Pedi Chapter 30- Family Centered Care, Partnerships with Parents, Future Challengs for the Pedi Nurse, Nursing Implications of Growth and Development

characteristics and guidance of the infant

-doubles weight by 6 months, triples by 1 year -vision at birth is 20/300; by 12 months is 20/100 -play requires stimulation activities involving motor skills, language, and social skills -likes toys that bang, shake, or can be pulled; enjoys playing peek a boo -likes verbal praise and encouragement GUIDANCE -encourage parents not to use baby talk but pronounce words correctly -sleep is usually established by spacing of feedings. encourage parents to give care during awake times before or after feedings

benefits of family based care

-families experience greater feelings of confidence and competence and less stress in caring for their children -dependence of families on professional caregivers decreases -costs of care decrease -professionals experience greater job satisfaction -both parents and providers are empowered to develop new skills and expertise

adolescent characteristics

-needs to be independent, will vacillate between independent and dependent roles, may be reflected by mood swings -will exhibit logic and reasoning; often questions values of parents -prefers being with peers to establish identity GUIDANCE -recommended milk as drink of choice because of increased needs for calcium

key elements of family centered care

-recognizing that the family is the constant in the childs life - facilitating parent-professional collaboration at all levels of health care -honoring racial, ethnic, cultural and socioeconomic diversity of families -sharing with parents, on a continuing basis and in a supportive manner, complete and unbiased information -encouraging and facilitating family to family support and networking -understanding and incorporating the developmental needs of infants, children, and adolescents and their families into health care systems -implementing comprehensive policies and programs that provide emotional and financial support to meet the needs of families -designing accessible health care systems that are flexible, culturally competent, and responsive to family-identified needs

toddler and child characteristics

-weight gain from 1-3 yrs is about 5 pounds per year. usually four times birth weight by 3 years of age -period of intense activity and exploration -will take one or two naps a day and sleep up to 9-12 hours -bowel and bladder control usually achieved by 3 years -practices parallel play -cognition regarding thinking and reasoning based on magical or egocentric processes -experiences physiologic anorexia, which allows the child to either binge or be picky depending on individual growth spurts and plateaus

family centered care

a philosophy of care that recognizes the family as the constant in the childs life and holds that systems and personnel are called on to support, respect, encourage, and enhance the strengths and competence of the family.

parent-professional partnership

a powerful mechanism for enabling and empowering families

a developmental approach emphasizes the childs

abilities and strengths and considers the childrens individuality and personality building on what they are ABLE to do.

play is the work of

childhood

preschoolers concept of illness

conceive illness as punishment for bad thoughts or behavior; believe that adults have the power to magically cure the illness if they want to

professionals enable families by

creating opportunities for all family members to make use of their abilities and competencies and to acquire new ones that are necessary to meet the needs of the child and the family.

factors that influence the childs response to the illness and hospitalization include

developmental age, past experiences with illness or hospitalization, family support system, and coping skills as well as the gravity of the diagnosis

two basic concepts in family centered care

enabling and empowerment

system based care

exclusionary practices such as not allowing the family to stay with their children during a procedure and restricting visitors as well as the number and age of visitors.

adolescents concept of illness

focus on discrete symptoms rather than overall effect of illness; often intellectually question and deal with information about illness; will at times use denial of illness or overcompensate in areas not affected

basis for anticipatory guidance with parents

for a pediatric nurse the basis is knowledge of growth and development

growth and development are complex processes that occur in stages as the body

grows and the mind and personality unfold

variables that affect development of children

illness or lack of stimulation, genetic makeup, environmental factors, ethnic background, religion, family size, socioeconomic bracket, education

family centered care means putting the family at the center of the caregiving process with their input serving as the major determinant of the

interventions provided

in a parent-professional partnership all persons contribute their

knowledge, skills, and resources toward the well being of the patient.

with family centered care parents have the same access to information about their child as all

members of the childs health care team. also hospitals welcome parents 24hrs a day

what is the foundation for effective partnership with nurses and parents

mutual respect

child based care

not synonymous with family based care for example often hospital dietary service will provide selections for children but fail to provide inexpensive meals for parents or consider family cultural and religious traditions.

children particularly young ones, sometimes change rapidly and therefore the nurse should continually reassess and modify the

nursing care plan to reflect these physical and developmental changes

the professional supports and strengthens the family's ability to

nurture and promote family development

infant concept of illnes

perceive as generalized discomfort and pain

today parents play the role of

planners in addition to recipients of services

each stage of development consists of

predictable, orderly events that are accomplished sequentially

parents serve as respected equals with

professionals and have the right to decide what is important for themselves and their family.

anticipatory guidance

psychological preparation of a patient for an event expected to be stressful, as you do when preparing a child for surgery by explaining what will happen and what it will feel like; also used to prepare parents for normal growth and development of their children

three key components of family centered care

respect, collaboration, support

children are vulnerable to the major stressors inherent in being hospitalized including

separation from family and familiar environment, loss of control, bodily trauma, and pain

school age children concept of illness

sometimes perceive illness as a result of bad or indiscreet behavior; sometimes have an accurate awareness of the location of body parts and a beginning of understanding of body processes and functions

who is the family centered approach most crucial for

special needs children who will most likely experience repeated contact with the health care system throughout their lives

empowerment describes

the interaction of professionals with families to bring about or cement families sense of control over their lives. it frees families to foster their own strengths, abilities and actions and thus enables them to make positive changes in their lives

cognitive impairment

the preferred term for mental retardation

in a true partnership, parents are respected as equals and enjoy their rightful role in deciding what is important for

themselves and their family

nurses role in regards to the family

to support and strengthen the familys ability to nurture and promote its members development

technologic advances will open up new areas of technical skills for pediatric nurses to master and use in patient care. t/f

true