Assignment: Pediatric Patient

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Assignment: Pediatric Patient

Assignment: Pediatric Patient

The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 500-750-word paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:

1. Compare the physical assessments among school-aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child.

2. Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.

3. Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Changes in body size are mirrored by changes in maturation. 
The physiological makeup of newborn or neonate differs significantly from that of an adult. 
Pediatricians are more concerned about congenital malformations, genetic variance, and developmental difficulties than adult physicians are. 
Children are not simply “small adults,” according to popular proverb. 
[28] 
When examining symptoms, giving drugs, and diagnosing ailments, the doctor must remember the infant or child’s undeveloped physiology.

 

The pharmacokinetic qualities of medications that enter the body are directly influenced by the physiology of children. 
Medications are absorbed, distributed, metabolized, and eliminated differently in developing children and adults. 
[28] 
[29] 
[30] 
Despite the results of completed studies and reviews, further study is needed to better understand how these factors should influence healthcare practitioners’ judgments when prescription and providing drugs to children. 
[28]

 

Absorption

 

The stomach is at the center of several drug absorption discrepancies between pediatric and adult populations. 
Because of their lower acid output, neonates and young infants have higher stomach pH, which creates more basic environment for medications taken by mouth. 
[29] 
[28] 
[30] 
Acid is required for the degradation of several oral medicines prior to their absorption into the body. 
As result of the slower breakdown and increased preservation in less acidic stomach region, children absorb more of these medications than adults. 
[29]

 

In addition, children have slower rate of stomach emptying, which decreases medication absorption.

 

[29][30]

 

Specific enzymes that come into touch with the oral medicine as it travels through the body play role in drug absorption. 
As children’s gastrointestinal tracts develop, their supply of these enzymes increases. 
[29] 
[30] 
Because children’s proteins are still developing, they have slower metabolism and higher drug amounts in their blood. 
Prodrugs, on the other hand, have the opposite effect because enzymes are required for their active form to enter systemic circulation. 
[29]

 

As children grow and develop, their percentage of total body water and extracellular fluid volume both drop. 
Pediatric patients have higher volume of distribution than adults, which has an impact on how hydrophilic medicines like beta-lactam antibiotics like ampicillin are dosed. 
[29] 
To account for this important change in body composition, many medications are given at higher weight-based doses or with altered dosing intervals in youngsters. 
[29] 
[28]

 

Plasma proteins are also lower in infants and neonates. 
As result, highly protein-bound medicines have fewer chances to attach to proteins, resulting in enhanced dispersion. 
[28]

 

Metabolism

 

Drug metabolism is primarily mediated by enzymes in the liver, and it might differ depending on which enzymes are impacted at given stage of development.

 

[29] 
Phase and Phase II enzymes mature and develop at varying speeds, depending on their individual mechanism of action (i.e. oxidation, hydrolysis, acetylation, methylation, etc.). 
Differences in metabolism between children and adults are influenced by factors such as enzyme capacity, clearance, and half-life. 
[29] 
[30] 
Even within the pediatric population, drug metabolism might change, differentiating neonates, infants, and young children. 
[28]

 

Elimination

 

The liver and kidneys play major role in drug elimination.

 

[29] The bigger relative size of the kidneys in newborns and young children leads to increased renal clearance of drugs that are removed by urine.

 

[30] 
Because preterm neonates and infants’ kidneys mature more slowly than fully matured kidneys, they are unable to pass as much medication. 
This can result in undesirable drug build-up, which is why for this population, lower doses and longer dosing intervals should be considered. 
[28] 
[29] 
Diseases that wreak havoc on kidney function can have similar effect, necessitating similar care. 
[29]

 

In terms of healthcare, pediatric autonomy is important.
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