Chapter 26 21st Century Pediatric Nursing All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 Major goal of pediatric nursing is to improve quality of health care for all children  Healthy People 2020 health indicators provide a framework for child health  In 2010, 24% of the U.S. population was made up of children Health Care for Children 2 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 Health promotion: World Health Organization (WHO) six leading causes of disease, disability, and death  Tobacco use  Injury and violence  Alcohol and substance use  Dietary and hygiene practices  Sedentary lifestyle  Sexual behavior Health Care for Children (Cont.) 3 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 Obesity and type 2 diabetes  Childhood injuries  Violence  Substance abuse  Mental health problems Childhood Health Problems 4 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

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 Infant mortality  Number of deaths per 1000 live births during first year of life  Neonatal mortality: <28 days of life  Postnatal mortality: 28 days to 11 months  Birth weight  Major determinant of neonatal death  Low-birth-weight (LBW) <2500 g (5.5 lbs) Mortality 11 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 Childhood mortality  Death rates for children >1 year of age are less than for infants  Ages 5 to 14 have the lowest death rate  Sharp increase occurs in adolescence Injuries Homicide Suicide Mortality (Cont.) 12 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 Specific groups of children have increased morbidity (illness)  Homeless  Living in poverty  Low-birth-weight  Chronic illness  Foreign born adopted children  Children in day care centers Morbidity 13 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 Philosophy of care  Attention to full range of human experiences  Integration of objective data  Application of scientific knowledge  Provision of caring relationships The Art of Pediatric Nursing 14 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 Family-centered care  Recognizes family as constant in child’s life  Systems must support, respect, encourage, and enhance strength and competence of family  Needs of all family members must be addressed  Concepts of enabling and empowering The Art of Pediatric Nursing (Cont.) 15 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 Therapeutic care  Settings  Personnel  Interventions  Reduce psychologic distress  Minimize physical distress  First do no harm Atraumatic Care 16 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 Therapeutic relationship  Family advocacy and caring  Disease prevention and health promotion  Health teaching  Injury prevention Role of the Pediatric Nurse 17 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 Support and counseling  Coordination and collaboration  Ethical decision making  Research  Evidence-based practice Role of the Pediatric Nurse (Cont.) 18 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 Clinical reasoning  A cognitive process that uses formal and informal thinking to analyze patient data  Evaluates the significant information and considers actions  Based upon the scientific method  Combined with the nursing process, a holistic approach to problem solving Providing Nursing Care to Children and Families 19 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 Assessment  Nursing diagnosis  Planning  Implementation  Evaluation  Documentation Nursing Process 20 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 All children need:  To be free from discrimination  To develop physically and mentally in freedom and dignity  To have a name and nationality  To have adequate nutrition, housing, recreation, and medical services United Nations’ Declaration of the Rights of the Child 21 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 All children need:  To receive special treatment if handicapped  To receive love, understanding, and material security  To receive an education and develop his or her abilities  To be first to receive protection in disaster United Nations’ Declaration of the Rights of the Child (Cont.) 22 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 All children need:  To be protected from neglect, cruelty, and exploitation  To be brought up in spirit of friendship among people United Nations’ Declaration of the Rights of the Child (Cont.) 23 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.

 The leading cause of death among African- American boys ages 15 to 19 years is:  suicide.  human immunodeficiency virus (HIV) infection.  firearm homicide.  occupational injuries. Question 24 All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.