Paediatric Nursing in Australia and New Zealand 3rd Edition by Jennifer Fraser, Donna Waters, Elizabeth Forster, Nicola Brown ISBN 9781108984652 1108984657

Part A Contexts of nursing care

1 Children and young people of Australia and New Zealand

Introduction

Monitoring health and wellbeing

Indicator measurement

Our children and young people

Health and wellbeing

Chronic conditions

Healthy development

Homes and families

Mothers and babies

Infants

Children

Childhood injury

Chronic diseases of childhood

Social and emotional health in childhood

Young people

Youth overweight and obesity

Youth injury

Youth substance use

Youth social and emotional health

Partnering with children and young people

Summary

Learning activities

Further reading

References

2 Child rights in Australia and New Zealand

Introduction

International convention

Australian and New Zealand legislation, charters and standards

Practice implications

Access to family

Vulnerable populations

Australian and New Zealand age-of-majority legislation

Priorities in relation to children’s rights and child-protection legislation

The responsibility to report child maltreatment

Summary

Learning activities

Further reading

References

3 Health services for New Zealand Māori and Aboriginal and Torres Strait Islander Australian children and young people

A note on terminology

Introduction

Cultural safety

Māori tamariki and rangatahi

Aboriginal and Torres Strait Islander children and young people

The health status of Māori tamariki and rangatahi

Historical factors and Te Tiriti o Waitangi

Māori Health Trends Report

He Korowai Oranga (Māori Health Strategy)

District Health Boards

Health Alliances

Child and Youth Wellbeing Strategy

The Ministry of Children

Whānau Ora

Tamariki and rangatahi health and community services

The Well Child Tamariki Ora Programme

SmartStart

Plunket

Kids Health NZ

Whānau stories

Aboriginal and Torres Strait Islander children and young people

Historical journey

The health status of Aboriginal and Torres Strait Islander children and young people

Cultural determinants of health

Cultural safety in paediatric nursing practice

Roles of health professionals working with Aboriginal and/or Torres Strait Islander children, their families and the wider community

Establishment of Aboriginal organisations and services including Aboriginal Community Controlled Organisations for self-determination

Summary

Learning activities

Acknowledgements

Further reading

References

4 Research with children and youth

Introduction

Research and evidence

What is research?

Generating new knowledge through research

Clinical audit and benchmarking

Translating knowledge from research

What is evidence?

Evidence-based practice

Evidence implementation

Researching with children and young people

Human research and ethics

History and human research ethics

Principles of human research ethics

Research merit and integrity

Autonomy and respect for persons

Assent and consent in research with children and young people

Opting-in, opting-out and refusal to participate

Standing parental consent

Beneficence

Best interests

Level of risk

Justice

Human research ethics committees

Meaningful research participation

Partners in research

Supporting participation

Partners in evidence implementation

Summary

Learning activities

Further reading

Evidence-based practice

Ethical conduct of research involving children and young people

References

Part B Nursing infants, young children and their families

5 Working with new families throughout the transition to parenthood

Introduction

Preconception and antenatal care

Preconceptual and antenatal health and wellbeing

Preparation for parenting

Antenatal education

Birthing choices

Monitoring of maternal health in the antenatal period

Monitoring of foetal growth and development

Discomforts of pregnancy

Mental health and wellbeing during pregnancy

Postnatal care

Postnatal care of the mother

Postnatal care of the newborn infant

Assessment of newborn transition

Respiratory changes

Circulatory changes

Thermoregulation

Fostering attachment and bonding in the early postnatal period

Infant care: Focus on feeding

Breastfeeding

Supporting breastfeeding

Feeding infants with a bottle

Summary

Learning activities

Further reading

References

6 Supporting families to manage child behaviour and sleep patterns, and promote optimal child development

Introduction

Current issues in child health and development

Children’s health and development: A snapshot

Determinants of children’s health and development

Child development: A social ecological model

The family environment

Optimising child development

Partnering with families to support child development

Managing behaviour

Behavioural development in childhood

Risk factors and consequences of behavioural problems

Approaches to behaviour management

Principles for managing behaviour

1. Have realistic expectations

2. Build positive parent–child relationships

3. Encourage desirable behaviours

4. Use effective discipline strategies

Sleep

Sleep in childhood

Approaches to managing sleep

Principles for supporting healthy sleep

1. Establish a regular sleep pattern

2. Have a consistent bedtime routine

3. Provide a comfortable sleep environment

4. Time daily activities to promote sleep

5. Use positive parenting strategies to manage problem behaviours

Healthy lifestyle

Nutrition and physical activity

Screen use

Principles to support a healthy lifestyle

1. Set realistic goals and identify obstacles

2. Provide plenty of opportunities to engage in healthy behaviours

3. Work together as a family

Summary

Learning activity

Further reading

References

Part C Nursing children and young people

7 School health, health promotion and health education

Introduction

School nursing

Variable role responsibilities

Conceptual frameworks for school nursing practice

Prevention level approach

Professionalising school nursing practice

School nurse expertise

Health promotion in the school setting

Health Promoting Schools Framework

School nursing within the HPS Framework

Australian Student Wellbeing Framework

Fundamentals of health education

Health literacy promotion

Effective communication

Adult-focused health education and professional development sessions

Classroom-based health education

Pedagogical considerations

Differentiated instruction and a safe and inclusive learning environment

Promoting student participation

Healthy growth and development

Priority health and wellbeing concerns

Addressing priority health and wellbeing concerns

Tackling childhood obesity

Pivotal role of schools

Primary prevention

Secondary prevention

Tertiary prevention

Summary

Learning activities

Further reading

References

8 Mental healthcare for children and adolescents

Introduction

Mental health problems and mental disorders

Attention Deficit Hyperactivity Disorder (ADHD)

Nursing assessment and interventions

Autism Spectrum Disorder (ASD)

Nursing assessment and interventions

Externalising disorders: Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD)

Internalising disorders: Anxiety and depression

Risk and protective factors

Promoting mental health in children and young people

The spectrum of child and youth mental health

Promoting resilience to support mental health in children and young people

Being valued, loved and safe

Promoting positive participation

Fostering a positive sense of identity and culture

Managing disordered eating and eating disorders experienced by children and young people

Mental health and technology: Nursing children and young people in the technological age

Twelve practical strategies for promoting mental health in children and young people

Summary

Learning activity

Further reading

References

9 Child and family: Psychosocial considerations and response to illness

Introduction

The psychosocial development of children and young people experiencing disruptions to health

Erikson’s theory of psychosocial development

Trust versus mistrust: Infancy (first year of life) and the sick infant

Attachment theory

Nursing assessment and interventions

Autonomy versus shame and doubt: Infancy (second year of life) and the sick toddler

Initiative versus guilt: Early childhood – the preschool years (3–5 years)

Industry versus inferiority: Middle and late childhood (primary school – 6 years to puberty)

Identity versus identity confusion: Adolescence (10–20 years)

Translation to practice and transition to adult care

Intimacy versus isolation: Early adulthood (twenties and thirties) and the sick young adult

Family considerations

Contemporary families

The Family Partnership Model

Family-centred care

Family assessment

Family genogram/ecomap

Family development

Family roles and functions

Family strengths

Stressors

Coping strategies

Considerations and challenges in conducting family assessments

Summary

Learning activities

Further reading

References

10 The acutely ill or injured child and adolescent: Nursing assessment and interventions

Introduction

Key nursing considerations for the acutely unwell child and adolescent

Fever

Dehydration

Assessment of dehydration

Hydration and diet for children with acute gastroenteritis

Intravenous therapy

Preparing the child and family for intravenous cannulation

Monitoring the intravenous site and infusion

Intravenous fluids: Types and volumes

Administering oral medications

Pain assessment and management

Observational and behavioural pain-assessment tools

Self-report tools

Pain management

Common acute illnesses in childhood and adolescence

Febrile seizures

Acute respiratory illness

Respiratory tract infections

Croup

Bronchiolitis

Asthma

Pneumonia

Acute otitis media

Abdominal pain

Assessment and management

Appendicitis

Injuries in children and adolescents

Head injury

Assessment and management

Musculoskeletal injuries

Assessment and management

Alcohol intoxication

Assessment and management

Paediatric perioperative care

Pre-operative care

Parental presence during induction of anaesthesia

Post-operative care

Summary

Learning activities

Further reading

References

11 Recognising and responding to the sick child

Introduction

Paediatric characteristics that increase the risk of illness and deterioration

Structured assessment of the paediatric patient

The Paediatric Assessment Triangle

The Primary Assessment Framework

Recognition of clinical deterioration using a Primary Assessment Framework

A – Airway

B – Breathing

Chest recession or retractions

Breath sounds and air entry

Oxygen saturation

C – Circulation

Heart rate and rhythm

Blood pressure

Peripheral pulses and perfusion

Capillary refill

Urine output

D – Disability

Paediatric neurological assessment tools

Responding to the sick child

Respiratory support

Airway and breathing

Oxygenation

Circulatory support

Paediatric sepsis

Paediatric basic and advanced life support

Parental presence during resuscitation

Summary

Learning activity

Nasopharyngeal suctioning and bronchiolitis

High-flow nasal cannulae therapy and bronchiolitis

Further reading

References

12 Evidence-based care of children with complex medical needs

Introduction

Chronic health conditions associated with complex medical needs

Down syndrome

Characteristics of Down syndrome

Families and children with complex medical needs

Nursing assessment and interventions

Respiration

Oxygen therapy

Tracheostomy and ventilation

Mobility

Nutrition and hydration

Enteral feeding

Communication

Transition to adult care

Important considerations during transition

Successful transition

Summary

Learning activity

Further reading

References

13 End-of-life and palliative care in paediatric care settings

Introduction

Pain

The WHO analgesic ladder

Side-effects of opioids

Non-pharmacological pain relief

Neurological symptoms

Fatigue

Dyspnoea

Gastrointestinal disturbances

Anxiety

Communication with children and adolescents

Communication and the family in paediatric end-of-life care

Culturally safe end-of-life care

Siblings

Grandparents

Self-care and professional boundaries

Summary

Learning activities

Further reading

References

Index