WELCOME

INTRODUCTION

The sick children needs hospitalization . It is a

stressful situation experienced for both
children and their families.
Hospitalization leads to interruption of the
child’s active growth and development.
 DEFINITION

The confinement of a child or infant in a

hospital for diagnostic testing or therapeutic
treatment.
 PURPOSE

Sick child are admitted to the hospital for a

variety of reasons including:
Scheduled tests
Procedures or surgery
Emergency medical treatment
Administration of medication
To stabilize or monitor an existing
condition
 HOSPITAL ENVIRONMENT FOR SICK
CHILD

The sick child prefers and benefits from being at home or in a

home like environment.
Following aspects of hospital environment may be stressful for
the child:-
 Social environment: it means people around the child in a
hospital apart from family.
 Physical environment: it means setting or place and things
around.
 Change in routine: the child may goes through many
procedures which is stressful situation for both mother and the
child.
 PREPARATION OF HOSPITAL
ENVIRONMENT FOR CHILD

• Nurses warm approach and the concern can help

the child and his family to cope up with
hospitalization in positive way.
• The child and his family should be introduced to
the physician incharge of the child.
• The child and the family should be acqainted with
the ward and places they may be required during
the day.
• The child must be made familiar with the
equipment’s around him and their sounds.
• Likes and dislikes of child related food should
be kept in mind while planning diet.
• The environment should be calm and quite to
promote sleep.
• Parents should be allowed to stay with the child.
• Involve the child in care of the child.
• Provide play and recreational therapy in
hospital.
• Ward setting should be pleasant and attractive.
 ADMISSION OF THE CHILD TO
HOSPITAL

• Each child within a family needs love and

security to develop feelings of trust and
self- esteem.
• Each child is a unique individual who has
needs based on his or her family
background, level of growth and
development and degree of illness.
• The paediatric nurse seeks to promote, maintain
and restore health in both child and their
parents.
• Each ill child should be under the accountable
care of one professional nurse.
• Within a safe environment, the child who is
admitted needs expert physical care, emotional
support.
• The terminally ill child and family and the
patient should be supported emotionally so that
child can die with dignity and with feeling of
being loved.
 EFFECTS OF HOSPITALIZATION ON THE
FAMILY
• Anxiety
• Fear
• Anger
• Disappointment
• Self-blame
• Guilt feeling
• Lack of confidence
• Competence for caring the child in illness and
wellness
 EFECTS OF HOSPITALIZATION
ON CHILDREN
POST HOSPITAL BEHAVIOR:
 IN YOUNG CHILDREN:-
 Initial aloofness towards parents
 Tendency to cling to parents.
 Demands for parent’s attention
 Vigorous opposition to any separation
 nightmares
 Withdrawal and shyness
 Temper tantrum
 Food finickiness
 Attachment to toy
 Regression in newly learned skills.
  IN OLDER CHILDREN :
 Emotional coldness
 Anger
 Jealousy
 NEONATE:
 Interruption in early stages of development
 Impairment of bonding and trusting relationship
 Inability of the baby to respond to parents and
family members.
  INFANTS:
• Seperation anxiety disturbance in the development
of basic trust.
• 4-8 month depression and withdrawal
• Interference of growth and delayed development.
• 8-12 months : limited tolerance to separation.
TODDLERS:
• PROTEST:-
 Frequent crying
 Rejecting nurses attention
 Urgent desire to find mother
 Showing distrust with anger and tears
• IN DESPAIR:-
 Hopeless
 Apathetic
 Look sad
 Cry continuously
 Anorectic
 Thumb sucking
• IN DENIAL:-
 Reacts by accepting care without protest and
represses all feelings.
 The child doesn’t cry in the absence of mother.
 Seem more attached to nurses.
• IN REGRESSION:-
 Stops using newly acquired skills.
 Return to behaviour of an infant.
  PRE-SCHOOLER REACTION
• Exhibits regression , repression, projection ,
displacement, identification . Denial withdrawal
and fantasy.
• Fear of pain
• Anxiety.
  REACTION OF A SCHOOL CHILD
• Fear
• Worry
• Mutilation
• Fantasies
• Modesty
• Privacy
• Phobia
• They react with different defence mechanism.
  REACTION OF ADOLESCENTS

• Lack of privacy.
• Independence.
• Anxiety
• Anger
• Uncooperative
• Rejection of treatment
• Depression
• withdrawal
 MODERN CONCEPTS OF
HOSPITALIZATION
1) visiting
2) Rooming in
3) Care by patient unit
4) Self care
5) Parent support group
 NURSING INTERVENTIONS
Preventing or minimizing separation
Minimize loss of control
Promoting freedom of movements
Maintaining child routine
Prevent or minimize bodily illness or pain
Providing developmentally appropriate activities
Providing opportunities for play and expressive
activities.
FUNCTIONS OF PLAY

Diversional activities
Development of moral values
Social development
Emotional development
Creative expression
 TYPES OF PLAY
• Emotional /dramatic play
• Instructional play
• Physiological play.
 ROLE OF A PAEDIATRIC NURSE
Nurse as :-
Caregiver
Educator
Counsellor
Advocate
Team member
Manager
Consultant
Cont….

Practitioner
Social worker
Recreationist
Researcher.
 PRINCIPLES OF PRE-OPERATIVE AND
POST OPERATIVE CARE OF INFANT
PREOPERATIVE:-
• Orient the child and the parents to the unit
• Discuss the surgical procedure to the parents and the child
• Plan and implement pre-operative teaching based on the
level of comprehension of child and family members.
• Describe the pre-operative and post- operative according to
the level of the child.
• Explain activity schedule to the child and the family.
 • Check and provide the following with the
help of pre-operative checklist:
 Monitor vitals
 Make sure the child is NPO
 Preoperative procedure should be completed.
 Dress the child with clean hospital gown before
transferring him/her to OT.
 Remove ornaments, dental appliances, contact lenses etc.
 Ensure the consent form for surgery.
 Attach ID band.
 Never leave the child unattended.
 Send the child to OT with familiar person.
 POST OPERATIVE
• Receive the child to post-operative bed.
• Place O2 and suction near the bed.
• Check airway and maintain a patent airway.