1. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Perspectives in Pediatric Nursing Lecture 3-A Perspectives in Pediatric Nursing Clinical Application for Child Health Nursing NUR 327 1

2. Mosby items and derived items © 2005, 2001 by Mosby, Inc. 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 Perspectives of Pediatric Nursing 2

3. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Definitions Neonatal period: <28 days of life Postnatal period: 28 days to 11 months Infant: the first year of life Perspectives of Pediatric Nursing 3

4. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Birth Weight Is the major determinant of neonatal death. LBW: <2500 g Lower birth weight = Higher mortality Perspectives of Pediatric Nursing 4

5. Mosby items and derived items © 2005, 2001 by Mosby, Inc. United Nations’ Declaration of the Rights of the Child 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 Perspectives of Pediatric Nursing 5

6. Mosby items and derived items © 2005, 2001 by Mosby, Inc. United Nations’ Declaration of the Rights of the Child (cont’d) To receive special treatment if handicapped To receive love To receive an education and develop his/her abilities To be protected from neglect, cruelty, and exploitation To be the first to receive protection in disaster Perspectives of Pediatric Nursing 6

7. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Pediatric Nurse Practitioners Services -Advanced education in pediatric nursing and health care (Hold national certification) Work closely with pediatrics and other health care providers. Give the three levels of health prevention. Perspectives of Pediatric Nursing 7

8. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Levels of Health Prevention Description Primary health prevention Prevent the occurrence of disease Secondary health prevention Early detection and intervention Tertiary health prevention Prevent further deterioration (rehabilitation) Perspectives of Pediatric Nursing 8

9. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Setting of Pediatric Health Nurse School nurse Hospital nurse Primary health centers Community health nurse Perspectives of Pediatric Nursing 9

10. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Roles of the Pediatric Nurse  Health promotion and disease prevention  Health teaching.  Support/counseling.  Applied the three levels of health prevention  Coordination/collaboration  Ethical decision making  Health care planning  Research Perspectives of Pediatric Nursing 10

11. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Statistical terms Birth rateThe number of birth per 1000 population Neonatal death rate The no. of deaths per 1000 live births occurring between birth and the first 28 days of life Infant mortality The no. of deaths per 1000 live births occurring at birth or on the first 12 months of extra uterine life Maternal mortality The no. of maternal deaths per 100,000 live births that occur as a direct result of thechildbearing process Perspectives of Pediatric Nursing 11

12. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Health promotion and nursing management of common health problems of infant, early childhood, school-age-children, and adolescence Perspectives of Pediatric Nursing 12 Lecture 3-B

13. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Infant Physical Tasks Physical Tasks: 0 - 6 months:  Fastest growth period  Head circumference is equal to or larger than chest circumference  Posterior fontanel closes at 3 months  Vital signs: HR and RR faster and irregular Physical Tasks 6 - 12 months:  Teeth begin to come in Perspectives of Pediatric Nursing 13

14. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Infant Nutrition Birth – 6 months:  Breast milk is most complete diet  Iron-fortified formulas are acceptable  No solid foods before 4-6 months 6 - 12 months:  Breast milk or formula continues  Diluted juices can be introduced  Introduction of solid foods: cereal, vegetables, fruits, meats Perspectives of Pediatric Nursing 14

15. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Toddler Physical Tasks: Slow growth period Anterior fontanel closes at 18 months Primary dentition (20 teeth) complete by 2½ years Develops sphincter control – toilet training possible Motor Tasks: Walks alone by 12 - 18 months Perspectives of Pediatric Nursing 15

16. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Toddler Nutrition  Able to feed  Appetite decreases- physiologic anorexia  Increased need for calcium, iron, and phosphorus – risk for iron deficiency anemia  Choking is a hazard Perspectives of Pediatric Nursing 16

17. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Preschooler Physical Tasks: Slow growth rate continues Motor Tasks: Walks up & down stairs  Able to start social side of eating  Establish good eating habits - obesity Perspectives of Pediatric Nursing Preschooler Nutrition 17

18. Mosby items and derived items © 2005, 2001 by Mosby, Inc. School-age Physical Tasks:  Slow growth continues  Weight doubles over this period  At age 12, girls are bigger than boys  Has all permanent teeth by age 12 Perspectives of Pediatric Nursing 18

19. Mosby items and derived items © 2005, 2001 by Mosby, Inc. School-Age Nutrition  “Junk” food becomes a problem  Busy schedules – breakfast is important  Obesity continues to be a risk  Nutrition education should be integrated into the school program Perspectives of Pediatric Nursing 19

20. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Adolescent Physical tasks:  Period of rapid growth  Puberty starts Perspectives of Pediatric Nursing Sexual Development Girls Boys Breasts developFacial Hair growth Menses begins Voice changes Enlargement of testes at 13 yrs 20

21. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Adolescent Nutrition Food intake needs to be balanced with energy expenditures Increased needs for: Calcium for skeletal growth Iron for increased blood cell development Zinc for development of skeletal, muscle tissue and sexual maturation Skipping breakfast, increased junk food, decreased fruits, veggies, milk Boys eat foods high in calories. Girls under-eat or have inadequate nutrient intake. Perspectives of Pediatric Nursing 21

22. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Play is the work of Children  Enhances Motor Skills  Enhances Social Skills  Enhances Verbal Skills  Expresses Creativity  Decreases Stress  Helps Solve Problems Perspectives of Pediatric Nursing 22

23. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Health Promotion Childhood Immunizations Nutrition Screenings throughout childhood (APGARS, newborn screenings, vision/hearing) Health Teaching Perspectives of Pediatric Nursing 23

24. Mosby items and derived items © 2005, 2001 by Mosby, Inc. Injury Prevention & Safety Issues  Accidents are the leading cause of death in infants and toddlers (falls, burns, poisons)  Toddlers and Preschoolers – drowning  School-age and adolescents – motor vehicle accidents  90% of all accidents are preventable! Perspectives of Pediatric Nursing 24