NSB231 Chapter Notes - Chapter 4 & 10: Chronic Condition, Nursing Assessment, Delayed Gratification
Week 5: Childhood Chronic Illnesses
Chapter 4: Psychosocial Development and Response to illness
• Chronic illness can disrupt the pace and timing of developmental milestone achievements
• Sense of difference from their peers
Psychosocial Developmental Stages
• Trust vs. Mistrust: Infancy
o Delayed gratification of infant's needs
o Persistent anxiety
o Grounded in the security of patient-infant relationships
• Autonomy vs. Shame and Doubt: Infancy
o Children may regress in their development gains
• Initiative vs. Guilt: Early Childhood
o Courage and independence
o Planning and problem-solving
o Target maternal anxiety
o Empower the child
o Increased risk of physical abuse
• Industry vs. Inferiority: Middle and Late Childhood
o Development of self-confidence
o Express individuality and independence
o Higher rates of emotional and behavioural problems
• Identity vs. Identify Confusion: Adolescence
o Impact of illness on their physical and psychosocial development
• Intimacy vs. Isolation: Early Adulthood
o Sense of connectedness
o Finding oneself
o Fear rejection and isolate themselves from others
Nursing Assessment and Interventions
• Implemented the child's routines
• Plan care around usual activities
• Favourite toy and books
Chapter 10: Evidence-based nursing assessment and interventions: The child and young person
with a chronic illness
Asthma
• Most common long-term chronic condition affecting children in Australia
• Underlying cause not known
• Chronic inflammation of the airways
• Early signs
o Cough, wheezing, difficult breathing, prolonged expiratory phase
Nursing Assessment and Interventions
• Review asthma plan
• Judging the severity of an asthma attack
• Oxygen saturation, heart rate, ability to talk, cry, accessory muscle used, level of consciousness
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