Importance of care in children

Children  are not  just  small adults. This is important  to keep  in mind when evaluating how children react to illness, perceive an illness, or react to the health care. Their body images, as evidenced in  their drawing, are different  from those of adults. The special care of hospitalized child is important because of  following factors. 

Inability to Communicate

Very young children do not have the vocabulary to describe  symptoms. The school Problems-I  age children can describe symptoms with accuracy. They may intend  their concerns, however, if they feel that someone expects symptoms to be more serious. They may minimize symptoms if they are afraid that illness will interfere with an activity. A child's symptoms should be determined as such by observation  and by the child's report.

Inability to Monitor Own Care and Manage Fear 

Adults who are hospitalized often ask about medication or procedures they are scheduled to undergo while the children are unable to monitor their own care this way. Children have fears of separation,  the dark, the unknown, intrusive procedures, and mutilation of body parts that adults  do not. 

Nutritional  Needs 

There are major physiologic differences  in the way illness affects children compared to  adults. Children need more nutrients (calories, protein, minerals  and vitamins) per kg of body weight than adults, because  their basic metabolic  rate is faster and they must take in compared to the enough nutrients  to maintain body requirement of 120 k/cal/kg body wt./day compared to the adults who require  30-35 k/cal/kg body wt./day. 

Fluid and Electrolyte Balance 

In the adult, extracellular water comprises approximately 23 per cent of total water but in a newborn and infant, extracellular water is closer to 40 per cent. infant does not have as much water stored in  the cells as an adults and thus is m' likely  to lose a devastating  amount of body water with diarrhoea  or vomiting. 

Systematic Response  to Illness 

Because their body systems are immature,  children tend to respond to disease systematically rather  than locally. Systemic reaction can delay diagnosis  and therapy and cause increased fluid and nutrient loss,  (circumstances, that  compound  an initial illness) and can result  in hospitalization. 

Age-specific Diseases 

Because  of  their growth requirement and their immaturity,  children are susceptible to some diseases that do not affect adults e.g. as infants are growing, a lack of vitamin D will cause rickets but the same does not affect adults. Most adults have achieved immunity  to diseases; children,  however, are susceptible  to  childhood diseases  such as measles. Polio, severe diarrhoea, dehydration, malnutrition. 

Care-by-Parent Unit 

Some hospitals have care-by-parent or family participation units where parents actually  live  in the hospital with the child. The nurse's responsibilities  in such a setting are to prepare the parent to meet the child's needs in  the hospital, to help the child maintain a schedule  similar to the one at home, to interpret medical procedures and scheduled diagnostic  tests, and to do health  teaching  and anticipatory guidance as necessary.  In the family unit the nurse can observe the parents, their skills, attitudes and techniques, and any problems  in parent-child  relations that may be apparent.