Pediatric nursing最新文献

Super Storm Sandy, one of the largest storms endured by the East Coast of theUnited States, devastated New Jersey and the eastern seaboard. Although naturaldisasters affect individuals of all ages, children are particularly vulnerable becausetheir sense of normalcy is altered. The purpose of this study was to explore theeffects that exposure to Super Storm Sandy had on children who resided in NewJersey. This was a non-experimental, quantitative, cross-sectional research study.Study participants were recruited via printed flyers at disaster resource sites and ona dedicated research team’s Facebook site. Each participant completed theHurricane Stressors Assessment Tool for Children and Adolescents as a webbasedsurvey related to their experiences with the hurricane. One hundred andforty-one (141) children participated in this study. Age groups (preschool, child, andadolescent) had varied results based upon developmental level. Age was positivelyassociated with finding it harder to concentrate and pay attention (r = 0.18, p =0.04); feeling sad, down, or depressed (r = 0.17, p < 0.05); being quiet and withdrawn (r = 0.16, p = 0.05); feeling irritable and grouchy (r = 0.26, p < 0.05); and findingit harder to complete schoolwork (r = 0.32, p < 0.001). Certain parental perceptionsof their child’s behavior were negatively associated with the age of the child.Children had varying degrees of experiences after Sandy. Adolescents were shownto be more aware and affected by the storm than younger children. Observationscan be used for intervention initiatives in the post-natural disaster period, encouraginghealthcare providers to acknowledge family and community healing to provideadequate mental health referrals in the post-disaster period.

Patient and family education is a critical element of diabetes management. Manychildren with new onset type 1 diabetes present with symptoms of diabeticketoacidosis (DKA) and are hospitalized at diagnosis. These children and theirfamilies receive their initial education in the hospital setting. As soon as bloodglucose levels are stabilized and the acidosis is corrected, the patient is dischargedhome, usually within three days (Nettles, 2005). There is little time toprovide the skills and education, as well as emotional support, for a smooth transitionto home. It is a challenge to achieve these goals if the only resource personfor diabetes education is the clinical nurse specialist (CNS). The CNS for a 14-bed pediatric unit sought to expand the role of the bedside nurse to being the primaryeducator of patients with diabetes through education and support. All nursesattended an eight-hour workshop on diabetes. A DKA protocol was developedthrough multidisciplinary collaboration, and nurses were educated on this protocol.Additionally, the CNS organized a diabetes resource cart that contains thetools for diabetes education. The protocol and education materials wereuploaded in the Pediatric SharePoint site to make them accessible to nurses. Most importantly, the CNS developed a structured patient education plan that isoutcome-oriented, and based on review of current literature and practices in theunit. This initiative resulted in an increase in nursing confidence and expertiserelated to diabetes care as demonstrated by competencies met by nurses andanecdotal evidence from nurses and patients’ caregivers.

Long thought to be purely psychological in origin, current research lends credenceto the idea that autism has a medical basis. Patients with autism can be among themost challenging patients that a healthcare provider may care for. Often the presentingsymptoms of autism make these patients difficult to examine and may alsomask underlying concurrent conditions. This article reviews some of the more commonconditions found concurrently in the autistic population.

Concussions are a form of traumatic brain injury (TBI). Concussion is defined by the American Academy of Neurology as a “trauma-induced alteration in mental status that may or may not involve loss of consciousness” (Kirkwood, Yeates, & Wilson, 2012, p. 1360). At least 1.7 million TBIs occur annually, with 75% being in the form of concussion. Almost half a million patients ages 14 years and younger visit emergency rooms annually for TBI (Centers for Disease Control and Prevention [CDC], 2011). Diagnosing a concussion can be difficult because symptoms vary among individuals and may be subtle and vague, and neuro-radiologic imaging studies typically reveal no abnormalities. Due to the varying degree of symptomatology and recovery, there are no specific recommendations on when it is safe for patients to resume normal activity. Complications can arise if a second injury occurs prior to complete healing from the initial concussion. This literature review identifies current recommendations on the screening and management of concussion in the pediatric population. A clear, concise definition of concussion is presented, as well as recommendations for concussion management. Return to play and return to learn guidelines are explored. The nursing role in concussion management is discussed, and future implications are explored.

Well-child visits can be ideal times for health education of children, parents, and caregivers. A trusting relationship with both children and their parents is the foundation for acceptance of any changes in health behaviors. Children grow rapidly, and poor health conditions during this time could be unfavorable or detrimental to their long-term wellbeing. Clinicians play pivotal roles in helping children understand the importance of working toward healthier lifestyles and preventing hypertension and obesity. Hypertension in obese and overweight children continues to increase, but these two conditions are preventable and can also be reversible if managed early. Data from four studies reviewed here indicate that diet and exercise can help reduce the incidence of hypertension in overweight/obese children. Primary care providers can incorporate specifically pointed physical activity and dietary change education into their daily practices, with attention directed toward helping children with hypertension to decrease their blood pressure for life.

Patient and family education is a critical element of diabetes management. Many children with new onset type 1 diabetes present with symptoms of diabetic ketoacidosis (DKA) and are hospitalized at diagnosis. These children and their families receive their initial education in the hospital setting. As soon as blood glucose levels are stabilized and the acidosis is corrected. The patient is discharged home, usually within three days (Nettles, 2005). There is little time to provide the skills and education, as well as emotional support, for a smooth transition to home. It is a challenge to achieve these goals if the only resource person for diabetes education is the clinical nurse specialist (CNS). The CNS for a 14-bed pediatric unit sought to expand the role of the bedside nurse to being the primary educator of patients with diabetes through education and support. All nurses attended an eight-hour workshop on diabetes. A DKA protocol was developed through multidisciplinary collaboration, and nurses were educated on this protocol. Additionally, the CNS organized a diabetes resource cart that contains the tools for diabetes education. The protocol and education materials were uploaded in the Pediatric Share Point site to make them accessible to nurses. Most importantly, the CNS developed a structured patient education plan that is outcome-oriented, and based on review of current literature and practices in the unit. This initiative resulted in an increase in nursing confidence and expertise related to diabetes care as demonstrated by competencies met by nurses and anecdotal evidence from nurses and patients' caregivers.