Childhood Health Problems

  • Childhood Health Problems
    • Oral health- dental caries is the most common chronic disease in childhood
      • Early childhood caries is a preventable disease, and nurses play an essential role in educating children and parents about practicing dental hygiene, beginning with the first tooth eruption; drinking fluoridated water, including bottled water; and instituting early dental preventive care.
    • Obesity & Type 2 DM
      • The most common nutritional problem among children in the United States
      • Overweight is defined as a BMI at or above the 85th percentile and below the 95th percentile for children and teens of the same age and sex.
      • Lack of physical activity related to limited resources, unsafe environments, and inconvenient play and exercise facilities, combined with easy access to television and video games, increases the incidence of obesity among low-income minority children.
    • Childhood injuries
      • Most common cause of death & disability in children
      • Risk factors
        • Sex
          • Preponderance of males; difference mainly the result of behavioral characteristics, especially aggression
        • Temperament
          • Children with difficult temperament profile, especially persistence, high activity level, and negative reactions to new situations
        • Stress
          • Predisposes children to increased risk-taking and self-destructive behavior; general lack of self-protection
        • Alcohol and drug use
          • Associated with higher incidence of motor vehicle injuries, drownings, homicides, and suicides
        • History of previous injury
          • Associated with increased likelihood of another injury, especially if initial injury required hospitalization
        • Developmental characteristics
        • Mismatch between child’s developmental level and skill required for activity (e.g., all-terrain vehicles)
        • Natural curiosity to explore environment
        • Desire to assert self and challenge rules
        • In older child, desire for peer approval and acceptance
        • Cognitive characteristics (age-specific)
        • Infant
          • Sensorimotor: explores environment through taste and touch
        • Young child
          • Object permanence: actively searches for attractive object; cause and effect: lacks awareness of consequential dangers; transductive reasoning: may fail to learn from experiences (e.g., perceives falling from a step as a different type of danger from climbing a tree); magical and egocentric thinking: is unable to comprehend danger to self or others
        • School-age child
          • Transitional cognitive processes: is unable to fully comprehend causal relationships; attempts dangerous acts without detailed planning regarding consequences
        • Adolescent
          • Formal operations: is preoccupied with abstract thinking and loses sight of reality; may lead to feeling of invulnerability
        • Anatomic characteristics (especially in young children)
        • Large head
          • Predisposes to cranial injury
        • Large spleen and liver with wide costal arch—
        • Predisposes to direct trauma to these organs
        • Small and light body
          • May be thrown easily, especially inside a moving vehicle
        • Other factors
          • Poverty, family stress (e.g., maternal illness, recent environmental change), substandard alternative child care, young maternal age, low maternal education, multiple siblings
      • Drowning is one of the leading causes of death; Children left unattended are unsafe even in shallow water
      • Burns are among the top three leading causes of death from injury in children 1 to 14 years of age
      • Improper use of firearms is the fourth leading cause of death from injury in children 5 to 14 years of age
    • Violence
      • Strikingly higher homicide rates are found among minority populations, especially African-American children.
      • Violence seems to permeate US households through television programs, commercials, video games, and movies, all of which tend to desensitize the child toward violence.
      • Families that own firearms must be educated about their safe use and storage.
    • Bullying
      • This is a serious problem and can involve emotional, physical, verbal, and cyber-related abuse
      • When youth are not well accepted by their peers, they are vulnerable to bullying; physical disabilities, obesity, and sexual orientation can be risk factors creating vulnerability.
    • Mental health problems
      • Nurses should be alert to the symptoms of mental illness and potential suicidal ideation and be aware of potential resources for high-quality integrated mental health services.