Anticipatory Guidance
Perry, pp. 991-999; 1033-1041; 1055;
1093; 1122-1124
Guidance and Safety
 Anticipatory guidance is about 2 things:
Caregiver understanding of child development
and thus anticipating the child’s needs and
understanding behavior
Educating caregivers about injury prevention
Nursing Responsibilities
 Need to be aware of risks in each age group in order
for anticipatory prevention teaching to occur.
 Also need to have understanding of child
development and behavior.
 Enables nurse to guide parents regarding
childrearing practices that will help prevent
 Ideally, discuss risks before each age group occurs.
Healthy People 2010
Objectives R/T Safety
 Commonalities in all age groups:
MVA/Pedestrian accidents
Head injuries
Food safety
Dog bites
Sports protection
Abuse/assault/rape (covered in a future course)
Injury Prevention
 In your text, all pediatric age groups will include all
or some of the following categories:
MVAs (#1 cause of death in all groups x infants)
Bodily injury
Anticipatory Guidance During
 Infancy includes all the injury prevention
 See interventions in Table 36-1, pp. 992-993
 See Patient Teaching Boxes on pp. 1000 &
Infancy cont’d
 Three leading causes of accidental death in
U.S. were suffocation, MVAs, drowning
 Remember that overall leading cause of
death in infants is congenital anomalies, not
 Infant needs constant supervision and
vigilance d/t increasing skills and curiosity.
During Early Childhood
(Toddlers and Preschoolers)
 Includes all categories; see Table 37-3, 1034-1035
 Also look at Guidance p. 1056
 Toddlers are at risk because of high activity level,
high curiosity, oral fixation, limited reasoning
ability, esp. for poisoning
 Preschoolers understand reasons for rules; child
care focus shifts from protection to education; good
time for development of long-term safety behaviors
(e.g. swimming lessons, bike helmets)
School Age
 Includes MVAs, drowning, burns, poisoning,
and bodily damage. See Table 39-2, p. 1095
 Less injuries d/t more refined coordination
and skills, and increased cognition and
 Also see Guidance on p. 1084.
 Adolescent concerns are pregnancy, STDs, eating
disorders, suicide, accidents, homicide
 Categories include MVAs, falls, drowning, burns,
poisoning , bodily damage. See Box 40-3, p. 1123
 Caregivers also need information regarding
developmental changes and process of gaining
independence—see Guidance on p. 1125
Adolescence cont’d
 MVAs—single greatest cause of serious and fatal
injuries in teens—60% male—alcohol frequently a
factor; 10% may have been suicides
 Firearms/other weapons—powder, paint, BB
 Sports injuries—football with boys; gymnastics
with girls. Important that sport fits body type and
ability and that protective gear is worn
Adolescence cont’d
 Adolescents have a sense of
indestructiveness accompanied by the “it
won’t happen to me syndrome” causing them
to take chances in areas of driving, sex, drugs
and alcohol, daredevil activities, and defying