Pediatric nursing immunization 800 words due 1/18/2020

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PPT_Chapter_31.pptx

Chapter 31: Health Supervision

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Principles of Health Supervision

Providing services proactively

Optimizing child’s level of functioning

Ensuring child is growing and developing appropriately

Promoting best possible health of child

Preventing injury and illness through child teaching

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Settings

Private physicians’ offices

Community health departments

Sliding-scale clinics

Homeless shelters

Day care centers

Schools

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Medical Home

Physician or nurse practitioner who has a long-term and comprehensive relationship with the family, leading to comprehensive, continuous, coordinated, and cost-effective care

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Benefits of Health Partnerships With Child, Parents, and Community

Mutual goal setting

Marshalling of resources

Development of optimal health practices

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Special Issues in Health Supervision

Cultural influences

Community influences

Health supervision and the chronically ill child

Health supervision and the internationally adopted child

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Question #1

Is the following statement True or False?

The community can be a contributor to a child’s health or it can be the cause of his or her illnesses.

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Answer to Question #1

True.

The community can be a contributor to a child’s health or it can be the cause of his or her illnesses.

The child is a member of a community as well as a family and a culture. The child’s health cannot be totally separated from the health of the surrounding community. Each community has unique strengths, weaknesses, and values that can affect a child’s health.

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Chronic Illness

Repeated assessments

Need to determine health maintenance needs

Frequency of visits

Types of interventions

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Coordination

Effective partnership among the child’s medical home, family, and community is vital for a child with a chronic illness.

Coordination of specialty care, community agencies, and family support networks enhances the quality of life and health of these children.

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Issues Covered in Psychosocial Assessments

Health insurance coverage

Transportation to health care facilities

Financial stressors

Family coping

School’s response to the chronic illness

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Three Components of Health Supervision

Developmental surveillance and screening

Injury and disease prevention

Health promotion

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Question #2

Is the following statement True or False?

The nurse providing pediatric health supervision should focus on the illness of children.

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Answer to Question #2

False.

The nurse providing pediatric health supervision should focus on the wellness of children.

The health supervision visit provides an opportunity to maximize health promotion for the child, family, and community and nurses have the ability to promote optimal health during these encounters. Health supervision visits should be viewed as part of a continuum of care, not as the accomplishment of isolated tasks.

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Screenings Conducted at the Health Supervision Visit

History and physical assessment

Developmental/behavioral assessment

Sensory screening (vision and hearing)

Appropriate at-risk screening

Immunizations

Health promotion

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Components of Developmental Surveillance

Noting and addressing parental concerns

Obtaining a developmental history

Making accurate observations

Consulting with relevant professionals

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Question #3

The nurse is conducting developmental surveillance on a child and his family. Which of the following is a component of this process?

a. measuring the child’s head circumference

b. administering vaccinations

c. addressing parental concerns

d. performing a physical assessment

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Answer to Question #3

c. addressing parental concerns

It is a component of developmental surveillance.

Developmental surveillance is an ongoing collection of skilled observations made over time during health care visits and includes noting and addressing parental concerns. Measuring the head circumference, administering vaccinations, and performing a physical assessment are components of the screenings conducted at the health supervision visit.

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Developmental Delay

Historical information obtained from the parent or primary caregiver about developmental milestones may indicate warning signs or identify risks for developmental delay

Any child who “loses” a developmental milestone needs an immediate full evaluation, since this indicates a significant neurologic problem

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Types of Screening

Risk assessment

Includes objective and subjective data to determine likelihood child will develop a condition

Universal screening

Screening of an entire population regardless of the child’s individual risk

Selective screening

Done when a risk assessment indicates the child has one or more risk factors for a disorder

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Specific Types of Screenings Performed

Metabolic

Hearing

Vision

Iron-deficiency anemia

Lead

Hypertension

Hyperlipidemia

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Criteria for Risk Assessment for Hearing Loss (Age 3 Months to 5 Years)

Auditory skill monitoring

Developmental surveillance

Assessment of parental concerns

Older than 4 years old

Difficulty hearing on the telephone

Difficulty hearing people in a noisy background

Frequent asking of others to repeat themselves

Turning the television up too loudly

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Using a Vision Screening Chart

Place the chart at the child’s eye level.

Place a mark on the floor 20 ft from the chart.

Align the child’s heels on the mark.

Have the child read each line with one eye covered and then with the other eye covered.

Have the child read each line with both eyes.

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Question #4

The nurse is preparing a child for a vision screening. How far would the nurse place the child from the chart?

a. 5 ft

b. 10 ft

c. 15 ft

d. 20 ft

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Answer to Question #4

d. 20 ft

The nurse would place the child 20 ft from the vision screening chart.

When screening for vision, the nurse would place the chart at the child’s eye level, place a mark on the floor 20 ft from the chart, and align the child’s heels on the mark.

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Immunity

Immunity

Ability to destroy and remove a specific antigen from the body

Passive immunity

Produced when the immunoglobulins of one person are transferred to another

Active immunity

Acquired when a person’s own immune system generates the immune response

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Types of Vaccines #1

Live attenuated vaccines

Killed vaccines

Toxoid vaccines

Conjugate vaccines

Recombinant vaccines

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Types of Vaccines #2

Diphtheria, tetanus, and pertussis

Haemophilus influenzae type B

Polio, measles, mumps, and rubella

Hepatitis A and B

Varicella

Pneumococcal and influenza

Rotavirus

Human papillomavirus

Meningococcal

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Barriers to Immunizations

Contraindications

anaphylactic or systemic allergic reaction to a vaccine component

pertussis immunization, encephalopathy without an identified cause within 7 days of the immunization

Parental concerns about vaccine safety are a significant cause of inadequate immunization as well as having more than one physician

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Health Promotion

Focuses on maintaining or enhancing the physical and mental health of children

Partnership development is the key strategy for success when implementing a health promotion activity

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Topics for Anticipatory Guidance

Promoting oral health care

Promoting healthy weight

Promoting healthy activity

Promoting personal hygiene

Promoting safe sun exposure

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