Need for respiratory or cardiac support, 4. Monitor vital signs 1. Instruct parents to take child for first dental exam between 1 and 2 years of age, then every six months, 5. It occurs most often in infants and young children. Greatest in first 24 to 48 hours because of tissue damage, b. Meet psychosocial needs of child who is isolated from others, a. Assessment Nursing Care Plans For Atrial Septal Defect. Peritoneal dialysis if severe complication, B Assess blood gases and serum electrolyte concentration, C Administer sodium bicarbonate, electrolytes, and vitamin K as prescribed, D Use hypothermia blanket for hyperthermia, E See General Nursing Care of Children with Poisoning, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), Walks alone with wide-based gait; creeps up stairs, Builds tower of two blocks; throws objects and picks them up, Drinks from cup with spillage; uses spoon clumsily, Has four- to six-word vocabulary, states name, Says “No,” even while complying with request, Growth decreases; appetite lessens (physiologic anorexia), Abdomen protrudes, larger than chest circumference, Runs clumsily; climbs stairs or up on furniture, Is ritualistic; has favorite toy or blanket; thumb sucking most prominent, Height: about 80 to 82 cm (32 to 33 inches), Walks up and down stairs, one step at a time, holding onto rail, Builds tower of six to seven cubes; uses cubes to form a train, Vocabulary: about 300 words; uses two- to three-word phrases; uses pronouns, Obeys simple commands; shows signs of increasing autonomy and individuality; makes simple choices when possible, Remains ritualistic, especially at bedtime, Can help undress self and pull on simple clothes, Does not share possessions, everything is “mine”, Has full set of 20 temporary teeth (dental care should begin between 1 and 2 years of age), Walks on tiptoe; stands on one foot momentarily, May attend to own toilet needs during day, Beginning to see self as separate individual from reflected appraisal of significant others, Becomes increasingly independent, ritualistic, and negativistic, Toilet training: most important integrative task for toddler, Physical maturation must be reached before training is possible; approach and attitude of parents play vital role, Sphincter control adequate when child can walk, Usual age for bowel training is 22 to 30 months, Daytime bowel and bladder control usually after 2 years of age, Night control usually several months to years after achievement of daytime control; if night wetting persists to 6 years of age, investigation into cause is indicated, Able to inform caregiver of need to urinate or defecate, Usually begins with bowel, then bladder; potty chair helpful so feet touch floor, Intermittent periods of urination and fecal soiling, Regression when there is stress (e.g., new sibling), Have specific time and place for elimination, Treat occasional “accidents” in matter-of-fact manner; avoid punishing, Need for autonomy: parents should support independence without overprotection, Be consistent; set realistic limits; provide choices that do not require “yes” or “no” answers, Plays alongside other children but not with them, Short attention span, requires frequent change of toys, Breaks toy through exploration and ingests small pieces, Ingests lead from lead-based paint on toys, Imitation and make-believe play begins by age 3 years, Play furniture, dishes, cooking utensils, telephone, Pedal-propelled (e.g., tricycle), straddle (e.g., rocking horse), Adequate nutrient intake to meet continuing growth and developmental needs, Sufficient calories for increasing physical activity and energy needs, Consumption of fresh, rather than processed, foods (e.g., fruits, vegetables), Psychosocial development in relation to food patterns, eating behavior, attitudes, Reflects patterns and preferences of culture, parents, and siblings, Calorie and nutrient requirements increase with age, despite slower growth, Increased variety in types and textures of foods; provision of choices to address growing independence, Increased involvement in feeding process; stimulation of curiosity about food environment; language learning, Consideration for appetite, choices, motor skills, Prefers sweet drinks; juices should be limited to 4 ounces (120 mL) or less per day to prevent dental caries, TV commercials influence selection of foods (e.g., fast foods, “empty-calorie” snacks, high-carbohydrate convenience foods), Anemia: increased need for foods containing iron (e.g., enriched cereals, meat, eggs, green vegetables); chewable iron-fortified vitamins; if liquid, iron supplements should be diluted and sipped through a straw; administer with vitamin C–containing beverage to promote absorption, Obesity or underweight: increased or decreased caloric intake; need for nutritional counseling, Low intake of calcium, iron, vitamins A and C may need supplementation, Mealtime struggles related to increased autonomy and parental attitudes toward food (e.g., “eat everything on plate”; “try new food”; “no dessert unless …”); need for parental counseling, Leading cause of death in children between 1 and 4 years of age, Incidence: children younger than 5 years of age account for more than half of all accidental deaths during childhood; more than half of accidental child deaths related to automobiles and fire, Accidents related to stage of growth and development; curiosity about environment, Walking or running, especially chasing after objects thrown into street, Inability to determine speed; lack of experience to foresee danger, Out of sight because of small size; can be hit by car backing out of driveway or when playing in leaves or snow, Failure to restrain in car (e.g., sitting in person’s lap; incorrect use of seat belt on car restraint), Investigating: pulls pot off stove; plays with matches; inserts object into wall socket, Climbing: reaches stove, oven, ironing board and iron, objects on tables, Developing fine motor skills; able to open bottles, cabinets, jars, Climbing to previously unreachable shelves and cabinets, Learning new tastes and textures; uses mouth to identify and explore objects; finds and eats/drinks what is within reach (e.g., cleaning products, medications), Child and parents do not recognize danger of playing in or near water, Unaware of inability to breathe under water, Puts everything in mouth; may aspirate small objects, Experiences basic fears of loss of love, of unknown, of punishment, Immobilization and isolation influence physical (particularly neurologic) and psychosocial development, Regression to earlier behaviors may occur, Prolonged loud crying, consoled by no one but parent or usual caregiver, Diminished interest in environment and play, Prepare parents and child for hospitalization, Promote parent-child relationship by limiting separation (open visiting hours have reduced incidence of separation anxiety), Prepare minimally for hospitalization because of limited cognitive ability to grasp verbal explanation, Determine routines and rituals concerning toilet training, feeding, bathing, sleep pattern; incorporate into the plan of care, Ask parents to bring child’s favorite items from home (e.g., blanket, toy, bottle, pacifier), Prepare parents for child’s reaction to separation; pounding toys helps release anger associated with temper tantrums or separation, Prepare parents for child’s regression to previous modes of behavior and loss of newly learned skills, Minimize separation anxiety and other emotional traumas during hospitalization, Encourage to stay with child in hospital; if possible, have one parent room-in throughout hospitalization, If not rooming-in, encourage frequent visits; explain that frequent visits for short periods of time are more therapeutic than one long visit, Associate visits with familiar events, such as “Mommy is coming after lunch”, If unable to visit, establish contact by phone and/or computer which enables visualization (e.g., Skype); be alert for behavioral changes when parents cannot stay or visit child, Assist to identify what, if any, care they wish to provide; support them in their decision, Involve appropriately because anxiety may be transmitted to child, Explain what care can be provided by parents and what care is provided by health team staff, Plan for consistent caregiver, as much as possible, who can offer individual attention, physical touch, and sensory stimulation, Establish routine similar to home routine by continuing rituals and providing favorite items from home, Maintain familiarity with home by talking about parents, having child listen to tape recordings of family members’ voices, showing photographs of family members, When family members leave, stay to provide comfort to child and to reassure parents, Accept regression; avoid teaching new skills, Encourage release of tension, especially aggression, through play (e.g., knocking blocks over, scribbling on paper, peg and pounding board), Comfort when sedation is necessary during procedures (e.g., CT scan, MRI), Affects more children in United States than any other chronic infectious disease (five times more common than asthma), By age 17 more than 7% of adolescents have lost at least one permanent tooth to decay, Risk factors: poverty, disability, HIV infection, inadequate diet, inadequate dental hygiene, Problems with eating, speaking, playing, learning, social development, Regular dental visits, preferably in first year, but at least in second year, Diet rich in vitamins and minerals; limited sweets and sweet drinks, Supplemental fluoride, depending on water supply and parental beliefs, Nursing Care of Children with Tooth Decay, Parental knowledge of preventative oral care, Diet history; type of snack foods and drinks, Teach parents to start cleaning teeth when they first erupt; use clean, damp cloth, Teach parents care of teeth beginning at 2 years of age, Begin using pea-size amount of toothpaste with fluoride, if needed, Brush twice a day, beginning at 2 years of age, Supervise brushing of teeth to ensure correct technique, Encourage parents to offer nutritious meals and snacks; limit sweet juices (120 mL per day), Instruct parents to take child for first dental exam between 1 and 2 years of age, then every six months, Recommend that parents discuss fluoride supplementation and dental sealants with health care provider, Receives regular oral health examinations and prophylaxis as needed.
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