NURS 380 Nursing

Care of Children
and Families

FALL 2019
 Course lead instructor
◦ Carrie Park, MSN, RN
◦ Office- Ramstad 334. Office hours variable/appt.
◦ Office: 253-535-7649 Cell: 253-370-5455
◦ Email- parkca@plu.edu

Clinical instructors
Course Information ◦ Amanda Woodcock, MSN, RN
◦ Cell: 253-278-5855
◦ Email: buechear@plu.edu

◦ Patrice Laster-Wilcox, RN, DNP

◦ Cell: 703-475-1643
◦ Email: lasterpj@plu.edu
Required Resources
Ball, Bindler, Cowen and Shaw (2017). Principals of Pediatric Nursing,
Seventh Edition.
SAKAI
Kaplan
Name badge/stethoscope (in clinical setting)
Enthusiasm!!!
Grading and Assignments

EXAMS- 75% (3 total, final

NOT cumulative)
PAPER- 20% due 11/8 (no
later than midnight)
KAPLAN REVIEW- 5%

**In order to pass this

course, you must get at
least a “C” in the didactic
portion and a “pass” on
the clinical evaluation.
 Role of the
Pediatric Nurse
Promote health/protecting from
illness and injury from newborn
through young adulthood
This Photo by Unknown Author is licensed under CC BY-SA Recognize presentation of disease
between kids and adults
Adapt nursing to age &
developmental level
Assist & educate family
Levels of Care

PRIMARY- FOCUS ON HEALTH SECONDARY- FOCUS ON DIAGNOSIS TERTIARY- RESTORATIVE,

PROMOTION/ILLNESS PREVENTION AND TREATMENT OF ILLNESS/INJURY REHABILITATIVE, OR QUALITY OF LIFE
CARE
 The pediatric health care
team
Infant/child/adolescent

Parents
Siblings
Provider
Child life specialist
Social worker
School nurse
This Photo by Unknown Author is licensed under CC BY-SA-NC Pediatric specialty team
 Racial & ethnic diversity of
children under 18 years of
age
Child Health-Quick Facts
73.6 million children between 0-17 yrs. In US
22.9% population (35% in 1960’s)
95% all children have some form of health insurance
21% live in poverty and have food insecurity
40% of kids ages 4-11 have detectable nicotine levels
19% kids age 6-17 are obese

White, non-Hispanic Black, non-Hispanic

*Childstats/gov.2016
Hispanic Asian
All other races
 Mortality- number of deaths over a specific
period
Neonatal-deaths in first Infant-deaths in first 12
28 days of life/1,000 live months of life/1,000 live
births births
Measurement
of Children’s
Health Status

Morbidity- the prevalence of a specific

illness in a population at a particular time
Causes of Infant Mortality
1. Congenital malformations
2. Low birth weight
3. SIDS

*Infant mortality in US was 5.96 deaths per 1,000 live births

in 2013
Infant Mortality
 Ages 1-4 Ages 5-14 Ages 14-17

Causes of • Unintentional • Unintentional • Unintentional

injuries injuries injuries
Childhood • Congenital • Cancer • Homicide
Mortality malformations, • Suicide • Suicide
deformations,
chromosomal
abnormalities
• Homicide
Childhood Morbidity
Varies according to age of child

Asthma affects 14% of US children

Diabetes

Obesity

Mental health issues

Legal Issues
Informed consent-provided by parent of legal guardian
Proxy consent
In emergency, treatment to preserve life or limb does NOT require
consent
If no emergency, non urgent treatment withheld until parent or guarding
can be reached
Exceptions-
Parents’ choice does not permit lifesaving treatment of the child.
Potential conflict of interest between child and parent (child abuse)
Child and parents don’t agree on major treatment options
Child participation in
health care decisions
Controlled by state law
Exceptions-emancipated minors, mature minors, healthcare for
certain conditions (contraception, pregnancy counseling,
prenatal care, test/treatment of STD/HIV, substance abuse,
mental illness
Assent- voluntary agreement from child to receive
treatment/participate in research
 Adolescents and Confidentiality

Explain limits of
Concerns about this Ways to promote- confidentiality- Get contact info for Keep literature small
influence whether or provide opportunity adolescent and give enough to keep in
not they seek health to talk in a private Something dangerous or life lab results/info wallet or purse
care setting threatening is revealed directly to them
EMR or insurance billing may reveal
private info to parents
Some conditions require mandatory
reporting- TB, HIV
Factors that influence
child health
Genetics-gender, race, temperament, genetically
linked diseases
Health status at birth, nutrition, lifestyle,
environment, stress/coping, access to health
care,
FAMILY!!!-
 Family influences

Family composition Family functioning Parenting roles

Nuclear, single parent, blended, Transition to parenthood Authoritarian
extended, gay/lesbian, foster Parental influences on the child Authoritative
Family size Permissive
Sibling relationships Indifferent
Parenting style Warmth/control Behavior or parent Child outcomes

Authoritarian High control Highly controlling, issues commands, inflexible May become fearful, withdrawn. Girls may be passive
Low warmth during adolescence. Boys often rebellious

Authoritative Moderately high control Accepts and encourages growing autonomy of child. Well adjusted, self reliant. Higher self-esteem. Better
High warmth Open communication. Flexible rules school performance

Permissive Low control Few or no restraints May become rebellious, aggressive, socially inept,
High warmth Unconditional love self indulgent. May be creative, outgoing, active
Much freedom, little guidance

Indifferent Low control No limit setting May show destructive impulses and delinquent
Low warmth Lacks affection behavior
Focused on stress in own life

Parenting
 Family development theory-categorize family’s progression over time
Family Theories according to typical stages in family life. There are predictable stages
but no rigid pattern.

Family systems theory- families are an “organized whole” and

individuals within family form an interactive interdependent system.
The family is more than the sum of its members.

Family stress theory-focuses on family’s ability to cope and adjust to

stressful events.
Family Assessment
Tools to gain information about family functioning- stressors,
strengths
Helps pediatric nurse work more effectively with family to
meet child’s healthcare needs
Information collected continuously
Multiple tools
◦ Genogram
◦ Family ecomap
◦ Family assessment model
 Communication

Cultural
Considerations Nutrition

Health beliefs and practices

 This Photo by Unknown Author is licensed under CC BY-SA This Photo by Unknown Author is licensed under CC BY-SA

QUESTIONS?