NURS 207: Promoting Pediatric Wellness in the Family & Community

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

20. 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 Changing Patterns of Family Life

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

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

29. Developmentally Appropriate Communication • Infants • Nonverbal • Crying as communication-Types of cries • Use of Transitional Objects

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

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