Anticipatory Guidance Perry, pp. 991-999; 1033-1041; 1055; 1093; 1122-1124

Guidance and Safety Anticipatory guidance is about 2 things: Caregiver understanding of child development and thus anticipating the child’s needs and understanding behavior Educating caregivers about injury prevention

Nursing Responsibilities Need to be aware of risks in each age group in order for anticipatory prevention teaching to occur. Also need to have understanding of child development and behavior. Enables nurse to guide parents regarding childrearing practices that will help prevent problems. Ideally, discuss risks before each age group occurs.

Healthy People 2010 Objectives R/T Safety Commonalities in all age groups: Poisoning MVA/Pedestrian accidents Fire Drowning Homicide/suicide Head injuries Food safety Dog bites Sports protection Abuse/assault/rape (covered in a future course)

Injury Prevention In your text, all pediatric age groups will include all or some of the following categories: Aspiration Suffocation/drowning MVAs (#1 cause of death in all groups x infants) Falls Poisoning Burns Bodily injury

Anticipatory Guidance During Infancy Infancy includes all the injury prevention categories See interventions in Table 36-1, pp. 992-993 See Patient Teaching Boxes on pp. 1000 & 1001

Infancy cont’d Three leading causes of accidental death in U.S. were suffocation, MVAs, drowning Remember that overall leading cause of death in infants is congenital anomalies, not accidents. Infant needs constant supervision and vigilance d/t increasing skills and curiosity.

During Early Childhood (Toddlers and Preschoolers) Includes all categories; see Table 37-3, 1034-1035 Also look at Guidance p. 1056 Toddlers are at risk because of high activity level, high curiosity, oral fixation, limited reasoning ability, esp. for poisoning Preschoolers understand reasons for rules; child care focus shifts from protection to education; good time for development of long-term safety behaviors (e.g. swimming lessons, bike helmets)

School Age Includes MVAs, drowning, burns, poisoning, and bodily damage. See Table 39-2, p. 1095 Less injuries d/t more refined coordination and skills, and increased cognition and understanding. Also see Guidance on p. 1084.

Adolescence Adolescent concerns are pregnancy, STDs, eating disorders, suicide, accidents, homicide Categories include MVAs, falls, drowning, burns, poisoning , bodily damage. See Box 40-3, p. 1123 Caregivers also need information regarding developmental changes and process of gaining independence—see Guidance on p. 1125

Adolescence cont’d MVAs—single greatest cause of serious and fatal injuries in teens—60% male—alcohol frequently a factor; 10% may have been suicides Firearms/other weapons—powder, paint, BB Sports injuries—football with boys; gymnastics with girls. Important that sport fits body type and ability and that protective gear is worn

Adolescence cont’d Adolescents have a sense of indestructiveness accompanied by the “it won’t happen to me syndrome” causing them to take chances in areas of driving, sex, drugs and alcohol, daredevil activities, and defying authority.