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School Age Children

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Karen Wilbur

on 23 October 2012

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Transcript of School Age Children

Accidental Injuries Curiosity and lack of coordination and cognitive abilities increase children's risk for accidental injuries
Leading cause of death before 1 year of age is accidental suffocation
Leading cause of death after 1 year of age is motor vehicle injuries
Traumatic brain injury results in the leading cause of injury
high school sports related concussions, cycling and skateboarding falls Childhood Health issues Affected by
Parental Influences
Environmental Hazards
Community Safety
Overall Quality of Home Life School Age Children Risks



Solutions Be Safe Correctly secure children in car seats or seat belts depending on the size and age of the child.
Use helmets and proper protective equipment. Lead Poisoning A preventable cause of childhood death, mental retardation, cognitive and behavioral problems.
One of the greatest public health achievements is the reduction of lead levels in children and adults.
Most lead poisoning results from contact with lead based paint and contaminated soil.
Rates remain high among children in low-income families, black and Hispanic children.
Prevention should include elimination of risks in the environment, particularly older housing units, more efficient tracking, and public education. Childhood Obesity 17% of children age 6-17 are obese, meaning they are above the 95th percentile
This rate has tripled since 1980
Rates of childhood obesity are higher among southern African Americans, the poor, and uneducated
Causes: high cost of healthy foods, food insecutiry, lack of access to safe places to exercise, American diet, fast food, increasing portion sizes, sugary drinks, video games, TV, reliable transportation.
Results: type 2 diabetes, social discrimination, obese in adulthood, HTN, CAD
As nurses, we can promote public awareness about healthy diet, exercise, and even breastfeeding. Everyone has the responsibility to promote healthy lifestyles, create safe environments and ensure access to medical care. Maintaining immunizations protects all members of the community, especially immunocompromised and pregnant women.
Some children remain under immunized because of fears that vaccines are linked to autism.
As nurses, we can help educate community members about the safety of vaccines and the consequences of undervaccination.
Vaccines protect against diseases like: Polio (eliminated because of public health efforts), Diptheria, Tetanus, Pertussis, Rotavirus, Measles, mumps, rubella, Hep A & Hep B, HIB, Varicella, influenza, pneumococcal, meningococcal, HPV Immunizations Child Maltreatment 900,000 children in the US were victims of child maltreatment in 2004
1500 died because of abuse or neglect
lack of reporting and recognition mean these levels are probably far greater.
child abuse = words or overt actions that cause harm to a child, potential harm, or threat of harm to a child. It is deliberate and intentional, but harm may or may not be intended.
child neglect = failure to provide for a child's basic physical, medical, emotional, or educational needs or to protect a child from harm or potential harm.
Nurses, social service workers, and teachers are required by law to report child abuse. Special Needs Children with special health care needs are those who have chronic physical, developmental, behavioral or emotional conditions that require health or related services beyond those required by other children. Medical home is an approach to providing coordinated, comprehensive and integrated system of care. It strengthens the ability of children with multiple serve needs to receive comprehensive care for complex conditions. Services include: public health, physical and mental health care, specialized diagnostic services, social services, and educational, vocational and sometimes corrective services. 14% of US children and youth have special health care needs Adolescent Health Issues Adolescents rarely use preventive services
Many engage in risk taking behaviors such as Alcohol and drug abuse, early and unprotected sex, unsafe driving, delinquent & violent activities Adolescent pregnancy Related factors:
growing up in poverty
being a child of a teen mom
Being a victim of sexual abuse or assault
Lack of involvement with friends, family
Dropping out of school Preventing Teen Pregnancy Abstinence promotion
education about contraception & its availability
Sex education
Character development
Problem-solving skill development
Peer counseling programs
Strategies for ensuring school success
Job training Violence 12-17 year olds are 2 times more likely than adults to be victims
Males are twice as likely as females to be victims
Black males are the racial group most likely to be victimized
Victimization rage is 14 per 1000 juveniles
Nearly all victims know their offender Related factors:
Social factors (unemployment, poverty)
history of violence in the home, media, and community Child abuse Gun ownership Stopping the Violence Neighborhood efforts to help young people diffuse anger & frustrations
Help parents, schools & religious organizations assist their youth in managing anger & resolving conflicts
Assure children & teens they are loved, appreciated and accepted for who they are and that help is available
Reduce unsupervised exposure to guns
Engage communities in strengthening law enforcement
Modify design or guns
Limit flow of illegal guns to youth STI's Most common is cancer & genital wart associated HPV (18.3%) Chlamydia is 2nd most common

26% of female adolescents are infected with at LEAST 1 STI HPV vaccine is available for 11-12 year old girls and prevents nearly 70% of cervical cancer 15% of female adolescents have more than 1 STI Barriers to prevention:
Lack of transportation
Confidentiality concerns
Lack of access to preventive health services Tobacco, Alcohol & Drug Use 20% of students smoked cigarettes in the 30 days prior to the survey
44.7% reported having had 1 drink of alcohol
26% reported having 5 or more drinks in a row
3.3% reported use of some form of cocaine
38.19% had used marijuana Healthy People 2020 Launched in 1979
has improved child/adolescent health (mortality, prenatal care, adolescent smoking, pregnancy and violence)
Sets broad national health goals for the twenty first century by defining the nation's health agenda and guides policy development Objectives reduce the proportion of obesity
increase the proportion of low income children who receive preventive dental service during the past year
increase the proportion of schools that require daily P.E. for all students
Increase compliance to guidelines for TV viewing and computer use
Reduce proportion of teens who have ridden with a driver who had been drinking alcohol in the past 30 days
Reduce the initiation of tobacco use among children, adolescents and young adults Health Promotion and Disease Prevention More significant and cost-effective for children
Can prevent costly problems, suffering, and lost human potential
Community-based organizations, research institutes, public agencies & private business can include:
clinical interventions, identifying trends and developing population based, community-wide or individual strategies to affect the trends
Philanthropic endeavors that fund initiatives at the community, state and regional levels for the purpose of testing a strategy or establishing an initiative
Public policy initiatives that create or improve programs or provide incentives for nongovernmental entities to address identified problems Monitoring & Tracking US Department of Health & Human Services
Federal Interagency Forum on Child and Family Statistics
National Center for Education Statistics
National Center for Health Statistics
US Dept. of Justice Statistics
US Bureau of Labor Statistics
US Census Bureau Health Care Coverage Programs About 8.7 million children don't have medical insurance
Most are Hispanic
Medicaid is for low-income people and is the largest source of medical and health-related funding for America's poor.
1980~ Medicaid eligibility for pregnant women, infants and children in higher income groups 88% of children under 18 have health insurance Children's Health Insurance Program (CHIP) formed in 1997
meant to help close gap between higher and lower income families
Serves ages up to 19 years
Covers 7.4 million but does not cover all poor children or children in the "gap group" Why not Medicaid or CHIP? Welfare stigma
complex application
Processes disturb privacy
May reveal illegal immigration status
May not be aware of eligibility
Language barrier Non-monetary Obstacles Transportation
scheduling conflicts
crowded clinics
other responsibilities and priorities
Providers are sometimes viewed as unconcerned with child's needs Maternal and Child Health Block Grant Program Part of Title V of the Social Security Act
Established 1935
Distributes federal funds to the states which contribute their own funds for maternal and child health services
Significant contribution to reducing infant mortality, prevention of disabling conditions in children and the improvement of overall health of women and children Community and Migrant Health Centers Programs 1965
Centers are located in medically underserved areas
Provide primary and preventive health care to 12.4 million low-income people
Funded by local governments, foundations, corporations and clients National Health Service Corps
Federal program for primary care services for children and adolescents
Provides scholarships and loan repayment plans to students in medical, nursing, and other such training programs who agree to provide service in underserved areas School-Based and School-Linked Health Services Originated in 1970s
focus is on adolescent (HS) needs
can discuss delicate issues like puberty, contraception and peer relationships
More conservative areas are slightly hesitant to permitting adolescent health care at or near schools WIC Created in 1972
Provides nutritious foods, education and counseling
serves low income pregnant and breastfeeding mothers, infants and children up to 5 years old
75% are infants and children
Provides vouchers for specific foods
saves in health care costs
improved birth outcomes
improved infant feeding practices
lower rates of childhood obesity Parental Responsibilities Prenatal care
provide nutritious food for infant and child beginning with breastfeeding
keep shots up to date
maintain a safe environment Community Responsibility Work to provide safe and supportive neighborhoods through supporting and/or sponsoring community-based comprehensive health, education and social service programs, community health campaigns, health fairs, immunization drives, car safety seat checks, bicycle safety helmet campaigns, crime prevention
Organizing and coordinating care systems/programs that encourage publicc awareness
Use the media to promote a positive self-image and well-being and discourage the media's use of violence and emphasis on sex as a means of advertisement or entertainment Employer's Role Offer affordable and accessible health care to employees and their dependents which offer full pregnancy and well-child health visits Government's Role More limited than in other countries
has no defined policies on child health
Community health nurses, social workers, physicians and caseworkers need to collaborate in order to better aid children and families
health initiatives involving outreach and referral interventions Community Health Nurse's Role Be aware of children's health status and care barriers
Know community health resources and services
Advocate for improved individual and community responses to children's needs
Research effective interventions to better serve women and children
Participate in publically funded programs and promote social interventions to better living situations of high-risk families
Work with a variety of other professionals to better the service, collaboration, and coordination such as linking local health and social services with the school system
Can influence planning and implementation of changes within the health care system on a variety of levels Ethically, a Nurse should: •Recognize the value of engaging in a shared dialogue with colleagues regarding ethical decision-making issues and understanding the possible legal implications of their decisions are equally important.
•Receive guidance from an ethics board or get a second opinion when unsure of which choice to make
•Stay informed of legislative changes on all levels to be current on important matters
•Embrace promotion of health and well being
•Protect clients from harm
•Be fair and just to all clients • Allocation decisions- given limited time and resources, what level of care should be offered?
• Maternal-fetal conflict: Sometimes ethical concerns are opposing • Client autonomy: Who should make care decisions for a young client, especially when opposing opinions arise? What age should a child become mature enough to help make health care decisions? State laws? • Privacy and confidentiality: gross noncompliance, neglect or abuse- are interventions appropriate? When is it appropriate for the nurse to break confidentiality? •Gaming the system: When rules hinder the nurse’s ability to serve the client’s best interest, is it acceptable to circumvent the system? What are the moral and legal costs of doing so?
•Cultural competence: How should the nurse respond to a client group that does not share the same cultural outlook on health? What is the nurse’s legal justification for responding in a certain way? •Health disparities and access to care: What are the nurse’s responsibilities in ensuring that women and children have access to health care? How can nurses influence policy decisions that impact community health care?

•Prenatal diagnosis and newborn screening: What are potential long-term consequences of identifying genetic conditions? Are parents fully informed of negative consequences of genetic diagnoses, including stigmatization, discrimination, and psychological consequences?
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