed pills
    • -position upright to avoid choking
    • -aim at inside of cheek for infants oral syringe meds
    • -measure med in syringe prior to letting child place in cup to drink
  20. Rectal medication administration to children
    • -for children under 3, fifth finger used for insertion
    • -lubricate suppository & hold buttocks together for few minutes to prevent expolsion
  21. Opthalmic and otic medication administration to children
    • -fearful of med placed in ears and eyes
    • -immobilization needed to prevent injury
    • -rest wrist on childs head
    • -med at room temp
    • -incorporate therapeutic play
  22. Topical medication administration to children
    • -skin of infants is thin and fragile
    • -covering area or keeping childs hand off area may be necessary to ensure adequate contact of medication with the skin
  23. Intramuscular medication administration to children
    • -do not use glutes until child has been walking x 1yr
    • -vastus lateralis best to use in children less than 3 yrs old
    • -limited amounts in certain sites
    • -deltoid only used for small vaccine doses
  24. Intravenous: medication administration to children
    • -veins are sm and fragile, fluid balance is critical
    • -maintenance of site is needed, hands, feet or scalp for infants
    • -pump require frequent monitoring
  25. What liquids can be given to children prior to surgery
    • -clear liquids 2 hours prior to surgery
    • -breast milk 4 hrs prior to surgery
    • -formula 6hrs prior to surgery
    • -milk and light meal consumed up until 6 hours prior to surgery
  26. what is the difference between chronic otitis media with effusion(OME) and Acute Otitis Media (AOM)
    -OME  is when there is fluid in the middle ear without inflammation, continues for more than 3 months, associated with hearing loss, treat pain and assess for hearing loss to dermine if tubes are needed

    -AOM  is when acute onset of ear pain, marked redness of tympanic memebrane, and middle ear effusion, treat with ear drops and antibiotics if no relief
  27. How can one prevent ear infections
    • -no smoking
    • -no wood burning stoves
    • -breastfeeding
    • -no pacifier at night
    • -promote Hib and Pneumococcal immunizations
  28. Why is there a waiting period of 3 months with no medications or medical care with OME
    -antibiotic, steroids, and antihistamines have not been effective and most children improve in 3 months
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Hospitalized Child
2013-04-13 12:49:27
Hospitalized Child

Hospitalized Child
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