The sick child

Unit Number - 3 of Child Health Nursing
learning Objectives - Describe the role of nurse in caring for a sick child Develop skill in carrying out nursing intervention while caring for pediatric age group.
Hours - 8
Teaching and Learning Activities - Lecture cum discussions Demonstration Simulation Role play
Assessment Methods - Short answers Objective type Essay type Return demonstration

Content of the chapter

a) Child’s reaction to hospital
b) Effect of hospitalization on the
family of the child
c) Role of nurse in helping child &
family in coping, with stress of
hospitalization & illness
Pediatric procedures:
a) Preparation of child for
diagnostic tests, collection of
specimens.
b) Calculation & Administration of
oral & parenteral medication
c) Procedures related to feeding
– Katori& Spoon
– Ryle’s tube & gastrostomy
d) Procedures relating to
elimination
– Enema
– Colostomy irrigation
e) Administration & analysis of
oxygen concentration, steam
inhalation, nebulization,
f) Other procedures:
– Pediatric Resuscitation
– Surgical dressing

Illness and hospitalization are stressful experiences for children and their families. Pediatric nursing aims to minimize stress, promote recovery, and support the child and family through therapeutic care.


a) Child’s Reaction to Hospitalization

Children react to hospitalization depending on age, developmental level, previous experience, and illness severity.

Common Reactions

  • Infants: Crying, irritability, feeding problems
  • Toddlers: Separation anxiety, regression, temper tantrums
  • Preschoolers: Fear of bodily harm, guilt, nightmares
  • School-age children: Fear of loss of control, boredom, anxiety
  • Adolescents: Loss of privacy, body image concerns, anger, withdrawal

b) Effect of Hospitalization on the Family of the Child

  • Emotional stress and anxiety
  • Guilt and fear regarding child’s illness
  • Financial burden
  • Disruption of family routine
  • Sibling jealousy and neglect
  • Parental fatigue and role strain

c) Role of Nurse in Helping Child & Family Cope with Stress of Hospitalization & Illness

  • Establish a therapeutic relationship
  • Provide age-appropriate explanations
  • Encourage parental presence
  • Use play therapy
  • Maintain routines as far as possible
  • Provide emotional support and reassurance
  • Involve family in care
  • Prepare child for procedures
  • Provide discharge teaching

PEDIATRIC PROCEDURES

a) Preparation of Child for Diagnostic Tests & Collection of Specimens

Preparation

  • Explain procedure in simple language
  • Use play or demonstration
  • Reduce fear and anxiety
  • Ensure parental presence
  • Obtain informed consent

Specimen Collection

  • Urine (clean catch / urine bag)
  • Stool (clean container)
  • Blood (aseptic technique)
  • Throat swab

b) Calculation & Administration of Oral & Parenteral Medication

Calculation

  • Based on weight or body surface area
  • Double-check dose
  • Follow rights of medication administration

Administration

  • Oral: Syrup, drops, tablet
  • Parenteral: IM, IV, SC
  • Use appropriate needle size
  • Monitor for adverse reactions

c) Procedures Related to Feeding

Katori & Spoon Feeding

  • Used for infants and young children
  • Maintain upright position
  • Feed slowly and patiently

Ryle’s Tube Feeding

  • Indications: Inability to swallow
  • Check tube placement
  • Administer prescribed feed
  • Maintain asepsis

Gastrostomy Feeding

  • Long-term feeding
  • Clean stoma site
  • Prevent infection
  • Monitor tolerance

d) Procedures Related to Elimination

Enema

  • Used to relieve constipation
  • Use correct solution and volume
  • Warm solution
  • Monitor child’s comfort

Colostomy Irrigation

  • Done to regulate bowel movements
  • Use lukewarm water
  • Maintain stoma hygiene
  • Provide psychological support

e) Administration & Analysis of Oxygen Concentration

Oxygen Administration

  • Methods: Nasal prongs, mask, hood
  • Monitor oxygen saturation

Steam Inhalation

  • Relieves respiratory congestion
  • Prevent burns
  • Supervise child

Nebulization

  • Delivers medication to lungs
  • Ensure correct dosage
  • Clean equipment after use

f) Other Pediatric Procedures

Pediatric Resuscitation

  • Follow ABC (Airway, Breathing, Circulation)
  • Use age-appropriate CPR techniques
  • Maintain airway
  • Monitor vital signs

Surgical Dressing

  • Maintain sterile technique
  • Observe wound for infection
  • Provide pain relief
  • Encourage healing

Conclusion

Care of the sick child requires technical skill, emotional support, and family involvement. Pediatric nurses play a crucial role in reducing stress, ensuring safe procedures, and promoting recovery, thereby improving outcomes for both the child and the family.