Pediatric care plan for infants.

Pediatric care plan for infants. Clinical nurses perform physical assessments on children across various settings ranging from home, the cl…

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Pediatric Care Plan

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            Clinical nurses perform physical assessments on children across various settings ranging from home, the clinic, the hospital, and the school.The physical examination constitutes part of a well-child assessment, prepares a child for admission examination in a hospital, or part of the initial assessment for home healthcare.

Regardless of the use, the physical examination offers subjective and objective information regarding the child whose findings become the bedrock of decision-making regarding the child’s health status and the basis of all nursing care. For the pre-kindergarten (pre-K), the nurse should be competent in carrying out a physical exam and utilizing knowledge of growth and development when preparing the child for a physical examination.

Consequently, the purpose of this paper is to develop a nursing plan that incorporates Erikson’s developmental theory to describe how a nurse would approach the pre-K child for a physical exam and prepare them for immunization.

Development of a Nursing Care Plan, Incorporating a Developmental Theorist

The nursing process acts as a systematic framework to offering patient-focused care with five sequential steps. It utilizes the basic principles of critical thinking, client-centered approaches combined with evidence-based practice recommendations, and nursing intuition. The five steps are assessment, diagnosis, planning, implementation, and evaluation. To develop the nursing care plan using the five steps of the nursing process, the nurse also incorporates the first three-step of Erik Erikson’s stages of psychosocial development (Orenstein, 2020).

As indicated in the diagram below, Erikson’s theory of psychosocial development endeavor to describe the effects of social experiences across the whole life span of which the Pre-K child has experienced trust versus mistrust in infancy, autonomy versus shame and doubt in early childhood, and initiative versus guilt during the pre- k stage.  During these stages, the key events in the child are feeding, toilet training, and exploration with outcomes of each being hope, will, and purpose, respectively.

Using the Nursing Process to Approach the Pre- K Child for a Physical Exam and Prepare Them for Immunization

Assessment

As the first step, assessment entails critical thinking skills and the collection of subjective and objective data. To get subjective data, the nurse uses verbal statements from the pre-K child, the caregiver, or the parent/guardian. During the assessment, the nurse will mainly use four techniques: inspection, palpation, percussion, and auscultation. To secure the full trust of the child, the nurse uses the parents’ capacities to guaranteed assist in the planning and implementation of care. The child’s safety, emotional warmth, stimulation, and guidance.

Diagnosis

Once the nurse has collected the subjective and objective data, the provider then formulates a nursing diagnosis by applying clinical judgment. According to Toney- Butler & Thayer (2020), the nursing diagnosis comprises Maslow’s Hierarchy of Needs from basic physiological needs like nutrition and toileting to safety and security where potential injuries are prevented to, love and belonging supportive relationship are nurtured.

The child’s self-esteem is also nurtured from this early age to ensure the child’s physical and emotional wellbeing. The nurse should consider Erikson’s stage 2 of autonomy versus shame and doubt. One has to remember that getting immunization is scary for the pre-K and even some parents. So the nurse should prepare the child so that the child does not suffer long-term emotional effects, thus turning future visits into a more positive experience for the child.

Planning

After the assessment and diagnosis stages, the third step of a nursing process is planning, whereby goals and outcomes are developed directly to impact the client’s care premised on   EBP guidelines. At this stage, the defining characteristic is goal-setting, where the nursing plan is tailored to offer personalized care that addresses an individual’s unique needs.

The nurse takes measures that reinforce the goal of a vaccination in that it seeks to stimulate an individual’s immune system to produce immunity to a specific disease protecting the individual from that disease like TB, Influenza amongst the immunizable diseases. The nurse should seek to tap into the initiative versus guilt and share the multi-year plan for immunization.

At this stage, the pre-K child will get the fifth dose of the DTaP vaccine, the fourth dose of polio, the second dose of MMR, the second dose of chickenpox, and the annual influenza vaccine.

The child at this stage feels they can lead others, and with equilibrium, individual initiative and readiness to work with others leads to the emergence of ego quality known as purpose. Specifically, the purpose here is to maintain good health.  The nurse should ensure the set goals are SMART – meaning they are specific, meaningful or measurable, attainable or action-oriented, result-oriented or realistic, and time-bound or timely.

Implementation

Having crafted a good immunization plan with the pre-K caregiver, the nurse then implements the nursing intervention. The WHO (2016) implementation of the selected vaccine calls the nurses in context to ensure the vaccines are reconstituted, administered, and necessary measures to reduce pain at the time of vaccination. Measures should also be in place for safe waste disposal with clear supervisory checklists. There should also b post-immunization indicators.

Evaluation

Evaluation happens to be the final step of the nursing process that has to include since it is important for a positive patient outcome. The evaluation stage involves a reassessment of the immunization activities. Only after the desired outcomes are realized may the nursing plan of care be adopted based on new assessment data.

Conclusion

In conclusion, this essay has determined that nursing care plans are vital in providing quality patient care. The application of the nursing process to act as a guide to nursing care is important. Throughout the 21st century, public health nurses in the US have made calls and initiate immunization plans to save many individuals from contracting vaccine-preventable diseases like TB and polio.

The nurse should always remember that assessment is the first part of the nursing process through which the precise needs of the patients are holistically identified.

References

Orenstein, G. A., & Lewis, L. (2020). Erikson’s stages of psychosocial development. StatPearls [Internet].

Toney-Butler, T. J., & Thayer, J. M. (2020). Nursing process. StatPearls [Internet].

World Health Organization. (2016). Planning and implementing high-quality supplementary immunization activities for injectable vaccines using an example of measles and rubella vaccines: a field guide.

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Pediatric care plan for infants.
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