Instructors Manual to Accompany Pediatric Nursing: Caring for Children and Their Families, Third Edition.

Instructor’s Manual to Accompany Pediatric Nursing: Caring for Children and Their Families, Third Edition.Copyright © 2012 Delmar Cengage Learning. All rights reserved. 1

CHAPTER 1

Overview of Pediatric Nursing

COMPETENCIES

Upon completion of this chapter, the reader will be able to:

•Discuss current societal trends and describe their influence on children in the United States.•Describe some of the effects of immigration, poverty, homelessness, migrant farm work, and violence on children and their health.•Discuss the current status of children’s physical and social health.•Identify five strategies to prevent unintentional childhood injuries.•Discuss the effects of problems with access to health care and lack of health insurance on children’s health status.•Identify elements of family-centered care.•Discuss the influence of professional standards on pediatric nursing.•Describe and discuss the importance of each role of the pediatric nurse.•Successfully complete the games and activities in the online student StudyWARE.

KEY TERMS

advocate affective learning atraumatic care caregiver case management clinical nurse specialist cognitive learning differentiated practice educator family-centered care infant mortality rate injury low birth weight manager pediatric nurse practitioner psychomotor learning standard of care

TEACHING METHODS AND STRATEGIES

Chapter 1 introduces the concept of pediatric nursing. As students begin the study of pediatric nursing, discussion of the key concepts in this chapter will help set the stage for further learning.

Lesson Plan: Overview of Pediatric Nursing

Methods •Lecture •Discussion •Power Point Slides Learning Experiences To introduce the key concepts, read the vignette on the first page of the chapter. Then discuss the issues affecting pediatric health care identified in this situation.Pediatric Nursing Caring for Children and Their Families 3e Nicki Potts, Barbara Mandleco (Solutions Manual All Chapters, 100% Original Verified, A+ Grade) 1 / 4

Chapter 1: Overview of Pediatric Nursing

Instructor’s Manual to Accompany Pediatric Nursing: Caring for Children and Their Families, Third Edition.Copyright © 2012 Delmar Cengage Learning. All rights reserved. 2 • How do the factors identified affect the health of children?• How can the nurse address these issues to improve health?After a short discussion, summarize the significance to pediatric nursing. Identify the importance of understanding pediatric nursing to promote the health of children.Content Outline Societal trends impacting children Immigration Poverty Homelessness Migrant farm workers Violence Current status of children’s health Infant mortality Child mortality Access to health care Perspectives on pediatric nursing Family-centered care Atraumatic care Roles of the pediatric nurse Caregiver Advocate Educator Researcher Manager/leader Differentiated practice roles Advanced practice roles Pediatric nurse practitioner Clinical nurse specialist Case manager Standards of care and standards of professional performance Meeting the challenges of the 21st century

Discussion and Group Activities The reflective thinking activities in this chapter allow the reader to begin to think about the issues facing pediatric nursing and the health care of children. Interspersing the situations into the content presentation may help students become involved in the class and develop a beginning understanding of pediatric nursing.

Reflective Thinking: Inquiring about Guns in the Home

Some families may not want to reveal the fact that they have guns in their homes. How can you approach the topic? How could you ask the family about ways that they keep themselves and their children safe?

Reflective Thinking: The Cost of Keeping LBW Infants Alive

Hospitals and health care delivery systems have poured substantial amounts of money into neonatal intensive care units to care for LBW infants. These babies are usually technology dependent and often require extensive medical equipment and nursing care in their homes. How do you feel about this emphasis on high- tech solutions versus allocating some resources to preventive services? 2 / 4

Chapter 1: Overview of Pediatric Nursing

Instructor’s Manual to Accompany Pediatric Nursing: Caring for Children and Their Families, Third Edition.Copyright © 2012 Delmar Cengage Learning. All rights reserved. 3

Reflective Thinking: Caregiver

Describe the responsibilities of caregivers you see on the pediatric unit where you have experience. Of all the responsibilities nurses have as caregivers for children and their families, which are the most important?Why?

Reflective Thinking: Educator

How often do you see pediatric nurses teach their clients? Families? Other staff? What can we do to improve teaching effectiveness? What needs to be done to increase client and family teaching opportunities?

Reflective Thinking: Researcher

Think of a project you might become involved in that would improve pediatric client outcomes. Describe three different reasons why nursing research is difficult for staff nurses to integrate into their role at the bedside.

ANSWERS TO CRITICAL THINKING QUESTIONS

Critical Thinking: Healthy People 2020

From the 10 leading health indicators found in Box 1-1, choose four that you think would have objectives pertaining to children ages 1 to 18 years and list them. For each one of the four you have chosen, write down an idea for the specific area that the objective should address. For example, if you were to choose priority areas for adults, one area would be cancer, and the specific area the objective could address is to increase the number of adults who receive a colorectal screening exam each year.Answer: Examples could be listed from these areas: • Physical Activity and Fitness: Specific focus of objective: increasing physical activity. Example of an actual objective: Increase to at least 30% the proportion of young people in grades 9 through 12 who engage in moderate physical activity for at least 30 minutes on five or more of the previous seven days (baseline 21% in 1995).• Nutrition: Specific focus of objective: reducing the number of children who are overweight. Example of an actual objective: Reduce to 5% or less the prevalence of overweight and obesity in children (ages 6–11) and adolescents (ages 12–19) (baseline: 11% of all children and 10% of all adolescents).• Tobacco Use: Specific focus of objective: reducing the number of children who begin smoking. Example of an actual objective: Reduce the proportion of young people in grades 9 to 12 who have used tobacco products.• Environmental Quality: Specific focus of objective: reducing environmental toxins a child is exposed to.Example of an actual objective: Reduce to no more than 15% the proportion of children aged 6 and younger who are regularly exposed to tobacco smoke at home (baseline more than 27% in 1994).• Injury/Violence Prevention: Specific focus of objective: reducing injury from child abuse. Example of an actual objective: Reduce the incidence of maltreatment of children younger than age 18 (no current baseline).• Immunization and Infectious Disease: Specific focus of objective: increasing the immunization status of children. Example of an actual objective: Increase to 90% the number of 2-year-old children who receive

vaccinations as part of comprehensive primary care (baseline: 66% in 1996).

Critical Thinking: Advocate

What would you do if the client or family has values and beliefs different than yours regarding treatment decisions? How would you respond?Answer: Crucial components of client advocacy may include providing information and supporting clients and families even if you do not agree with their decisions. If situations arise frequently where you do not agree with family decisions, and you often feel uncomfortable, you may want to consider transferring to another unit.

Critical Thinking: Teaching a 4-Year-Old

A 4-year-old boy has been admitted to the same day surgery department for a tonsillectomy and adenoidectomy. How would you prepare him for the experience both prior to surgery and after surgery?Answer: Tell the little boy that he will have his tonsils and adenoids out because they have been causing his recent and frequent sore throats. The doctor will let him breathe some medicine that will make him sleepy 3 / 4

Chapter 1: Overview of Pediatric Nursing

Instructor’s Manual to Accompany Pediatric Nursing: Caring for Children and Their Families, Third Edition.Copyright © 2012 Delmar Cengage Learning. All rights reserved. 4 so he won’t feel the doctor remove the tonsils and adenoids. After the tonsils and adenoids are removed in the operating room, he will be taken to another room (post-anesthesia care unit) where nurses will take care of him.His throat may hurt after the operation, but he will be able to have medicine and cool drinks to help take care of the pain and make his throat feel better. He will be able to go home later that afternoon, and his parents will be able to give him the medicines at home.

ANSWERS TO REVIEW ACTIVITIES

• Describe how poverty affects children.

Answer: Poverty affects children in many ways. Children growing up in poverty display diminished physical health. They have higher rates of death and illness from most causes except suicide and motor vehicle accidents. Asthma, respiratory infections, anemia, and GI infections are more common. There is an increase in the infant mortality rate for children born into poverty. Nutritional deficits are more common, including stunted growth. Cognitive abilities are lower and there is an increase in emotional and behavioral issues.

• Define infant mortality and child mortality.

Answer:

Infant mortality: The number of infant deaths during the first year of life per 1,000 births.Child mortality: The number of deaths per 100,000 children. his is usually specified for a specific age range.(i.e., number of deaths per 100,000 children ages 1-4).

• What can nurses do to prevent firearm-related injuries and deaths in the home, school, and community?

Answer: Nurses have a major teaching role in the area of injury prevention from firearms. In the home, nurses should focus on the risks of having firearms in the house, recommend the safest approach is not to have a firearm in the house, review safe storage of firearms, encourage teaching children not to handle firearms, explain that handguns and semiautomatic weapons are the greatest risk to children, and remind caregivers it is easier to keep guns from adolescents than adolescents from guns.In the school, nurses have a role in the implementation of violence prevention programs within the curriculum. Nurses also can influence the development and support for after-school programs for youth.In the community, nurses can influence the media by encouraging violence-free programming for children, supporting legislation regulating guns and weapons, and working to improve safe play areas for children.

• Which of the following is the leading cause of death in children under 19 years of age?
• Cancer
• Heart disease
• Congenital anomalies
• Unintentional injuries

Answer: D. Unintentional injuries

• Name a few major health protection measures that have reduced the incidence of childhood mortality?

Answer: Requiring prescription medications to have child-resistant covers

Using child car seats and bicycle helmets Installing smoke detectors in homes Requiring that children’s sleepwear be flame retardant Enclosing swimming pools with fences

• What strategies can nurses include in their practice that relate to family-centered care?

Answer: Nurses can seek input from caregivers, incorporate the caregiver’s input into the plan of care, and teach the family health care interventions. Providing education and increasing the knowledge of the caregivers will help empower them to make informed decisions about the care of their child. Other areas which enhance family-centered care include: allowing visitors of any age, not limiting the number of visitors, providing adequate sleeping accommodations, providing meals or discounts on meals, providing free parking, and encouraging family attendance at interdisciplinary conferences.

• Describe each of the roles that nurses take when interacting with children and their families, and explain how

they are connected to one another.

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