RNSG 2201

Care of Children &

Families
CLASS RULES
1. No eating or drinking in the classroom.
2. ALL communication devices turned off
during class.
3. Lap top & recorder may be used for lectures.
4. Quiet in the hallways at all times.
5. Backpacks and other belongings UNDER the
chair or in the corner of the room for
everyones safety. Do not block doorway.
6. Be on time.
DENVER II
1. Purpose detect developmental
delays
2. Ages birth to 6 years
3. Functional areas: 125 tasks or
items in
a. Personal-social
b. Fine motor adaptive
c. Gross motor
d. Language
DENVER II
4. Kit Items
Test form Red yarn pom-pom Small bell
Small plastic doll Bottle to feed doll Tennis
ball
Plastic cup with handle Bottle with
cheerios
Small, clear glass bottle with 5/8 inch opening
10 1 inch square wooden blocks (2 each) of
yellow, red, green, blue and orange
Colored pencil (different color from previous
testing)
DENVER II
Read page 78-80 in your textbook.
Form is viewable on-line
DENVER II
5. Calculation of Age Line
Todays date as: Year 2013 Month 08 Day 28
Childs birthdate: 2011 09 11
Borrow to subtract: 2012 +12+8=20
28 days
Childs birthdate: 2011 09 __ _
11_____
Answer: 1 year 11 months 17 days

IF the child is less than 2 years of age and was 2 or more
weeks premature subtract the number of weeks
premature from the age line.
DENVER II
5. Calculation of Age Line
Todays date as: Y ear 2013 Month 08 Day 28
Answer: 1 year 11 months 17 days
If child was 6 weeks premature: Subtract 6 weeks by
converting the 4 months to 2 months and 8 weeks
as applicable to situation.
Answer: 1 year 11 months 17 days which equals
1 year 9 months 8 weeks 17 days
SUBTRACT 6 weeks =
1 year 9 months 2 weeks 17 days
or
1 year 10 months 3 days
DENVER II
5. Calculate the age line: Todays date:
Childs Birthdate:
Where would you draw the age line?
Year Month Day
201 0 03
If < 2 yrs. and 2 or more week premature; adjust
age line:
DENVER II
5. Calculate the age line: Todays date: 2014
01 - 15
Childs Birthdate: 2011 12
- 31
Where would you draw the age line?
Year Month Day Year Month Day
2014 01 15 Convert: 2013 1+12=13 -30= 12
30+15 =45
2011 12 31 2011 12 31
Answer: 2 yrs. O mon. 14 days
Remember: A month = 30 days.
If < 2 yrs. and 2 or more week premature;
adjust age line since this child is under 2
years of age.
DENVER II
6. Administration of the Denver II
Well child
Acquire permission from parent
Best if caregiver is present
Establish rapport
Assess child
Mood
Behaviors prior to interactions
Reactions
DENVER II
7. Pass vs Reported Item (125
items)
Pass child is able to perform
task
(25%, 50%, 75% and 90% -
mark)
Reported only those items
marked with R in the block
can be reported
DENVER II
8. Observations
a. Childs overall behavior
b. How the child reacted to the
tester
c. Parent-child relationship
d. Attention span of the child
IMMUNIZATIONS
Immunization Schedule for 2013 http://www.
cdc.gov/vaccines
Vaccine Information Statement (VIS) given
to parent. Parents must sign consent.
VAERS www.fda.gov/cber/vaers/vaers.htm
www.vaers.hhs.gov
Refusal to Vaccinate http://www.dshs.state.tx.
us/immunize
Documentation, etc
www.immunize.org
www.cispimmunize.org
ARE CHILDREN MINIATURE ADULTS?
HEALTH ASSESSMENT
Privacy HIPAA
Communication with the Family
Introduction verify relationship to child
Establishing rapport
Active listening
Therapeutic Communication
Family education
Anticipatory guidance
Family empowerment
Keeping child connected with family
Evaluation of care
RELIGION & CULTURE
Role of nurse is to consider & elicit religious
& cultural information from the family
Religious preference & religious practices
Decision-making practices
Child-rearing practices
Family support
Communication practices
Health & illness practices
HEALTH ASSESSMENT
Communication with the Child
Friendly approach; eye level
Use cognitively appropriate terminology
Take into consideration the childs
developmental abilities, too
Explain all treatments & procedures
Allow developmentally appropriate play
Provide sensory information
See textbook for age specific
communication
PLAY
is the
UNIVERSAL LANGUAGE
of CHILDREN
Play is a childs WORK
Favorite toy or object such as a blanket
Use of transitional objects
Is permissible to play with the child as
part of your nursing care and
interventions
HEALTH ASSESSMENT
Similar to Adult Health History
History prenatal, birth,
immunizations, growth & development
(G&D) milestones
Allergies latex, environmental, foods,
drugs
Habits & Rituals mimic home
Family History & Interaction
parent/child relations
Diet History
Growth & Development
HEALTH ASSESSMENT
Physical Exam
Is not sequential, is
opportunistic!
Do RR and HR FIRST while quiet
Do not use instruments first
Do painful procedures last
(ears)
Pull down & back < 3 y. o.
Pull up and back > 3 y. o.
HEALTH ASSESSMENT
Physical Exam
Specifics for each age group and
system will be discussed with that
body system
Allow the parents to console
afterward
Reward after the exam with a
sticker
GROWTH & DEVELOPMENT
Growth Charts
See Appendix A, pp. 1122-1128
Height & weight
Two years & under, head
circumference
Denver II
Milestones
GROWTH & DEVELOPMENT
REVIEW Physical Assessment
REVIEW developmental
theories
Erikson: Psychosocial
Piaget: Cognitive