Nursing during medical treatment
A child is not a small adult. Children grow, feel fear quickly and cannot always say what hurts. So the nurse changes how she cares.
- Explain in short, true, simple words. Say what will happen and what it will feel like.
- Play: toys, drawing and stories lower fear. Play can also show the child what a drip or a mask is.
- Keep safe: medicine dose is worked out from the child body weight. Two nurses check it. Bed rails go up. Hands are washed before touching the child.
- Watch the vital signs: temperature, pulse, breathing and colour. Babies can get worse quickly.
- Keep family close. A parent is the best comfort. This is called family-centred care.
- Consent: parents or guardians give permission. The child is still asked and heard, as far as his or her age allows.
Acute phase
An acute illness starts suddenly and is often strong: high fever, fast breathing, or vomiting and loose motions that dry the body. It may last days or weeks, then it is cured or turns chronic.
Nursing focus: watch closely and act early. Check temperature, pulse and breathing often. Keep a drip running at the right speed. Give medicine on time. Record what the child drinks and passes. Tell the doctor at once about danger signs such as hard breathing, fits, or a child who is too sleepy.
Also calm the parents. They are frightened too.
Chronic phase
A chronic illness lasts a long time, for months or years. Examples are asthma, diabetes in children, or a heart problem from birth.
Nursing focus: teach and support. The child and family must learn the medicine, the food rules and the warning signs. Help the child go to school, play and make friends. Look out for tiredness of the whole family. Check that the child is growing and learning well. Let the child take small jobs, like marking a medicine chart, so he or she feels in control.
Terminal phase
In the terminal phase, doctors know the illness cannot be cured. The goal changes from cure to comfort and dignity.
Nursing focus: ease pain and other discomfort, keep the child clean and warm, and let him or her play or rest as wished. Keep parents and brothers and sisters close. Speak honestly and gently. Listen to their fear and grief. Respect their culture and beliefs. After the child passes away, support the family and the nurses on the team. This care is often called palliative care.
Try it
Try it: Take a teddy and play nurse. Explain to the teddy, in three short sentences, what a thermometer does. Then ask a younger child to guess what you will do. In the 3D, press the three phase buttons and say aloud what the nurse watches in each.
Key formulas and definitions
- Child care = Explain + Play + Keep safe
- Acute = sudden and strong: watch and act fast
- Chronic = long illness: teach and support
- Terminal = no cure: comfort, dignity and family
- Dose for a child = dose per kg x weight in kg (then split by number of doses)
Worked examples
1. A 5-year-old is afraid of the injection. What should the nurse do?
Explain in simple words, let the child hold a toy injection, let the parent stay, say it will pinch for a short time, and praise the child after.
2. A child weighs 12 kg. The dose is 15 mg per kg per day, in 3 equal doses. Find one dose.
Total per day = 15 x 12 = 180 mg. One dose = 180 / 3 = 60 mg.
3. Which phase is it: a child with asthma who has used an inhaler for three years?
Chronic phase. The nurse teaches inhaler use, triggers and school care.
Common mistakes
- Talking only to the parent and ignoring the child.
- Using a dose for adults. Child doses depend on weight.
- Telling a child "it will not hurt" when it will. Be truthful and kind.
- Thinking terminal care means doing nothing. It means active comfort care.