Family Response to Health Promotion

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Family Response to Health Promotion

• Ricci, ch 31

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Health Promotion

• Maintaining or enhancing the physical and mental
  well-being of children.
• Components of health promotion
• Identifying risk factors
• Facilitating lifestyle changes
• Helping families identify and connect with
  available resources

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Factors Necessary for Health Promotion

• Caring, supportive family
• Medical and dental home
• Community support and partnerships
• Education and anticipatory guidance

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Anticipatory Guidance

• A form of primary prevention
• Requires the nurse to be knowledgeable about
  developmental milestones, injury risks, and
  common childhood illnesses.
• Can cover such subjects as immunizations, injury
  prevention, nutrition, expected skills, and
  common developmental concerns of parents.

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Important Topics for Overall Child Health

• Regular checkups which include assessment of
  physical, developmental, and mental health.
• Injury and disease prevention
• Oral health
• Eating habits
• Importance of activity
• Personal hygiene
• Sun exposure
• In all areas, parents need to be an example
  practice what you preach.

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Developmental Screening

• Nurses can do using Denver Developmental
  Screening Test.
• Children can be assessed in day care setting
  using Ages and Stages.
• HCP can do developmental assessment during
  routine health screening visits.
• If concerns are uncovered during screening, child
  should be referred. Risk factors p. 1055 and
  1056.
• Children with developmental delays need closer
  supervision to promote optimum development.

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Injury and Disease Prevention

• Screening tests such as vital signs, eye and ear
  exams, and labs can help detect problems early
  (secondary prevention).
• Type of injury the child is at risk for depends
  on age. Examples are MVAs, burns, drowning,
  aspiration, poisonings, falls, homicide, and
  suicide.

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Promoting Oral Health

• Dental caries can lead to systemic complications
  resulting from infection
• Diet high in sugars, use of tobacco, and poor
  hygiene can contribute to caries and gum disease
• Regular visits to dentist is essential in
  preventing problems

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Promoting Healthy Eating

• Obesity is a continually growing health problem
  among children
• Combination of poor diet and inactivity
• Parents need to incorporate activity and health
  eating into childrens daily lives. By making it
  a family lifestyle, it gives child a sense of
  belonging.
• Takes more effort and planning so there is a high
  degree of noncompliance

10
Promoting Activity

• Inactivity and TV and computer use can contribute
  to obesity and social isolation.
• Parents need to start early
• Try different non-competitive activities
• Parents need to participate and make it a family
  effort

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Promoting Personal Hygiene

• Handwashing is a learned behavior. Boys sometimes
  dont get the same emphasis on this as do girls.
• School age children need to be reminded and
  encouraged to shower and brush.
• Adolescents need emphasis in areas associated
  with pubescent changes.

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Promoting Safe Sun Exposure

• Start young. Blistering predisposes a child to
  melanoma and other skin cancers later in life.
• Light and freckled skin types are highest risk.
• Use SPF of 15 or higher
• Avoid sun between 10 and 2.
• Reapply lotion often.

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Immunization Management

• Recommendations come from CDC and American
  Academy of Pediatrics
• Schedules on pp. 1067 and 1068 are current and
  cover birth to 18 years.
• Meningococcal strongly recommended for
  college-bound adolescents
• If kids are late, several injections may be given
  together.
• Some vaccines cover more than one disease in one
  shot.

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Common Reactions

• DTaP, Hib, Hepatitis, IPV, Varicella, PCV,
  Influenza, Rotovirus, Hepatitis redness,
  swelling, soreness, slight fever within a few
  days
• MMR same as above plus rash, swollen glands
  from 7-60 days

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Severe, Unexpected Reactions

• Most severe reactions occur with the pertussis
  component of the DTP (fever of 105, shock-like
  state, seizures, persistent inconsolable crying,
  encephalopathy)
• Federal law has made it possible for families to
  receive financial compensation for children with
  severe, vaccine-associated injuries.

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Immunizations Safety

• Although there are specific contraindications to
  each vaccine, the only permanent contraindication
  to all is anaphylaxis or systemic allergic
  response.
• Temporary contraindications include moderate to
  severe illness, pregnancy, immunosuppression,
  pregnancy, receiving blood products recently.
• Minor illnesses or low-grade fevers are not a
  contraindication.
• With all vaccines, make sure of routemay be IM
  or SQ and make proper needle and site selection.

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VAERS and VIS

• Vaccine Adverse Event Reporting System
• For agency to report any adverse reactions after
  administration of any vaccine
• Vaccine Information Statements (VIS)
• Information statements from CDC that must be
  given to parents before administration
• Provides updated information for parent/guardian
  of child being vaccinated

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Nursing Responsibilities

• Be aware of precautions and contraindications
• Encourage parents to immunize
• Fully inform parents about disease and
  immunization
• Benefits and risks of vaccine
• Side effects to expect
• Ask about previous side effects
• What to do if they have concerns
• Importance of staying on trackgive them a copy
  of immunization record

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Responsibilities contd

• Accurate documentation and record keeping. Make
  sure lot is included in documentation.
• Document that information was explained to parent
  or guardian. Just their signature on the form may
  not be enough.
• Have a way to track and monitor childs progress
• Implement strategies for ensuring compliance (see
  Family Centered Care, p. 990)

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Parental Barriers

• Fear of side effects and injuryfrom vaccine and
  from injection itself
• Lack of knowledge and belief in myths
• Avoiding multiple injections causing child to get
  behind
• Multiple children
• Transience
• Cost
• Lack of medical home