Children Welfare and Immune System problems Children s

Children Welfare and Immune System problems. Children ‘s understanding of illness Children thought of illness in terms of punishment for doing something wrong. Research has demonstrated that children see illness in other terms, such as catching germs; as an experience they can avoid through certain behaviours, for example, by eating good food or doing as they are told.

As children become older they also begin to realize that illness can have both physiological and psychological aspects ( Bibace and Walsh, 1981 cited in Mike Walsh pp. 80). Bibace and Walsh ( 1981) use the cognitive development proposed by Piaget as a framework for their study. Piaget described children as passing through stages of cognitive development. As they move from stage to stage their understanding of what is going on around them evolves.

Two to seven-year-old children are seen as being in the preoperational stage. Such children are egocentric and may give life to inanimate objects. The older child is far more able to think in abstract terms and hypothesize about events and the future ( Sylva and Lunt, 1982 cited in Walsh 1997).

Children’s developing understanding of illness Age Stage Beliefs Phenomenism 2 -7 you. ’ Contagion Illness just happens Illness is located in people or objects. ‘Colds come when people get near Contamination People get colds because they go outside Internalization without a hat. Explanation of illness is vague, but they understand that illness can get into the body, e. g. people get colds because they breathe in bacteria.

7 -12 Physiological People get colds by breathing in viruses from Others. The virus gets into the bloodstream. 12 Upwards psychophysiological People get heart attacks because they worry too much, ‘ the tension can affect your heart’.

Piaget described children as passing through stages of cognitive development. As they move from stage to stage their understanding of what is going on around them evolves. Two to seven-yearold children are seen as being in the stage. pre-operational

Such children are egocentric and may give life to inanimate objects. The older child is far more able to think in abstract terms and hypothesize about events and the future ( Sylva and Lunt, 1982 cited in Walsh 1997, pp. 81).

Physical Needs Shelter Protection Fresh air and sunlight Security and rest Prevention of illness or injury Training in life skills Emotional Needs Affection Continuous individual care Personal identify Dignity and self-respect Opportunity to learn from experience.

The Immune System The body is protected from harmful agents by a complex system. The effects of dysfunction in this complex system can involve any or all of the body systems and , as such, can present the child with many varied problems. It is likely that you will meet the challenges presented by children with problems of the immune system and therefore it is essential that you have a working knowledge of the system’s normal function and the mechanisms of dysfunction.

The organs that contribute to protection of the body are: v Non-immunological host defences – skin, cilia, mucous membranes, tears and saliva. v Inflammatory response – vascular and cellular changes that eliminate dead tissue, microorganism, toxins, and inert foreign matter. v Mononuclear phagocytic system ( reticuloendothelial system ) – removes pathogens from blood and tissues by phagocytosis – mainly by magrophages.

Immune system – includes organs, tissue and cells circulating in the blood. Primary organs – bone marrow and thymus. Thymus – a two-lobed lymphoid gland situated behind the sternum and extending Upwards to the thyroid gland. It is important in fetal life, infancy and childhood, when it grows to reach a maximum at puberty, after which it becomes smaller.

Assessment Assessing children with potential immune problems can be confusing and requires you to keep many different aspects in your mind at once. Immune problems often produce multi-system effects and you need to take a through history and a general physical assessment. You need the ability to recognise immune-related signs and symptoms, keeping in mind the different types of immune dysfunction identified above.

The first step in assessing the child is to talk to him and his carers. v Bleeding/bruising tendencies- this helps to identify platelet/clotting dysfunction, which can occur in some v. Deficiencies and immune disorders. v any swellings that might have been noticed in the neck, armpits or groin. If so find out their nature ( painful, tender, red). Swollen lymph nodes may be indicative of infection, inflammation, certain leukaemias or lymphatic tumours.

v. Energy levels. Find out if the child has shown fatigue or weakness. Ask questions about normal Energy levels and any noticeable changes. Relate to child’s normal daily activities. v Temperature. Has the child had a fever? If so, has it been constant or intermittent in nature? Frequently recurring fevers may indicate impaired immune system or increased cell proliferation.

v Joint pain- if so where and what has been the nature of the pain? v. Ask questions about general health. v Does the child have any allergies? v Is the child taking any medications ? Steroids, some chemotherapy agents and some antibiotics can compromise the immune system. v Take a family history – this may highlight any potential hereditary problems.

Human Immunodeficiency Virus ( HIV) infection. The human immunodefiency virus (HIV) causes damage to the immune system. It is associated with a spectrum of disease, ultimately presenting as acquired immune deficiency syndrome (AIDS). Reidy et al. 1991 cited in Ramsay J and Moules T ( 2008) suggest that the role of the nurse in caring for a child with HIV disease can be based upon five needs, to:

v Maintain physical integrity. One of the most important aspects of care is infection control (a) to prevent the spread of the virus and ( b) to protect the child frm infection ( which is particularly important when the child is admitted to hospital). Each hospital will have its own infection-control policies but you need to be aware of the principles of standard precaution. v. Communicate. Many difficult issues arise when considering this aspect of care. It is imperative that the family is given room and opportunity to communicate with healthcare staff. The channels for should be obvious and available to the child and family. communicating

v Feel worthwhile and useful. Mac Kenzie (1994) highlights the importance of developing a close relationship with the family based on trust and mutual respect. Acknowledgement of the caring skills of the family is vital so that you avoid making them feel inadequate. v Act according to a set of beliefs and values. According to Friedemann (1989) it is important that the nurse and the family share the same goals. This may be difficult if the values and goals of the family are different from those held by the nurse. However, to maintain and an effective relationship the nurse must be able to set aside her own beliefs and respect those of the family.

Learn. Children with HIV or AIDS should be allowed to attend school. You must ensure that families and children receive up to date information. The family need a sound understanding of the nature of HIV disease and its modes of transmission.