Chapter 26

21st Century Pediatric Nursing

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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

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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.)

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Obesity and type 2 diabetes Childhood injuries Violence Substance abuse Mental health problems

Childhood Health Problems

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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

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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.)

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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

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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

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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.)

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Therapeutic care Settings Personnel Interventions Reduce psychologic distress Minimize physical distress First do no harm

Atraumatic Care

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Therapeutic relationship Family advocacy and caring Disease prevention and health promotion Health teaching Injury prevention

Role of the Pediatric Nurse

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Support and counseling Coordination and collaboration Ethical decision making Research Evidence-based practice

Role of the Pediatric Nurse (Cont.)

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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

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Assessment Nursing diagnosis Planning Implementation Evaluation

Documentation

Nursing Process

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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

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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.)

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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.)

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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

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