How Speech Disorder Affects Learning

When a child is diagnosed with speech disorder, and in particular a receptive language disorder, that child is more likely to find verbal information difficult to understand and process. It can be hard for the child to understand, let alone to remember what is being said when this information is presented in the form of something that the child needs to remember for school or household. The ability to properly understand and remember verbal information or instructions may impact significantly on the ability of the child to perform tasks or tasks as expected.

When a child is instructed, this can be very problematic. A child with a language delay may have trouble following instructions, especially when the instructions are only given orally and when several words or steps are contained.

Children with language skills can also find it difficult to learn how to read and write. Research has shown that the development of reading skills is very important in verbal abilities. Kids who have a challenge in verbal communication are supposed to combine sounds with letters and then separate them so that they can successfully learn how to read and write. For children with language disorders, this ability can be particularly difficult.

 

How to Help a Child Diagnosed with Speech-Language Disorder

In order to allow children who are diagnosed with a speech disorder to remember what has been said and/or followed, information should be divided into smaller pieces and repeatedly until the child has all the information encoded. The child can also be very helpful by having written information to accompany what is said.

Children who have difficulty with verbal information or instructions can sometimes be seen as less intelligent than they really do because both children and other students cannot process information. This can lead to improper placement in school environments. Nevertheless, the child may perform on a par to his/her peers if the information is repeated or displayed alternatively. Furthermore, a child may ignore what has been said or even defy not to follow through. This could lead to unfair punishment, demoralizing a child and discouraging further learning attempts. Obviously this is not fair to the child, and parents, instructors and professionals who work with the child must advocate understanding the problems of the child with age-appropriate speech qualifications. This is important for them.

It is important for children to repeat and practice with these skills in order to contribute to reading and writing skills. This can be done at home with parents and/or caregivers or possibly with tutors or special educational services within the school system. Hopefully, a speech-speaking pathologist who can help caregivers and educators to get the child’s best understanding and helps evaluate children who are struggling to learn the speech-speaking skills.

 

It is important to understand that these potential learning difficulties exist for those taking care of and working with children diagnosed with a speech disorder. These kids need the patience of their adults, understand their diagnosis, advocates to help them obtain the necessary services and accommodation and encouragement to learn.

How to WRITE NURSING CASE STUDY IN APA

A case study is a comprehensive study to analyze a particular disease, region or event. It requires that the researcher takes a lot of time to interact with the study object, to collect evidence and to reinforce the final claims of the study.

A written case study requires consideration and planning in nursing. Students have to complete all the preliminary steps before starting the writing process, which are often ignored by most students. Certain mandatory steps to consider are to determine the focus and format of the paper.

Secondly, the student should take the step of gathering facts by bringing the content of the paper together and summing up what he intends to have. The final stage is building or performing the paper in the APA format before it has been edited by the student. Most students fear these steps and frequently try to write my APA case study for me.

A case study in APA comprises several parts, each of which discusses a particular issue based on the subject of the case study. For example, if you have a particular disease and rely on a number of patients, you need to have an evaluation section that describes the problems and diagnostic terms of each patient extensively. The researchers must explain precisely why they have chosen a certain diagnosis and not the other options available.

In addition, a case study in this field should include a nursing plan and its objectives. You should explain how the care plan improves the quality and life of the patient’s recovery process. It is obvious that the nursing plan is positive, how it will be implemented and the staff responsible for it will be implemented. The writer should also identify measurable goals to determine the success of the plan.

Definitely, it can be a tough challenge, but before you search for write my APA case study for me, ensure you understand what you are doing. The best nursing paper writing service with confident and professional essay writers are from nursinghomeworks.com. Review collegenursingtutors.com and discover why we are leading the industry from our customers. By giving us the chance to help you get a top case study in the APA, you can also be part of our success. Our promises to you are as follows:

Write My Nursing Case Study in APA for me

The highest number of well-known nursing and medical writers are from collegenursingtutors.com. We have recruited a team of writers who have an eye on quality and only go to the most successful writers. If you come to us to help you write your APA case study, we will help you to increase your understanding by working closely with specialists on your field.

Research

We have access to online and in our libraries to thousands of medical and nursing sources. If you place an order with us, you can be sure that we conduct a thorough investigation that will validate all our claims in the paper.

 

Great formatting

Our writers know all the guidelines for citation and formatting. You will only be able to show their unparalleled excellence in your case studies in APA. We also ensure that we follow the instructions and guidance of your professor when the paper is formatted.

Plagiarism free

Our writers are guided by high work ethics and will do everything possible to provide a unique case study. Every assignment we write is from scratch, and we follow the instructions of the customer. We then use state of the art plagiarism detection software to ensure that the paper is 100% original.

Unlimited revisions.

We give all our customers 14 days to make as many revisions as they want after the order has been completed. This we do as a way of adapting the paper to the tastes of the customer. You just have to make sure you do not give new instructions.

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It is high time that you contacted collegenursingtutors.com if you have an approaching deadline and you haven’t found a solution. We will write your case study for you in APA. We’re going to be quick and even give you time to review your paper before you send it to your teacher.

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Tips for Organizing Sources for Research Papers

Sources give information. A source can be an individual, archive, object (for example painting, map, potsherd), area, and so forth With regards to undergrad (and graduate) research papers, we’re typically managing composed sources. There are three classifications of sources: essential, auxiliary, and tertiary.

Discovering Sources

So we realize that finding various sorts of sources is significant, yet how would you begin? Here are a 4 hints:

  1. Become acquainted with Your Library and Librarians

Now and again understudies never utilize more than their foundation’s online list. For instance, a library that offers short presentations and even inside and out instructional exercises on different programming including reference chiefs, planning programs, and even Adobe Photoshop. In the event that we need a source that isn’t situated in our library or in our consortium, we can in any case demand them. I additionally discovered that our library has a committed control explicit custodian. This implies they have a decent comprehension of the kinds of materials we are working with and the sources we are searching for. I’ve contacted our archaic exploration custodian various occasions and he has been more than accommodating.

  1. Check Google Scholar

Google researcher is an extraordinarily helpful, amazing, and FREE web index that showcases query items just from insightful sources. These sources can incorporate articles, books, expositions, licenses, and so forth for a given source, you will regularly have the option to peruse a theoretical (or portion) and snap on an immediate connection that will lead you to the source.

There are further instructional exercises that tell you the best way to viably look and oversee results and inside the device. While Google Scholar is very ground-breaking and accommodating, I have discovered that it doesn’t generally find dark, yet significant, messages for some archeological themes. Regardless, it is a brilliant spot to begin when searching for sources.

  1. Find Literature Reviews

Finding a magnificent survey article on your theme or a part of your subject resembles striking gold. Why? Indeed, somebody has just accomplished crafted by finding a large number of the significant essential and auxiliary hotspots for you. While I would not depend entirely on one audit article for your sources, (since individuals can fail to remember things and the article probably will exclude the latest conversations on a given subject) they are an incredible spot to begin.

Expert’s proposals or doctoral papers can likewise be an incredible asset for finding sources. Graduate understudies need to give a writing survey in the last record they produce for their degree. Some expound in these survey sections. This probably won’t be a good time for their panel, yet it’s extraordinary for you! There are various online information bases that give admittance to papers. Check with your library to see which ones you approach.

 

Likewise, since there is no supernatural recipe for finding a survey article, it merits inquiring as to whether they are aware of any sources. Presently please recall the tips I offered in past post, explicitly, doing your own examination first.

  1. Look at Academia or ResearchGate

In the event that you blend long range interpersonal communication and sharing exploration you end with stages like Academia. These stages permit researchers to set up their own profile and offer their examination with people in general. This is finished by either by giving a reference or a PDF duplicate of their work. You do need to make a record to obtain entrance, however it’s free. These social stages are very helpful when attempting to find sources, particularly some harder to get to material.

Overseeing Sources

As you begin to gather sources, a reference chief is indispensable. A reference administrator is a device that permits you to record, track, and gather references and bibliographic sources.

There are various articles out there that think about reference chiefs. The key is to get one that works for you and use it! Trust me, it will save you a great deal of time and you will be undeniably more coordinated.

Drawing in With Sources

As I was moving toward my complete tests, I was rapidly getting overpowered by the sheer measure of perusing I needed to do and the ensuing amalgamation. What does that even mean? It implies that composing ought to be an indispensable part of your understanding cycle.

For what reason is this significant? For one thing, the majority of us don’t recall all that we read so it’s acceptable to record things. Besides, composing as you read permits you to constantly draw in and reflect with the material you’re chipping away at, accordingly, drawing you nearer to the composing objective you are pursuing.

At the beginning, moving toward a research project can appear to be overwhelming for a considerable lot of us. When you discover sources and drew in with them by composing as you read, you end up with quality notes that equilibrium summing up data and working out your own contemplations about the point.

 

 

 

 

 

 

 

 

 

 

Personality Traits of Nurses

As new nurses are entering the workforce, identifying and encouraging specific nursing qualities will help hospitals and health systems recognize strong nursing candidates for hire and understand which current nurses on staff would make great leaders. It’s helpful to consider these 13 qualities of a good nurse that will help them be successful in navigating and thriving in today’s healthcare landscape.

Qualities of a Good Nurse

  1. Caring

While it may seem like a given, most people assume that all nurses enter the field because “caring” is one of their leading qualities—but this shouldn’t necessarily be an assumed nursing characteristic. Many nurses who choose the nursing career path to prioritize job security, are interested in using it as a starting point for another career or have a lack of alternative ideas/options.

But as a nursing quality, caring makes all the difference to patients. A nurse showing a natural tendency to truly care about how their patients feel will have a significant impact on their success in the nursing field, which makes caring a key indicator of a nurse’s success.

  1. Communication Skills

Strong communication skills are critical characteristics of a nurse. A nurse’s role relies on the ability to effectively communicate with other nurses, physicians, disciplines across other units, patients, and their families.

Without the ability to interpret and convey communication correctly, medical errors are more likely to occur, patients often feel neglected or misinformed, and the entire unit will feel the impact.

  1. Empathy

With nurses caring for perhaps thousands of patients throughout their careers, it can be all too easy to become desensitized or remember what it was like to be a “nonclinical” person. A characteristic of a good nurse is one that shows empathy to each patient, making a true effort to put themselves in their patients’ shoes.

By practicing empathy, nurses are more likely to treat their patients as “people” and focus on a person-centered care approach, rather than strictly following routine guidelines.

  1. Attention to Detail

Nurses are undoubtedly under immense pressure as they balance receiving orders from physicians with using their own knowledge skills and critical judgment to provide the highest quality patient care. Add to this combination caring for multiple patients simultaneously, and the risk for human error can seem almost inevitable.

A good nurse knows the stakes are high and that unlike in most other industries, they’re responsible for peoples’ wellbeing and more importantly—their lives. Having strong attention to detail is one of the nurse personality traits that can easily and quickly determine how successful they’ll be in their role.

  1. Problem Solving Skills

While clinical knowledge and training are taught throughout a nurse’s education, on the job training is the most effective way to help shape a nurse’s problem-solving skills. And although years of experience can help hone this skill, some naturally possess better problem-solving skills as part of their qualities and traits of a nurse.

Problem-solving skills are essential to nursing, as nurses generally have the most one-on-one time with patients and are often responsible for much of the decision-making related to their care.

  1. Critical Thinking

While having a strong willingness to learn is an important skill in a good nurse, putting that knowledge into successful practice requires an ability to think critically—especially in high-stress situations. A nurse with highly functioning critical thinking skills is one of the most important characteristics of a professional nurse.

  1. Sense of Humor

To derive satisfaction from such a mentally and physically exhausting career, nurses that can find time for a laugh are typically more successful in their roles. Because nurses encounter varying degrees of high-stress situations, taking the opportunity to enjoy the downtime and incorporate a lighthearted attitude can provide a sense of stress relief beyond measure.

  1. Commitment to Patient Advocacy

A great nurse understands that patient advocacy is a mindset that must be practiced every day, with every patient, throughout every stage of the care continuum. Many patients enter a hospital or healthcare setting disoriented, confused, and unable to truly “speak up” and advocate for their safety. Having a nurse that practices with a strong passion for patient advocacy will ensure they’re always fighting for the very best care for their patients.

  1. Willingness to Learn

With technological improvements and breakthrough studies in science, the healthcare industry must prove to be successfully adaptive to provide the highest quality patient care possible. Nurses spend more bedside time with patients than any other role in healthcare and their willingness to learn and put new knowledge into practice is one of the leading traits of a good nurse.

By engaging with new nurses to instill an expectation of continuous learning, while creating a positive environment for them to learn from experienced nurses, nursing leaders will set new nurses up for success. If you have any inquiries, visit HERE.

 

 

 

What is Background of The Study?

The background of the study is a part of a research provided in the introduction section of the paper. The background of the study is a compilation of adequate information that is based on the analysis of the problem or proposed argument, the steps and methods needed to arrive at the design and the implementation of the results achieved and feasible solutions.

It is different from the introduction. The introduction only contains the preliminary information about your research question, or thesis topic and readers will be learning in your paper. It is simply and overviews the research question or thesis topic. But the background of your study is more in-depth and explains why your research topic or thesis is worth the time of your readers. Your paper background of study will provide your readers with context to the information talked about throughout your research paper. It can include both relevant and essential studies.

Background of the study is used to prove that a thesis question is relevant and also to develop the thesis. In summary, a good background of the study is the work done to determine that your research question or thesis topic is a problem and that the method used is the one required to solve the issue or answer the question.

How to Write Background of the Study in a Research Paper

Stage 1. At the beginning stages of formulating your thesis, many of the issues are still very unclear, and you need to solidify your thoughts, you should conduct preliminary research. You conduct this preliminary research on the specific topic, and the area of study will help you to put forward a research question or thesis statement that will finally lead to more relevant and specific research. You can visit a library, check the Internet and other electronic databases to find preliminary sources such as scholarly journals and books about your background of the study.

Stage 2. Read and gather the information you need to develop a thesis statement or research question that will guide your thesis. You should take notes and also keep an accurate track of the sources of information you have used up to this point. A lot of people use note cards, but it’s easier and better to use electronic note-taking programs in this electronic age. Just make sure to use a form or recording that is comfortable and easier for you. Also, make sure you cite the source of every information you are using on each note so that you won’t forget where you got the information from, just in case you want to use it in your thesis.

Stage 3. Develop and pen down research question or thesis statement. Think about the things you’ve read and searched for issues or solutions that have been found by other people and then formulate your stance or opinion on the issue. Write out your position or opinion as an authoritative statement. You can decide to do more detailed research at this point and look for more sources that are more relevant to your research question or thesis.

Stage 4. Complete your research using question and thesis statement as your guide. You should be able to find sources that are relevant to your specific thesis and provide more insight into your research question. It is critical that your sources provide information on the history and past researches related to your thesis or research question.

Stage 5. As you create your background study, create relevant sections. When you start writing, create five different sections that have the key issues, major findings, and the controversies that are surrounding your research question or thesis and also a section that provides evaluation and a conclusion.

Stage 6. Identify the further studies that need to be done in the in the conclusion section. And also mention possible solutions to the issue that have not been put into consideration in the past.

Stage 7. Do a revision and editing of your background of the study. You can write out several drafts of your work, revising, editing, and adding more information as you do so before coming up with the final one. Make sure each draft is better than the previous. You can also ask someone else to help you go through it.

We hope this information has been helpful to you. Read also other useful posts on our nursinghomeworks.com to improve your writing skills.

How to Write a Statement of the Problem Effectively

A statement of the problem is used by researchers as a claim that will outline the problem which the study addresses. A statement of the problem is an actual way of defining an issue and then provide a solution immediately. Always think about the problem and the suggested solution before writing a problem statement, and have findings to support it.

Tips of Writing a Problem Statement

  1. Describe the problem itself

A problem statement can be written in different ways, but the best strategy is to give background information for your reading audience to understand the problem first. Explain briefly how it would have been if the problem wasn’t there.

For example, if you work at a train station and you notice the way passengers get on your train is time-consuming. You can start your statement of the problem by giving details of a state where getting in the system is time-consuming. You can add that the station’s board should state this: “The getting in code that is used by this train station should focus in ensuring that each passenger enter the train quickly so that the train can leave as soon as possible

  1. Expound your problem

The aim of a statement of a problem in research is to present the problem concisely for the readers to understand. For instance, let’s say that you have come up with a more efficient way of passengers getting in the train, you can go on like, “However, the train’s passenger entering system currently is the most unproductive way of resources and time.

  1. Describe the financial costs of the problem

After you have stated your problem, you’re going to explain why you think it’s important. In the world of business, money is the most important thing. In this case, you’re going to talk about the effects of your problem’s finance on the organization you’re writing for. For example, is the problem you’re talking about preventing your business from generating more revenue? Is it costly?

Let’s use the train station, for instance, you can talk about the financial cost of the problem this way: “The ineffectual of the getting in currently is financially distressing the company.” Averagely, the train station is wasting 10 minutes on each entering time leading to so many hours of waste per day.

  1. Support your claim

Always support your claim with logical proof. In an academic statement of the problem, you will be required to provide evidence by referencing in the paper of your problem statement. In other circumstances, you can just use commentary or any other form of interpretation for your mention.

  1. Suggest a solution

After describing what the problem is and why it is a big deal, you can explain how to solve it. For instance, in the train station, the solution to the time consuming getting in is the new system we have invented. You can proceed in two sentences to give more details of the new system. It’s because our main focus is on the body paragraph.

  1. Describe the importance of the solution

Now that your readers are fully aware of what is going to be done, proceed and let them know why this solution is important. You can concentrate on the financial effects of the solution, like what cost should be cut and what profit it will make. For instance, you can talk about the income that the train station will save with the solution provided.

  1. Sum up the problem and its solution

Once the company’s vision has been issued, you have introduced the perfect perception for your company, outlined the problem that’s preventing you from achieving this vision, and came up with a solution, you are almost finished. What you have to do is summarize all your main arguments.

For instance, you might conclude about the train station like this: “The application of the new protocol in the train station is important for the generation of the company’s revenue.” At this point, the reader is aware that the current getting in the process is not effective. The new one is the best.

  1. Summarize with a thesis statement

A thesis is a single sentence that sums up your argument. A good thesis will identify the problem and offer a solution.

The establishment of the statement of a problem is an essential part of the research paper. We hope that these tips have helped you to reach the objective of writing a perfect statement of a problem. If you’re still having any doubts, you can visit us on nursinghomeworks.com for more assistance.

Write Nursing Dissertation in APA Format

Nursing is one of today’s most popular professions. In addition to the idea of participating in life-saving and patient care, nursing is an attractive career, due to the benefits its practitioners receive. Students that choose to become nurses renounced that they do more to convince their teachers that they are willing to join the profession than to understand the field’s practical qualifications. You must therefore study and memorize such things as diagnoses, doses and the lingo, which may be quite mouthful. We do not think it needs to be this hectic to be called a nurse, so we do the best to write your APA nursing dissertation. For most students, APA nursing dissertation is particularly hard to produce.

You are torn between the skills you need to care for your patients and write papers and take your course. You are torn between the skills. Although we believe that you should not pay as much attention to the latter as the former, you must be careful that the two abilities are important to your career. For example, if you do not understand the basic skills for the profession, you will not be competent in your practice. Likewise, if you do not write and submit your infants on time, you are not eligible to participate in the career. Such a dilemma causes students to wonder who is going to write my APA dissertation for them.

We ensure that we have your paper written from scratch and keep an eye on your instructions, your professor’s guidelines and the instructions for formatting. We therefore strongly discourage the option of purchasing APA nursing dissertation online before we see whether the writing style meets your needs. Nursinghomeworks.com reviews will show you why we are the most credible in the industry.

If you’re in a dilemma and you want someone to write your APA nursing dissertation, we’re your best bet in guaranteeing high quality and reliable services. We have several examples in nursing papers that we hope will help you decide to work with us quickly as they demonstrate the depth of the research we have carried out on behalf of every client.

Write my Nursing APA dissertation for me

You are probably looking for writers who help you impress your professors in a high quality paper if you go online with your written application of my APD dissertation. We are what you’re looking for. We have the highest academic skills in the fields of medicine and other sciences. Also in the industry, we’ve been long enough to understand what teachers want in their APA dissertation.

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There is a lot of research required in a nursing APA dissertation. It has to be detailed and supported by data from authoritative sources as an important document in the case of a nursing student and the nursing profession. In addition to being flawless, the final document provides an essential addition to knowledge.

Delivery on-time

Helps beat you any deadline by collegenursingtutors.com. When you place an order, a form with your deadline will be provided to you. Our writers shall immediately start the job and deliver it before the agreed time or date.

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We have a 24/7 customer support team that ensures comfort and happiness. Whenever you have a question or concern, contact us and be sure we’ll find a quick solution for you. This makes nursinghomeworks.com one of the industry’s leading nursing services, as we respond in real time to all of your needs.

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We allow each customer a 14-day period to make revision requests after submitting their dissertation on the agreed date. This is a way to further cultivate student opinions, making the paper even more personalized.

Tips to Reduce the Length of Your Research Paper Abstract

The abstract is perhaps the most important section of your research paper. Apart from the title, it may be the only part of the paper anyone reads.

The abstract may also be the only part of your paper that has a word limit. Most word limits specify a maximum of between 250 and 300 words and some journals require that abstracts be as short as 150 words.

Tips to Help you Write a Short Abstract

  1. Why do journals impose word limits on abstracts?

There are several reasons your abstract needs to be short and concise. Journals want readers to buy your article, and they want other researchers to cite your study in their own articles. More citations means a higher impact factor for the journal. The best way to sell your study is to grab the reader’s attention with a great title and abstract. Finally, there is the issue of space. Journals want your abstract to fit on half a page so that a reader won’t have to scroll to read all of it.

  1. Omit needless hedge words and adverbs.

Omit needless words. Many writers, especially academic writers, pepper their writing with words that simply don’t need to be there.

A “hedge” is a word or phrase you use when you are concerned about making a claim instead of stating a fact. It’s always a good idea to be careful, especially in academic writing, but many authors use hedge words when they don’t need to. Among the most overused hedge words are the verbs “seem” and “appear.” In the examples below, you’ll see why taking away the hedge words does not alter the meaning.

Hedge: Maroney syndrome seems to impair quality of life.

No Hedge: Maroney syndrome impairs quality of life.

  1. Remove awkward and unnecessary transitions.

Conjunctive adverbs are better known as “transition terms,” and although they can be very usually in creating structure and flow within the body of a paper, in the abstract they are often redundant or even incorrectly used. Among the more commonly used conjunctive adverbs are: however, moreover, therefore, furthermore, additionally, and thus.

The conjunction “moreover” is perhaps the most commonly used needless adverb in scientific papers. Some writers use it because they believe it makes them sound more “academic.” Others use it because they may know that it’s a grammatical faux-pas to start a sentence with the conjunction “And.” Nevertheless, “moreover” can virtually always be removed from a sentence without altering the meaning.

  1. Use the active voice instead of the passive voice.

One way to shorten your abstract is to apply a rule you might have learned in primary school: use active voice instead of passive voice. In active voice constructions, the subject carries the action. In passive voice, the subject is acted upon, usually by an unnamed actor. Scientists seem to be in love with the passive voice, as it can be found in many papers, simply adding to the word count and making the write less engaging.

  1. Do not include statistical methods or findings in the abstract.

Most scientific articles include statistics. Usually, the statistical methods are described in detail in the Methods section of a paper. But many authors feel compelled for some reason to mention statistics in the abstract, perhaps to get the details out first. But unless your paper is primarily about statistics, it is best to keep statistics out of the abstract and stick to language that expresses the most important use and findings of the study. Not only do statistics add to your word count, but they also interrupt the flow of your argument.

  1. Consent, approval, and other stuff that doesn’t belong in an abstract

Some authors place information about patient consent and institutional review board approval in the abstract. Whereas this information is indeed essential, it is not necessary to put it in the abstract. Like statistics, consent and approval statements interrupt the flow of your argument. Readers expect to find information about consent and approval in the Methods section. Leaving this out of your abstract will certainly free up your space to describe the importance of your study.

  1. Word limits are not targets

Keep in mind that a limit of 250 words does not mean that you should attempt to come as close as possible to the limit. The best abstracts include all essential information well before reaching word limit. Use the above tips to help you create a leaner, tighter abstract that will hook readers and entice them to read your full study.

For more helpful suggestions on academic and research writing, nursinghomeworks.com.

 

Congenital Heart Defects: Caring for Your Child

Caring for children with congenital heart defects can be challenging. The following tips may help you care for your child so that he or she is as healthy and comfortable as possible. These tips may also help you cope with the difficulties that parents often experience.

Caring for your child in the hospital

You and your child might take many trips to the hospital or doctor’s office for tests, procedures, or surgery.

It’s normal to be frightened and worried about your child being in the hospital. Ask questions about any procedures that you don’t understand or any special care that is needed. In general, try to be with your child as much as possible.

What to expect

While your child is in the hospital for surgery, treatment may involve:

  • Receiving intravenous(IV) fluids until your child wakes up after surgery and can eat.
  • Having oxygen levels in the blood measured with a pulse oximeter.
  • Making adjustments to help make breathing easier. Your child may have the head of the bed or crib raised, be given oxygen (through a hood, tent, or face mask), or sometimes be given treatment with a breathing machine called a ventilator.
  • Draining fluids from the chest after surgery. Pressures within the body also may be measured.

How to help

The following are tips to help your child while he or she is in the hospital:

  • Take some of your child’s familiar things to the hospital. Favorite toys or blankets will help the child feel more at ease.
  • If you cannot stay with the child, visit often.
  • Take some pictures of the family. Place them where your child can easily see them. Talk about what is happening with other family members or sing favorite songs.
  • Tell the nurses about your child’s habits, typical routines, and general preferences.
  • Tell the nurses about any special words that your child may use to tell others what he or she needs.
  • If your child is a newborn, hold and touch him or her often to promote bonding.
  • As much as possible, help the hospital staff with your child’s care. Find out whether you will be responsible for any treatments at home. Take this time to learn how to do these treatments while the hospital staff is there to teach you.

Coping with oxygen problems

Some heart defects, called cyanotic defects, cause oxygen problems. This means that the child’s body isn’t getting a normal amount of oxygen. Children with cyanosis may have a bluish tint to the skin.

If your child has “blue spells”:

  • Attempt to calm the child. This is the most important thing you can do.
  • Try placing the child with his or her knees to the chest—either on the back with the knees drawn up to the chest or in a sitting position with the chest to the knees.
  • You may need to give your child oxygen if the spells are severe and don’t improve with a change in position. Oxygen is given by placing a small tube at the entrance to the nostrils. Your doctor will determine the proper amount of oxygen needed.
  • Try to prevent the cyanosis by keeping your child warm, decreasing activity, and frequently feeding small meals.
  • Notify your child’s doctor when a blue spell occurs.

Oxygen therapy

Your child may need extra oxygen at home. It is given through a small tube that rests at the entrance to your child’s nose. Oxygen can cause a fire to burn very rapidly, so no smoking or open flames are allowed in the room where oxygen is being used. The amount of oxygen will be prescribed by your child’s doctor. Don’t change the amount of oxygen you give your child without the advice of your doctor.

Giving medicine

Be sure you know how to give your child’s medicines safely. Heart medicines can be very strong, so they can be dangerous if they are not given correctly.

  • Be sure you understand how much medicine to give and how to give it.
  • If your child takes a blood thinner, be sure to get instructions about how to give this medicine safely. Blood thinners can cause serious bleeding problems.
  • If you aren’t comfortable giving medicine to your child, ask a health professional to help you.
  • A home health nurse can help. Talk to your doctor about having a home health nurse visit you. The nurse can set up a schedule for the medicines, show you how to store them, and help you become more comfortable giving them.

Getting your child to eat well

Nutrition is very important for children who have heart defects. Getting your child to eat right can be a challenge. Children with congenital heart defects:

  • Often tire when eating, so they eat less and may not get enough calories. Feeding may take longer than you expect.
  • Tend to use more calories (have a higher metabolic rate) than other children.

To help overcome feeding difficulties or lack of weight gain:

  • Learn to recognize your baby’s first signs of hunger, such as fidgeting and sucking on a fist. This will help you to begin feeding before your baby starts to cry. Your baby will have more energy to eat well if he or she isn’t tired from crying.
  • Use a soft, special nipple made for babies born early (premature infants). These nipples make it is easier for your baby to get enough formula or breast milk if you bottle-feed.
  • Burp your baby often, especially when using a bottle. Babies who have trouble sucking take in large amounts of air when they eat, which makes them feel full before they get enough breast milk or formula.
  • Feed small, frequent meals. Smaller meals don’t require as much energy to eat or digest.

If you have difficulty preparing balanced meals, talk with a registered dietitian. Ask your doctor whether you should increase the number of calories in each meal.

Preventing infections

A congenital heart defect can raise the risk of an infection in the heart called endocarditis. To help prevent this infection, your child needs to take excellent care of his or her teeth throughout life. Good oral care can limit the growth of mouth bacteria that could get into the bloodstream and lead to infection. Call your child’s doctor if he or she has signs of a skin infection or infected wound.

Some children take antibiotics before having any dental and surgical procedures that could put bacteria or fungi into the blood. The antibiotics lower the risk of getting endocarditis.

Make sure that your child gets all the recommended vaccines, which helps keep your child healthy. Make sure family members and people who are in close contact with your child also get recommended vaccines.

Helping with emotional issues

Children and teens with congenital heart defects may have self-esteem issues because of how they look. They may have scars from surgery, and they may be smaller, have clubbing, or have limits on how active they can be.

Children may feel alone and have trouble coping because they have to stay in the hospital often. Most children deal well with having a heart defect. But some children with serious heart defects may have a hard time feeling “normal.”

Taking care of yourself

Dealing with a lifelong and possibly life-threatening illness in your child can have a strong impact on your life as a parent. It can be hard to accept that your child has a serious illness. And it’s normal to worry about the effect the condition will have on your child’s future.

Try to take good care of your own physical and emotional healths. Doing so will help give you the energy needed to care for your child with special needs.

It might help to:

  • Learn all you canabout your child’s heart defect.
  • Stop blaming yourself.You didn’t cause the heart defect. Many things occurred for the defect to happen. No single factor causes congenital heart defects.
  • Allow yourself to grieveabout having a child with a heart defect.
  • Ask questions.Don’t expect to remember everything that is involved in caring for your child. Ask questions when you don’t understand. Ask your doctor for written directions on caring for your child. If directions are written, you can look at them later and call the doctor if you have questions.
  • Join a support group.It’s helpful to be in contact with organizations and people who can offer support and answer your questions. Talk with your health professional to see whether there is a local support group you might join. A support group is a good place to meet other parents who are dealing with similar issues.
  • Talk to a counselor.It’s normal to feel sad. You may grieve because your baby is not the perfectly healthy infant you imagined. If you or a family member continues to feel extremely sad, guilty, or depressed or is otherwise having trouble dealing with your child’s illness, talk with a doctor.
  • Get financial help if needed.Expenses can quickly multiply if your child’s heart defect requires several hospital stays and tests. You may qualify for help from organizations. Talk with your doctor about a referral to a social worker or financial counselor who can help you.

Family counseling

Coping with a child who has a lifelong illness impacts the entire family. If you feel that you or your family needs help dealing with the condition, talk with a health professional about counseling.

 

Dehydration in older adults: ways of maintaining

Dehydration is a reduction in total body water volume and may be defined as significant when over 3% of body weight is lost. However, it is often difficult to determine precisely how much weight has been lost and whether it is all due to water loss. Dehydration is usually regarded as present when it is accompanied by changes in biochemical indices and by clinical features (see below, under diagnosis).

Prevalence of dehydration in institutional care

Studies within nursing homes have found that dehydration is frequent. One prospective study found dehydration events occurred in 31% of residents over 6 months and another found that 98% of residents consumed less than the daily recommended fluid intake. In another study some 91 of 339 elderly nursing home residents who became ill had biochemical features of dehydration. Many hospital admissions of nursing home residents are associated with dehydration and the electrolyte disturbances that may indicate dehydration. In one study, 34% of nursing home patients admitted to hospital were diagnosed with dehydration. Another study found 84% of hypernatraemic patients developed this during admission to hospital – only 16% were hypernatraemic on admission.

Consequences of dehydration

Dehydration is associated with increased hospitalisation and mortality. It may not be easy to distinguish between poor outcomes due to an underlying illness and poor outcomes from dehydration itself. In one study of 130 nursing home residents there were 48 febrile episodes over a 4 month period and 14 febrile residents had biochemical markers of dehydration. Of the 5 febrile residents who died, all had markers of dehydration. This unintended dehydration and associated increased mortality should be distinguished from the dehydration that frequently accompanies terminal illnesses such as cancer and renal failure.

Risk factors for dehydration

The greatest risk factor for dehydration is poor oral intake. In the study of 48 febrile episodes in nursing home residents, 11 patients were noted by staff to have poor oral intake and nine of these (82%) developed biochemical markers of dehydration. In a study of hospitalized patients, 86% of patients who developed hypernatraemia in hospital lacked free access to water.

Other significant risk factors for dehydration in a study of 339 elderly residents who became ill included female gender, age over 85, four or more chronic conditions, use of more than four medications and being bedridden . Among those who were most severely dehydrated, inability to feed oneself and impaired functional status were additional risk factors. In another study, diuretic use was a risk factor for electrolyte disturbances in elderly people requiring hospitalization. Diuretic use is a recognised risk factor in the genesis of renal impairment and electrolyte disturbances, especially in older people, and is likely to increase the risk of dehydration in nursing home residents.

The availability of appropriately skilled staff to assist residents is also a factor that contributes to the risk of dehydration. Dr Kayser-Jones’ research in the USA has repeatedly revealed that inadequate staffing, lack of assessment and disregard for personal and cultural preferences contribute to inadequate fluid intake and dehydration in residential care. These findings have been replicated by others – in a recent study weight loss and dehydration were 17% less likely in facilities that provided residents with at least 3 hours of nursing assistant care daily compared with those providing less than 3 hours daily.

Older people have a reduced thirst in response to fluid deprivation and their hormonal response to dehydration (secretion of anti-diuretic hormone) may also be impaired. These changes may be even more pronounced in residents with Alzheimer’s disease, a common condition in residential care. These factors both make older people more prone to dehydration and also indicate that thirst cannot be relied upon as an indicator of dehydration.

Normal Fluid Intake

Fluid intake must replace measurable losses (urine, faeces and occasionally others such as drain tubes) and insensible (not easily measured) losses from respiration and through the skin. The recommended minimum total fluid intake is 1500–2000 mL, (equivalent to 6–8 250 mL cups) a day. This comes from all sources including soups and beverages.

Signs of dehydration include dry mucous membranes, reduced tissue turgor (elasticity), reduced sweating, sunken eyes, tachycardia, low blood pressure and postural blood pressure drop, altered consciousness including confusion, increasing functional impairment, weakness, constipation, reduced urine output and more concentrated (darker) urine. Unfortunately many of these signs are quite subjective, with no defined “normal” ranges, and thus poor positive and negative predictive values for the diagnosis of dehydration. Some of these signs can be present in other conditions – for instance, low blood pressure can be due to over treatment with medications that lower blood pressure, in cardiac failure and when there is autonomic neuropathy. Indeed, over-reliance on low blood pressure as a sign may lead to over diagnosis of dehydration.

In a study of 102 consecutive medical admissions in people older than 65 with a diagnostic coding of dehydration (16% admitted from nursing homes), only 17% had biochemically confirmed dehydration (serum osmolarity above 295 mOsmol) suggesting over-diagnosis by physicians, probably due to over-reliance on physical signs or other less accurate biochemical indices. Another study of 150 elderly patients and residents with dehydration (defined as hypernatraemia) found that most of the classical signs of dehydration were irregularly present. There were four signs that were significantly and independently associated with hypernatraemia – abnormal subclavicular and thigh skin turgor, dry oral mucosa and recent changes in consciousness.