CHILD HEALTH MAINTENANCE Define:

1. Child- a human being either girl or boy between the stages of birth and puberty. 2. Health- is a state of complete physical, mental, social and spiritual wellbeing and not merely the absence of disease or infermity.

3. Health maintenance- is the process of analyzing and synthesizing information make

judgements about the health status of an individual or to determine his/ her need for healthcare.

a. Identify needs , clinical problems or nursing diagnosis that forms the basis for nursing care. b. Involves interventions that promote healthy behaviors and wellness. CHILD NURSING Child nursing- is a scientific, systematic, wholistic, approach to the nursing care of the child.
The systematic refers to nursing process: assessment, diagnosis, planning, inplementing, evaluating. Thie process is cyclical and is likely to come to a end when a goal has been achieved.

PEDIATRIC NURSING Pediatric nursing focuses on protecting children from illness and injury, assisting them to attain optimal levels of health regardless of health problems and rehabilitation. Jane W. Ball et. al

The role of the pediatric nurse as refers to: 1. 2. 3. 4. 5. 6. 7. Family advocate/ Advocate Prevention (Disease prevention/ Health promotion) Health teaching/ Research Supporting and Counsellling Restoration/ Restorative Cordination and Collaboration Health Care Planning

1. FAMILY ADVOCATE/ ADVOCATE

A advocate stands between the person and anyother source. The primary responciblity of the pediatric nurse is to the child and his/ her family. The nurse works with the family and together they identify goals, needs and plan interventions that are most likely to solve the defined problems.

Goals are to:

1. Ensure families are aware of all available health services benificial to the client. 2. Inform child and family adiquately about treatment procedures. NB: The child can not be dealt with outside of the family. 3. To become involved in childs care when necessary and change and/ or support health practices. 4. Become knowledgeable about UN declaration in or of the rights of the child. 5. Provide a individualized care to the child that considers the childs feelings, fears, likes or dislikes. The care provided should be consistant with the needs of the child at various stages of development. Also, care should be geared towards the optimum physical needs and emotional needs of the child. Eg. Play activities which allow for the childs fears and need for aggression to be released. 6. To resolve personal values and beliefs so that they do not interfer with the delivery of care to the child. 7. To educate families about good health practices. 8. To press for political and legistlative changes in the wellbeing of the child. 9. To ensure that the policies and resources of the health care agencies meet the psycho-social needs of the children and families. 10. To protect the child and family by taking appropriate means and actions relating to any incident of incompetence, on ethical or illigal practices by any member of the health care team.

2. PREVENTION (DISEASE PREVENTION/ HEALTH PROMOTION)

This preventative role of the pediatric nurse is very important in light of the aim of primary health care. It is concerned with the prevention of illness and maintenace of health rather than the treatment of disease and disability.

The goals are to:

1. Plan care that will foster every aspect of growth and development of the child which include; nutrition, immunization, dental care, socialization discipline and schooling. The nurse either intervene directly or refers to other health persons or agencies. 2. Provides education and anticipatory guidance. Eg. Problems which appear at various stages of development. So that, the aim here is to prevent potential problems in regards to safety of the home. 3. Promote mental health, that is, the psychological wellbeing of the child eg, being humane in giving injections and in carrying any other procedure that may cause pain or discomfort. Also, make an effort to adjust your posture, facial expression and manerism.

3. HEALTH TEACHING/RESEARCH
- Research is conducted to determine effective methods for treating a childs health condition or providing care. This therefore provides a scientific basis for nursing proctice. The pediatric nurse is therefore responcible for keeping currnet with new prediatric research findings and identifying when changes in practice are needed and further discuss these. Health care facilities also use research to develop their guidelines for practice. The pediatric nurse can help identify research questions assist with the research design and collect data when working with advanced practiced nurse researchers or other health health care professionals. It is difficult to separate health teaching by the pediatric nurse from her role as family advocate and prevention coordinator.

These goals may be:

1. The goals maybe classified as direct or indirect health teaching goals. First goal DIRECT for eg., may include discussing the dangers of early childhood theories or cavities. If infants with teeth fall asleep with juice or milk remaining in their mouth. The latter INDIRECT for eg., may include referring families to heath related professionals. E.g., the nutritionist/dietician. if child have weight loss or weight issues that are adversely affcting their health they may even be helping the child and family to understand a diagnosis medication or treatment. 2. Translated into a teaching and learning exercise; where role playing is used by the nurse to teach the child the child and family any bit of information

relating to the cae of the child. For eg., how to brush teeth affectively or how to wear a pair of crutches. 3. These goals maybe evaluated at the end of the health teaching session, the nurse must be able to ascertain from the child and family if learning has taken place.

4. SUPPORTING AND COUNSELING

Supporting a child and Fmilty My include the verbal and non- verbal communication along with listening, touching and ones physical presence which will support or feed ones emotion need. Counseling on the other hand involves, a mutual or common exchange of ideas thoughts and opinions that may lead to the mutual solving of a problem at the end of this session, child and family may have resolved any conflict or problem; feeling better about themselves and the situation (self esteem); share a closer bond or referred for additional advanced professional help or assisstance.

5. RESTORATION/RESTORATIVE
Any health care activity performed or carried out by the Pediatric Nurse should be aimed at restoring the child and family to optimum health. It is always importantto assess the emotional physical developmental and spiritual state of each child as these can alter or influence the disease process significantly: and by evaluating or assessing you will delinate this.

6. CORDINATION/COLLABORATION
Working in isolation does not serve the childs best interest therfore the Pediatric nurse as a member of the health team collaborates and coordinates nursing services along with the activities of other professionals as it relates to the care of the child and family. Every nurse is to work interdependently with the child and family collaborating on the needs and interventions so that the final care plan is one that truly meets the childs needs. However, this aspect of of health planning is often left lacking. Numerous disciplines ofthen times work together to formulate a comprehensive approach without consulting with clients regarding their ideas preferences or cultural practices. By learning bout the values of the different ethnic groups in the community religious beliefs and cultural practices that have an impact on health care practices you can develop an individualized nursing care plan for each child and family.

7. HEALTH CARE PLANNING

Up to this point, the nurses role has been viewed through the nucleus as a family. Nurses have been rarely involved in the health care planning especially on a political or legislative level that mostly involve the decision making body of government. Health care planning also involves promoting the highest quality of existing ones as well as providing new services. Nurses must at all times ensureto practice according to the code of ethics for nurses. The Prdiatric Nurse should also be invoved in making sure their collegues implement the standards of care through education, role place, and super vision.

CODE OF ETHICS
1. The nurse provides services with respect for human dignity and the uniqueness of the client unrestricted by considerations of social or economi status, personal attributes, or the nature of health problems. 2. The nurse safeguards the clients right to privacy by judiciously protecting information of a confidential nature. 3. The nurse acts to safeguard the client and public when health care and safety are affceted by the incompetent, unethical, or illegal practice of any person. 4. The nurse assumes responsibility and accountability for individual nursing judgement and actions. 5. The nurse maintains competence in nursing. 6. The nurse exercises minformed judgement and uses individual competence and qualifications as criteria in seeking consultation, accepting responsibilities, and delegating nursing activities to others. 7. The nurse participates in activities that contribute to the ongoing development of the professions body of knowledge. 8. The nurse participates participates in activities in the professions efforts to implement and improve standards of nursing. 9. The nurse participates in the professions efforts to establish and maintain conditions of employment coducive to high-quality nursing care. 10. The nurse participates in the professions effort to protect the public from misrepresentation and to maintain the integrity of nursing. 11. The nurse collaborates with members of the health professionals and othe citizens in promoting community and national efforts to meet the health needs of the public.