Nursing Children and Childbearing Families - Essay Example

Questions and Answers Question A family’s social characteristics may influence the potential risks that impact on children’s health. a) Identify four (4) key family social characteristics Four social characteristics of a family that have been identified to negatively influence a child’s health are consumption of illicit substances, poverty, single parenting and stressful relationship between members of the family especially between parents (Atrash, 2006). b) Briefly discuss how each identified characteristic may impact on a child’s health.

Poverty is often associated with malnutrition and poor hygiene. It contributes to growth retardation in the baby due to poor supply of proper nutrition to the mother and increased perinatal mortality. Health conditions like protein energy malnutrition, iron deficiency anemia, recurrent infections and multivitamin deficiencies can also occur. Consumption of illicit drugs, smoking and alcohol abuse during pregnancy leads to development of growth retardation and fetal anomalies in the baby. Children are often neglected when parents are indulged in these activities.

They also follow the foot prints of their parents and resort to illicit drug abuse, smoking and alcohol abuse. Stressful relationship between family members, especially between parents causes emotional and psychological turmoil to the child. The parents, who are engaged in their personal stress are unable to take care of their children resulting in poor nutrition and poor health. These children also do not receive timely medical attention. Stress during pregnancy can lead to premature death, premature rupture of membranes, postnatal feeding problems and intrauterine growth retardation.

Single parent is as such a stressful condition to the parent and the child and can result in decreased care and monitoring of the child leading to poor nutrition. Single mothers do not have any support to take care of the baby after birth (Atrash, 2006). Question 2. Discuss how developmentally appropriate effective communication approaches would be implemented by a nurse when initiating communication and introducing equipment with a hospitalized child of three years. While dealing with a 3 year old child, the nurse must ensure that the rights of the child and also the family members are upheld (Haumueller, 1994).

While meeting the child for the first time, the nurse must self-introduce herself in a warm and welcoming manner and inform the child and her family members that she is responsible for the care of the child. The nurse must use plain language to talk with the child. She must gain consent before application of any equipment on the child by a language that is simple and also understandable by the child (Wood, 2007). Question 3. Develop a brief discussion of the key guidance a Registered Nurse would give to a parent of a 1 year old who asks for information regarding the risks and benefits of immunisation with the Measles, Mumps rubella vaccine?

MMR vaccination provides immunity against measles mumps and rubella. The combination vaccine is administered at 1 year of age. It is important to administer children with these vaccines because all the 3 diseases are highly contagious viral illnesses with distressing clinical symptoms and potential scope for debilitating complications. The infections are easily acquired from other children or adults suffering from the diseases. The vaccine is generally safe and has been introduced into the marker only after rigorous trials and evaluation.

Efficacy of the vaccine is more than 90 percent. Even in case the child develops illness despite vaccination, the course of the disease is usually mild. As far as disadvantages is concerned, side effects can occur like any other vaccine. Mild reactions include rash and fever. Other reactions include soreness and induration (CDC, 1998). Severe anaphylactic reactions are very rare. In the past, some concerns about the association of this vaccine with autism have been raised, but this has been disproved through research.

(Patil, 2011). Question 4 a) Describe what other patient information a Registered Nurse would collect in order to accurately assess Lillie’s hydration status. The nurse needs to enquire about the number and quantity of loose stools the child has been passing per day, the consistency of stool: whether watery or semisolid, whether the stools are foul smelling, the number of times the child has passed urine in the day and the time of last urination, whether the child is active, irritable, listless or lethargic and what food and fluids were given during the illness (Jones et al, 2002).

The nurse also needs to ask if the child has been vomiting and if yes, how many times, the quantity and whether it is projectile or non-projectile. By knowing the number of loose stools, it is possible to gauge the possibility of dehydration. Decreased urine output, irritability, listnessness and lethargy are signs of moderate to severe dehydration. It is important to know about vomiting because vomiting worsens dehydration caused due to loose stools and also prevents rehydration by throwing out any food or fluid intake (Jones et al, 2002).. b) Describe what other patient observations would be performed by a Registered Nurse in order to accurately assess Lillie’s hydration status Observations to assess the hydration status include general appearance of the patient: irritability, playfulness or drowsiness, fullness of anterior fontanelle; whether the eyes are dry or sunken, whether there is dryness of lips, oral mucosa and tongue; pulse rate and volume: whether feeble or bounding; breathing: whether acidotic; skin: whether warm or cold and clammy and turgor is normal; perfusion; and recording of urine output.

Blood pressure recording is also important to assess dehydration (Nettina, 2006). Lilly is lethargic and listless. She has tachycardia (150 per minute) , sunken eyes, dry eyes, lips and oral mucosa, depressed fontanelle, decreased skin turgor, decreased urine output (passed urine only once in the last 12 hours), mildly decreased blood pressure (85/50mmHg) and decreased perfusion. c) Identify the normal range and what patient data would constitute an abnormal finding for each of the patient observations you have described in Question 7.

b (other than those provided in the case) The anterior fontanelle in normal children is full. In cases of dehydration, the fontanelle is depressed. Children with no dehydration are playful, those with mild to moderate dehydration are cranky and irritable, those with severe dehydration are inactive, drowsy and listless (Kitt and Kaiser, 1995). In children with normal hydration or mild dehydration, the eyes are full and the mucosa of the eyes, lips, tongue and mouth are moist. In moderate dehydration, there is dryness of eyes and lips, in severe dehydration the eyes are sunken and tongue is dry.

Skin turgor is reduced in severe dehydration. Normal range of pulse rate is 70-11 per minute. Pulse rate is mildly elevated in mild dehydration (more than 120 per minute). In moderate dehydration, pulse rate is not only elevated, but also bounding, in severe dehydration, pulse rate is feeble and more than 140 per minute. Blood pressure is normal or mildly elevated in mild dehydration. In moderate and severe dehydration, there is fall in blood pressure. In severe dehydration, acidosis can occur as evident by poor perfusion and raised respiratory rate.

Perfusion of the skin is more than 2 seconds in severe dehydration. Cold and clammy skin can occur even in mild dehydration (Nettina, 2006). References Atrash, H.K., Johnson, K., Adams, M., Cordero, J.F. (2006). Family’s social characteristics may influence the potential risks that impact on children’s health. Maternal Child Health, 10, S3-S11. CDC. (1998). Measles, Mumps, and Rubella -- Vaccine Use and Strategies for Elimination of Measles, Rubella, and Congenital Rubella Syndrome and Control of Mumps: Recommendations of the Advisory Committee on Immunization Practices (ACIP).

Retrieved on 28th April, 2011 from http://www.cdc.gov/mmwr/preview/mmwrhtml/00053391.htm Haumueller, M.E. (1994). Nurse-patient communications.Accid Emerg Nurs., 2(4):216-9. Jones, G., Endacott, R., and Crouch, R. (2002). Emergency Nursing Care: Principles and Practice. London: Cambridge University Press. Kitt, S., and Kaiser, J. (1995). Emergency Nursing: a physiologic and clinical perspective. London: Rediff Books. Nettina, S.M. (2006). Manual of Nursing Practice. Singapore: Lippincott. Patil, R.R. (2011).

MMR vaccination and autism: Learnings and implications. Hum Vaccin., 1;7(2), 21-24. Wood, I. Communicating with children in A & E: what skills does the nurse need? Accid Emerg Nurs., 5(3), 137-41.