Transcript for:
Pediatric Nursing Lecture Notes

Hi, I'm Meris with Level Up RN, and in this video,  we're going to get started with the principal   section of the pediatric nursing deck. I'm  going to be following along using our pediatric   flashcards, of course. These are available on our  website, leveluprn.com, if you want to grab a set   for yourself. And if you already have a set,  I would invite you to follow along with me.   Okay, let's get started. So, first up, we're going  to be talking about different types of families.   So this is important for you to understand so  that you can understand what a family is. Now,   remember that a family is whatever the family  says, it is, right? So it's not up to us to make   a determination about who is considered a part  of a family, but these are some general concepts   of what families might look like. So we have the  nuclear family. A nuclear family is the household   consisting of two parents and their children. So  this is kind of what I think of, the 1950s white   picket fence, right? This is that the two parents,  their children. That is the nuclear family.   It kind of helps me remember because I think of  nuclear tensions in the '50s, things like that. So   that's what a nuclear family is. Now, a blended family is going to be   including the parents with their biological  children from previous marriages.   So this one I think of as the Brady Bunch,  right? We have two parents who are together,   but they may have biological children of their own  together, but they may also be bringing children   from previous marriages or relationships,  right? So Brady Bunch is our blended family.   Now, an extended family is going to be consisting  of the parents and the grandparents being present.   So if we have a household where we have parents,  children, and grandparents, that is going to be   an extended family. A single-parent family, so  this is what it sounds like. The head of the   household might be widowed, could be divorced, or  just unmarried. So this is going to be a single   parent and the biological children. And then  binuclear family, binuclear meaning two nuclear,   so this is going to be a post-divorce family  with co-parenting by the mother and the father.   So the children are members of two households.  So we have a family. Maybe they divorce, and now,   we have a mom in one house, a dad in the  other house, and the parents go between   the two households. That is a binuclear family. Okay. Moving on, we're going to be talking about   family theories. The two main ones that I want to  cover today are family systems theory and family   stress theory. Now, family systems theory means  that the family is an interdependent unit. They   all depend on one another, right? So this means  that any change or stressor that is experienced by   one member of the family affects the entire family  unit. So if dad is experiencing a stressor at work   or if the child is experiencing a stressor  at school, then the whole family is affected   by this change or this stress. That's family  systems theory. Family stress theory states   that the family's response and coping strategies  to routine and unexpected stressors are the focus.   So how does the family respond to these  sorts of changes, these sorts of stressors,   and what kind of coping strategies do they  have as a unit? That is family stress theory.   Now, moving on, we're going to talk about types of  parenting, and I would say that this is a pretty   important concept because it's important for  you to understand what type of parenting a child   may be experiencing, and that can help you to  understand what types of rules they're exposed to,   how their behavior is addressed or not addressed,  and just kind of what is the dynamic at home.   So we have four big ones here, and let's start  with authoritarian. Authoritarian is going to be   the strict type of parenting. This is high  control, so lots of rules, lots of control,   low warmth. So we don't see a lot of warmth or  open, loving sort of parenting going on here.   There are inflexible rules. We're very strict.  We don't have flexibility in the rules here,   and little communication with the child.  So this might be the family where,   because I said so, end of story, right? There's  no communication about why these are the rules   or why this is the expectation. Now, we do  have a cool chicken hint here on this card:   authoritarian is terrible, right? So this is  thought to be one of the types of parenting that   is not ideal. It is high control, low warmth. Now, moving on to authoritative,   so this is not one of our cool chickens, but  I think of authoritative is give and take, so   if that helps you use it. But this is moderate to  high control, but high warmth, right? So here, we   have flexible rules, so as the situation changes,  the rules change, and open communication with the   child. So, "Hey, I know that this may seem like  a really strange rule. The reason we have this   rule is to keep you safe in the following ways,  right?" Or, "Because of your behavior last week,   we're going to be instituting a new rule where  blah-blah-blah." We're communicating with the   child. We're explaining the rationale behind these  rules and behaviors. We also have a lot of warmth,   a lot of open communication and love,  right? This is the ideal parenting style,   authoritative give and take, right? So that is  the ideal parenting style. And we have two more.   We have permissive. Permissive parents are  going to be indulgent. There is low control,   but high warmth, right? So there's very few  constraints, very few rules. But there's lots of,   "I love you so much. You're so great. I think the  world of you." But there's not a lot of control.   This may be the parents who want to be seen as  the friends, right? "I want my mom to be my best   friend." They may have a permissive parenting  style. And lastly, we have the indifferent   or passive parenting style. In this case, we are  thinking more of a neglectful environment. We   have low control and low warmth. So there are very  little rules, but we are also showing very little   positive feedback or love to this child. There  are no limits, and there is a lack of affection.   So I hope all of those makes sense because  if you can get a little bit tricky there,   but always think about it in terms  of control and warmth. Each one   has a different kind of mix of those things. Okay, now everyone's favorite stuff. We're going   to be talking about Piaget's theory of cognitive  development. As you can see, we have a really nice   chart here. We did the hard work for you. We've  separated it by the stage, the age range, and the   key characteristics. I would greatly encourage  you to review this chart if you are struggling   with Piaget's because we really put it all here in  black and white for you, and a little bit of bold,   red text. Now, big ones that I want to point out  to you would be sensorimotor, sensorimotor meaning   I am exploring the world through my senses and my  touch, right? This is going to be from birth to   age two. This is the point in time where children  develop object permanence. So that is, when I move   the pen behind the piece of paper, do you still  know that it exists? That is object permanence.   This is going to be a really important time  because the child is experiencing the world with   their senses. So they're going to be touching  everything. They're also going to be mouthing   things. This is where you see children putting  toys in their mouths, licking things, right?   So if you've ever seen a small child, they're just  putting everything in their mouths, which puts   them at risk for choking, right? Very big risk for  choking in that birth to age two range based on   the Piaget's theory. Pre-operational is going to  be ages two to seven. This is where we might have   magical thinking or animism, where we give-- we  treat inanimate objects as though they are alive.   Maybe we're treating our stuffed animals like  they have thoughts and feelings and voices.   Concrete operational is going to be from 7 to  11 years old. This is where we're starting to   develop that logical thought and we're having a  more accurate understanding of cause and effect.   Conservatism is an important concept  here in this stage, which is that,   when something changes its form, the amount does  not change, right? So if I have ice and that ice   melts into water, it's still the same amount  of that matter. It has just changed its form.   Now, lastly, we have-- from age 11 into adulthood,  we have formal operational. So this is where we   have the ability to have abstract thought.  This is something that is very difficult for   children to grasp until they reach that age of  about 11 years old. Okay, moving on, our last   topic today is going to be Erikson's theory of  psychosocial development. I know everyone just   loves Piaget and Erikson. Very important stuff  here, though. Again, we made you this super   nice chart. It's all broken down by age, the age  range, the psychosocial crisis, all of the things   that you need to know. So, again, if you're  struggling with Erikson, look at this card.   Okay, so infancy, that's birth to one year. The  biggest thing here is trust versus mistrust.   When I cry, does somebody come? When I have a  need, is it addressed? That's a very important   thing for a child to understand and develop  that trust in their parent or caregiver.   Toddlers age one to three years are going to have  autonomy versus shame and doubt. So this is where   they may be trying to do things on their own. Are  they allowed to explore the world and do those   things on their own, or are they told, "No, no,  no, don't do that. You're too little for that,"   right? That's going to be important. We want to  allow for choices and autonomy and independent   thinking. The preschoolers, three to six  years, they are going to have initiative   versus guilt. So this is going to be where we are  interacting socially, and we may be initiating   play activities. So, "Do my friends want to play  with me, or do they not?" Right? That's going   to be a big deal there. So we want to give these  opportunities for play and creative expression.   Now, school age, 6 to 12, this is a really big  one too. This is going to be industry versus   inferiority. These kids love school, right? They  love crafts. They love learning. This is where   we're learning new skills and gaining a sense of  pride and accomplishment in the things that we   have done, created, or learned. So I don't know if  you remember that age you might have really loved   school. That would be the appropriate Erikson  stage for you at that age, which then changes   when you hit adolescence. But from adolescence,  ages 12 to 18 years, here, we have identity versus   role confusion. So this is where we're starting  to get that sense of who am I, right? How do I   fit into society? This is where we're going to  start to identify with our friend group and see   how we don't identify with other groups. We want  to have that sense of inclusion, and this is   why adolescents are so easily susceptible to peer  pressure. Okay. I hope that review was helpful for   you. I'm going to give you some quiz questions to  test your knowledge of key facts, so stay tuned.   Okay, I hope you were paying attention because  I've got some good questions for you today.   How would you describe a family where a child's  parents are divorced, but they co-parent the child   from two different households? What term  is used to describe that type of a family?   All right. Next up, a child describes  to the nurse that, in their household,   there are no real rules, but they  describe their parents as being warm   and loving. What type of parenting  does the nurse believe this to be?   Okay, third question. What is a key risk to  children ages zero to two based on Piaget's   theory of cognitive development? Hope you were  paying attention. This is an important one.   Okay. Lastly, the nurse is caring for a child who  says that they feel sad to miss school because   they love learning. In which age range might the  child be, and what is the name of the Erikson's   stage they are in? So two questions there. What  age range, and what is the name of the stage?   Let me know how you did. I can't wait to  hear. Thanks so much, and happy studying.   True story. My son choked on a  hot dog when he was 18 months old.   We did not give our son a hot dog when he was 18  months old. I want to be very clear about that.   But we had given my daughter a hot dog; cut  up, but a hot dog. She was several years older,   and a piece of it had fallen off of her plate and  rolled underneath the TV stand. And the next day,   my son, who was eight months old, was crawling  around on the floor, and what does he do? He   sees this thing, picks it up, and puts it in  his mouth. Again, he's exploring the world,   using his senses, sensorimotor. He's eight  months old, exact right age range. Sure enough,   he choked on that and nearly-- I mean, he could  have died. Luckily, I happened to be home,   and I was able to pick him up. I did CPR-- not  CPR, but I did the choking resuscitation for him,   and it wasn't coming out, and I was panicking  a little bit and had my husband call 911.   And I kept doing the back slaps and chest  thrusts because I knew you did that until   they go unresponsive. And I think it was like  the fifth round; it finally came out. I mean,   he was blue. It finally came flying out  of him, and he took a great, deep breath,   and then he just immediately started crying,  but I was so relieved. And that's when I became   really hypervigilant about looking under things  because you have to think about the fact that   you perceive the world from a different  physical level than the child does. And so,   at the end of the night, when we were cleaning up,  I would literally get down on my hands and knees   and crawl around to look under things  like the TV stand, the table, the couch,   to see if there was anything that I wasn't  seeing from my big adult perspective that   would pose a risk to my son. So very scary,  very legitimate risk for choking in that age. I invite you to subscribe to our channel  and share a link with your classmates and   friends in nursing school. If you found value  in this video, be sure and hit the like button,   and leave a comment and let us know  what you found particularly helpful.