COMMON CHILDHOOD

ILLNESSES
HEALTH HISTORY

 Presenting health concern

 Present illness
 Analyzing a symptom
 History
 Birth history
 Previous illnesses, injuries, operations
 Allergies
 Current medications
 Immunizations
 Growth and development
 Habits
 Family health history
HEALTH HISTORY –
REVIEW OF SYSTEMS
 General
 Skin
 Head/Eyes/Ears/Nose/Mouth/Throat/Neck
 Respiratory/Chest
 Cardiovascular
 Gastrointestinal
 Genitourinary
 Neurological
 Mental Health
COMMON ILLNESSES IN
CHILDHOOD
 Chicken pox  Rotavirus
 Fifth disease  Roseola infantum
 Hand, foot, mouth disease  Scabies
 Head lice  Strep throat
 Impetigo  Scarlet fever
 Norovirus  Pneumonia
 Pink eye
 Pinworms
CHICKEN POX
(VARICELLA)
 Routine, airborne, and contact precautions in hospital.
 Administer skin care; give bath and change clothes and linens
daily.
 Administer antipyretics and antihistamine for pruritus.
 Administer acetaminophen for fever.
 May give antiviral agent acyclovir (Zovirax); varicella-zoster
immune globulin (VariZIG) or immune globulin intravenous (IGIV)
after exposure in high-risk children
FIFTH DISEASE
(ERYTHEMA INFECTIOSUM)
 3 stage rash
 Isolation of child is not necessary, except
hospitalized child who is placed on routine
and droplet precautions.
 Administer antipyretics, analgesics, anti-
inflammatory medications.
 May result in serious complications (anemia,
hydrops) or fetal death if mother is infected
during pregnancy (primarily second
trimester)
SIXTH DISEASE
(ROSEOLA INFANTUM)
 Persistent high fever for 3–4 days in child who appears well.
 Precipitous drop in fever to normal with appearance of rash
 Administer antipyretics.
 Ensure adequate oral fluid intake.
SCARLET FEVER

 Routine and droplet precautions until 24 hours after initiation of

treatment.
 Treat with full course of antibiotics (penicillin).
 Administer analgesics and antipruritis.
 Ensure compliance with oral antibiotic therapy.
 Encourage fluids during febrile phase.
ROTAVIRUS

 Leading causes of severe diarrhea in infants and young children.

 Two rotavirus vaccines are available. Both vaccines are
administered orally.
 Parents should return to the health care provider if the child is
not well.
HEAD LICE

 Common parasite in school-age children.

 Infestation of the scalp by Pediculus humanus
capitis.
 Itching is usually the only symptom with nits
observable on hair.
 Treatment consists of the application of
pediculicides and manual removal of nit cases.
 Nurses should emphasize that anyone can get
pediculosis; it has no respect for age,
socioeconomic level, or cleanliness.
 IMPETIGO

 Impetigo contagiosa—Staphylococcus
 Reddish macule, becomes vesicular,
ruptures easily, leaving superficial,
moist erosion.
 Pruritis common.
 Treat with topical bactericidal
ointment and antibiotics.
 Common in toddlers ad preschoolers.
RESPIRATORY SYNCYTIAL VIRUS

 Bronchiolitis is a common acute viral infection with upper

respiratory symptoms and lower respiratory infection of the
bronchioles due to inflammation.
 Most frequent cause of hospitalization.
 Palivizumab may be given.
 Supportive care.

PNEUMONIA

 Inflammation of the pulmonary parenchyma.

 Primary disease or complication of another illness.
 Viral, bacterial, mycoplasmal or aspiration of foreign
substances.
COMMON CONDITIONS IN
CHILDHOOD
 Injury
 Between the ages of 1 and 11 years, unintentional injuries –
especially injuries related to motor vehicle crashes – are the leading
cause of death
 Chronic conditions:
 Asthma
 Diabetes
 Cancer
 Obesity
 Mental Health Disorders
OBESITY

 Childhood obesity has negative health outcomes.

 Caloric intake exceeds caloric requirements.
 Can be influenced by metabolic, hypothalamic, heredity, social,
cultural & psychological factors.
 Decreased physical activity plus increased screen time.
 Family and cultural influences; family mealtime has been proven
beneficial.
ASTHMA

 Chronic inflammatory disorder of the airways.

 Airway obstruction, bronchial hyperresponsiveness, and
inflammation.
 Wheezing, breathlessness, chest tightness, and cough.
 Triggers may precipitate or aggravate asthmatic exacerbations.
CHAPTER 44
Pediatric Variations of
Nursing Interventions
LEARNING OBJECTIVES

1. Explain methods for collecting information from client and

families about the health status of children.
2. Describe assessment techniques used to collect information
about the health status of the child experiencing common
childhood illnesses.
3. Use play in therapeutic procedures for children.
4. Describe the nurse’s role in caring for children with
common illnesses.
5. Outline general hygiene and care procedures for
hospitalized children.
INFORMED CONSENT

 Patient and legal surrogate must receive sufficient information

to make an informed health care decision.
 Appropriate information
 Decision-making capacity
 Voluntariness
 Written informed consent prior to medical or surgical treatment.
 Emergency treatment without consent; a health care provider
must do what is immediately necessary without consent.
PREPARATION FOR PROCEDURES

 Focus of care is on psychological preparation of the child and

family.
 Decreases anxiety
 Promotes assistance
 Supports their coping skills
 Preadmission teaching programs
 Child life specialist
 Use nonthreatening words and phrases
 Incision = special opening
 PREPARATION FOR PROCEDURE

Infant Toddler Preschool School-Age Adolescent

Involve parent Explain Demonstrate Allow child to Provide privacy
procedure equipment use equipment and explain
Memory; Expect Keep Plan for longer Involve in
procedure in resistance, use equipment out teaching decision making
separate room, firm, direct of sight until session, prepare and planning of
use analgesics approach needed/used 1 week before procedure
Model desired Prepare Point out on Encourage Impose as few
behaviour, immediately drawing, involve active restrictions as
opening mouth before, avoid child, give participation, possible
delays choices decision making
USE OF PLAY IN PROCEDURES

 Integral part of forming relationships with children.

 Play can be used to teach, express feelings, or achieve a
therapeutic goal.
 Include in preparing children for and encouraging the assistance
during procedures.
 Encourage play after procedures.
GENERAL HYGIENE AND BASIC
CARE
 Maintaining healthy skin.
 Minimize tape use.
 Monitor sites of probes/electrodes and intravenous lines.
 Bathing.
 Cleanse skin with mild soap.
 Cleansing the eyes, oral and diaper/perineal area daily.
 Oral hygiene.
 Continue while in hospital.
 Hair care.
 Once daily brushing/combing.
 Washing 1-2 times per week.
FEEDING THE SICK CHILD

 Loss of appetite is a symptom common to most childhood

illnesses.
 Dehydration is always a hazard when children have a fever or
anorexia, especially when accompanied by vomiting or diarrhea.
 Gentle persuasion with preferred beverages will usually meet
with success.
 Using play techniques can also be effective.
 Praise children for what they do eat and avoid punishment for
not eating.
CONTROLLING ELEVATED
TEMPERATURES
 Most frequently from fever but occasionally caused by
hyperthermia,
 One of the most common symptoms of illness in children and is
of great concern to parents.
 Fever (hyperpyrexia) vs hyperthermia.
 Therapeutic management for relief of discomfort from a fever.
 Antipyretic medications include:
 Acetaminophen
 Aspirin
 NSAIDs
SAFETY

 Environmental factors in hospital requires high vigilance by staff

to avoid incidents.
 IV administration; continuous vs intermittent or saline locks
 Toy safety is also important in the hospital setting.
 Appropriate for age, condition and treatment.
 Preventing falls begins with identifying children prone to falling.
 Be aware of medication effects post anesthesia or sedation.
 Identify children with altered mental status or mobility.
THERAPEUTIC HOLDING AND
RESTRAINTS
 In therapeutic holding, the parent or caregiver holds the child in
a secure, comfortable position that provides close physical
contact for 30 minutes or less
RESTRAINTS

 A restraint is any method, physical or mechanical, that restricts

a person’s movement, physical activity, or normal access to their
body.
 Physical restraints are used for children with an artificial airway
or airway adjunct for delivery of oxygen, in-dwelling catheters,
tubes, drains, lines, pacemaker wires, or suture sites.
 Chemical restraints are pharmaceutical interventions
administered to keep the individual safe.
 Environmental restraint refers to the restraining of an individual
within a physical space, such as in a locked unit in a mental
health facility.
RESTRAINTS
INFECTION CONTROL

 Routine practices are used to reduce the risk of transmission of

microorganisms.
 There are 5 major components to routine practices:
 Risk assessment, hand hygiene, personal protective equipment
(PPE), environmental and administrative controls.
 Hand hygiene is the most critical infection-control practice.
TYPES OF PRECAUTIONS

 Additional precautions for documented or suspected infections

or colonization.
 Also used when medical procedure increases risk of transmission to
the patient.
 Routine precautions
 Airborne precautions
 Droplet precautions
 Contact precautions