NUR235 Exam 1
how do children differ from adults? - Respond differently to antigens due to their developing immune
system
- Have more extracellular fluid (more prone to dehydration)
- Fewer antibodies, have not been exposed to many pathogens (more susceptible to infections)
- Fever first sign of infection (responds systemically)
- Less sense of control (anxiety and stress)
- Communication barriers, difficulty communicating their symptoms
family centered care ○ Families are clients too
○ Assess family coping
○ Promote visitation
○ Promote rooming-in
○ Include parents in care
○ Provide supportive resources
anticipating the child/family needs Anticipate and address the needs of both the child and the family
throughout the illness trajectory
- Keeping the family informed about the child's condition and involving them in care decisions
- Support families to spend time with child
- Respect and accommodate cultural beliefs
- Address child's pain and comfort needs
rooming-in The baby remains with the mother in her room during the entire hospital stay
,hospitalization/illness: infant 0-1 year
○ Cannot express their needs: crying, facial expressions, body language
○ Separation anxiety from caregiver, differentiates faces at 6 months
○ Stranger anxiety
○ Sensory overload: noises, lights, too much activity leading to fussiness, crying, etc.
○ Cluster care: grouping care to allow longer periods of rest/minimal disturbances
○ Caregiver consistency: provides sense of security and predictability for infants
infant nursing care during intervention - Distraction
- Music
- Feeding
- Sucking
- Calm, soothing voice
- Assess body language & facial expressions
infant pain scale and cues FLACC (2-7): facial expression, leg movement, activity, cry, consolability
Subjective cues:
- facial grimacing
- increased irritability
- crying difficult to comfort
- poor feeding, decreased appetite
Objective cues:
- tachycardia
- tachypnea
- flaring of nostrils
,- increase tension
hospitalization/illness: toddler 1-3 years
○ Limited understanding
- Favorite word is no
- Provide choices
- Role playing: ex listening to stuffed animal heart
○ Limited ability to verbalize discomfort and follow directions
○ May act out when afraid- negativism
○ May have separation anxiety
○ Regressive behavior
○ Encourage parents to provide routine care (bathing, hygiene, dressing, bedtime routine)
toddler nursing care during intervention - Offer choices
- Preparation prior
- Simple explanations and language
- Therapeutic play
toddler play therapy Imaginative play, role-playing with dolls or stuffed animals, and interactive games
- Helps toddlers express emotions, understand concepts, and cope with stress
negativism in toddlers Doing the opposite of what others want in response to fear
management:
- Being calm
- Offer choices
, - Praise cooperative behavior
- Routine and predictability
regressive behavior Moving backwards in development
- Ex: thumb sucking, incontinence
- Not abnormal in hospital setting
toddler pain scale and cues FLACC ( <3 yrs): facial expression, leg movement, activity, cry, consolability
Wong-Baker Faces scale (3 years): child chooses the face that suits how they feel
Non-communicating pain checklist (≥ 3yr): behaviors observed for 10 minutes and scored
Subjective cues:
- crying, "ow"
- clinging to caregiver
- regression
- withdrawal
Objective cues:
- guarding area
- change in appetite
- body stiffness
- restlessness
hospitalization/illness: preschooler 3-6 years
○ Limited understanding
○ May think hospitalization as a punishment, they think they did something wrong and this is
punishment
○ Avoid medical jargon/double meaning medical terms
how do children differ from adults? - Respond differently to antigens due to their developing immune
system
- Have more extracellular fluid (more prone to dehydration)
- Fewer antibodies, have not been exposed to many pathogens (more susceptible to infections)
- Fever first sign of infection (responds systemically)
- Less sense of control (anxiety and stress)
- Communication barriers, difficulty communicating their symptoms
family centered care ○ Families are clients too
○ Assess family coping
○ Promote visitation
○ Promote rooming-in
○ Include parents in care
○ Provide supportive resources
anticipating the child/family needs Anticipate and address the needs of both the child and the family
throughout the illness trajectory
- Keeping the family informed about the child's condition and involving them in care decisions
- Support families to spend time with child
- Respect and accommodate cultural beliefs
- Address child's pain and comfort needs
rooming-in The baby remains with the mother in her room during the entire hospital stay
,hospitalization/illness: infant 0-1 year
○ Cannot express their needs: crying, facial expressions, body language
○ Separation anxiety from caregiver, differentiates faces at 6 months
○ Stranger anxiety
○ Sensory overload: noises, lights, too much activity leading to fussiness, crying, etc.
○ Cluster care: grouping care to allow longer periods of rest/minimal disturbances
○ Caregiver consistency: provides sense of security and predictability for infants
infant nursing care during intervention - Distraction
- Music
- Feeding
- Sucking
- Calm, soothing voice
- Assess body language & facial expressions
infant pain scale and cues FLACC (2-7): facial expression, leg movement, activity, cry, consolability
Subjective cues:
- facial grimacing
- increased irritability
- crying difficult to comfort
- poor feeding, decreased appetite
Objective cues:
- tachycardia
- tachypnea
- flaring of nostrils
,- increase tension
hospitalization/illness: toddler 1-3 years
○ Limited understanding
- Favorite word is no
- Provide choices
- Role playing: ex listening to stuffed animal heart
○ Limited ability to verbalize discomfort and follow directions
○ May act out when afraid- negativism
○ May have separation anxiety
○ Regressive behavior
○ Encourage parents to provide routine care (bathing, hygiene, dressing, bedtime routine)
toddler nursing care during intervention - Offer choices
- Preparation prior
- Simple explanations and language
- Therapeutic play
toddler play therapy Imaginative play, role-playing with dolls or stuffed animals, and interactive games
- Helps toddlers express emotions, understand concepts, and cope with stress
negativism in toddlers Doing the opposite of what others want in response to fear
management:
- Being calm
- Offer choices
, - Praise cooperative behavior
- Routine and predictability
regressive behavior Moving backwards in development
- Ex: thumb sucking, incontinence
- Not abnormal in hospital setting
toddler pain scale and cues FLACC ( <3 yrs): facial expression, leg movement, activity, cry, consolability
Wong-Baker Faces scale (3 years): child chooses the face that suits how they feel
Non-communicating pain checklist (≥ 3yr): behaviors observed for 10 minutes and scored
Subjective cues:
- crying, "ow"
- clinging to caregiver
- regression
- withdrawal
Objective cues:
- guarding area
- change in appetite
- body stiffness
- restlessness
hospitalization/illness: preschooler 3-6 years
○ Limited understanding
○ May think hospitalization as a punishment, they think they did something wrong and this is
punishment
○ Avoid medical jargon/double meaning medical terms
