INFANTS AND CHILDREN

1
INFANTS AND CHILDREN
2
INTRODUCTION

• CHILDREN ARE NOT MINITURE ADULTS
• They are developing
• They are vulnerable
• They are between their physiological and
  psychological growth
• A young child is emotionally immature
• They do not understand reality

3
GUIDELINES WHEN DEALING WITH INFANTS CHILDREN

• Understand growth and development
• Each child has their own individual rate of
  growth and development
• Interpretations are literal
• They may misunderstand medical terminology
• Because speech is acquired early in life adults
  think children can reason as an adult

4
GUIDELINES WHEN DEALING WITH INFANTS CHILDREN

• Establish a trusting relationship
• Speak in a quiet gentle voice
• Squat, kneel to speak to the child at eye level
• Always be truthful

5
GUIDELINES WHEN DEALING WITH INFANTS CHILDREN

• A young childs needs are often essential and
  immediate
• Children have vivid imaginations, therefore do
  not threaten them
• Observe non-verbal communication
• Reassure the child that they are not to blame for
  their illness

6
GUIDELINES WHEN DEALING WITH INFANTS CHILDREN

• Provide emotional support after traumatic
  experiences
• Do not offer a child a choice when there are none
• Refrain from labeling children be a good
  girl/boy and dont cry
• children have a right to cry in hospital

7
WHEN TRANSPORTNG

• BE AWARE THAT THEY WILL BE ANXIOUS
• They may fear
• Separation
• Bodily injury and pain
• Physical restriction
• Loss of routine and rituals
• Enforced dependency and loss of independence
• Strangers
• Loss of body image

8
THE CHILD MAY ALSO FEEL

• Confused
• Angry
• Cheated
• Distressed
• Bored/lethargic
• Out of routine
• Misunderstood
• Being punished

9
ASSESSMENT

• GENERAL APPEARANCE
• Facial expression
• Posture
• Hygiene
• Nutritional status
• Behaviour
• development

10
ASSESSMENT

• SKIN
• Colour,Texture,Temperature,Moisture,turgor
• Lesions, scratches, bruises, scaliness,
  infestation, scars, bite marks, inflammation,
  rashes, oedema

11
ASSESSMENT

• HAIR
• Quality, texture, distribution, elasticity,
  evidence of infestation
• NAILS
• Colour, shape, texture, quality

12
ASSESSMENT

• MOUTH
• Condition of lips, tongue, teeth, gums
• Presence of sores, coating, bad breath, ulcers,
  bleeding

13
ASSESSMENT

• EYES
• Pupil size (EARL)
• Colour of sclera
• Presence of inflammation, discharge, excessive
  watering, puffiness of the lids, squint
• Any impairment of vision

14
ASSESSMENT

• EARS
• Accumulation of wax, discharge, presence of pain
• Any hearing impairment
• CHEST LUNGS
• Shape, symmetry, movement, breath sounds

15
ASSESSMENT

• ABDOMEN
• Contour eg distension or rigidity
• Condition of skin covering the abdomen
• Movement eg visible peristalsis
• Presence of hernias

16
PREPARATION FOR ADMISSION TO HOSPITAL

• Preparation is directed towards overcoming fears
  and anxieties, such as the fear of
• Separation
• Pain
• Loss of routine
• Loss of independence
• strangers

17
FACTORS WHICH INFLUENCE THE WAY A CHILD REACTS TO
ILLNESS

• The age of the child and ability to comprehend
  the situation
• The amount of preparation by the parents prior to
  hospitalisation
• The condition of the child
• Cultural backgrounds
• Reaction of the parents
• Relationship between the hospital staff and
  parents

18
RESPONSE OF THE ILL OR INJURED CHILD

• Unlike adults, children often present with signs
  and symptoms of an illness, which may seem
  unrelated to the particular condition

19
PHASE OF DISTURBANCE

• Initial Phase protest
• the child may scream or cry for the parents and
  refuse the attention of anyone else
• Second Phase Despair
• Crying generally subsides and the child may
  become withdrawn and apathetic
• Third Phase Detachment
• Child appears to have adjusted, but in reality
  is detaching himself from his parents in an
  attempt to escape the pain and wishing they were
  there.

20
RESPONSE OF THE ILL OR INJURED CHILD

• Changes occur quickly and can be dramatic
• Infants cannot communicate their feelings
• The staff must observe any changes in condition

21
NURSING ADMISSION

• Vital signs, weight, height, urinalysis
• Nursing history
• Family data
• Medical history
• Activities of daily living

22
GENERAL ASPECTS OF PAEDIATRIC NURSING

• Complete honesty
• Recognise the childs need for love
• Continuity of nursing care
• Minimise the hospital type equipment
• Show respect/ right of privacy
• Maintain independence

23

• Allow for periods of regression
• Provide opportunities for play
• Encourage free expression
• Preparation for discharge

24
PAEDIATRIC PROCEDURES

• Explain in simple terms
• Dont tell the child it wont hurt
• Dont tell the child not to cry
• Dont restrain the child any more that necessary
• Remain with the child and provide support

25
PAEDIATRIC PROCEDURES

• Involve the parent if possible
• Encourage the child to participate
• Provide distraction
• Hold and cuddle the child after the procedure