Menstrual Hygiene for Girls

Female empowerment and welfare around the world are largely based upon the menstrual hygiene. Although sanitary pads and proper toilets are necessary; another important aspect is to make such an environment for the female that supports their ability to handle their menstruation with dignity. Menstrual Hygiene Day is celebrated on 28th May every year.

Measures Taken To Maintain Menstrual Hygiene 

1) The girls should bath or shower at least one time in a day. 

2) Good quality sanitary napkins should be used. Those having sensitive skin should not use plastic-lined sanitary napkins as it causes rashes and itchiness on rubbing against the skin. 

3) They should wear clean underwear and change it daily. 

4) Washing genital area with soap or vaginal hygiene products should be prohibited as the good bacteria may get killed. After using toilet or after urination, vaginal area should be cleaned with warm water. 

5) Genitals should be always washed or wiped from front to back as chances of bacterial infection increase while cleaning from back to front (i.e., from anus to vagina and urethral opening). 

6) To avoid vaginal irritation, it should be dried properly after each wash. It is recommended to use antiseptic powder for keeping the genital area dry, before wearing sanitary napkin, and after washing the vagina. 

7) For protection against infections, they should be advised to change sanitary napkins in every six hours and tampons in every two hours. 

8) After changing sanitary napkins, tampon or menstrual cup, hands should be washed properly with warm water and soap. 

9) Females should wear loose and comfortable clothes during periods to allow air flow in the vaginal areas and avoid sweating around the sensitive areas. 

10) Menstrual hygiene is very important for health, welfare, strength and productivity of all females. 

Materials Used In Menstrual Hygiene 

1) Menstrual Cloth: 

These cloths are recyclable fabric pieces used for external purpose, as undergarments and to absorb menstrual fluid. These cotton fabrics are mostly new or are the old reused ones. 

2) Reusable Pads:

 These are worn externally to the body inside the underwear for the absorption of menstrual fluid. Various natural and synthetic materials are used for making sanitary pads. They can be reused for around a year by washing and drying after use. 

3) Disposable Pads: 

These are also worn externally to the body inside the underwear for the absorption of menstrual fluid. These are available in different sizes, absorbing range and are made up of mixture of plastics, rayon and cotton. They should be discarded after 8 hours of use. 

4) Tampons: 

These are absorbent materials that are inserted into the vagina to absorb the menstrual fluid to prevent leakage by their property of expanding with moisture. They are available in different sizes, and are made from cotton and/or rayon. They should be disposed of after 8 hours of use. 

5) Menstrual Cup: 

It is a bell-shaped device that is inserted into the vagina for the collection of menstrual fluid. It is kept in place by the vaginal walls and develops a seal. It is made up of medically-used silicone. It is used for 6-12 hours and collects three times more blood than pads or tampons. It collects three times more blood than pads or tampons and should be emptied every 6-12 hours. After which it should be rinsed and re-inserted. The menstrual cup should be boiled for at least 5-10 minutes after each menstruation cycle

Role of Parents in Sex Education

Sex education provides knowledge, ability and encouragement for making healthy choices about sex and sexuality. Children should understand that no one should touch their body without their permission. They should know that other people can touch them in some ways but not in wrong ways. They should know that except for their parents or health-care providers, no one should ask them to touch their genitals. If they know about what is right and what is wrong, they will be more able to tell their parents about sexual abuse (if they experience it). Children should learn to ask before touching someone (e.g., hugging, tickling). 

They should learn about limits (e.g., understanding when someone takes a step away, and should respect that person’s signal for space). Children should be taught about privacy around body issues (e.g., they should know when it is appropriate to be naked). Children should learn about other body parts and their functions. For example, some children of this age think that girls have one opening for both stool and urine, some believe that babies grow in the same place their food goes, and so on. 

Steady growth and development occur in the school-age years. Staying physically active during this developmental phase builds up the fundamental skills required for a healthy and active life as an adult. These skills include agility, balance, coordination, and endurance. Learning and developing these skills will also affect the child’s confidence and self-respect, and will provide them with a sense of accomplishment and independence.

Objectives and Importance of Sex Education 

1) To teach children about the reproductive structures of men and women and to provide information about birth. 

2) To educate children to understand their role and responsibility of their own gender by obtaining sex knowledge. For the development of their future relationships with friends and lovers, the children need to understand the differences and similarities between the body of male and female. 

3) Sex education helps the individuals to accept themselves and teach how to deal with their personal relationships. 

4) It also makes individuals aware of their responsibility towards others and oneself. 

Process of Sex Education 

1) Choose the Right Time, Ask Questions and Provide Answers: 

i) Sex education should be provided in suitable situations. 

ii) Children should be made to watch relevant TV programmes to make them think and ask questions about it. 

iii) Discussion of sex with children in the presence of other people should be avoided as they may feel discomfort or embarrassed.

2) Establish their Confidence and Holistic Development: 

Children should be educated to have relevant and positive thoughts of sex to obtain self-acceptance. 

3) Use Proper Materials Keep-up with Time:

i) The growth of children’s intelligence should be understood to provide answers even for the same question to fulfil their curiosity. 

ii) Before giving answers to children’s questions, their knowledge about the topic should be evaluated and then answer using the words they know. 

4) Understanding Themselves and their Children 

i) Mutual trust is very essential to establish. 

ii) Parents should take part in the children’s activities and conversations to understand their way of thinking and their values and also to develop the communication with children to teach concepts about sex. 

iii) Parents should discuss about sex issues of children and give related solutions. 

5) Be Kind and Patient:

i) Parents should listen to their children carefully, be kind and patient to them, and talk in a soft and natural way. 

ii) Instead of getting angry when the views of children about sex differ from that of parents, they should listen to them and peacefully explain their views to them. 

6) Be Honest and Objective:

 i) Parents should give honest and relevant answers to children’s questions on sex. 

ii) Parents should find out whether or not the children know the answers. If not, they should help them to search the answers in books or from other sources. 

7) Make use of Education Materials: For better discussion on sex education, many books or videotapes can be used by the parents. 

8) Broaden their Social Circle and Seek Support: 

i) For expanding the social circle of children, they should be encouraged to participate in extra-curricular activities. 

ii) Parents should know the content of sex education being provided to schools for better coordination with them. 

iii) Parents should take part in programmes organised for parents based on children’s growth and sex education to obtain suitable information. 

Bones in Human Body, types of bones and structure of bones?

Definition of Bones:

Osteology is the study of bones and teeth. It is usually applied in the fields of anthropology, forensic science, and archaeology for various functions like the determination of nutritional value, health, and also to determine the position of bone within the body.

Types of Bones in Human Body:

Bones are categorised into five classes on the basis of the following salient features:

1) Long Bones: 

These bones are characterised by the presence of a shaft. They have longer lengths as compared to the widths. They end in a number of extremities, e.g., femur, tibia, fibula, humerus, ulna, and radius. They are usually slightly curved, thus impart high strength to these bones.

2) Short Bones: 

These bones are characterised by an almost equal length and width, e.g., ankle and wrist bones. They are more or less cubical in shape. 

3) Flat Bones: 

These bones are characterised by a thin shape or structure. They offer wide surfaces for muscle attachments and thus provide substantial mechanical protection, e.g., cranial bones (protecting the brain), the sternum and ribs (protecting the organs in the thorax), and the scapula (shoulder blades). 

4) Irregular Bones: 

As the name suggests these bones are asymmetrical in shape and therefore are said to have complicated shapes. They are shaped to fulfill certain specific functions within the body. For example, the vertebrate and some facial bones; provide major mechanical support to the body while also protecting the spinal cord. 

5) Sesamoid Bones: 

These bones develop in some tendons in areas where there is considerable friction, tension, and physical stress. Therefore, these bones are formed in the palms of the hands and the soles of the feet [patellae (knee caps)]. 

6) Sutural Bones: 

These bones are very small and are found within the sutural joints in between the cranial bones. They are categorised on the basis of their location and not shape. For example, suture bones are present in the cranium.

Macroscopic Structure of Bones:-

Internally, bones differ in their structural composition and comprise the following structures: 

1) Compact Bone: 

It is the hard outermost layer of bone. This bone is named compact as it has minimum voids and gaps and hence is also known as dense bone or cortical bone. The tissue is responsible for providing a smooth, white, and sturdy outlook to the bones. 

Haversian systems or osteons are the main characteristics of compact bone (figure 4.2). These are minute cylindrical structures. Osteons consist of concentric layers of collagen called Haversian lamellae; within these lamellae a central Haversian canal is present. These Haversian canals carry blood vessels, lymph vessels, and nerve fibres. A transverse canal known as Volkmann’s canal is found to connect Haversian systems with one another. Small tiny spaces known as lacunar are present in compact bones. These lacunae have tissue fluid and spider-shaped osteocytes. 

These osteocytes have long processes known as canaliculi, which join with each other and form a network. Periosteum covers the outer surface of bones. It is made up of a dense layer of vascularised connective tissue. 

It has two layers, the internal layer is osteogenic while the outer layer is fibrous in nature. Periosteum does not cover the joints. It is heavily innervated with nerves, blood vessels, and lymph vessels.

Cross-Sectional Structure of Compact and Cancellous Bone

2) Trabecular Bone: 

It is also known as spongy bone or cancellous bone. The interior of the bone is filled with trabecular bone tissue. This tissue is a network of open cells containing spongy or cancellous bones. The trabecular bone contains rods and plate-like elements which make the overall network of bones lighter and provides space for blood vessels and bone marrow. This lighter mass constitutes 20% of the total mass of bone but has ten times greater surface area than the compact bone.

Microscopic or Cellular Structure:

Bones are made up of different types of cells such as: 

1) Osteoblasts: 

These are mononucleate cells formed by the precursor osteoprogenitor cells. They are present on the outer portion of osteoid seams and lead to the formation of a proteinaceous mixture called osteoid. The osteoid gets mineralised by the addition of calcium and phosphorus to form the bone. 

2) Osteocytes: 

Osteoblasts that have migrated into the bony matrix gets trapped and give rise to osteocytes or mature bone cells. They occupy specific spaces called lacunae. They are the mature cells of bone. They tend to regulate the response of bone to stress, probably due to the presence of mechano-sensory receptors. 

3) Osteoclasts: 

These are large, multinucleated cells responsible for remodelling of bone in order to reduce their volume. This process is also known as bone resorption. These cells are located in small depressions on the surface of bones which are called Howship’s lacunae or resorption pits. In case of fracture or breakdown of bones, these resorption pits are left behind and appear as scalloped surfaces. 

i) They also consist of collagen fibres lying parallel to other fibres present in that layer.

ii) In lamellar bone, the direction of fibres is opposite in each alternate layer. This arrangement gives strength to bones so that they can withstand torsion forces. 

iii) When a bone breaks, the lamellar bone is replaced with a woven bone (since it grows rapidly) and this is termed as a bony substitution. It takes place on the hyaline cartilage which is then calcified. 

What is Cell in Human Body ? Functions and Components of Cell?

A cell is the basic structural and functional unit of all living organisms. All living organisms can be categorized into unicellular (e.g., protozoa, yeast, and bacteria) or multicellular organisms (e.g., plants and humans). A human body consists of about 100 trillion cells with a size and mass of 10µm and 1 nanogram respectively.

Cells are of two types: 

1) Prokaryotic Cells: 

These cells do not have a well-developed nucleus, though they have some other organelles present as in the eukaryotic cells. For example, archaebacteria, etc. 

2) Eukaryotic Cells: 

These cells have a well-developed nucleus and other organelles. For example, plants, animals, etc. A cell performs the following functions: 

1) Cell Growth and Metabolism: 

Cells grow either by increasing their number or their size. During the metabolism, various anabolic and catabolic processes occur. In catabolic processes, the breakdown of complex molecules occurs within the cells to produce energy; while during the anabolic processes, cells utilize energy to synthesize complex biomolecules and perform other biological functions. 

2) Cell Division: 

It involves the splitting of a single cell, i.e., the mother cell splits into two daughter cells. This results in the growth of multicellular organisms and the breeding (vegetative reproduction) of unicellular organisms. During the cell division, DNA is also synthesized and the process is known as replication. 

3) Protein Synthesis: 

It occurs within the cells, by two major steps, i.e., transcription and translation. 

4) Molecule Transport: 

The cell must be able to acquire nutrients and other molecules to survive.

Components of Cell 

A cell comprises the following three basic components: 

1) Cell membrane (or plasma membrane), 

2) Cytoplasm, and 

3) Nucleus. 

Cell Membrane/Plasma Membrane:-

The cell membrane is a selectively permeable biological membrane, allowing only certain substances to pass through it. It acts as a barrier between the inner and outer surface of the cell. It is also known as the plasma membrane or plasmalemma. It comprises mainly of proteins and lipids, along with other living molecules. These molecules are important for the normal functioning of the cells, e.g., in an ion channel conductance, cell adhesion, and cell signalling.

Properties of Cell Membrane:-

 1) It guards the cell against the external environment. 

2) It allows cellular transport between cells. 

3) It has transmembrane receptors (binding the signaling molecules) which helps in signal transduction and provide selective receptivity. 

4) It helps in recognising a cell. 

5) It has binding sites for the constituents of the cytoskeleton present in the external environment. 

6) It divides the cell into smaller sections having different structures and functions. 

7) It offers a stable site for the catalysis and binding of enzymes.

8) It allows the fusion of cell membrane with other membranes of cell organelle through special points of attachment. 

9) It regulates the transfer of certain specific molecules through the cell membrane, e.g., gap junctions. 

10) It enables motility of the cellular organelles. 

Structure (Fluid Mosaic Model):

To explain the nature and functions of cell membrane various models had been proposed in past, as mentioned below: 

1) Danielli and Davson model/Lamellar theory, 

2) Unit Membrane model, 

3) Robertson’s model, 

4) Lipid Bilayer model, and 

5) Fluid Mosaic model.

Structure of the Cell Membrane

However, out of the above given models, the Fluid Mosaic Model (figure 2.2) is the most accepted one. The fluid mosaic model of the plasma membrane was given by S.J. Singer (University of California) and G.L. Nicholson (Salk Institute) in the early 1970s. 

According to this model, proteins do not form a continuous layer extending from one side of the membrane to the other rather it is present in the form of globules, dotted randomly in a mosaic pattern. Some globules of the protein penetrate into the membrane to deeper extents; some of them remain attached to the membrane surface, while some globules extend through it and adhere to the other side. It explains the rigidity of the cell membrane. Experiments on viscosity of membrane show that it has a fluid-like consistency. This fluidity allows movement of lipid and protein molecules within it. Due to the fluidity and mosaic arrangement of the protein molecules, this model is known as the Fluid Mosaic Model.

Functions of Cell Membrane:

Cell membrane has the following functions: 

1) Protection of Cells: The receptors present on the cell membrane allow chemical messages to pass between the ells and systems, and thus provides protection to cells.

2) Providing Cytoskeleton and Mechanical Support: It provides a specific shape to the cell. It provides mechanical support and maintains the membrane potential. Attachment proteins present on cell membrane bind the extracellular and intracellular components. 

3) Separation from Surroundings: In an animal cell, it separates the internal environment from that of the external. Other organisms, including fungi, plants and bacteria, consist of an additional layer known as cell wall, forming the outermost protective layer. 

4) Permeability: It is a selectively permeable membrane as it allows the passage of solvent and several selected solutes while holding back the others. 

5) Tissue Formation: Groups of similar cells together form tissues. 

6) Particle Transportation: This occurs by various mechanisms like ion channel, carrier proteins, and ion pumps. Chemical exchange of solute between extracellular medium and cytosol is mediated by transport of channel and carrier proteins. 

7) Contribution to Enzyme Activity: It controls the activity of enzymes which further participate in metabolism and immune system. 

8) Control of Neurohormonal Flow: Receptor proteins on cell membrane mediate the flow of neurohormonal and other chemical information from extracellular medium to the cytosol. 

What is the meaning of Human Anatomy and Physiology?

The systematic study of the human body is performed under two disciplines, i.e., anatomy (structure) and physiology (function). Anatomy is the study of different structures of the human body and their relationship with each other, while physiology is the study of the functioning of these structures. Anatomy is made up of two Greek words, ana means up and temos means to cut. Anatomy is the science of body structures and coordination among the various body structures. It is a general term which includes human anatomy, animal anatomy (zootomy), and plant anatomy (phytotomy).

Anatomy is sub-divided into: 

1) Gross Anatomy: It is also known as topographical anatomy, regional anatomy, or anthropotomy. It includes the study of such anatomical structures which can be seen with the naked eyes. 

2) Microscopic Anatomy: In this type of anatomy, very minute anatomical structures (tissues and cells) are studied with the help of microscopes. 

3) Superficial Anatomy or Surface Anatomy: This type of anatomy is of prime importance as it includes the study of anatomical structures that can be seen from the body. With the knowledge of superficial anatomy, physicians or veterinary surgeons gauge the position and anatomy of the associated deeper structures. 

4) Comparative Anatomy: In this type of anatomy, the comparison of anatomical structures both gross and microscopic present in different animals is studied

The Greek words physics (nature) and logos (study) combine to form the term physiology, which covers the study related to the mechanical, physical, and biochemical functions of living organisms. It can be also defined as the study related to the science of various body functions and their working.

Scope of Human Anatomy and Physiology:- 

The anatomy and physiology together form the foundation of medical sciences; their scope is vast that can be summarised in the following terms: 

 1) Study of human anatomy provides an essential base for the understanding of physiology and pathophysiology, 

2) Helpful in the study of human evolution and development, 

3) Inquiring into the fascinating complexity of the structure and function of the human body, 

4) Mass therapy and athletics health-related field training,

5) As a foundation for advanced scientific studies, 

6) To understand the pathology of disease and pathological changes, 

7) To determine the techniques of surgeries, 

8) To know the parameters of normal health, 

9) To understand the effects of various factors in the physiological processes and its effects like a change in the environment, etc., and 

10) Overall effective maintenance of individual and community health.

Definition of Various Terminologies Used in Anatomy 

For study point of view, medical science divides the body into various anatomical planes (flat surfaces), which are the imaginary lines (vertical or horizontal) drawn through an upright position of the body.

 The anatomical terminology of the body can be studied under three groups: 

1) Directional terms, 

2) Sectional planes/planes of the body, and 

3) Body cavities

Directional Terms 

Directional terminologies are used to locate one body structure with respect to the other. The anatomical position of a human can be described with the help of the following terms: 

1) Superior (Upper, Cranial) End: The end of the head lies in the uppermost position, therefore it is known as the superior end of the extremity. 

 2) Inferior (Lower) End: This part starts from the extremity of the main body or the trunk along the legs in the downward direction or ground. 

 3) Anterior or Ventral End: This includes the body parts present on the front side, like chest, nipples, abdomen, and external genitalia. 

4) Posterior or Dorsal End: This includes the body parts present on the back side, i.e., vertebral column (also known as the backbone), shoulder blades, and buttocks. 

5) Supine Position: In this position, the face is towards the upper side (roof) while the back faces downwards. 

6) Prone Position: In this position, the face focuses downwards or towards the ground. 

7) Medial Position: It is an imaginary line passing through the longitudinal axis of the body, dividing it into two equal halves from the middle, starting from front to the back. 

8) Lateral Position: It is that anatomical position of the body in which it is divided into two fragments through the midline and the body structures remain away. 

9) Proximal: It describes a body part that is closer to a point of attachment or closer to the trunk of the body than another part. For example, the elbow is proximal to the wrist

10) Distal: This position is the opposite of proximal. It means that a particular body part is farther from the point of attachment or farther from the trunk of the body than another part. For example, the fingers are distal to the wrist. 

11) Superficial: This position means situated near the surface. 

12) Peripheral: This position means outward or near the surface

Planes of the Body

 Following are the various planes in which the human body is classified: 

 1) Sagittal: 

In this plane, an imaginary line slicing the body (from head to toes) into two halves with erratic proportion is drawn, from top to the down. A mid-sagittal plane runs parallel to the medial plane, i.e., the plane of sagittal runs from the middle. Distinct to that of coronal plane, it starts from the nose to back of the head and moves vertically from one ear to the other.

2) Horizontal: 

This plane is parallel to the ground and passes through the body at the 90° angle to both coronal and medial plane. 

3) Coronal: 

This plane divides the body into anterior (front) and posterior (back) portion, by passing through the body at a right angle to the medial system. Medically, anterior means the front portion and posterior means the back potion. Some terms can be used interchangeably like ventral for front and dorsal for the back. 

4) Lithotomy Position:

 In this position, the individual is lying on the back with thighs fully stretched and knees directing towards the roof.

Body Cavities

 Cavities are the spaces of the body, containing viscera and internal organs. The two main cavities of the body are dorsal cavity and ventral cavity. Ventral cavity is a large cavity which is further subdivided into the thoracic and abdominopelvic cavity. Both these cavities are separated by dome shaped respiratory muscles called diaphragm. 

The different types of body cavities are

1) Thoracic Cavity: 

This cavity is present ventrally on the upper side of the body. It is also known as the chest cavity, which is laterally attached to the ribs (covered by costal, pleura) and caudally to the diaphragm (covered by the diaphragmatic pleura). This cavity contains the trachea, lungs, heart, oesophagus, nerves, and large blood vessels. 

2) Abdominal and Pelvic Cavity: 

The ventral cavity is also known as the abdominopelvic cavity. This cavity is further divided into two parts: 

i) Abdominal Cavity: This cavity is laterally attached to the body wall, posteriorly by the pelvic cavity, and anteriorly by the diaphragm. This cavity contains maximum part of the gastrointestinal tract, kidneys, and adrenal glands. 

ii) Pelvic Cavity: This cavity is bounded dorsally by the sacrum, laterally by the pelvis, and anteriorly by the abdominal cavity. The pelvic cavity contains the maximum part of the urogenital system as well as the rectum. 

3) Dorsal Cavity: This cavity is the smallest amongst the other two main cavities. In this cavity, the organs are situated more posteriorly within the body. Further, the dorsal cavity is sub-divided into two parts. The first part includes cranial cavity (upper portion which houses the brain,) and the second part includes spinal cavity (lower portion which houses the spinal cord).

Challenges in Child Health Nursing

 Following are the problems faced by Nursing Professionals in Child Health Nursing:-

 1) Genetic Disorders: With the help of decoding and sequencing of the human genome, the diagnosis of genetic disorders has become accurate. At the present time, researchers and scientists are facing problems in identifying strengths and limitations of the genome versus exome sequencing to detect the genetic causes of primary immune deficiencies and then use the information for clinical applications. 

 2) Communication problems: Nurses listen to their patient's concerns and answer their questions about medical procedures and treatments to help them understand their plans of care. Because pediatric nurses are caring for children, they may experience challenges in communicating with their patients, particularly if a child is too young to understand why they require medical treatment. Other children may be nervous about their treatment, which may cause them to become unresponsive and refuse to answer a nurse's questions. To resolve these challenges, pediatric nurses often use their creativity to develop alternative methods of communication.

3) Prenatal Diagnosis: Advancements in prenatal epidemiology helps in early identification and treatment of congenital heart malformations. Epidemiological, clinical, cellular, and molecular studies suggest that the foetal life conditions play a critical role in developmental programming. 

4) Workplace hazards:- Working as a pediatric nurse may put these professionals in contact with various workplace hazards. A pediatric nurse may become exposed to a virus or pathogen through contact with a patient's bodily fluids. They may work with chemicals, such as those found in chemotherapy medications. Pediatric nurses are often responsible for carrying or lifting patients, which can cause them physical strain. While they take many precautions to ensure their safety, these workplace hazards can be a risk for pediatric nurses.

5) Prematurity: With the improvement of prenatal screening and diagnosis, identification of high-risk neonates allowed the referral for delivery near high level neonatal intensive care units, with substantial benefits for neonatal outcomes. 

6) Frustrated parents:- Pediatric nurses may encounter parents or caregivers who feel frustrated with their child's treatment plan. At times, these parents may become angry with pediatric nurses, such as when nurses are communicating a physician's changes to a child's medical treatment or discussing an unexpected complication. Nurses in this field can remember that parents and caregivers may be stressed or worried about their child's health. They can show these parents compassion and offer their support to help them through the situation.

4) Neonatal Physiology: With the introduction of 3-D cardiac magnetic resonance with phase-contrast imaging, information on physiology of blood circulation in neonates can be easily obtained. Also, this technique can be performed without sedating or anaesthetising the neonates. 

5) Traumas: Recent studies have shown that the permanent disability due to traumatic brain injuries in children is mainly accounted for by mild injuries (and not by severe injuries). Consequently, steps should be taken to prevent mild and severe injuries so that the levels of disability after traumatic brain injuries can be reduced. 

6) Introducing New Devices and New Drugs: Research and development of drugs and devices for paediatric patients is complicated due to small patient population, characteristics of paediatric physiology and pathophysiology, and practical and ethical difficulties in designing pre-clinical and clinical trials. In pre-clinical trials, identifying appropriate experimental models, clinically significant efficacy end points, assessment of risks and benefits, and methods to monitor cardiovascular safety, are challenging. 

7) Education and Training of Care-givers: Providing training on non-technical skills is enhancing the safety of patients. Still a recognized educational model to support the design of patient safety is not available; however, a number of theories are there to guide educators in future instructional designs.

8) Schedule:-Many pediatric nurses, particularly those who work in hospitals, work long shifts. Often, these nurses work 12-hour shifts three days a week. It can be challenging for nurses to take breaks during their shifts because they're often responsible for monitoring many patients at one time. Sometimes, a nurse manager may ask a pediatric nurse to work overtime if there are staffing shortages or patient emergencies. Pediatric nurses often work on weekends and holidays, which means they may have less time to spend with family and friends.

What is Child Health Nursing ? Principles and Factors of Child Health Nursing

 

The word paediatric has been derived from the Greek word paedia meaning child and iatri meaning treatment and ics meaning branch of science. Thus, paediatrics is the branch of medical science that deals with child development and care and with the diseases of childhood and their treatment. Paediatrics also refers to the complete and continued care of children, in wellness as well as illness. Abraham Jacob (1830-1919) is the Father of paediatrics because of his contributions to this field.

Historical Background of Child Health Nursing:-

The historical background of paediatrics is as follows: 

1) The first reference of breast milk properties and child hygiene was introduced in 225 BC in Indian Susruta Sanhita. 

2) Hippocrates (a Greek philosopher), also known as the Father of Modern Medicine, made important contributions to the diseases occurring in children‟s. 

3) Kashyapa and Jeevaka (the first Indian paediatricians) worked on children's diseases and child care.

 4) Kashyapa and Samhita wrote the first manuscript on the management of children's diseases. Susruta and Samhita wrote about Ayurvedic medicine that can be used for treating diseases in children. It was the first written record of Paediatrics. Susruta, known as Indian Hippocrates, wrote about child-rearing practices, infant feeding, and childhood diseases. 

5) Charak (the count physician of Peshawar) wrote on the Care and Management of Newborns in his Sansthan and ashtanga-hidaya. 

6) Rhazes (an Arab physician) wrote the first book on the diseases of children. 

7) In 1472 AD, the first written book on Paediatrics, named Bagallarder’s, was printed in Italian. 

8) Thomas Phare wrote the first book in English on children‟s disease in 1545 AD. 

9) First paediatric hospital was opened in Paris in 1802. Children‟s Hospital of Philadelphia was opened in the USA. 

10) Dr Abraham Jacob established the first child clinic in New York and started giving special lectures on diseases of children in 1860. At this time, Paediatrics was established as a field. 

11) The first department of paediatrics was established in Harvard Medical School in 1888 AD. At this time, it was realised that childhood diseases are different from adult diseases

Principles of Child Health Nursing:-

A paediatric nurse should follow the below-mentioned principles of child health nursing, which govern their interaction with the children and their parents: 

1) The nurse should answer all the queries of the parents regarding their children. 

2) The nurse should build a working relationship with the parents and their children from the time of the first meeting. 

3) The nurse should know that all behaviours of a child hold some meaning. 

4) The nurse should accept the parents and their children exactly as they are. 

5) The nurse should be concerned towards the parents and children. 

6) The nurse should make the parents and children understand that their problems are important to her and she is there to provide solutions to those problems. 

7) The nurse should always acknowledge the parent‟s right to make decisions about their child. 

8) The nurse should allow the parents and children to express their positive as well as negative emotions. 

9) The nurse should ask questions on a single idea or reference so that the parents and children easily understand what is being asked. 

10) The nurse should use the local language and speak in an easy-to-understand language. 

11) The health team members should make the parents feel that they are working collaboratively for the treatment of their child. 

12) The nurse should always be compassionate for the children and their parents

Factors of Child Health Nursing:-

Factors Responsible for the Growth of Modern Paediatrics The following factors influence the growth of modern paediatrics: 

1) Progress of medical science and recent advancements in the field of medicine excluding antibiotics.

 2) Development in the field of basic science (physics, chemistry, and biology). 

3) Growing interest in public health and public welfare. 

4) Improved social laws. 

5) Improved health services. 

6) Emphasising disease prevention and health promotion. 

7) Establishment of separate paediatrics hospitals, MCH clinics, under five family welfare centres, etc.

 8) Initiation of child welfare programmes. 

9) Initiation of health promotion and disease prevention programmes. 

10) Realisation of special needs of infants and children. 

11) Changing the attitude of society towards infants and children.