Pediatric nursing
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Review
In-home toxic chemical exposures and children with intellectual and developmental disabilities.
Despite the focus on preventing toxic chemical exposures during pregnancy, the perinatal period, and childhood, health professionals have given little attention to the risks and effects of toxic chemical exposures on children with intellectual and developmental disabilities (DD). Children with DD may be at higher risk due to behaviors that persist past a developmentally appropriate age, communication skills, motor skills, nutrition issues, and health problems related to DD. This article examines exposure of children to lead, mercury, and environmental tobacco smoke, three toxicants known to affect children's health and development. The authors identify sources of these toxicants, examine research documenting their effects on children, consider strategies to prevent and manage exposure, identify characteristics and behaviors placing children with DD at increased risk of exposure, and discuss implications for health providers.
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Sickle cell disease anemia is an inherited blood disorder that affects many people of color in the U. S. Patients with sickle cell disease make abnormal blood cells that tend to clog and occlude blood vessels. ⋯ Hydroxyurea therapy significantly reduces the number of deaths from sickle cell complications. Additionally, hydroxyurea significantly reduces the number of hospitalizations, vaso-occlusive crisis, and acute chest problems; thereby reducing severity of the disease. Pediatric studies also have shown that hydroxyurea can be safely used in children.
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Of all the various healthcare professionals that provide care to children and their families facing life's end, no one spends more time at the bedside observing, critically thinking, consulting, and providing direct care than the pediatric nurse. Previous research, however, demonstrates that undergraduate education has not prepared nurses to provide optimum end-of-life (EOL) care (Ferrell, Grant, & Virani, 1999; Ferrell, Virani, & Grant, 1999). Although many reasons have been cited in the literature for this inadequacy, the fact remains that when nurses complete their basic education and enter practice, they often are grossly unprepared to care for children and families in need of end-of-life care (Field & Behrman, 2003).