1. NURS 207: Promoting Pediatric Wellness in the Family & Community
Allan J. V. Cresencia, MSN, CPN, RN
Samson Yigezu, PhD, RN
Christine Limann, BSN, RN
West Coast University - Los Angeles

2. Lecture #1 Covers Introduction to the Course
Growth and Development Concepts

3. Pediatric Nursing Different from ADULT Nursing
Nursing care of the PATIENT and FAMILY
Focused on HEALTH PROMOTION and ILLNESS PREVENTION
Also, HEALTH RESTORATION and MAINTENANCE
More on Ambulatory Care than Hospitalization

4. Pediatric Nursing Trend: Family Centered Nursing Care
Community-Based Nursing Care
Community, Demography, Epidemiology, Economics
Family Influences on Child Health Promotion
Family Dynamics, Developmental Theory, Special Parenting Situations

5. Health During Childhood
Health is a state of complete physical, mental, and social well-being and not merely the ABSENCE of DISEASE
—The World Health Organization

6. Childhood Mortality
Injuries are leading cause of death in children older than 1 year
Motor vehicle crashes
Drowning
Burns
Poisoning
Firearms

7. Childhood Morbidity
May denote acute illness, chronic disease, or disability
Difficult to define and measure
The “new morbidity”
Social, behavioral, educational problems that may alter health

8. Family-Centered Care
Recognizes the family as the constant in a child’s life
Systems must support, respect, encourage, and enhance the strength and competence of the family
Needs of all family members must be addressed

9. Family-Centered Care
Concept of “enabling”
Concept of “empowerment”

10. Nursing Process Assessment Nursing diagnosis Planning Implementation
Evaluation
Documentation

11. Transcultural Nursing
Be aware of your own frame of reference
Recognize and appreciate diverse views and beliefs of clients
Being a part of the “nursing culture”

12. Relationship with Health Care Providers
Cultural perceptions or beliefs
“Time flies” vs. “time walks”
Communication
Respect
Eye contact
Food customs

13. Health Beliefs and Practices
Natural forces
Supernatural forces
Imbalance of forces
Health practices
Similarities among cultures regarding prevention and treatment of illness
Prenatal influences from folklore

14. The Child and Family in North America
Increased geographic and economic mobility
Decreased transmission of traditional customs of the culture of origin
“Cultural pluralism”

15. Interaction of Youngsters from Different Backgrounds

16. Family Influences on Child Health Promotion
Chapter 3

17. Family Consanguineous—blood relationship Affinal—marital relationship
Family of origin—family unit born into
“Household”—being used more frequently
“Whomever the client considers it to be”

18. Change in Family Structure over Time

19. More Family Structures
Traditional nuclear family
Blended family
Extended family
Single-parent family
More Family Structures
Binuclear family
Communal family
Same-sex parenting

20. Changing Patterns of Family Life
Mobility Patterns
Reduced Government Aid Programs
The Homeless Family
Increasing Number of One-Parent Family
Increasing Divorce Rate
Decreasing Family Size
Dual-Parent Employment
Increasing Family Responsibility for Health
Increased Abuse in Families

21. Family Roles and Relationships
Parental roles
Learning roles through socialization
Family size and configuration
Siblings and spacing of children
Is 3 years the magic number for spacing children?

22. Family Function Strengths Functioning style Vulnerable families
Dysfunctional families

23. Communicating with Parents
Encourage the parent to talk
Direct the focus
LISTEN!
Use silence as a response
Be empathetic

24. Communicating with Parents (cont.)
Define the problem
Solve the problem
Provide anticipatory guidance
Avoid blocks to communication

25. PRINCIPLES OF COMMUNICATION
Make communication developmentally appropriate
Get on the child’s eye level
Approach child gently and quietly
Always be truthful
Give child choices as appropriate

26. On Child’s Eye Level

27. Involve the Child in the Communication
Clip art

28. PRINCIPLES OF COMMUNICATION (cont.)
Avoid analogies and metaphors
Give instructions clearly
Give instructions in a positive manner
Avoid long sentences, medical jargon; think about “scary” words
Give older child the opportunity to talk without parents present
Ex: “little stick in the arm” “cough your head off”
Scary: Cut, Sticks, Tubes, etc.

29. Developmentally Appropriate Communication
Infants
Nonverbal
Crying as communication-Types of cries
Use of Transitional Objects
Types of cries: Caregiver’s understanding

30. Developmentally Appropriate Communication (cont.)
Early childhood
Focus on child in your communication
Explain what, how, and why
Use words child will recognize
Be consistent: don’t smile when doing painful things

31. “Stick in the Arm”

32. Developmentally Appropriate Communication (cont.)
School-age
Want explanations and “reasons why”
Concern about body integrity
Reassurance needed

33. Developmentally Appropriate Communication (cont.)
Adolescent
Be honest with them
Be aware of privacy needs
Think about developmental regression
Realize importance of peers
Honesty will help gain their trust
Privacy is from their viewpoint
Illness>>act much younger; with pain>>act much younger
I want Mommy, etc.
Peers: whole group in hospital room
Socialize with other hospitalized teens//determine appropriateness

34. Play Children’s “work” Child’s “developmental workshop”
As therapeutic intervention
As stress reliever for child/family
As pain reliever/distracter
As barometer of illness
It is WHAT THEY DO
It is HOW they learn and mature
Example of tea party to increase po intake
Too sick to play>>getting better>>start to play again