Wiki_-_paeds_pic2.jpg Pediatric Nursing



As nurses caring for the pediatric patient it is important to remember that children are not just small adults. “Each pediatric patient is a unique individual actively engaged in gaining control over and learning about his world” thus “using a developmentally based approach when providing care can ease the stress of the unfamiliar sights, equipment, sounds and smells of the perioperative setting” (Taylor, 2008, p 267). The following Wiki explores the need for specialization of nurses working in the pediatric field. The challenges of caring for the pediatric patient such as their unique anatomy and physiology, ever changing developmental stages, and special considerations when administrating medications will be discussed. (Katherine, A. -Content Editor)

The acute nature of symptoms associated with childhood diseases make pediatric nursing a specialty within itself. The child’s anatomy and physiology allow illnesses to occur suddenly and become severe quickly. (Leifer, 2003). Children’s airways, for example, are exceptionally narrow; this poses acute medical risks such as choking on small food particles and mucus. Furthermore, diseases that cause further narrowing of the airway, such as allergies and asthma, are life threatening to children. Children also have a high need for fluid intake and are unable to store extra fluids. Consequently, children can become dehydrated quickly. Due to this potential for rapid onset and acuity of illness, it is imperative for nurses to be working with the pediatric population to be specialized. (Leifer, 2003). (Amber R. - Multimedia Lead)

Caring for of the pediatric patient is further complicated by their developmental needs. The developmental needs of children are a primary concern for medical staff as they are specific to the child. As children grow and develop they connect and perfect skills in preparation for learning more complicated ones. Developmental milestones are monitored and evaluated through the use of a growth chart, a standard of measurement that compares others of the same sex, age, and race. Chronic illness decreases the child’s sense of security and independence which greatly impacts the growth and development of the child. As a result, behaviour problems can quickly develop. It is the responsibility of the nurse to help foster these feelings and promote healthy growth and development. (Leifer, 2007). (Tracy F. Project Manager)


The pediatric population encompasses a wide variety of individuals with varying sizes, ages, weights and stages of development (Eanast, Elder, Martini, Roberts, & Ford, 2007). These areas need also to be considered in the area of medication administration. Drug dosages must be calculated individually according to the weight of the child. However, weights of sick children fluctuate rapidly resulting in constant recalculations, thus leading to an increased opportunity for error. Furthermore, pediatric patients suffer more adverse drug events as they have less physiologic reserves to buffer errors (Fortescue et al.,2003). Drug administration is further complicated when only adult concentrations are in stock. Critical safety data is unavailable as a small quantity of drugs marketed for use by children have been clinically evaluated, because many people view experimentation involving children as unethical (Eanast et al., 2007). Further studies are needed to make medications for pediatrics safe. (Tammy K. - Design Lead)

Pediatric nursing is a specialty that requires precision and the utmost care. Without meticulous concern and awareness, a patient’s condition can very quickly become severe and even life-threatening. Developmental milestones impact the nursing care of children, as does their smaller anatomy and physiology. Drug administration to the pediatric patient is often challenging due to the individuality of medication calculations and the potential for error. Ultimately, “the nurse must understand how to provide nursing care to children of various ages to enhance their physical, mental, emotional, and spiritual development according to their specific needs and comprehension” (Leifer, 2003). (Esther J. - Design Lead)



Journal for Specialists in Pediatric Nursing
References

Ernast, T.B., Elder, D.P., Martini,L.G., Roberts, F., & Ford, J.L. (2007). Developing Paediatric Medicines: Identifying the Needs and Recognizing the Challenges. Journal of pharmacy and Pharmacology, 59(8), 1043-1055.

Fortescue, E.B., Kaushal, R., Landrigan, C.P., McKenna, K., Clapp, M.D., Federico, F., Goldman, D.A., Bates, D,W.(2003). Prioritizing Strategies for Preventing Medication Errors and Adverse Drug Events in Pediatric Patients. Pediatrics, 111(4), 722-729.

Leifer, G. (2003). An Overview of Growth, Development, and Nutrition. Introduction to Maternity and Pediatric Nursing, (p. 348). St. Louis, Missouri.

Leifer, G. (2007). Introduction to Maternity & Pediatric Nursing.(p.345-55). Missouri: Saunders.

Taylor, E. (2008). Providing Developmentally Based Care for Preschoolers. AORN Journal, 88(2), 267-273. Retrieved from http://www.aornjournal.org/article/S0001-2092(08)00190-7/abstract