Informed Consent, Med Admin, Hospitalization, & Concept of Death - Pediatric Nursing | @LevelUpRN
TLDRIn this comprehensive video, Meris from Level Up RN discusses key principles in pediatric nursing, focusing on the distinction between consent and assent for children's medical procedures. She emphasizes that while parents or guardians provide informed consent, children can offer assent, expressing their willingness to participate in treatment. Meris also covers best practices for administering oral medications to children, stressing the importance of using calibrated devices and avoiding mixing medication with a whole bottle of liquid. The video highlights the significance of maintaining a routine for hospitalized children, advocating for parental presence, and using age-appropriate language to explain procedures. Meris discusses therapeutic play techniques and the importance of allowing children to interact with medical equipment to reduce fear. She also touches on the different stages of understanding illness and death according to a child's age, providing insight into how nurses can best support children's emotional and developmental needs. The video concludes with quiz questions to reinforce the key points discussed.
Takeaways
- 📜 **Consent vs. Assent**: In pediatric nursing, informed consent is required from a child's legal guardian for invasive procedures or research participation, while assent is the child's voluntary agreement to treatment or research, with the final decision resting with the parent.
- 🚑 **Emergency and Mature Minors**: In emergencies, implied consent allows treatment without formal authorization. Mature minors (14-18 years old) can consent for specific treatments like STI testing, contraception, and substance abuse treatment.
- 🏥 **Medication Administration**: When administering oral medication to children, use calibrated devices for accurate measurement, avoid calling medicine 'candy', and never blow in an infant's face as it can cause choking.
- 🍼 **Mixing Medications**: Medications can be mixed with a small amount of liquid or food for easier administration, but not in entire bottles or large servings to ensure accurate dosage.
- 🧒 **Child's Routine in Hospital**: Maintaining a routine is crucial for children during hospitalization as it provides comfort and reduces the impact of the hospital environment.
- 👩⚕️ **Parental Presence**: Encouraging the presence of parents or guardians can provide reassurance and comfort to children, especially younger ones, in a hospital setting.
- 🌿 **Topical Anesthetics**: Using topical anesthetics like EMLA cream before painful procedures can reduce fear and discomfort associated with medical interventions.
- 🗣️ **Age-Appropriate Communication**: Nurses should explain medical procedures using language suitable for the child's age to avoid causing unnecessary fear or confusion.
- 🧸 **Therapeutic Play**: Utilizing play techniques and child-life specialists can help children understand medical procedures and cope with hospital experiences.
- 📚 **Peer Interaction**: Encouraging peer interaction and maintaining educational continuity is important for school-age children and adolescents' social and emotional well-being.
- 🏥 **Pain-Free Environment**: Performing painful procedures in a treatment room, not the child's room, helps maintain a positive association with the child's hospital room.
- 🧠 **Understanding of Illness and Death**: Children's comprehension of illness and death varies by age, with a full understanding of death's permanence typically developing around six years old.
Q & A
What is the primary difference between consent and assent in pediatric nursing?
-Consent refers to the formal authorization given by a child's caregiver, parent, or guardian for an invasive procedure or participation in research. Assent, on the other hand, is the voluntary agreement given by the child themselves to accept treatment or participate in research, but the final decision remains with the parent or guardian.
Under what circumstances can a minor provide their own consent for medical treatment?
-An emancipated minor, who has been legally recognized as an adult, can provide their own consent. Additionally, mature minors aged 14 to 18 can consent to certain treatments such as STI testing and treatment, contraception services, substance abuse treatment, and some mental health services.
What is implied consent in the context of pediatric emergency care?
-Implied consent is a situation where consent is assumed without being explicitly given. In an emergency, such as a life-threatening situation, medical treatment may be provided to a child without the need for formal consent from a parent or guardian, as it is assumed that a rational caregiver would want to preserve the child's life.
Why is it important to use a calibrated device when administering oral medications to children?
-A calibrated device ensures accurate measurement of the medication, which is crucial for the child's safety and the effectiveness of the treatment. Kitchen utensils like teaspoons are not accurate measuring devices and should not be used for medication dosages.
How should a nurse educate a caregiver on the correct method to measure liquid medication for a child?
-The nurse should instruct the caregiver to use a calibrated device such as a measuring teaspoon, syringe, or medication cup. They should also demonstrate the correct technique of measuring the liquid at eye level to account for the meniscus and ensure accurate dosage.
What is the significance of maintaining a routine for hospitalized children?
-Children thrive on routine, and disruptions to their daily activities can have a significant impact on their well-being. Maintaining a routine can provide a sense of normalcy and comfort during a hospital stay, which is particularly important for younger children.
Why is parental presence encouraged during a child's hospitalization?
-Parental presence provides emotional support and reassurance to the child, helping them to feel safe and secure in the unfamiliar hospital environment. It is especially important for younger children who rely heavily on their parents for emotional stability.
How can therapeutic play techniques benefit hospitalized children?
-Therapeutic play techniques help children understand medical procedures and express their fears and concerns in a developmentally appropriate way. It can also help them to cope with stress and anxiety associated with hospitalization.
Why is it recommended to perform painful procedures in a treatment room rather than the child's hospital room?
-Performing painful procedures in a separate treatment room helps to maintain the hospital room as a therapeutic and non-threatening environment. This can reduce fear and anxiety associated with the hospital room and promote a more positive healing space for the child.
At what age do children typically begin to understand the permanence of death?
-Children typically begin to understand the permanence of death around the age of six years old, which is when they enter the school-age developmental stage.
How can allowing a child to touch medical equipment help reduce fear and anxiety during a hospital stay?
-Allowing a child to touch and explore medical equipment under supervision can help demystify the equipment, making it seem less intimidating and less likely to cause pain or harm. This can reduce fear and anxiety and promote a more cooperative approach to medical procedures.
Outlines
📝 Principles of Pediatric Nursing: Consent and Assent
In the first paragraph, Meris discusses the principles of pediatric nursing, focusing on the distinction between consent and assent. Consent is the formal authorization from a child's caregiver for an invasive procedure or research participation, while assent is the voluntary agreement from the child to accept treatment or participate in research. Meris emphasizes that parents or guardians have the final say unless it's an emergency or the minor is emancipated. She also covers the rights of mature minors (14 to 18 years old) to consent for specific treatments and advises checking state laws for variations. The importance of using age-appropriate language and techniques when dealing with children in healthcare settings is highlighted.
💊 Best Practices for Administering Oral Medications to Children
The second paragraph focuses on the best practices for giving oral medications to children. Meris stresses the importance of using a calibrated device for accurate measurement and advises against using kitchen utensils. She explains the concept of the meniscus and the need to measure liquids at eye level. Meris also discusses the risks of calling medication 'candy' or using startling techniques that could lead to choking. She suggests that medications can be mixed with a small amount of liquid or food, and that flavorings may be available through pharmacies. Additionally, she provides a technique for administering liquid medication to infants to prevent aspiration.
🏥 Hospitalization Best Practices for Children
In the third paragraph, Meris outlines best practices for the nursing care of hospitalized children. She emphasizes the importance of routine and parental presence for younger children, the use of topical anesthetics like EMLA cream before painful procedures, and the use of age-appropriate language to explain medical procedures. Meris also highlights the value of allowing children to make choices where possible, using therapeutic play techniques, and facilitating peer interaction for school-age children and adolescents. She also discusses the concept of performing painful procedures in a treatment room to keep the child's hospital room a positive space.
🧒 Understanding Illness and Death at Different Ages
The fourth paragraph deals with the concepts of illness and death as understood by children of different ages. Meris explains that infants and toddlers do not have a concept of death and may experience separation anxiety. Preschoolers, with their magical thinking, may view death as temporary and could blame themselves for illnesses. School-age children begin to understand the permanence of death around the age of six and may exhibit disruptive behavior as a coping mechanism. Adolescents have an adult-like understanding of death but are deeply concerned with body image and peer relationships, which can be affected by illness or injury.
Mindmap
Keywords
💡Informed Consent
💡Assent
💡Emancipated Minor
💡Mature Minor
💡Calibrated Device
💡Meniscus
💡Therapeutic Play
💡Peer Interaction
💡Pain-Free Site
💡Developmental Stages
💡Body Image
Highlights
The importance of understanding the difference between consent and assent in pediatric nursing, especially when it comes to invasive procedures and research participation.
Informed consent for minors can only be provided by a parent or legal guardian, with exceptions in emergencies or specific conditions where an emancipated minor or mature minor can consent for themselves.
Implied consent applies in life-threatening situations where a parent or guardian is not present, allowing medical treatment to proceed without formal authorization.
Mature minors, typically aged 14 to 18, can provide consent for specific treatments such as STI testing, contraception, substance abuse treatment, and some mental health services, subject to state laws.
Assent refers to a child's voluntary agreement to accept treatment or participate in research, but the final decision remains with the parent or guardian.
Best practices for administering oral medications to children include using calibrated devices and avoiding the use of kitchen teaspoons for measurements.
Measuring liquid medications at eye level is crucial to account for the meniscus and ensure accurate dosages.
Medication should not be referred to as candy and certain techniques, like blowing in an infant's face, can increase the risk of choking and are not recommended.
Medication can be mixed with a small amount of liquid or solid food for easier administration, but not in entire bottles or large servings to ensure accurate intake.
The use of flavorings and the consultation with pharmacies for medication administration in children is suggested for better compliance.
Proper technique for administering liquid medication to infants involves placing the medication along the side of the mouth to prevent aspiration and choking.
Maintaining routine and providing parental presence is important for hospitalized children to reduce the impact of hospitalization on their daily lives.
Topical anesthetics like EMLA cream should be used before painful procedures to minimize discomfort and fear in children.
Using age-appropriate language and explanations can help reduce fear and anxiety in children undergoing medical procedures.
Allowing children to make choices where possible can provide a sense of control and reduce the negative impact of hospitalization.
Therapeutic play techniques and child-life specialists can be used to help children understand medical procedures and cope with their hospital experience.
Allowing children to touch and familiarize themselves with medical equipment can reduce fear and anxiety.
Encouraging peer interaction and maintaining connections with school is important for school-age children and adolescents during hospital stays.
Painful procedures should be performed in a treatment room to keep the child's hospital room a positive and pain-free environment.
Understanding a child's concept of illness and death varies by age, and it's crucial to communicate and support them based on their developmental stage.
Transcripts
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