PAEDIATRIC NURSING

MS FLORENCE BEINEMPAKA

Definition
Paediatrics: Branch of medicine concerned with children: the branch of medicine concerned with the care and development of children and with the prevention and treatment of children's diseases. Paed: child, children

 Pediatric nursing is a medical specialty that promotes the care, both urgent and preventative, of children and youth. Nurses in this field must have a wide range of knowledge, including the physiological differences between children and adults. This specialized care propels nurses into different roles, including caregiver, advocate and educator.

Who is a child?
UN convention on the Rights of Child defines a child as every human being below the age of 18 unless under the law applicable to the child, majority is attained earlier. Biologically, a child is anyone between the stages of infancy and adulthood. A child is a human being between the stages of birth and puberty. The legal definition of child refers to a minor, or somebody who is yet to become an adult.

Historical development
Origins traced back from the 14th century First law concerning childhood is attributed to the founder of Rome-Romulus. This gave fathers the power to kill with deformities and second son but this horrible practice was abolished by emperor constatine. Historical information dedicated to children were to ensure proper nourishment to the infant, body care and ends with practical suggestions to strenghen constitution,physical education and the mind.

Historical contd
Dr solano (98-128 AD) founder of the medical schools and author of Demorbis mulierum considered the 1st treteaties of science in obstetrics and gynaecology and some information regarding the child such as double ligation of the umblical cord, cleaning of ears and mouth with oil, wrappingtechniques, nutrition and breastfeedingand care and the disturbances of early childhood.

History contd
Highly regarded as the precussor of paediatrics The arab doctors that helped to put up paediatric expertise include: Avicenna (930-1037) describes in detail exanthematous fevers,acute meningitis,pleurisy, apoplexy and vomiting in children Albucasis (1013-1106) provides indications neonatology

History contd
Rhazes (890-923) measles, smallpox, and scalet fever Aldobrandin of Siena in mid 13th century wrote treties on hygiene starting from early childhood Paul Bagellardo 15th century eczema, skin, muscle spasms, epilepsy, insomnia, eye diseases, diseases dependent on the ear, nose, throat, mumps abscess tonsil, stomatitis, altered dentition, cough, vomiting, diarrhoea, worms and hernia.

History
He also dealt with the treatment system, detailed description of symptoms and the clinical symptomatology.

On the American scene

The end of the 19th century was regarde as the dark ages of paediatrics The 1st half of the 20th century regarded as the dawn of improved healthcare for children Began in the 1st half of the 1800s under the influence of the perussian born physician Abraham jacobi(1830-1919) regarded as the father of paediatrics

 One of his outstanding achievements was the start of the milk stations. Mothers could bring their sick children for treatment ,learn the importance of pure milk and its proper preparation. This crusade helped bring the diary industry under legal control The decline in infant mortality since 1900 was achieved through prevention, health promotion measures- improved sanitation and paeusterization of milk.

History contd
Before these regulations unsanitary milk supply was a chief source of infantile diarrhoeaand bovine tuberculosis.

Social welfare of children

Lillian Wald(1867-1940) a social reformer founded the Henry street settlement in New yolk city. The founder of public health / community nursing Nsg services, social work and organized programes of social, cultural and educational activities were being provided As caused of diseases were identified, emphasis on isolation and asepsis occurred.

 In 1900s children with contagious diseases were isolated from adult patients Parents were prohibited from visiting because the might transmit diseases to and from home Even toys and personal articles of clothing were kept from the child.

Isolation and Asepsis

Spits and Robinson in 1940 identified the effects of isolation and maternal deprivation This has brought about the surge in psychological health of children Resulted in changes in hospitalized children such as rooming in , sibling visitation, child life/play, programmes such as pre hospitalization preparation, parent education and hospital schooling.

LANDMARKS IN CHILD HEALTH NURSING

1771 New Yolk hospital one of the 1st teaching hospitals in USA provided classroom presentations designed for nurses 1851 the hospitals of sick children was founded in London 1855 one of the earliest known paediatric textbook was

 1896 nurses association Alumni of the united states of Canada was founded later it became the ANA 1903 Recognition of nurses was initiated 1912 Us children Bureau which overseas childrens health and environment was established. 1970s health became a more comprehensive concept than suggested by the traditional definition which indicated merely absence of diseases.

 Nursing process cleave was developed Nurses developed their roles as child advocates ensuring the highest quality of health care for children.

Future trends
Shift in focus from treatment of disease to promotion of health will expand the nurses role in ambulatory care with prevention and health teaching receiving major emphasis. Technological influences related to patient care as well as knowledge in computer in the work setting.

Future trends
Changing demographics and their impact to paediatric nursing Disease pattern and emerging ones

Qualities of a good paediatric nurse

Good observer Honest and trustful Sympathetic, kind, patient and cheerful Love to work with children Interest in family care Able to provide teaching to children and their families.

Roles of a paediatric nurse

Therapeutic relationship- to relate meaningfully to the children and their families and yet separate enough to distinguish their own feelings and needs Family advocate- the nurse must work with the family members identify their goals and needs and plan interventions that best meet the defined problems-assist to make informed decisions

Roles contd
Health teaching- involves transmitting information at the childs and family level of understanding and desire for information appropriate health teaching with generous feedback and evaluation to promote learning Support/ counseling Support- by listening , touching and physical presence- most helpful with children because they facilitate non-verbal communication

 Counseling- mutual exchange of ideas and opinions that provide the basis for mutual problem solving. Also enables the family to attain higher level of functionality, greater self esteem and closer relationships Restorative role most basis of the nurses role. Meeting the physical, emotional needs of the patients continual assessment and evaluation of physical status. The nurse must be aware of normal findings in order to intelligently identify and document deviations

 -Coordination and collaboration- as a member of

 A child's head is larger in proportion to his body than an adult's head is in proportion to his body In babies, the body's temperature control mechanism is immature and unstable Children have smaller airways with more soft tissue and a narrowing at the cricoid cartilage

DIFFERENCES BETWEEN A CHILD'S BODY AND AN ADULT'S BODY

 The respiratory rate of a child is faster than that of an adult. A child's trachea opening and the esophagus opening are closer together than in an adult. Children dehydrate easily Children have less blood than adults. This makes children at greater risk than adults from bleeding to death or developing severe shock from a relatively minor wound.

Stages of childhood
General definitions for the ages and stages of a child include: Newborn or Neonate - birth to 28 days Infant - 1 to 12 months Toddler - 1 to 3 years Preschooler - 3 to 5 years School Age - 5 to 11 years

 Preteen or Tween - 11 to 12 years Teen - 13 and older These are not universal definitions though. The State of Texas actually defines an infant as 'a child from birth through 17 months' and a toddler as being from 'from 18 months through 35 months,' so those are likely the definitions that you should use.

Role of family in child care

Ethical and cultural issues in child care

Informed consent: parents legal custodians of minor children and are customarily requsted to give informed consent on behalf of the child. If is able to understand may assent to treatment but should be given time to ask questions. Children need to be actively involved in descisions regarding their care when appropriate.

Child rights vs parents rights

Parents or guardins

Role of nurse in paediatrics

Direct nursing care to children and their families. Follows the nursing process to provide the framework for delivery of direct paed. Nsg. Care. assessment.,identify the diagnosis that describe the responses of the child and family to the illness or injury and implements and evaluates Nsg. Care. This meets the childs physical and emotional needs. Guide and help the family to support their child in, out hospital and at home.

 Patient education: Improves treatment results Patient advocacy: acting to safeguard and advance the interests of another. Case management: meets the childs medical, nursing developmental, educational, and psychosocial needs. it is a process of coordinating the delivery of health care services in a manner that focuses on quality and cost outcomes

 It promotes continuity of care. Discharge planning: this promotes smooth, rapid, and safe transition into the community and improves the results of treatment that begun in the hospital.