3rd year paediatric Assignment one

Instructor:- D/r Wase

Name Mekdes Zelalem Temsgen

ID NO 1585
Section A(one)
Department Nursing

Submitted date:- 24/06/2022

— Submitted to: - Telegram

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1, discuss the magnitude of the problem ( morbidity and
mortality ) associated with the majer disease in children ?

Morbidity and mortality from childhood illnesses has remained a

major point of interest globally. Malaria, respiratory tract infection
and diarrheal diseases are the leading causes of childhood morbidity
and mortality. Preventable diseases such as, pneumonia, diarrheal
diseases and malaria are major causes of childhood morbidity and
mortality world-wide.

The State of the World's Children 2012 report showed that globally,
7.6 million children under 5 years of age die annually and 3.7 million
deaths occur in Sub-Saharan Africa

Ethiopian context Childhood morbidities are a major cause of

mortality of children in the developing countries particularly in
Ethiopia. Regardless of the noticeable improvement in the reduction
of under-five death in Ethiopia, childhood diarrheal and fever are still
the leading cause of death. In Ethiopia, the burden of child mortality
is alarming and calls for determined efforts in combating such health
problems. Therefore, this study aimed to investigate the risk factors
for childhood morbidity specifically for diarrhoea and fever.

 What is Morbidity?

The morbidity rate refers to the number of people affected by a

particular disease. This helps the health officials to make risk
management and adopt national health systems according to the
needs of the population.

 What is Mortality?

Mortality shows the number of deaths in a particular population. It is

expressed as the number of deaths per 100 people per year.

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 2.List important child health indicators.

Health indicators are quantitative or statistical measures or

instruments used for the measurement of health status of an
individual or defined group. They are variables that can be used to
measure the changes in the level of health target achievement, or as
indirect or partial measures of complex situations.

The health indicators developed for the Child Health

 Perinatal Health.
 Health Care Utilization.
 Use of Prescription Medications.
 Infant and Child Mortality.
 Education.
 Nutrition and Physical Activity.
 Childhood Chronic Conditions.
 Community and Social Services

 Indicators can be numerical (rations, proportions, rates), or

qualitative (existence or absence of an event).Health indicators are
divided into several main domains: demographic and socio-economic
factors,

 indicators of health status,

 indicators health determinants,
 indicators of health systems,
 indicators of health policy,

  A programme indicator in public health is basically a number,

proportion, percentage or rate that helps measure ( “indicate”) the
extent to which planned activities have been conducted

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(process and output indicators) and programme achievements have
been made (outcome and impact indicators).

3.Describe the role of the paediatric nurse

The role of the paediatric nurse is constantly changing. These

changes are as a result of expanding medical and nursing practice.
Emerging challenges in different aspects of child care, consumer
demands & the technological advancements.

The role of the paediatric nurse may vary from one institution to
others but basic responsibilities remain the same.

Roles of paediatric nurse are:-

 Primary care give
 Coordinator and collaborator
 Advocate
 Health educator
 Counsellor
 Case manager
 Recreationist
 Social worker and
 Researcher

1, primary care give :- paediatric nurse should provide preventive,

promotion curative and rehabilitative care in all level of health
services . in hospital care of sick children including comfort, feeding,
bathing, safety, etc. at community set up basic responsibilities
include health assessment immunizations, primary health care and
referral etc.

2, coordinator & collaborator :- the nurse plays an extremity

important role with the combination of health care team members.

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Nurse maintains good inter personal communication with the child
family and health team members.

The nurse coordinates nursing care with other services from meeting
the needs of children

3, nurse advocate:- the paediatric nurse acts as an advocate to

safeguard the child’s right to assist &to provide best care from the
health care provide Ex: it can rang from consulting dietary
department for special food to arrange from meeting to discuss plan
of care with other health team members.

4, Health educator :- the nurse goal of health teaching is to provide

information to the child parents and significant other abut
prevention of illness promotion or health maintenance.

Characteristics of nurse teacher includes:- 4Cs

 C--- confidence
 C--- competence
 C--- communication
 C--- caring & empathy

5, nurse consultant :- the pediatric nurse can act as consltant

to guide parents for maintenance and promotion of health
for Ex guiding parents about feeding practices accident
prevention
6, nurse counsellor :- providing guidance to parents in health
hazards of children and health them for own decision
making in different situations.
7, case manager:- the pediatric nurse should organize care,
monitor and evaluate patient treatment for successful
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outcome she/he acts as a manager of pediatric care units in
hospital clinics and community
8, Recreationist :- the pediatric nurse play supportive role for
the child to provide play facilities for supportive role for the
child to provide play facilities for recreation and diversion. It
helps to decrease crisis imposed by illness or hospitalization .
9, social worker :- paediatric nurse can participate in social
services or refer child & family child welfare agencies for
necessary support.
10, nurse researcher :- research is an integral part of
professional nursing paediatric nurse should participate or
perform research activities . it help to provide basis for
changes in nursing practice improvement in the child health
care and evaluate the care
Role of paediatric nurse
The paediatric nurse role is unique because of developmental
immaturity and vulnerability of children the goals of nursing
care of children based on primary health care are:
1. Promote the health maturation as a physical, intellectual
and emotional being within the context of his family and
communities ( primary level)
2. Provid health care for the child who requires treatment
from disease (s) ( secondary level) . dealing with the
child disabilities ( tertiary level). Therefore, the role the
pediatric nurse includes:
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  In primary level:-
Through health education to child and his parents and
providing child basic needs and immunization she can
 Maintain child health
 Help the child achiveves his optima 9 growth and
development.
 Prevent diseas and their complications.
 In secondary level :-
The nurse has to provide care to sick
 Children and their families by
1. Assessing their needs
2. Planning for care
3. Implementation the plan
4. Evaluating children’s condition
5. Providing health teaching to children and
their parents
 In tertiary level
The nurse should assist children to return to their
maximal level of functioning following illness and /
or disability .
4.Describe the nursing care of hospitalized children.
Hospitalization was a stressful and painful or experience
for children who were sick show that children might feel not
only anxiety and lack of safety, but also get some
psychological problem at present or even last in the future.
During this process, children were sensitive to unfamiliar
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environment and afraid of to get in touch with people who
took care of them in hospital. Nurses play an important role
in children’s hospitalization process. Treatment or therapy is
vital for children, however, support for hospitalized children
and their families are easily neglected.
 indicated that an increasing number of psychologists
and medical staffs have realized that hospitalization
may affect mental and emotional development of
children.
 Children would not only appear psychological changes
like separation anxiety, loss of control, uncertainty,
and helplessness, but also physical symptoms such as
sleep loss and awaken.
5, Discuss Tb in paediatrics.
Tuberculosis (TB) in Children

What is tuberculosis in children?

Tuberculosis (TB) is an ongoing (chronic) infection caused by

bacteria. It usually infects the lungs. But other organs such as the
kidneys, spine, or brain may be affected. TB is most often spread
through droplets breathed or coughed into the air. A child can be
infected with the TB bacteria and not have active disease.

TB may be staged like this:-

Latent TB infection.  This is when a child has TB bacteria in their

body, but does not have symptoms. The infected child’s immune
system causes the TB bacteria to be inactive. For most people who
are infected, the TB will be latent for life. This child would have a
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positive TB skin or blood test but a normal chest X-ray and no TB
symptoms. They can't spread the infection to others.

TB disease.  This is when a child has signs and symptoms of an active

infection. This child would have a positive or negative TB skin or
blood test, and testing showing active TB disease in the lungs or
another site in the body. They can spread the disease if the infection
is in the lungs and it is untreated.

What causes TB in a child?

TB is caused by bacteria. It’s most often caused

by Mycobacterium tuberculosis (M. tuberculosis). Many children
infected with M. tuberculosis never develop active TB and
remain in the latent TB stage.

 TB bacteria is spread through the air when an infected

person coughs, sneezes, speaks, sings, or laughs. A child usually
does not become infected unless they have repeated contact
with the bacteria. TB is not spread through personal items, such
as clothing, bedding, cups, eating utensils, a toilet, or other
items that a person with TB has touched.

Which children are at risk for TB?

Any child can develop TB after being exposed. A child is more at risk
for TB if they:

 Live with someone who has TB

 Are homeless
 Come from a country where TB is common
 Have a weak immune system, including from diabetes, HIV or
medicines that can weaken the immune system.

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  Very young children are more likely than older children to have
TB spread through their bloodstream and cause complications,
such as meningitis.
What are the symptoms of TB in a child?
 Symptoms can occur a bit differently in each child, and they depend on the child's age. The
most common symptoms of active TB in younger children include:
 Fever
 Weight loss
 Poor growth
 Cough
 Swollen glands (some may begin to drain fluid through the skin)
 Chills

The most common symptoms of active TB in older children include:

 Cough that lasts longer than 3 weeks

 Pain in the chest
 Blood in sputum
 Weakness
 Tiredness
 Swollen glands (some may begin to drain fluid through the skin)
 Weight loss
 Decrease in appetite
 Fever
 Sweating at night
 Chills
TB diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and
health history. They may also ask about your family’s health history.
They will give your child a physical exam.

One way of diagnosing TB is with a TB skin or blood test. In the

skin test, a small amount of testing material is injected into the top
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layer of the skin. If a certain size bump develops within 2 or 3 days,
the test may be positive for TB infection. For the TB blood test, a
small amount of blood is taken from the child’s arm or hand. It takes
a few days for results to come back.

Your child may also need a chest X-ray, sputum testing, or a

biopsy of abnormal glands or other body tissue.

How is TB treated in a child?

Treatment may include a short-term hospital stay to be treated with

medicine.

 For latent TB, several medicine options are available. Children

over 2 years old can be treated with once-weekly medicine for
12 weeks or several months of daily medicine.
 For active TB, a child will be given 2 to 4 medicines for 6
months or more. With active TB, children usually start to get
better within a few weeks of starting treatment. After 2 weeks
of treatment with medicine, a child is usually not contagious.
Treatment must be fully finished as prescribed.
It is important that your child take all of the medicines for the
entire time period.

Talk with your child’s healthcare provider about the risks, benefits,
and possible side effects of all medicines.

How can I help prevent TB in my child?

 TB can be prevented by lowering your child’s risk of exposure

to others with the infection.
 Active TB can be prevented by having latent TB diagnosed and
treated.

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