Adolescents and the Sick Child Flashcards
% of sick children growing
A child is living longer with chronic disease
In the past they would die
Goals for Normalization
Allow the family to function to their fullest capacity
Identify sources of stress or concern and evaluate the families and child’s strengths and weaknesses
1 Family Concern
Child’s health and well being
Then sibling needs, home routines, financial and practical needs
Child Concerns
The sick child is worried about about their parents and siblings
Changes across development
Loss of control, missing school, missing important events, being different than peers and fear of death
Family Centered Care
Collaboration
Respect- Information sharing- Collaboration- Empowerment- Respect
The Hospitalized Child
Does not like feeling out of control
Concept of pain and illness change over time
Fall Risk
Set limits, almost always witnessed- pj’s too big
Environment is clean and safe
Side rails UP
Stressors
Separation Anxiety = Protest- Despair- Detachment
Normal and expected
Interventions: primary care the same, minimize disruption, and differences from the home
Loss of Control
Give choices between two options
Develops trust
Parents feel out of control as well!
Pain
Very fearful
Past experiences
Anxiety affects pain response!
Source- a shot- GOING to hurt
To minimize stressors
Minimize # of care takers Maintain normal routine Provide choices Encourage independence Involve family Provide clear and appropriate explanations Listen and acknowledge fear Complete pain assessment and manage
Early Adolescence
9-12 years
Middle Adolescence
13- 16 years
Late Adolescence
17- 20 years
Biologic Development
Puberty is universal
Cultural differences
Adolescence is variable with different cultures
Girls Puberty
1st sign- breast bud development
2 years after you should get your period
Rapid growth prior to menarch
>13 years with no buds means you are delayed
Boys Puberty
Loosening of the scrotum sac Development of pubic hairs Starts at 11/12/13 About 2 years AFTER girls Spine and torso grow a little longer
Cognitive Development
Tied to your environment and experiences!
Piaget
Concrete Thinking and Formal Operations More self conscious and aware Pre-frontal cortex changes the most Concrete operational thought 7-11 years: can somewhat see another view point Formal operation 12+ : think abstractly
Psychosocial Development
No identity- would be hard to get out of bed in the morning and know what to do
Identity
Largely related to sports
Parents may have established an identity for you- in adolescence it changes
Autonomy
Talking to friends
Gradual pulling away from parents
What is important to you
Body Image
Important to feel similar to peers
Do not like to feel different
Contexts of Development
Friends Team Social Media** getting the response you want?? School Family Church Work
