Pediatric Nursing Lecturer. Dr.

Rayyan Ibrahim Khaleel

Ninevah University / College of Nursing

Pediatric Nursing
Year Three /Semester Two
General Nursing Program
2023-2024

Prepared by

Lecturer. Dr. Rayyan Ibrahim Khaleel

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 Pediatric Nursing Lecturer. Dr. Rayyan Ibrahim Khaleel

Introduction to Child Health and Pediatric Nursing

Lecture outlines:
Upon completion of the chapter, you will be able to:
1. Discuss different methods of measuring child health.
2. Discuss the philosophy of pediatric nursing care.
3. Identify the major roles and functions of pediatric nursing, including the
scope of practice and the professional standards for pediatric nurses.
4. Explain the components of the nursing process as they relate to nursing
practice for children and their families.

Children are the future of our society. Their overall health has improved,
and rates of death and illness in some areas have decreased, but we still must focus
on children’s health both in the United States and globally. Habits and practices
established in childhood have profound effects on health and illness throughout
life. As a society, creating a population that cares about children and promotes
preventative and quality health care and positive lifestyle choices is crucial.
Pediatric nurses play a major role in this task. They are often “in the trenches”
advocating on various issues, drawing attention to the importance of health care
for children, encouraging focus on education and prevention, and assisting
families who lack resources or access to health care.
CHILD HEALTH:
Children are a gift to this world, and, as such, it is society’s responsibility to
nurture and care for them. In the past, health was defined simply as the absence of
disease; health was measured by monitoring the mortality and morbidity of a
group. Over the past century, however, the focus of health has shifted to disease

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 Pediatric Nursing Lecturer. Dr. Rayyan Ibrahim Khaleel

prevention, health promotion, and wellness. The World Health Organization

(WHO, 2018) defines health as “a state of complete physical, mental, and social
well-being, and not merely the absence of disease or infirmity.”

Mortality Data:
Mortality is the number of individuals who have died over a specific period. This
statistic is generally presented as rates per 100,000 population and is calculated
from a sample of death certificates. The National Center for Health Statistics,
under the U.S. Department of Health and Human Services, collects, analyzes, and
disseminates these data.
NEONATAL AND INFANT MORTALITY RATE:
Neonatal mortality is the number of infant deaths occurring in the first 28
days of life per 1,000 live births. The infant mortality rate refers to the number of
deaths occurring in the first 12 months of life. It also is documented as the number
of deaths in relation to 1,000 live births. The infant mortality rate is used as an
index of the general health of a country. Generally, this statistic is one of the most
significant measures of children’s health. In 2017, the infant mortality rate in the
United States was 5.8 per 1,000 live births.
The main causes of early infant death in the United States include congenital
anomalies, short gestation, low birth weight, sudden infant death syndrome,
maternal complications during pregnancy, respiratory distress syndrome,
unintentional injuries, and bacterial sepsis. Preterm births and low birth weight are
key risk factors for infant death; lower the birth weight, higher the risk of infant
mortality.
CHILDHOOD MORTALITY RATE:
Childhood mortality is defined as the number of deaths per 100,000
population in children between 1 and 14 years of age. The childhood mortality rate
in the United States has decreased significantly since 1980, but disparities by
gender, age, race, and ethnicity persist. In 2015, the mortality rate for children

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 Pediatric Nursing Lecturer. Dr. Rayyan Ibrahim Khaleel

between ages 1 and 4 years was 24.9 per 100,000, with the leading cause of death
being unintentional injuries followed by congenital malformations. The mortality
rate for children aged 5 to 14 years was 13.2 per 100,000, with the leading cause
being unintentional injuries followed by cancer. Other causes of childhood
mortality include suicide, homicide, diseases of the heart, influenza, and
pneumonia.
Even as research continues into the preventable nature of childhood injuries,
unintentional injury, such as motor vehicle accidents, fires, drowning, bicycle or
pedestrian accidents, poisoning, and falls, remains a leading cause of mortality and
morbidity in children. These injuries have far-reaching consequences for children,
families, and society in general. Risk factors associated with childhood injuries
include young age, male gender, low socioeconomic status, low maternal
education level, poor housing, parental drug or alcohol abuse, or low support
within the family. These deaths can often be prevented through education about
the value of using car seats and seat belts, the dangers of driving under the
influence of alcohol and other substances, and the importance of pedestrian and
bicycle safety, fire safety, water safety, and home safety.

Morbidity Data:
Morbidity is the measure of prevalence of a specific illness in a population at a
particular time. It is presented in rates per 1,000 population. Morbidity is often
difficult to define and record because the definitions used vary widely. For
example, morbidity may be defined as visits to the physician or diagnosis for
hospital admission. Also, data may be difficult to obtain. Morbidity statistics are
revised less frequently because of the difficulty in defining or obtaining the
information. In general, however, 58.2% of children in the United States enjoyed
excellent health and 26.3% had very good health as reported in a summary of
health statistics for children in 2016. Factors that may increase morbidity include
homelessness, poverty, low birth weight, chronic health disorders, foreign-born
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 Pediatric Nursing Lecturer. Dr. Rayyan Ibrahim Khaleel

adoption, attendance at day care centers, and barriers to health care. For example,
18% of children live in poverty and have a higher incidence of disease, limited
coordination of health services, and limited access to health care, except for visits
to the emergency department. The overall poverty rate is 12.7%, which is the
second consecutive decline. The most important aspect of morbidity is the degree
of disability it produces, which is identified in children as the number of days
missed from school or confined to bed. In 2016, approximately 32% of school
children, aged 5 to 17, did not miss any school due to illness or injury; however,
3.7% missed 11 or more days of school because of injury or illness Common
health problems in children include respiratory disorders, gastrointestinal
disturbances, which lead to malnutrition and dehydration; and injuries. In 2012,
diseases of the respiratory system, pneumonia, acute bronchitis, and asthma were
the major causes of hospitalization in children 1 to 17 years of age followed by
mood disorders, appendicitis, and epilepsy and Convulsions

One trend in the United States is the increasing number

of children with mental health disorders and related
emotional, social, or behavioral problems. The American
Academy of Pediatrics estimates one in five children in
the United States have mental health-related problems
These problems may limit the child’s educational success.
They also increase the child’s risk for significant mental
health problems later in life or emotional problems and
possible use of firearms, reckless driving, promiscuous
sexual activity, and substance abuse during adolescence.

PEDIATRIC NURSING:
Pediatric nursing is the practice of nursing involved in the health care of
children from infancy through adolescence. In the United States, the number of
children younger than age 18 years is approximately 73.7 million, accounting for
almost 22.6% of the population. The definition of nursing, “the protection,
promotion, and optimization of health and abilities, prevention of illness and
injury, alleviation of suffering through the diagnosis and treatment of human
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 Pediatric Nursing Lecturer. Dr. Rayyan Ibrahim Khaleel

response, and advocacy in the care of individuals, families, communities, and

populations,” also applies to the practice of pediatric nursing However, the
overall goal of pediatric nursing practice is to promote and assist the child in
maintaining optimal levels of health while recognizing the influence of the family
on the child’s well-being. This goal involves the practice of health promotion and
disease prevention as well as assisting with care during disease or illness.

Philosophy of Pediatric Nursing:

Children need access to care that is continuous, comprehensive, coordinated,
family centered, and compassionate. This care needs to focus on their changing
physical, developmental, and emotional needs. Pediatric nurses provide this care
by focusing on the family, providing atraumatic therapeutic care, and using
evidence-based practice. These three concepts represent an overarching
philosophy of pediatric nursing care. Parents or guardians play a critical role in the
health and well-being of children. Providing care through a family-centered
approach leads not only to better outcomes but also to better consumer
satisfaction. The family is the child’s primary source of support and strength. The
knowledge that the family has about a child’s health or illness is vital. Family-
centered care involves a mutually beneficial partnership between the child, the
family, and healthcare professionals. It applies to the planning, delivery, and
evaluation of health care for children of all ages in any setting Evidence-based
practice involves the use of research findings in establishing a plan of care and
implementing that care. It is a clinical decision-making approach involving the
integration of the best scientific evidence, patient values and preferences, clinical
circumstances, and clinical expertise to promote best outcomes.

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 Pediatric Nursing Lecturer. Dr. Rayyan Ibrahim Khaleel

Role of the Pediatric Nurse:

The primary role of the pediatric nurse is to provide direct nursing care to
children and their families, being an educator, and manager. As a child and family
advocate, the nurse safeguards and advances the interests of children and their
families by knowing their needs and resources, informing them of their rights and
options, and assisting them to make informed decisions. In the role of educator,
the nurse instructs and counsels children and their families about all aspects of
health and illness. The pediatric nurse ensures that communication with the child
and family is based on the child’s age and developmental level. The pediatric
nurse also serves as a collaborator, care coordinator, and consultant.
Collaborating with the interdisciplinary healthcare team, the pediatric nurse
integrates the child’s and family’s needs into a coordinated plan of care. In the role
of consultant, the pediatric nurse ensures that the child’s and family’s needs are
met through such activities as support group facilitation or working with the
school nurse to plan the child’s care.

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