Children contract infections regularly during early childhood, so they can experience episodes of acute illness. They are also at greater risk of injury. For the most part, these episodes are of short duration and resolve with the care of parents at home, sometimes with support from community healthcare professionals such as a general practitioner. However, in some instances the illness can reach a level of severity that requires nursing care and medical treatment in a hospital setting. Infants and children are still developing, so they have physiological and anatomical differences from adults that require specialist skills and knowledge. Hospital environments can be challenging for both the young child and their family. In this chapter, some key nursing considerations and interventions for the acutely unwell and injured child and adolescent will be discussed. This is followed by an exploration of some of the illnesses and injuries children and adolescents can acquire that may require hospital care. You will be asked to reflect upon the nursing management of some of these conditions through review of case studies and reflective questions.

As a nurse caring for paediatric patients, it is important to develop the ability to recognise and respond to a sick infant or child. This is so important that a variety of projects have been undertaken, both internationally and throughout Australia and New Zealand, to ensure that nurses working with paediatric patients are able to recognise, respond promptly to and appropriately manage sick and deteriorating infants and children. Paediatric early warning tools help clinicians to recognise a deteriorating infant or child, and trigger an escalation in care to prevent further deterioration and achieve favourable outcomes. This chapter provides a basic understanding and knowledge so you will be able to recognise and respond to a sick and deteriorating child.

Although most children in Australia and New Zealand enjoy a long life expectancy and high level of wellbeing, paediatric death remains a sad reality for some families, and end-of-life care for children presents an important and challenging area of paediatric nursing practice. Paediatric palliative care begins when a disease is first diagnosed and continues throughout the illness trajectory. It therefore includes, but is not limited to, end-of-life care. Paediatric end-of-life care is the care provided to the child and family towards the end of a child’s life and includes care of the child’s body and support for the family following the child’s death. Although there are distinctions between the two terms, in this chapter they will be used interchangeably. This chapter provides a beginning understanding of some of the common symptoms experienced by, and concerns for, children in end-of-life care and their management, including pain, the management of side-effects of opioids, fatigue, dyspnoea, gastrointestinal disturbances and anxiety. It also discusses communication with dying children and adolescents, and the importance of family communication and support.

This chapter presents guidelines and recommendations for managing emotional and behavioural responses related to children’s experiences of illness. It provides an overview of psychosocial development to best illustrate the relationship between child development and response and adaptation to illness. The relationship is bidirectional – that is, responses are shaped according to the psychodevelopmental stage of the child or young person, and at the same time developmental outcomes are impacted by the experiences and challenges of both acute and chronic illness. The family is also impacted when a child or young person is experiencing illness. Families are central to the care of children – in fact, the paediatric patient and their wider family provide the focus for care. This chapter therefore also explores what it means to be a family and family-centred care, and presents frameworks that can be used to assess and consider the psychosocial needs of families when a child is experiencing illness.