Sam’s Health Part B: Child Development
Nancy and Paul want Sam to live like a normal child and participate in activities regardless of his CF. It is important Sam does not engage too closely with other children who also have CF.
Nancy and Paul consult Sam’s Pediatrician and he provides health education to them regarding Sam’s growth and development.
Sam cannot understand his health condition, at this age and he is focused on exploring the world and learning from others. The reactions and interactions he has with his family will shape his future self-confidence.
Sam is enrolled in a swimming class
- They enroll him in swimming classes but Sam feels shame when swimming in a group class with other children because they do not play with him in the pool.
- Some of the children are fearful of Sam’s skin which has a mottled and pruritic appearance due to his chloride sweat similar to dermatitis, as well as his frequent coughing and wheezing, they do not understand that Sam has a genetic health condition.
- Nancy consults Sam’s pediatrician who informs them that Sam has been having more temper tantrums recently and she cannot understand why as he enjoyed swimming previously.
- The pediatrician informs Nancy to continue to bring Sam to his swimming lessons and eventually his tantrums will resolve as physical activity is necessary to support his growth and development and to be patient with him since he’s still adjusting to his new routine.
Q&A
How does swimming benefit CF clients compared to other sports specifically?
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- Increases lung elasticity and cardiopulmonary circulation as holding the breath to exercise increases metabolic demands and activates the sympathetic nervous system to open the airway to breathe in more O2 and increases the Heart rate optimizing circulation
- Improves Pulmonary Function capacity
- Children with CF typically have a lower Forced Expiratory Volume (FEV1) this test is measured to assess individuals lung capacity over 1 second, having an output less than 70% indicates decreased exercise performance capacity, decreased respiratory function, and this contributes to malnutrition and physical inactivity in children
- Pulmonary function testing (FEV1) is used to trend and quantify changes in a CF clients lung capacity over several years
- Facilitates bronchodilation and enhances mucous clearance from the airways mimics antihistamine medication effects, as mucous obstruction decreases the surface area available for the alveoli to complete respiratory gas exchange
Q&A
Give an example of Autonomy that Nancy may offer Sam regarding his swimming lessons?
Nancy asks Sam if he would like to continue swimming with group or private lessons, Sam chooses to continue with private lessons.
Autonomy vs Shame/ Doubt
- At this stage the Toddler is reliant on their caregiver to organize a routine for them they need familiar faces and constant reassurance as they explore the world and try new activities.
- Toddlers typically mirror the emotions and actions of their caregivers. Sam has experienced shame and doubt because he does not understand why the other children ignore him.
- The children ignoring Sam are most likely reinforcing the words and judgments expressed by their parents towards Sam and his family without understanding the situation entirely.
- Sam is at risk for regression (losing recently achieved milestones) and separation anxiety in this environment as this is causing him stress and to feel shame. His independence is being threatened and he does not feel confident in meeting new people or going to new places.
Q&A
What are some examples of regression?
An example of regression would be a Toddler that was successfully potty trained previously experiencing a traumatic event and they now wet the bed frequently or need diapers
