Hospitalized Child

• -6 months old aware of themselves
• -unaware of effects of illness
• -anxious when approached by strangers

• -understand illness but not cause
• -know germs but not how they spread
• -names and locations of body parts (limited)
• -internal organs and functions vague
• -view illness as punishment, or magical
• -events that happen prior to illness maybe associated with the illness

• -understand how germs are spread
• -more understanding of disease and how body organs function
• -body parts and function is maturing

• -aware of physiliogic, psychologic, and behavioral causes of illness and injury
• -understand that disease may involve causes and effects and that multiple organs and body parts may be involved
• -symptoms r/t certain organ functions
• -concerned w appearance and perceive an illness in terms of its effect on their body image

• -seperation from parents
• -loss of self-control, autonomy, privacy
• -painful/invasive procedures
• -fear of bodily  injury and disfigurement

• -seperation anxiety
• -stranger anxiety
• -painful procedures
• -immobilization
• -sleep deprivation, sensory overload

• -separation anxiety
• -loss of self control
• - immobilization
• -painful procedures
• -bodily injury, multilation
• -fear of dark

• -separation anxiety, abondonement
• -loss of self -control
• -bodily injury, multilaiton
• -painful procedures
• -fear of dark and monsters

• -loss of control
• -loss of privacy
• -bodily injury
• -separation from family and friends
• -painful procedures
• -fear of death

• -loss of control
• -fear of altered body image
• -disfigurement, disability, death
• -spearation from pear group
• -loss of privacy

• -encourage parental prescence
• -adhere to childs routine
• -use topical anesthetis or preprocedural sedation
• -quiet enviroment and decrease stimuli
• -allow parents to hold in lap
• -allow choices
• -explain all procedures
• -allow night-light
• -encourage peer interaction via internet, phone
• -include in plan of care
• -encourage discussion of fears and anxieties
• -ask if want parental involvement

• -screaming
• -crying
• -clinging to parents
• -resisit other adults attemps of comfort

• -sadness
• -quiet, "settled in"
• -withdrawl or compliant behavior
• -crying when parents return

• -lack of protest when parents leave
• -appearace of being happy and content w everyone
• -shows interest in surroundings
• -close relationships not established

• -reg. info about their child's condition, prognosis, tx
• -healp, encouragement, and support formt he nursing staff
• -a trusting, confidential relationship with the nursing staff

• Pediatric Intensive Care Unit
• -provides specialized care to infants and children, including children with life threatening conditions requiring advanced support and continuous monitoring

• -know purpose of procedure
• -expirienced procedure before? Good/bad
• -What does the child think will happen
• -is procedure painful
• -what techniques does child use to gian control in challenging situations
• -will the parents or other caregiver be present to provide support

• -performed in a tx room to promote sense of security
• -perform quickly and efficiently
• -praise child after procedure

• -children under 5 cannot swallow pills
• -use 1 spoonful of food or 1-2ml fluid for crushed pills
• -position upright to avoid choking
• -aim at inside of cheek for infants oral syringe meds
• -measure med in syringe prior to letting child place in cup to drink

• -for children under 3, fifth finger used for insertion
• -lubricate suppository & hold buttocks together for few minutes to prevent expolsion

• -fearful of med placed in ears and eyes
• -immobilization needed to prevent injury
• -rest wrist on childs head
• -med at room temp
• -incorporate therapeutic play

• -skin of infants is thin and fragile
• -covering area or keeping childs hand off area may be necessary to ensure adequate contact of medication with the skin

• -do not use glutes until child has been walking x 1yr
• -vastus lateralis best to use in children less than 3 yrs old
• -limited amounts in certain sites
• -deltoid only used for small vaccine doses

• -veins are sm and fragile, fluid balance is critical
• -maintenance of site is needed, hands, feet or scalp for infants
• -pump require frequent monitoring

• -clear liquids 2 hours prior to surgery
• -breast milk 4 hrs prior to surgery
• -formula 6hrs prior to surgery
• -milk and light meal consumed up until 6 hours prior to surgery

-OME  is when there is fluid in the middle ear without inflammation, continues for more than 3 months, associated with hearing loss, treat pain and assess for hearing loss to dermine if tubes are needed

-AOM  is when acute onset of ear pain, marked redness of tympanic memebrane, and middle ear effusion, treat with ear drops and antibiotics if no relief

• -no smoking
• -no wood burning stoves
• -breastfeeding
• -no pacifier at night
• -promote Hib and Pneumococcal immunizations

-antibiotic, steroids, and antihistamines have not been effective and most children improve in 3 months