care of sick child bsc nursing students for helping them

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1. Care of sick child

2. Introduction The sick children need hospitalization .it is a stressful experience for both children and their families. Hospitalization leads to interruption of the child‘s active growth and development. The child is removed from daily routine of home and brought in an unfamiliar setting causing loss of contact with siblings, relatives.

3. Hospital environment for sick child Hospitalization may be emotionally and developmentally damaging to the child. It causes stress due to imbalance between environment and social demands and societal demands and child’s coping abilities. Following aspects of hospital environment may be stressful for the child.

4. Count… Social environment   Social environment means the people around. When a child is admitted in a hospital his social environment includes members of health team and others patients and their relatives apart from one or two of his /her family members.  This is a strange social environment for the child.

5. Count… Physical environment Physical environment means the setting or place things around. Hospital’s physical environment includes ward or room, machines and equipment. There are many unfamiliar objects, sounds and smell in hospital which are stressful for the child.

6. Count… Change in routine  The children admitted in hospital may have to undergo various diagnostic and therapeutic procedures which are stressful for both the children and their family.  Hospitalization leads to altered nutritional and sleep pattern of child. During hospitalization child may be kept NPO or given nasogastric feeding or parenteral feeds as prescribed by the physician.

7. Preparation of hospital environment for the child Preparation of hospital environment for the child  Nursing staff should know about the baby schedule. Brings music at helps relax your baby. Bring your child favorites toy, blanket or stuffed animal.  Allow your child to choose his or her favorite things to bring to the hospital.

8. Count… Read books about going to the hospital. Encourage your child to use play medical kits. The environment should be calm and quiet to promote sleep.  Nurses warm approach and their concern can help the child and his family to cope-up with hospitalization in a positive way. Impact of hospitalization on child and family.

9. Impact of hospitalization on child and family IMPACT ON PARENTS / RESPONSE OF PARENTS
The factors include;-
Lack of information and knowledge related to child’s illness.
Fear of procedures and treatment of child.
Fear of unknown that what happen to child in future.
Fear of financial burden on family.

10. Count…. IMPACT OF HOSPITALIZATION ON CHILD  Hospitalization is a completely new experience for infants and children. Since parents tend to be anxious. Impact of hospitalization on pediatrics patients depends upon their age and stage of development. It depends upon their age and stage development

11. Count… REACTION OF INFANTS
Infants reaction are mainly separation anxiety and disturbance of development of basic trust, when the infant is separated from mother and when illness and hospitalization. Emotional withdrawal and depression are found in the infants of 4 to 8 months of age.

12. Count… REACTIONS OF TODDLERS  Protest-  The toddler frequent crying, rejecting nurses’ attention, urgent desire to find mother and showing signs of distrust with anger and tears, especially when with mothers.

13. Count… Despair -  The toddler becomes hopeless, apathetic, anorectic, looks sad, cry continuously and use comfort measures like thumb sucking fingering lip and tightly clutching a toy.

14. Count… Denial –
The child reacts by accepting care without protest and represses all feelings. The child does not cry in the absence of mothers and see more attached to nurses.

15. Count.. REACTIONS OF PRESCHOOL CHILD: The preschool children adopt various mental mechanisms (defense mechanism) to adjust with the stressful experiences of hospitalization and prolonged illness. They react by exhibiting regression projection, replacement, identification, denial withdrawal and fantasy. The stage of protest in preschool children is usually regression.

16. count… REACTION OF SCHOOL CHILD
School children respond to hospitalization with fear, anxiety, and frequent guilt. Fear or Mutilation and death is seen in school children. As school children are excessively concerned about their body image, they need physical stimulation and may masturbate.

17. Count…. REACTION OF ADOLSCENTS Adolescents may have a difficult time in adjusting to hospitalization. Hospital rules and regulations may cause frustration in adolescents.

18. Role of Nurse to help to cope with stress of illness and hospitalization of child Provide family centered care with different approach to specific age group.
In Neonates: Provide continual contact between baby and parents with active involvement by rooming in and sensory motor simulation as appropriate.

19. Count… In Infants: Encourage mother to balance her responsibilities and minimize separation with confidence and competence. Basic needs of the infant should be fulfilled promptly with attention and appropriate handling from a limited number of personnel. Mother can be allowed during procedure. Tension and loneliness can be relieved by toys.

20. Count… In Toddlers:- Provide rooming-in and unlimited visiting hours to express child’s feeling. No punishment to the child. Home routine can be continued especially regarding sleeping, eating, bathing etc. Familiar toys and articles can reinforce the child’s sense of security.

21. Count… Allow play and choice whenever possible and arrange physical setting to encourage independence. Parents should provide love and understanding to help the child to restore trusting relationship. Hostility and withdrawal of love can cause the child’s loss of trust, self-esteem and independence.

22. Count… In Preschool Children:
Minimize stress of separation by providing parental presence and participation in care.
Plan to shorten the hospital stay, as possible.
Help the child to accept the stressful situation by love and concern.
Set limits for the child and provide opportunity to verbalize the feelings.

23. Count… Careful preparation for all procedures by privacy and explanation according to level of understanding.
Encourage the child to participate in self-care and hygiene as appropriate.
Remove fear by adequate explanation.
Reassure the child that no one is to blame for the illness and hospitalization.
Discourage the parents reinforcing negative feelings to the child.

24. Count…. In School Children:-
Help the parent to prepare the child for elective hospitalization.
Respect the child’s need for privacy and modesty during examination.
Thorough nursing history should be obtained to plan the care.
Help the child to identify problems and to ask questions.

25. Count… Use treatment rooms whenever possible to perform painful and invasive procedures.
Explain the procedure and its purpose with reassurance.
Encourage the child in self- care, play and to continue school work when the condition permits.

26. Count … In Adolescent:
Help parents to prepare adolescents for planned Hospital admission
Assess the impact of illness and hospitalization and presence of misconceptions
Hospital staff, Hospital routine and facilities available in the hospital unit should be explained soon after admission.

27. Count …. Obtain thorough nursing history about illness, habit, recreation, hobbies etc.
Respect the need for privacy, recreation, personal preferences on self-care and food habit
Involve the adolescent patient in planning of care and help them to accept restrictions and health teaching.

28. Count …. Explain all the procedures and reassured to accept the plan of care and to corporate.
Provide opportunities for recreation, Peer relationship, interaction with other adolescent patient and expression of feeling.
Assist parents to deal effectively adolescence response related to stress of illness and hospitalization.

29. Count …. Nurse guide the hospitalized child in Health Promotion and restore ration activities.
It is important for nurses to recognize and respond to the needs of hospitalized child with the help of parents and family members