PEDIATRIC NURSINGPEDIATRIC NURSINGCaring For Children Caring For Children and Their Familiesand Their Families

PEDIATRIC NURSINGPEDIATRIC NURSINGCaring For Children Caring For Children and Their Familiesand Their Families

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What is Pediatric Nursing?

• Caring for children and families• Promoting health and wellness

through– Clinical practice– Education– Research– Advocacy

Special Competencies• Medication dosage calculation• Pediatric-specific skills• Neonatal, infant and child resuscitation• Play therapy• Family-centered care• Developmentally appropriate care and

communication

Peds Nursing Issues• Safety of culture and environment• Access to healthcare• Divorce, abuse, drug use-

exposure in home• Lack of prenatal care and

appropriate screenings• Violence and bullying in school

• Injury and accidents• Nutrition and obesity rates; eating

disorders• Peer pressure, drug and alcohol use• Sexual activity and rates of STD and

teen pregnancy• Mental health• Child abuse and neglect

Care Settings• Acute care- hospital setting• Critical care hospital unit• Specialty clinics for children with

special needs• Public health department• School • Home health and hospice care• Primary care facilities

Definition or Family• Family is who they say they are• Biological • Legal• Emotional• Two or more persons• Nuclear, alternative, adoptive,

foster, and group

Growth and Development

• Growth vs Development• Freud• Erickson• Paiget

• Kohlberg- moral (won’t focus on)

Communication• Techniques• Verbal• Nonverbal• Purpose??

• Infant• Toddlers• Preschoolers• School age• Adolescent

Emotional Factors• Separation anxiety• Stranger anxiety• Tantrums• Depression• Self image• Insecurity

Safety/Accident Prevention

• Environmental• Equipment• Medication• Anticipatory guidance• Risk factors

Pain Management• Nonpharmacologic• Pharmacologic

– Non-opioid– Opioid

Anatomic Differences• Respiratory

– Small, short, narrow airways– Obligatory nosebreathers

• Skin– Larger body surface area– Increase fluid loss– Problems with temp regulation

• Cardiac– Increased heart rate– Congenital anomalies– Decreased blood pressure– Increased oxygen demand– Increased metabolic demand

• Renal– Kidneys less able to concentrate urine– Increased specific gravity– Small changes=big consequences– Differing lab values by age group– Small bladder capacity– Prevent UTI– 1-2mL/kg/hr

• GI– Feces changes based on diet and age– Dietary inclusions– Allergies– Congenital disorders

• Neuro– Primitive reflexes– Replaced slowly with gross and fine

motor movement

• Hematology– Rapid heart rate and higher

hematocrit increase oxygen delivery– Lab results vary by age group

• Immune– Need acquired immunity in infancy– Immunizations– Immature immune system

• Musculoskeletal– Spurts and lulls– Mastery of motor skills is influenced

by environment and stimulation– Highly individualized

• Endocrine– Inability to regulate blood glucose

levels for first few years