Health promotion

• Health promotion
  • Sleep and Rest
    • To prevent sudden infant death syndrome (SIDS) – 90% of death occurs before 6 months of age – Parents should be advised to:
      • Be breastfed (if possible) 
      • Be put to sleep in a crib or other infant sleep location- not in a sofa, futon or adult bed 
      • Put to sleep on a firm surface, in the same room as caregivers but not sleeping with anyone else
      • Clothed in a sleep sack with no blanket 
      • Nothing soft placed in the crib 
      • Kept away from cigarette smoke 
      • Given a pacifier at the beginning of nap and bedtime 
      • Slats of crib should be no wider than 2 3/8 inches apart to avoid strangulation 
      • Sleep area should be placed away from blinds and curtain strings that can be wrapped around neck
  • Parent education
    • Diapers should be changed frequently to prevent diaper rash 
    • When bathing an infant: 
      • The baby should never be left alone or near water to prevent diaper rash 
      • All needed supplies should be collected before immersing baby in the water 
      • Bath water should be 105 degreed F to prevent burning 
      • Childproofing home should start at 4 months
  • Child abuse issues
    • Shaken baby syndrome (SBS) 
      • A serious syndrome that can result when an infant is violently shaken 
      • SBS can result in permanent damage including mental retardation and physical disability or death from bleeding brain
      • parents often misunderstand normal child behavior and should be taught 
      • If child abuse is suspected, the nurse must report the abuse
  • Immunizations

• • • Communicating with parents about immunizations
      • Provide accurate and user-friendly information on vaccines (the necessity for each one, the disease each prevents, and potential adverse effects).
      • Realize that the parent is expressing concern for the child’s health.
      • Acknowledge the parent’s concerns in a genuine, empathetic manner.
      • Tailor the discussion to the needs of the parent.
      • Avoid judgmental or threatening language.
      • Be knowledgeable about the benefits of individual vaccines, the common adverse effects, and how to minimize those effects.
      • Give the parent the vaccine information statement (VIS) beforehand and be prepared to answer any questions that may arise.
      • Help the parent make an informed decision regarding the administration of each vaccine.
      • Be flexible and provide parents with options regarding the administration of multiple vaccines, especially in infants, who must receive multiple injections at 2, 4, and 6 months of age (i.e., allow parents to space the vaccinations at different visits to decrease the total number of injections at each visit; make provisions for office visits for immunization purposes only [does not incur a practitioner fee except for administration of vaccine], provided the child is healthy).
      • Involve the parent in minimizing the potential adverse effects of the vaccine (e.g., administering an appropriate dose of acetaminophen 45 minutes before administering the vaccine [as warranted]; applying EMLA [lidocaine-prilocaine] or LMX4 [4% lidocaine] to the injection sites before administration; following up to check on the child if untoward reactions have occurred in the past or parent is especially anxious about the child’s wellbeing).
      • Respect the parent’s ultimate wishes