1. Copyright 2005 Thomson Delmar Learning. Thomson and Delmar Learning are trademarks used herein under license. BASICS OF PEDIATRIC CARE CHAPTER 55 Texas State Technical College VNSG 1307 Pedicatric Nursing

2. Copyright 2005 Thomson Delmar Learning. Thomson and Delmar Learning are trademarks used herein under license. PREPARING THE CHILD AND FAMILY FOR HOSPITALIZATION Admission Protection/safety The child having surgery Discharge/discharge planning

3. Copyright 2005 Thomson Delmar Learning. Thomson and Delmar Learning are trademarks used herein under license. Making the Connection Refer to the following chapters to increase your understanding of pediatric care Basic nursing Legal & Ethical Responsibilities Life Cycle Cultural Considerations Loss, Grief, & Death Wellness Concepts Medication Administration & IV Therapy Pain Management Adult Health Nursing Anesthesia Surgery

4. Copyright 2005 Thomson Delmar Learning. Thomson and Delmar Learning are trademarks used herein under license. PEDIATRIC PROCEDURES Growth measurements Vital signs Developmental assessments Child safety devices Specimen collection Intake and output

5. Copyright 2005 Thomson Delmar Learning. Thomson and Delmar Learning are trademarks used herein under license. ADMINISTRATION OF MEDICATIONS Children’s reactions to medication administration are affected by developmental characteristics. Most common method of determining medication amounts is based on the child’s weight or body surface area.

6. Copyright 2005 Thomson Delmar Learning. Thomson and Delmar Learning are trademarks used herein under license. ORAL MEDICATIONS Liquids, pills, tablets, and caplets. Frequently in a liquid that tastes “good” and is colorful. Become aware of medications that are bitter or unpleasant. Use methods to decrease the unpleasant taste.

7. Copyright 2005 Thomson Delmar Learning. Thomson and Delmar Learning are trademarks used herein under license. INTRAMUSCULAR INJECTIONS Widely used. Children have reported that injections are the most stressful and painful experiences of health care.

8. Copyright 2005 Thomson Delmar Learning. Thomson and Delmar Learning are trademarks used herein under license. OTIC MEDICATIONS Warm to room temperature. To instill the solution in a child under 3 years of age, pull the pinna of the ear back and down. In a child over 3, the pinna is pulled back and up.

9. Copyright 2005 Thomson Delmar Learning. Thomson and Delmar Learning are trademarks used herein under license. INTRAVENOUS MEDICATIONS Children are at risk for fluid overload. All children receiving IV fluids should receive those fluids through a volumetric infusion pump. Site assessment includes color of site, tension of skin, and skin temperature.

10. Copyright 2005 Thomson Delmar Learning. Thomson and Delmar Learning are trademarks used herein under license. THE DYING CHILD Infants and toddlers have no clear concept of death. Children between 3 and 5 may view death as a kind of sleep. School-age children begin developing the concept of death as final.

11. Copyright 2005 Thomson Delmar Learning. Thomson and Delmar Learning are trademarks used herein under license. THE DYING CHILD (continued) Adolescents have a maturing understanding of death. Children can sense when they are seriously ill. The child usually experiences fear of death, of dying alone, and of pain.

12. Copyright 2005 Thomson Delmar Learning. Thomson and Delmar Learning are trademarks used herein under license. THE DYING CHILD (continued) The nurse can: Promote socialization. Provide avenues for self-expression. Deal directly with the child’s questions. Allow death to occur with dignity.

13. Copyright 2005 Thomson Delmar Learning. Thomson and Delmar Learning are trademarks used herein under license. PARENTS OF THE DYING CHILD Family begins anticipatory grieving. Denial, anger, and depression. Parents have many fears. Families need help to focus on the time that remains with the child. Nurse should use openness and honesty with the child and family.

14. Copyright 2005 Thomson Delmar Learning. Thomson and Delmar Learning are trademarks used herein under license. SIBLINGS OF THE DYING CHILD May experience anticipatory grief also. May resent attention given the dying child. May fear that it will happen to them. May need help in adapting to their parents’ grief. Siblings need acknowledgment of their feelings.

15. Copyright 2005 Thomson Delmar Learning. Thomson and Delmar Learning are trademarks used herein under license. THE NURSE OF THE DYING CHILD Requires confidence, empathy, and competence. Must manage personal stress. Must be comfortable with own mortality. Experiences denial, anger, depression, guilt, and ambivalence.