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Test Bank for Wong’s Essentials of Pediatric Nursing, 8th Edition: Marilyn J. Hockenberry

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Test Bank for Wong’s Essentials of Pediatric Nursing, 8th Edition: Marilyn J. Hockenberry

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 ISBN: 9780323053532
Author: Marilyn J. Hockenberry, David Wilson
The #1 pediatric nursing textbook on the market, this book is known for its accuracy, current research, and highly readable writing style. It provides a foundation in child development and health promotion, and covers specific health problems — organized by age groups and body systems, so you can individualize care at the appropriate level for each child. A streamlined approach, superior illustrations, and a full-color design make it easy to find and understand key nursing information.

Table of Content:

  1. ORGANIZATION OF THE BOOK
  2. UNIFYING PRINCIPLES
  3. The Family as the Unit of Care
  4. An Integrated Approach to Development
  5. Focus on Wellness and Illness: Child, Family, and Community
  6. SpecialFeatures
  7. FAMILY-CENTERED CARE
  8. EVIDENCE-BASED PRACTICE
  9. COMMUNITY FOCUS
  10. CRITICAL THINKING EXERCISES
  11. nursing process
  12. CULTURAL AWARENESS
  13. ATRAUMATIC CARE
  14. FYI
  15. nursingcareplans
  16. FAMILY FOCUS
  17. ETHICAL CASE STUDY
  18. NURSINGALERT
  19. NURSINGTIP
  20. nursingcareguidlines
  21. emergencytreatment
  22. Nursing Care
  23. Culturally Competent Care
  24. The Critical Role of Research and Evidence-Based Practice
  25. CANADIAN CONTENT
  26. TEACHING/LEARNING PACKAGE
  27. AVAILABLE FOR PURCHASE
  28. ACKNOWLEDGMENTS
  29. Interactive Review — Essentials of Pediatric Nursing
  30. UNIT ONE CHILDREN, THEIR FAMILIES, AND THE NURSE
  31. Interactive Review — Unit One
  32. Chapter 1 Perspectives of Pediatric Nursing
  33. LEARNING OBJECTIVES
  34. RELATED TOPICS and ADDITIONAL RESOURCES
  35. IN TEXT
  36. HEALTH CARE FOR CHILDREN
  37. BOX 1-1 Healthy People 2010
  38. GOALS
  39. LEADING HEALTH INDICATORS
  40. HEALTH PROMOTION
  41. NUTRITION
  42. DENTAL CARE
  43. IMMUNIZATIONS
  44. CHILDHOOD HEALTH PROBLEMS
  45. OBESITY AND TYPE 2 DIABETES
  46. CHILDHOOD INJURIES
  47. FIG. 1-1 The American culture’s intake of high-caloric fatty foods contributes to obesity in children.
  48. TABLE 1-1 Mortality from Leading Types of Unintentional Injuries, United States, 1997 (Rate Per 100,000 Population in Each Age-Group)
  49. FIG. 1-2 Motor vehicle injuries are the leading cause of death in children older than 1 year of age. The majority of fatalities involve occupants who are unrestrained. The American culture’s intake of high-caloric fatty foods contributes to obesity in children.
  50. BOX 1-2 Childhood Injuries: Risk Factors
  51. Developmental characteristics
  52. Cognitive characteristics (age specific)
  53. Young child
  54. FIG. 1-3 A, Drowning is one of the leading causes of death. Children left unattended are unsafe even in shallow water. B, Burns are among the top three leading cause of death from injury in children ages 1 to 14 years.
  55. FIG. 1-4 Improper use of firearms is the fourth leading cause of death from injury in children 5 to 14 years of age.
  56. FIG. 1-5 Mechanical suffocation is the leading cause of death from injury in infants.
  57. FIG. 1-6 Poisoning causes a considerable number of injuries in children under 4 years of age. Prescription drugs should never be left where young children can reach them.
  58. VIOLENCE
  59. COMMUNITY FOCUS
  60. Violence in Children
  61. SUBSTANCE ABUSE
  62. MENTAL HEALTH PROBLEMS
  63. MORTALITY
  64. INFANT MORTALITY
  65. TABLE 1-2 Infant Mortality Rate (IMR) for Countries of >2,500,000 Population with IMR Equal to or Less Than the U.S. Rate for 2004 (Rate Per 1000 Live Births)
  66. CHILDHOOD MORTALITY
  67. TABLE 1-3 Infant Mortality Rate and Percentage of Total Deaths for 10 Leading Causes of Infant Death in 2004 (Rate Per 1000 Live Births)
  68. TABLE 1-4 Five Leading Causes of Death in Children in the United States: Selected Age Intervals, 2005 (Rate Per 100,000 Population)
  69. MORBIDITY
  70. CHILDHOOD MORBIDITY
  71. THE ART OF PEDIATRIC NURSING
  72. PHILOSOPHY OF CARE
  73. FAMILY-CENTERED CARE
  74. BOX 1-3 Key Elements of Family-Centered Care
  75. ATRAUMATIC CARE
  76. ROLE OF THE PEDIATRIC NURSE
  77. THERAPEUTIC RELATIONSHIP
  78. FAMILY ADVOCACY AND CARING
  79. nursingcareguidelines
  80. Exploring Your Relationships with Children and Families
  81. NEGATIVE ACTIONS
  82. POSITIVE ACTIONS
  83. DISEASE PREVENTION AND HEALTH PROMOTION
  84. BOX 1-4 United Nations’ Declaration of the Rights of the Child
  85. HEALTH TEACHING
  86. SUPPORT AND COUNSELING
  87. COORDINATION AND COLLABORATION
  88. ETHICAL DECISION MAKING
  89. BOX 1-5 American Nurses Association Standard 12: Ethics
  90. MEASUREMENT CRITERIA
  91. RESEARCH
  92. CRITICAL THINKING AND THE PROCESS OF NURSING CHILDREN AND FAMILIES
  93. CRITICAL THINKING
  94. EVIDENCE-BASED PRACTICE
  95. TABLE 1-5 The Nursing Process and Evidence-Based Practice
  96. BOX 1-6 Evidence-Based Practice Template
  97. ASK THE QUESTION
  98. SEARCH FOR EVIDENCE
  99. CRITICALLY ANALYZE THE EVIDENCE
  100. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  101. REFERENCES
  102. NURSING PROCESS
  103. BOX 1-7 Nursing Process
  104. Assessment
  105. Nursing Diagnosis
  106. BOX 1-8 Classification Systems for Nursing Diagnoses
  107. HUMAN RESPONSE PATTERNS
  108. FUNCTIONAL HEALTH PATTERNS
  109. TAXONOMY II DOMAINS
  110. FAMILY FOCUS
  111. Using Defining Characteristics to Select an Appropriate Nursing Diagnosis
  112. Planning
  113. Implementation
  114. Evaluation
  115. Documentation
  116. nursingcareguidelines
  117. Documentation of Nursing Care
  118. KEY POINTS
  119. References
  120. Chapter 2 Community-Based Nursing Care of the Child and Family
  121. LEARNING OBJECTIVES
  122. RELATED TOPICS and ADDITIONAL RESOURCES
  123. IN TEXT
  124. NURSING IN THE COMMUNITY
  125. COMMUNITY CONCEPTS
  126. COMMUNITY
  127. Community Health Nursing
  128. Roles and Functions
  129. BOX 2-1 Evolving Role of the Pediatric Nurse: Natural and Man-Made Disasters
  130. Preparedness and planning
  131. NURSINGALERT
  132. DEMOGRAPHY
  133. EPIDEMIOLOGY
  134. Distribution of Disease, Injury, or Illness
  135. Epidemiologic Triangle
  136. Levels of Prevention
  137. FIG. 2-1 The epidemiologic triangle.
  138. BOX 2-2 Frequently Used Mortality and Morbidity Rates
  139. CRUDE BIRTH RATE
  140. CRUDE DEATH RATE
  141. CAUSE-SPECIFIC DEATH RATE
  142. AGE-SPECIFIC DEATH RATE
  143. INCIDENCE OF DISEASE
  144. PREVALENCE OF DISEASE
  145. Screening
  146. ECONOMICS
  147. EVIDENCE-BASED PRACTICE
  148. Acanthosis Nigricans and the Risk of Type 2 Diabetes in Children
  149. ASK THE QUESTION
  150. SEARCH FOR EVIDENCE
  151. Search Strategies
  152. Databases Used
  153. CRITICALLY ANALYZE THE EVIDENCE
  154. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  155. References
  156. COMMUNITY NURSING PROCESS
  157. BOX 2-3 The Community Nursing Process
  158. COMMUNITY NEEDS ASSESSMENT AND DIAGNOSIS
  159. NURSINGTIP
  160. COMMUNITY PLANNING
  161. COMMUNITY IMPLEMENTATION
  162. COMMUNITY EVALUATION
  163. BOX 2-4 An Example of Community Assessment and Planning
  164. COMMUNITY NEEDS ASSESSMENT AND DIAGNOSIS
  165. PLANNING
  166. IMPLEMENTATION AND EVALUATION
  167. KEY POINTS
  168. References
  169. INTERNET RESOURCES
  170. Chapter 3 Family Influences on Child Health Promotion
  171. LEARNING OBJECTIVES
  172. RELATED TOPICS and ADDITIONAL RESOURCES
  173. IN TEXT
  174. GENERAL CONCEPTS
  175. DEFINITION OF FAMILY
  176. NURSINGALERT
  177. FAMILY THEORIES
  178. Family Systems Theory
  179. TABLE 3-1 Summary of Family Theories and Applications
  180. Family Stress Theory
  181. Developmental Theory
  182. FAMILY NURSING INTERVENTIONS
  183. BOX 3-1 Duvall’s Developmental Stages of the Family
  184. STAGE I-MARRIAGE AND AN INDEPENDENT HOME: THE JOINING OF FAMILIES
  185. STAGE II-FAMILIES WITH INFANTS
  186. STAGE III-FAMILIES WITH PRESCHOOLERS
  187. STAGE IV-FAMILIES WITH SCHOOLCHILDREN
  188. STAGE V-FAMILIES WITH TEENAGERS
  189. STAGE VI-FAMILIES AS LAUNCHING CENTERS
  190. STAGE VII-MIDDLE-AGED FAMILIES
  191. STAGE VIII-AGING FAMILIES
  192. BOX 3-2 Family Nursing Interventions
  193. FAMILY STRUCTURE AND FUNCTION
  194. FAMILY STRUCTURE
  195. Traditional Nuclear Family
  196. Nuclear Family
  197. FIG. 3-1 Children benefit from interaction with grandparents, who sometimes assume the parenting role.
  198. Blended Family
  199. Extended Family
  200. Single-Parent Family
  201. Binuclear Family
  202. Polygamous Family
  203. Communal Family
  204. Gay/Lesbian Family
  205. FAMILY STRENGTHS AND FUNCTIONING STYLE
  206. BOX 3-3 Qualities of Strong Families
  207. FAMILY ROLES AND RELATIONSHIPS
  208. PARENTAL ROLES
  209. ROLE LEARNING
  210. Family Size and Configuration
  211. FIG. 3-2 Family structure promotes strong relationships among its members.
  212. Sibling Interactions
  213. Spacing of Children.
  214. Sibling Functions.
  215. FIG. 3-3 Older school-age children often enjoy taking responsibility for the care of a younger sibling.
  216. More Active Sibling Relationships.
  217. Ordinal Position
  218. The Only Child.
  219. Multiple Births
  220. BOX 3-4 Influence of Ordinal Position on Children
  221. FIRSTBORN CHILDREN
  222. MIDDLE CHILDREN
  223. YOUNGEST CHILDREN
  224. ONLY CHILDREN
  225. FIG. 3-4 Fraternal twins.
  226. BOX 3-5 Characteristics of Twins
  227. MONOZYGOTIC (MZ) OR IDENTICAL TWINS
  228. DIZYGOTIC (DZ) OR FRATERNAL TWINS
  229. Parental Adjustment.
  230. PARENTING
  231. MOTIVATION FOR PARENTHOOD
  232. PREPARATION FOR PARENTHOOD
  233. TRANSITION TO PARENTHOOD
  234. Parental Factors Affecting Transition to Parenthood
  235. Parental Age.
  236. FIG. 3-5 Fathers who assume care of their children may feel more comfortable and successful in their parenting role.
  237. Father Involvement.
  238. Parenting Education.
  239. FIG. 3-6 Quality time spent with a child is essential to a family’s health and well-being.
  240. Support Systems.
  241. FIG. 3-7 Learning new roles together as a mother and father can enhance parenting relationships.
  242. PARENTING BEHAVIORS
  243. Parental Styles of Control
  244. LIMIT SETTING AND DISCIPLINE
  245. Minimizing Misbehavior
  246. FAMILY-CENTERED CARE
  247. Minimizing Misbehavior
  248. General Guidelines for Implementing Discipline
  249. Types of Discipline
  250. FAMILY-CENTERED CARE
  251. Implementing Discipline
  252. NURSINGALERT
  253. FIG. 3-8 Time-out is an excellent disciplinary strategy for young children.
  254. SPECIAL PARENTING SITUATIONS
  255. FAMILY-CENTERED CARE
  256. Using Time-Out
  257. PARENTING THE ADOPTED CHILD
  258. FIG. 3-9 An older sister lovingly embraces her adopted sister.
  259. Issues of Origin
  260. CRITICAL THINKING EXERCISE
  261. Parenting the Adopted Child
  262. QUESTIONS
  263. Adolescence
  264. Cross-Racial and International Adoption
  265. NURSINGALERT
  266. PARENTING AND DIVORCE
  267. BOX 3-6 Stages of the Divorce Process
  268. ACUTE PHASE
  269. TRANSITIONAL PHASE
  270. STABILIZING PHASE
  271. Impact of Divorce on Children
  272. BOX 3-7 Feelings and Behaviors of Children Related to Divorce
  273. INFANCY
  274. EARLY PRESCHOOL CHILDREN (AGES 2 TO 3 YEARS)
  275. LATER PRESCHOOL CHILDREN (AGES 3 TO 5 YEARS)
  276. EARLY SCHOOL-AGE CHILDREN (AGES 5 TO 6 YEARS)
  277. MIDDLE SCHOOL-AGE CHILDREN (AGES 6 TO 8 YEARS)
  278. LATER SCHOOL-AGE CHILDREN (AGES 9 TO 12 YEARS)
  279. ADOLESCENTS (AGES 12 TO 18 YEARS)
  280. Age- and Sex-Related Responses to Divorce.
  281. Telling the Children.
  282. Custody and Parenting Partnerships
  283. SINGLE PARENTING
  284. Single Fathers
  285. PARENTING IN RECONSTITUTED FAMILIES
  286. PARENTING IN DUAL-EARNER FAMILIES
  287. Working Mothers
  288. FOSTER PARENTING
  289. ACCOMMODATING CONTEMPORARY PARENTING SITUATIONS
  290. EVIDENCE-BASED PRACTICE
  291. Daycare for Preschool Children
  292. ASK THE QUESTION
  293. SEARCH FOR EVIDENCE
  294. Search Strategies
  295. Databases Used
  296. CRITICALLY ANALYZE THE EVIDENCE
  297. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  298. References
  299. KEY POINTS
  300. answers to CRITICAL THINKING EXERCISE
  301. PARENTING THE ADOPTED CHILD
  302. References
  303. Chapter 4 Social, Cultural, and Religious Influences on Child Health Promotion
  304. LEARNING OBJECTIVES
  305. RELATED TOPICS and ADDITIONAL RESOURCES
  306. IN TEXT
  307. CULTURE
  308. FIG. 4-1 Ethnicity is an individual’s association with shared cultural, social, and linguistic heritage.
  309. SOCIAL ROLES
  310. Self-Esteem and Culture
  311. SUBCULTURAL INFLUENCES
  312. FIG. 4-2 Teenagers from different cultural backgrounds interact within the larger culture.
  313. Ethnicity
  314. Socioeconomic Class
  315. Poverty
  316. Homelessness
  317. Migrant Farmworker Families
  318. Immigrant Children
  319. Religion
  320. Schools
  321. FIG. 4-3 Soon after an infant is born, many families have special religious ceremonies.
  322. Communities
  323. Peer Cultures
  324. THE CHILD AND FAMILY IN NORTH AMERICA
  325. Minority-Group Membership
  326. CULTURAL AWARENESS
  327. Overview of Race and Hispanic Origin in Census 2000
  328. NURSINGALERT
  329. NURSINGALERT
  330. CRITICAL THINKING EXERCISE
  331. Reducing Cultural Shock
  332. QUESTIONS
  333. CULTURAL SHOCK AND CULTURAL COMPETENCE
  334. NURSINGALERT
  335. CULTURAL AND RELIGIOUS INFLUENCES ON HEALTH CARE
  336. SUSCEPTIBILITY TO HEALTH PROBLEMS
  337. Hereditary Factors
  338. Physical Characteristics.
  339. Socioeconomic Factors
  340. Poverty.
  341. Homelessness.
  342. Migrant Farmworker Families.
  343. Immigrant Families.
  344. CULTURAL CUSTOMS
  345. NURSINGTIP
  346. Cultural Relativism
  347. Relationships with Health Care Providers
  348. FIG. 4-4 A father with his hospitalized child.
  349. NURSINGALERT
  350. Communication.
  351. NURSINGTIP
  352. Food Customs
  353. nursingcareguidelines
  354. Culturally Sensitive Interactions
  355. NONVERBAL STRATEGIES
  356. VERBAL STRATEGIES
  357. FIG. 4-5 Food customs outside the home can differ significantly from traditional cultural practices
  358. HEALTH BELIEFS AND PRACTICES
  359. Health Beliefs
  360. Natural Forces.
  361. Supernatural Forces.
  362. Imbalance of Forces.
  363. Health Practices
  364. BOX 4-1 Cultural Practices Possibly Considered Abusive by the Dominant Culture
  365. BOX 4-2 BELIEF Framework for Integrating Culture and Spirituality into the Nursing Assessment
  366. NURSINGALERT
  367. RELIGIOUS BELIEFS
  368. IMPORTANCE OF CULTURE AND RELIGION TO NURSES
  369. TABLE 4-1 Religious Beliefs That May Affect Nursing Care
  370. BOX 4-3 Exploring Your Cultural Competence: ASKED Model of Cultural Competence
  371. NURSINGALERT
  372. TABLE 4-2 Broad Cultural Characteristics Related to Health Care of Children and Families
  373. KEY POINTS
  374. answer to CRITICAL THINKING EXERCISE
  375. REDUCING CULTURAL SHOCK
  376. References
  377. Chapter 5 Developmental Influences on Child Health Promotion
  378. LEARNING OBJECTIVES
  379. RELATED TOPICS and ADDITIONAL RESOURCES
  380. IN TEXT
  381. GROWTH AND DEVELOPMENT
  382. FOUNDATIONS OF GROWTH AND DEVELOPMENT
  383. Stages of Development
  384. Patterns of Growth and Development
  385. Directional Trends.
  386. FIG. 5-1 Directional trends in growth.
  387. BOX 5-1 Developmental Age Periods
  388. PRENATAL PERIOD–CONCEPTION TO BIRTH
  389. INFANCY PERIOD–BIRTH TO 12 MONTHS
  390. EARLY CHILDHOOD–1 TO 6 YEARS
  391. MIDDLE CHILDHOOD–6 TO 11 OR 12 YEARS
  392. LATER CHILDHOOD–11 TO 19 YEARS
  393. Sequential Trends.
  394. Developmental Pace.
  395. FYI
  396. Sensitive Periods.
  397. Individual Differences
  398. BIOLOGIC GROWTH AND PHYSICAL DEVELOPMENT
  399. External Proportions
  400. FIG. 5-2 Growth rates for the body as a whole and three types of tissues. Lymphoid: thymus, lymph nodes, and intestinal lymph masses. Neural: brain, dura, spinal cord, optic apparatus, and head dimensions. General: body as a whole; external dimension; and respiratory, digestive, renal, circulatory, and musculoskeletal systems.
  401. FIG. 5-3 Changes in body proportions occur dramatically during childhood.
  402. TABLE 5-1 General Trends in Height and Weight Gain During Childhood
  403. Biologic Determinants of Growth and Development
  404. NURSINGTIP
  405. Skeletal Growth and Maturation
  406. Neurologic Maturation
  407. Lymphoid Tissues
  408. Development of Organ Systems
  409. TABLE 5-2 Dietary Reference Intake for Calories and Protein Throughout Adolescence*
  410. PHYSIOLOGIC CHANGES
  411. Metabolism
  412. FYI
  413. Temperature
  414. Sleep and Rest
  415. BOX 5-2 Attributes of Temperament
  416. TEMPERAMENT
  417. BOX 5-3 Activities to Promote Mastery Motivation
  418. Significance of Temperament
  419. DEVELOPMENT OF PERSONALITY AND MENTAL FUNCTION
  420. THEORETIC FOUNDATIONS OF PERSONALITY DEVELOPMENT
  421. Psychosexual Development (Freud)
  422. TABLE 5-3 Summary of Personality, Cognitive, and Moral Development Theories
  423. Psychosocial Development (Erikson)
  424. FIG. 5-4 The stage of initiative is characterized by physical activity and imagination while children explore the physical world around them.
  425. THEORETIC FOUNDATIONS OF MENTAL DEVELOPMENT
  426. Cognitive Development (Piaget)
  427. Language Development
  428. Moral Development (Kohlberg)
  429. Spiritual Development (Fowler)
  430. DEVELOPMENT OF SELF-CONCEPT
  431. Body Image
  432. Self-Esteem
  433. ROLE OF PLAY IN DEVELOPMENT
  434. CLASSIFICATION OF PLAY
  435. CONTENT OF PLAY
  436. FIG. 5-5 Children derive pleasure from handling raw materials.
  437. FIG. 5-6 After infants develop new skills to grasp and manipulate, they begin to conquer new abilities such as getting on a play motorcycle.
  438. SOCIAL CHARACTER OF PLAY
  439. FIG. 5-7 Parallel play.
  440. FIG. 5-8 Associative play.
  441. FIG. 5-9 Cooperative play.
  442. FUNCTIONS OF PLAY
  443. Sensorimotor Development
  444. Intellectual Development
  445. Socialization
  446. Creativity
  447. Self-Awareness
  448. Therapeutic Value
  449. Moral Value
  450. FIG. 5-10 Play is therapeutic at any age and provides a means for release of tension and stress.
  451. TOYS
  452. Toy Safety
  453. SELECTED FACTORS THAT INFLUENCE DEVELOPMENT
  454. HEREDITY
  455. NEUROENDOCRINE FACTORS
  456. FAMILY-CENTERED CARE
  457. Toy Safety*
  458. SELECTION
  459. SUPERVISION
  460. MAINTENANCE
  461. STORAGE
  462. COMMUNITY FOCUS
  463. Healthy Food Choices
  464. NUTRITION
  465. INTERPERSONAL RELATIONSHIPS
  466. FIG. 5-11 Peers become increasingly important as children develop friendships outside the family group.
  467. SOCIOECONOMIC LEVEL
  468. DISEASE
  469. ENVIRONMENTAL HAZARDS
  470. COMMUNITY FOCUS
  471. Sun Protection Basics
  472. STRESS IN CHILDHOOD
  473. Coping
  474. INFLUENCE OF THE MASS MEDIA
  475. Reading Materials
  476. Movies
  477. Television
  478. FYI
  479. BOX 5-4 Factors That Encourage Learning or Performing Television-Influenced Behaviors
  480. BOX 5-5 Five Important Ideas to Teach Children and Adolescents About Television
  481. NURSINGTIP
  482. Video Games
  483. FAMILY-CENTERED CARE
  484. Television Viewing
  485. Internet
  486. DEVELOPMENTAL ASSESSMENT
  487. DENVER II
  488. BOX 5-6 Denver II Scoring
  489. INTERPRETATION OF DENVER II SCORES
  490. INTERPRETATION OF TEST
  491. RECOMMENDATIONS FOR REFERRAL FOR SUSPECT AND UNTESTABLE RESULTS
  492. DENVER II PRESCREENING DEVELOPMENTAL QUESTIONNAIRE
  493. KEY POINTS
  494. References
  495. UNIT TWO ASSESSMENT OF THE CHILD AND FAMILY
  496. Interactive Review — Unit Two
  497. Chapter 6 Communication and Physical Assessment of the Child
  498. LEARNING OBJECTIVES
  499. RELATED TOPICS and ADDITIONAL RESOURCES
  500. IN TEXT
  501. GUIDELINES FOR COMMUNICATION AND INTERVIEWING
  502. ESTABLISHING A SETTING FOR COMMUNICATION
  503. Appropriate Introduction
  504. Assurance of Privacy and Confidentiality
  505. FIG. 6-1 Child plays while nurse interviews parent.
  506. NURSINGALERT
  507. COMPUTER PRIVACY AND APPLICATIONS IN NURSING
  508. TELEPHONE TRIAGE AND COUNSELING
  509. NURSINGALERT
  510. BOX 6-1 Telephone Triage Guidelines
  511. RESOURCES FOR TELEPHONE TRIAGE PROTOCOLS
  512. COMMUNICATING WITH FAMILIES
  513. COMMUNICATING WITH PARENTS
  514. Encouraging the Parent to Talk
  515. Directing the Focus
  516. Listening and Cultural Awareness
  517. Using Silence
  518. Being Empathic
  519. Providing Anticipatory Guidance
  520. NURSINGTIP
  521. Avoiding Blocks to Communication
  522. Communicating with Families Through an Interpreter
  523. BOX 6-2 Blocks to Communication
  524. COMMUNICATION BARRIERS (NURSE)
  525. SIGNS OF INFORMATION OVERLOAD (PATIENT)
  526. nursingcareguidelines
  527. Using an Interpreter
  528. NURSINGALERT
  529. COMMUNICATING WITH CHILDREN
  530. Communication Related to Development of Thought Processes
  531. FIG. 6-2 Nurse assumes position at child’s level.
  532. BOX 6-3 Characteristics of Communicative Development in Young Children
  533. PERLOCUTIONARY STAGE (0 TO 8-9 MONTHS)
  534. EMERGING ILLOCUTIONARY STAGE (8-9 TO 12-15 MONTHS)
  535. CONVENTIONAL ILLOCUTIONARY—EMERGING LOCUTIONARY STAGE (12-15 TO 18-24 MONTHS)
  536. nursingcareguidelines
  537. Communicating with Children
  538. FIG. 6-3 A young child may take the expression ‘a little stick in the arm’ literally.
  539. nursingcareguidelines
  540. Communicating with Adolescents
  541. BUILD A FOUNDATION
  542. COMMUNICATE EFFECTIVELY
  543. NURSINGALERT
  544. COMMUNICATION TECHNIQUES
  545. Play
  546. BOX 6-4 Creative Communication Techniques with Children
  547. VERBAL TECHNIQUES
  548. ‘I’ Messages
  549. Third-Person Technique
  550. Facilitative Response
  551. Storytelling
  552. Mutual Storytelling
  553. Bibliotherapy
  554. Dreams
  555. ‘What If’ Questions
  556. Three Wishes
  557. Rating Game
  558. Word Association Game
  559. Sentence Completion
  560. Pros and Cons
  561. NONVERBAL TECHNIQUES
  562. Writing
  563. Drawing
  564. Guidelines for Evaluating Drawings
  565. Magic
  566. Play
  567. HISTORY TAKING
  568. PERFORMING A HEALTH HISTORY
  569. Identifying Information
  570. Chief Complaint
  571. BOX 6-5 Outline of a Pediatric Health History
  572. Identifying information
  573. Chief complaint (CC)
  574. Present illness (PI)
  575. Past history (PH)
  576. Review of systems (ROS)
  577. Family medical history
  578. Psychosocial history
  579. Sexual history
  580. Family history
  581. Nutritional assessment
  582. Present Illness
  583. nursingcareguidelines
  584. Analyzing the Symptom: Pain
  585. TYPE
  586. LOCATION
  587. SEVERITY
  588. DURATION
  589. INFLUENCING FACTORS
  590. History
  591. NURSINGALERT
  592. nursingcareguidelines
  593. Taking an Allergy History
  594. NURSINGALERT
  595. BOX 6-6 Habits to Explore During a Health Interview
  596. BOX 6-7 Anticipatory Guidance’Sexuality
  597. AGES 12 TO 14 YEARS
  598. AGES 15 TO 18 YEARS
  599. Sexual History
  600. Family Medical History
  601. Family Structure
  602. nursingcareguidelines
  603. Initiating a Comprehensive Family Assessment
  604. NURSINGALERT
  605. Psychosocial History
  606. BOX 6-8 Family Assessment Interview
  607. GENERAL GUIDELINES
  608. STRUCTURAL ASSESSMENT AREAS
  609. Family Composition
  610. Home and Community Environment
  611. Occupation and Education of Family Members
  612. Cultural and Religious Traditions
  613. FUNCTIONAL ASSESSMENT AREAS
  614. Family Interactions and Roles
  615. Power, Decision Making, and Problem Solving
  616. Communication
  617. Expression of Feelings and Individuality
  618. Review of Systems
  619. NUTRITIONAL ASSESSMENT
  620. DIETARY INTAKE
  621. nursingcareguidelines
  622. Review of Systems
  623. BOX 6-9 Nutrition Assessment
  624. DIETARY HISTORY
  625. ADDITIONAL QUESTIONS FOR INFANTS
  626. CULTURAL AWARENESS
  627. Food Practices
  628. CLINICAL EXAMINATION
  629. TABLE 6-1 Clinical Assessment of Nutritional Status
  630. EVALUATION OF NUTRITIONAL ASSESSMENT
  631. GENERAL APPROACHES TOWARD EXAMINING THE CHILD
  632. SEQUENCE OF THE EXAMINATION
  633. PREPARATION OF THE CHILD
  634. nursingcareguidelines
  635. Performing Pediatric Physical Examination
  636. FIG. 6-4 Using paper-doll technique to prepare child for physical examination.
  637. FIG. 6-5 Preparing children for physical examination.
  638. TABLE 6-2 Age-Specific Approaches to Physical Examination During Childhood
  639. FIG. 6-6 Child preventive care time line. The information on immunizations is based on recommendations issued by Advisory Committee on Immunization Practices, American Academy of Pediatrics, and American Academy of Family Physicians. B, Birth; HIV, human immunodeficiency virus; PKU, phenylketonuria; STDs, sexually transmitted diseases.
  640. PHYSICAL EXAMINATION
  641. GROWTH MEASUREMENTS
  642. Growth Charts
  643. NURSINGALERT
  644. NURSINGALERT
  645. Length
  646. Height
  647. FIG. 6-7 These children of identical age (8 years) are markedly different in size. Child on left, of Asian descent, is at 5th percentile for height and weight. Child on right is above 95th percentile for height and weight. However, both children demonstrate normal growth patterns.
  648. NURSINGTIPS
  649. Weight
  650. FIG. 6-8 Measurement of head, chest, and abdominal circumference and crown-to-heel (recumbent) length.
  651. FIG. 6-9 Measurement of height.
  652. FIG. 6-10 A, Infant on scale. B, Toddler on scale. Note presence of nurse to prevent falls.
  653. Skinfold Thickness and Arm Circumference
  654. Head Circumference
  655. PHYSIOLOGIC MEASUREMENTS
  656. BOX 6-10 Fever in Infants and Children
  657. BOX 6-11 Recommended Temperature Screening Routes in Infants and Children
  658. BIRTH TO 2 YEARS
  659. 2 TO 5 YEARS
  660. OVER 5 YEARS
  661. ATRAUMATIC CARE
  662. Reducing Young Children’s Fears
  663. Temperature
  664. BOX 6-12 Alternative Temperature Measurement Sitesfor the Ill Child
  665. SKIN
  666. URINARY BLADDER
  667. PULMONARY ARTERY
  668. ESOPHAGEAL SITE
  669. NASOPHARYNGEAL SITE
  670. TABLE 6-3 Temperature Measurement Locations for Infants and Children
  671. NURSINGALERT
  672. NURSINGALERT
  673. Pulse
  674. BOX 6-13 Types of Thermometers Used to Measure Temperature in Infants and Children
  675. ELECTRONIC THERMOMETER
  676. INFRARED THERMOMETER
  677. EAR-BASED TEMPERATURE SENSOR
  678. EAR SENSOR (LIGHTOUCH LTX)
  679. AXILLARY SENSOR (LIGHTOUCH LTN)
  680. DIGITAL THERMOMETER
  681. LIQUID CRYSTAL SKIN CONTACT THERMOMETER (CHEMICAL DOT THERMOMETER)
  682. EVIDENCE-BASED PRACTICE
  683. Temperature Measurement in Pediatrics
  684. ASK THE QUESTION
  685. SEARCH FOR EVIDENCE
  686. Search Strategies
  687. Databases Used
  688. CRITICALLY ANALYZE THE EVIDENCE
  689. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  690. References
  691. TABLE 6-4 Grading of Pulses
  692. Respiration
  693. Blood Pressure
  694. TABLE 6-5 Normative Dinamap Blood Pressure Values (Systolic/Diastolic; Mean Arterial Pressure in Parentheses)
  695. FIG. 6-11 Determination of proper cuff size. A, Cuff bladder width should be approximately 40% of circumference of arm measured at a point midway between olecranon and acromion. B, Cuff bladder length should cover 80% to 100% of circumference of arm. C, Blood pressure should be measured with cubital fossa at heart level. Arm should be supported. Stethoscope bell is placed over brachial artery pulse, proximal and medial to cubital fossa and below bottom edge of cuff.
  696. FIG. 6-12 Sites for measuring blood pressure. A, Upper arm. B, Lower arm or forearm. C, Thigh. D, Calf or ankle.
  697. TABLE 6-6 Recommended Dimensions for Blood Pressure Cuff Bladders
  698. TABLE 6-7 Differences in Oscillometric Systolic Blood Pressure Between Arm and Lower Extremity Sites in Normal Children
  699. NURSINGALERT
  700. NURSINGALERT
  701. nursingcareguidelines
  702. Using the Blood Pressure Tables
  703. NURSINGALERT
  704. GENERAL APPEARANCE
  705. SKIN
  706. Accessory Structures
  707. TABLE 6-8 Differences in Color Changes of Racial Groups
  708. FIG. 6-13 Examples of flexion creases on palm. A, Normal. B, Transpalmar crease.
  709. LYMPH NODES
  710. HEAD AND NECK
  711. NURSINGALERT
  712. NURSINGALERT
  713. FIG. 6-14 Location of superficial lymph nodes. Arrows indicate directional flow of lymph.
  714. NURSINGALERT
  715. EYES
  716. Inspection of External Structures
  717. FIG. 6-15 External structures of eye.
  718. Inspection of Internal Structures
  719. FIG. 6-16 Structures of fundus.
  720. NURSINGALERT
  721. Vision Testing
  722. FIG. 6-17 A, Corneal light reflex test demonstrating orthophoric eyes. B, Pseudostrabismus. Inner epicanthal folds cause eyes to appear misaligned; however, corneal light reflexes fall perfectly symmetrically.
  723. FIG. 6-18 Alternate cover test to detect amblyopia in patient with strabismus. A, Eye is occluded, and child is fixating on light source. B, If eye does not move when uncovered, eyes are aligned.
  724. NURSINGALERT
  725. NURSINGALERT
  726. EARS
  727. Inspection of External Structures
  728. FIG. 6-19 Ear alignment.
  729. Inspection of Internal Structures
  730. ATRAUMATIC CARE
  731. Reducing Distress from Otoscopy in Young Children
  732. FIG. 6-20 Position for restraining child (A) and infant (B) during otoscopic examination.
  733. FIG. 6-21 Positioning head by tilting it toward opposite shoulder for full view of tympanic membrane.
  734. FIG. 6-22 Landmarks of tympanic membrane with ‘clock’ superimposed.
  735. FIG. 6-23 Positioning for visualizing eardrum in infant (A) and in child older than 3 years of age (B).
  736. NURSINGALERT
  737. Auditory Testing
  738. NOSE
  739. Inspection of External Structures
  740. FIG. 6-24 External landmarks and internal structures of nose.
  741. TABLE 6-9 Audiologic Tests for Infants and Children
  742. Inspection of Internal Structures
  743. MOUTH AND THROAT
  744. FIG. 6-25 A, Encouraging child to cooperate. B, Positioning child for examination of mouth.
  745. ATRAUMATIC CARE
  746. Encouraging Opening the Mouth for Examination
  747. Inspection of Internal Structures
  748. FIG. 6-26 Interior structures of mouth.
  749. FIG. 6-27 Rib cage.
  750. CHEST
  751. FIG. 6-28 Imaginary landmarks of chest. A, Anterior. B, Right lateral. C, Posterior.
  752. FIG. 6-29 Movement of chest during respiration.
  753. FIG. 6-30 Location of lobes of lungs within thoracic cavity.
  754. LUNGS
  755. BOX 6-14 Classification of Normal Breath Sounds
  756. VESICULAR BREATH SOUNDS
  757. BRONCHOVESICULAR BREATH SOUNDS
  758. BRONCHIAL BREATH SOUNDS
  759. nursingcareguidelines
  760. Effective Auscultation
  761. Auscultation
  762. ATRAUMATIC CARE
  763. Encouraging Deep Breaths
  764. BOX 6-15 Various Patterns of Respiration
  765. HEART
  766. FIG. 6-31 Position of heart within thorax.
  767. NURSINGALERT
  768. Auscultation
  769. FIG. 6-32 Location of pulses.
  770. NURSINGALERT
  771. TABLE 6-10 Sequence of Auscultating Heart Sounds*
  772. FIG. 6-33 Direction of heart sounds for anatomic valve sites and areas (circled) for auscultation.
  773. NURSINGTIP
  774. TABLE 6-11 Grading of the Intensity of Heart Murmurs
  775. ABDOMEN
  776. FIG. 6-34 Location of structures in abdomen.
  777. Inspection
  778. FIG. 6-35 Location of hernias.
  779. NURSINGALERT
  780. NURSINGTIP
  781. ATRAUMATIC CARE
  782. Promoting Relaxation During Abdominal Palpation
  783. Auscultation
  784. Palpation
  785. FIG. 6-36 Palpating femoral pulses.
  786. NURSINGALERT
  787. NURSINGALERT
  788. GENITALIA
  789. FIG. 6-37 Major structures of genitalia in uncircumcised postpubertal male.
  790. Male Genitalia
  791. FIG. 6-38 A, Preventing cremasteric reflex by having child sit in ‘tailor’ position. B, Blocking inguinal canal during palpation of scrotum for descended testes.
  792. Female Genitalia
  793. FIG. 6-39 External structures of genitalia in postpubertal female. Labia are spread to reveal deeper structures.
  794. NURSINGALERT
  795. ANUS
  796. BACK AND EXTREMITIES
  797. Spine
  798. NURSINGALERT
  799. Extremities
  800. Joints
  801. FIG. 6-40 Bowleg.
  802. FIG. 6-41 Knock-knee.
  803. Muscles
  804. NEUROLOGIC ASSESSMENT
  805. Cerebellar Function
  806. BOX 6-16 Tests for Cerebellar Function
  807. Finger-to-nose test
  808. Heel-to-shin test
  809. Romberg test
  810. Reflexes
  811. Cranial Nerves
  812. FIG. 6-42 Testing for triceps reflex. Child is placed supine, with forearm resting over chest, and triceps tendon is struck. Alternate procedure: child’s arm is abducted, with upper arm supported and forearm allowed to hang freely. Triceps tendon is struck. Normal response is partial extension of forearm.
  813. FIG. 6-43 Testing for biceps reflex. Child’s arm is held by placing partially flexed elbow in examiner’s hand with thumb over antecubital space. Examiner’s thumbnail is struck with hammer. Normal response is partial flexion of forearm.
  814. FIG. 6-44 Testing for patellar, or knee jerk, reflex, using distraction. Child sits on edge of examining table (or on parent’s lap) with lower legs flexed at knee and dangling freely. Patellar tendon is tapped just below kneecap. Normal response is partial extension of lower leg.
  815. FIG. 6-45 Testing for Achilles reflex. Child should be in same position as for knee jerk reflex. Foot is supported lightly in examiner’s hand, and Achilles tendon is struck. Normal response is plantar flexion of foot (foot pointing downward).
  816. FIG. 6-46 Testing cardinal positions of gaze. Muscles responsible for movement: SR, Superior rectus; IR, inferior rectus; MR, medial rectus; IO, inferior oblique; SO, superior oblique; LR, lateral rectus.
  817. TABLE 6-12 Assessment of Cranial Nerves
  818. KEY POINTS
  819. References
  820. Chapter 7 Pain Assessment and Management in Children
  821. LEARNING OBJECTIVES
  822. RELATED TOPICS and ADDITIONAL RESOURCES
  823. IN TEXT
  824. PAIN ASSESSMENT
  825. BOX 7-1 Developmental Characteristics of Children’s Responses to Pain
  826. YOUNG INFANT
  827. OLDER INFANT
  828. YOUNG CHILD
  829. SCHOOL-AGE CHILD
  830. ADOLESCENT
  831. BEHAVIORAL MEASURES
  832. FIG. 7-1 Full, robust crying of preterm infant after heel stick.
  833. FIG. 7-2 The face of pain after heel stick. Note eye squeeze, brow bulge, nasolabial furrow, and widespread mouth.
  834. TABLE 7-1 Selected Behavioral Pain Assessment Scales for Young Children
  835. PHYSIOLOGIC MEASURES
  836. SELF-REPORT MEASURES
  837. TABLE 7-2 Pain Rating Scales for Children
  838. MULTIDIMENSIONAL MEASURES
  839. FIG. 7-3 Adolescent Pediatric Pain Tool: body outlines for pain assessment. Instructions: ‘Color in the areas on these drawings to show where you have pain. Make the marks as big or as small as the place where the pain is.’ Tool has been completed by a child with sickle cell disease.
  840. BOX 7-2 Manifestations of Acute Pain in the Neonate
  841. PHYSIOLOGIC RESPONSES
  842. Vital signs
  843. Oxygenation
  844. Skin
  845. Laboratory evidence of metabolic or endocrine changes
  846. Other observations
  847. BEHAVIORAL RESPONSES
  848. Vocalizations
  849. Facial expression
  850. Body movements and posture
  851. Changes in state
  852. PAIN ASSESSMENT IN SPECIFIC POPULATIONS
  853. PAIN IN NEONATES
  854. CHILDREN WITH COMMUNICATION AND COGNITIVE IMPAIRMENT
  855. TABLE 7-3 Pain Assessment Scales for Infants
  856. FIG. 7-4 Non-communicating Children’s Pain Checklist.
  857. CULTURAL ISSUES IN PAIN ASSESSMENT
  858. CHILDREN WITH CHRONIC ILLNESS AND COMPLEX PAIN
  859. PAIN MANAGEMENT
  860. NONPHARMACOLOGIC MANAGEMENT
  861. nursingcareguidelines
  862. Nonpharmacologic Strategies for Pain Management
  863. GENERAL STRATEGIES
  864. SPECIFIC STRATEGIES
  865. DISTRACTION
  866. Relaxation
  867. Guided Imagery
  868. Positive Self-Talk
  869. Thought Stopping
  870. Behavioral Contracting
  871. Informal
  872. Formal
  873. FIG. 7-5 Sucking following oral sucrose can enhance analgesia before a heel stick in a preterm infant.
  874. EVIDENCE-BASED PRACTICE
  875. Reduction of Minor Procedural Pain in Infants
  876. ASK THE QUESTION
  877. SEARCH FOR EVIDENCE
  878. Search Strategies
  879. Databases Used
  880. CRITICALLY ANALYZE THE EVIDENCE
  881. Venipuncture Versus Heel Lance for Blood Sampling.
  882. Glucose vs EMLA Cream for Venipuncture in Neonates
  883. Sucrose for Minor Painful Procedures (Heel Lance and Venipuncture)
  884. Sucrose Compared with Glucose for Analgesia for Minor Pain (Heel Stick)
  885. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  886. Sucrose
  887. Glucose
  888. Topical Anesthetics
  889. References
  890. FIG. 7-6 Mother using kangaroo hold with her newborn infant. Note placement of the infant directly on the mother’s skin.
  891. COMPLEMENTARY PAIN MEDICINE
  892. PHARMACOLOGIC MANAGEMENT
  893. TABLE 7-4 Nonsteroidal Antiinflammatory Drugs (NSAIDs) Approved for Children*
  894. TABLE 7-5 Dosage of Selected Opioids for Children
  895. TABLE 7-6 Coanalgesic Adjuvant Drugs
  896. NURSINGALERT
  897. Patient-Controlled Analgesia
  898. TABLE 7-7 Management of Opioid Side Effects
  899. TABLE 7-8 Equianalgesia of Selected Analgesics
  900. BOX 7-3 Routes and Methods of Analgesic Drug Administration
  901. ORAL
  902. SUBLINGUAL, BUCCAL, OR TRANSMUCOSAL
  903. Actiq
  904. INTRAVENOUS (IV) (BOLUS)
  905. IV (CONTINUOUS)
  906. SUBCUTANEOUS (SC) (CONTINUOUS)
  907. PATIENT-CONTROLLED ANALGESIA (PCA)
  908. FAMILY-CONTROLLED ANALGESIA
  909. NURSE-ACTIVATED ANALGESIA
  910. INTRAMUSCULAR
  911. INTRANASAL
  912. INTRADERMAL
  913. TOPICAL OR TRANSDERMAL
  914. RECTAL
  915. REGIONAL NERVE BLOCK
  916. INHALATION
  917. EPIDURAL OR INTRATHECAL
  918. FIG. 7-7 Nurse programming a patient-controlled analgesia pump to administer analgesia.
  919. Epidural Analgesia
  920. TABLE 7-9 Suggested Intravenous Patient-Controlled Analgesia Opioid Infusion Orders
  921. FIG. 7-8 Epidural analgesia catheter placement.
  922. FIG. 7-9 Dressing covering site of epidural catheter.
  923. Transmucosal and Transdermal Analgesia
  924. FIG. 7-10 LMX is an effective analgesic before intravenous insertion or blood draw.
  925. EVIDENCE-BASED PRACTICE
  926. EMLA Versus LMX for Pain Reduction During Peripheral Intravenous Access in Children
  927. ASK THE QUESTION
  928. SEARCH FOR EVIDENCE
  929. Search Strategies
  930. Databases Used
  931. CRITICALLY ANALYZE THE EVIDENCE
  932. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  933. References
  934. FIG. 7-11 The LidoSite system delivers analgesia quickly to the intravenous site.
  935. EVIDENCE-BASED PRACTICE
  936. Lidocaine Iontophoresis for Pain Reduction During Peripheral Intravenous Access in Children
  937. ASK THE QUESTION
  938. SEARCH FOR EVIDENCE
  939. Search Strategies
  940. Databases Used
  941. CRITICALLY ANALYZE THE EVIDENCE
  942. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  943. References
  944. EVIDENCE-BASED PRACTICE
  945. Buffered Lidocaine for Pain Reduction During Peripheral Intravenous Access in Children
  946. ASK THE QUESTION
  947. SEARCH FOR EVIDENCE
  948. Search Strategies
  949. Databases Used
  950. CRITICALLY ANALYZE THE EVIDENCE
  951. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  952. Buffered Lidocaine
  953. References
  954. Timing of Analgesia
  955. BOX 7-4 Side Effects of Opioids
  956. GENERAL
  957. SIGNS OF TOLERANCE
  958. SIGNS OF WITHDRAWAL SYNDROME IN PATIENTS WITH PHYSICAL DEPENDENCE
  959. Initial Signs of Withdrawal
  960. Later Signs of Withdrawal
  961. Monitoring Side Effects
  962. nursingcareguidelines
  963. Managing Opioid-Induced Respiratory Depression
  964. IF RESPIRATIONS ARE DEPRESSED
  965. IF PATIENT CANNOT BE AROUSED OR IS APNEIC
  966. COMMUNITY FOCUS
  967. Fear of Opioid Addiction
  968. Evaluation of Effectiveness of Pain Regimen
  969. FIG. 7-12 Weaning flow sheet to monitor opioid weaning in neonates.
  970. PAINFUL AND INVASIVE PROCEDURES
  971. POSTOPERATIVE PAIN
  972. RECURRENT HEADACHES IN CHILDREN
  973. RECURRENT ABDOMINAL PAIN IN CHILDREN
  974. CANCER PAIN IN CHILDREN
  975. PAIN AND SEDATION IN END-OF-LIFE CARE
  976. KEY POINTS
  977. References
  978. UNIT THREE THE NEWBORN
  979. Interactive Review — Unit Three
  980. Chapter 8 Health Promotion of the Newborn and Family
  981. LEARNING OBJECTIVES
  982. RELATED TOPICS and ADDITIONAL RESOURCES
  983. IN TEXT
  984. ADJUSTMENT TO EXTRAUTERINE LIFE
  985. IMMEDIATE ADJUSTMENTS
  986. Respiratory System
  987. Circulatory System
  988. PHYSIOLOGIC STATUS OF OTHER SYSTEMS
  989. Thermoregulation
  990. Hematopoietic System
  991. Fluid and Electrolyte Balance
  992. Gastrointestinal System
  993. BOX 8-1 Change in Stooling Patterns of Newborns
  994. MECONIUM
  995. MILK STOOL
  996. Renal System
  997. Integumentary System
  998. Musculoskeletal System
  999. Defenses Against Infection
  1000. Endocrine System
  1001. Neurologic System
  1002. Sensory Functions
  1003. Vision.
  1004. Hearing.
  1005. Smell.
  1006. Taste.
  1007. Touch.
  1008. NURSING CARE OF THE NEWBORN AND FAMILY
  1009. ASSESSMENT
  1010. Initial Assessment: Apgar Scoring
  1011. FIG. 8-1 A, New Ballard Scale for newborn maturity rating. Expanded scale includes extremely preterm infants and has been refined to improve accuracy in more mature infants. B, Intrauterine growth: birth weight percentiles based on live single births at gestational ages 20 to 44 weeks.
  1012. TABLE 8-1 Infant Evaluation at Birth—Apgar Scoring System
  1013. Clinical Assessment of Gestational Age
  1014. Weight Related to Gestational Age.
  1015. BOX 8-2 Tests Used in Assessing Gestational Age
  1016. Posture
  1017. Square window
  1018. Arm recoil
  1019. Popliteal angle
  1020. Scarf sign
  1021. Heel to ear
  1022. FIG. 8-2 Three infants, same gestational age, weight 600, 1400, and 2750 g, respectively, from left to right.
  1023. General Measurements.
  1024. FIG. 8-3 Measurement of infant length.
  1025. FIG. 8-4 Mother taking axillary temperature with digital thermometer.
  1026. FIG. 8-5 Measurement of blood pressure using oscillometry.
  1027. NURSINGALERT
  1028. General Appearance.
  1029. Skin.
  1030. Head.
  1031. NURSINGTIP
  1032. FIG. 8-6 A, Location of sutures and fontanels. B, Palpating anterior fontanel.
  1033. FIG. 8-7 Head control in infant. A, Inability to hold head erect when pulled to sitting position. B, Ability to hold head erect when placed in ventral suspension.
  1034. Eyes.
  1035. NURSINGTIP
  1036. Ears.
  1037. Nose.
  1038. Mouth and Throat.
  1039. Neck.
  1040. Chest.
  1041. Lungs.
  1042. Heart.
  1043. NURSINGTIP
  1044. Abdomen.
  1045. NURSINGALERT
  1046. Female Genitalia.
  1047. Male Genitalia.
  1048. Back and Rectum.
  1049. NURSINGALERT
  1050. Extremities.
  1051. Neurologic System.
  1052. Transitional Assessment: Periods of Reactivity
  1053. FIG. 8-8 A, Plantar or grasp reflex. B, Babinski reflex. 1, Direction of stroke. 2, Dorsiflexion of big toe. 3, Fanning of toes.
  1054. TABLE 8-2 Assessment of Reflexes in the Newborn
  1055. FIG. 8-9 Moro reflex.
  1056. Behavioral Assessment
  1057. FIG. 8-10 Tonic neck reflex.
  1058. FIG. 8-11 Crawl reflex.
  1059. TABLE 8-3 States of Sleep and Activity
  1060. BOX 8-3 Clusters of Neonatal Behaviors in Brazelton Neonatal Behavioral Assessment Scale
  1061. Habituation
  1062. Orientation
  1063. Motor performance
  1064. Range of state
  1065. Regulation of state
  1066. Autonomic stability
  1067. Reflexes
  1068. Patterns of Sleep and Activity.
  1069. nursingcareguidelines
  1070. Violence in Children
  1071. nursingcareguidelines
  1072. Physical Examination of the Newborn
  1073. Cry.
  1074. Assessment of Attachment Behaviors
  1075. Physical Assessment
  1076. MAINTAIN A PATENT AIRWAY
  1077. nursingprocess
  1078. The Healthy Newborn and Family
  1079. ASSESSMENT
  1080. DIAGNOSIS (PROBLEM IDENTIFICATION)
  1081. PLANNING
  1082. IMPLEMENTATION
  1083. EVALUATION
  1084. TABLE 8-4 Physical Assessment of the Newborn
  1085. NURSINGALERT
  1086. NURSINGALERT
  1087. MAINTAIN A STABLE BODY TEMPERATURE
  1088. PROTECT FROM INFECTION AND INJURY
  1089. Identification
  1090. Eye Care
  1091. nursingcareguidelines
  1092. Ophthalmia Neonatorum Prophylaxis
  1093. NURSINGTIP
  1094. Vitamin K Administration
  1095. Hepatitis B Vaccine Administration
  1096. Newborn Screening for Disease
  1097. Universal Newborn Hearing Screening
  1098. ATRAUMATIC CARE
  1099. Heel Punctures
  1100. Bathing
  1101. FIG. 8-12 Bath time is an excellent opportunity for parents to learn about their newborn.
  1102. Care of the Umbilicus
  1103. NURSINGALERT
  1104. Circumcision
  1105. BOX 8-4 Risks and Benefits of Neonatal Circumcision
  1106. RISKS
  1107. BENEFITS
  1108. ATRAUMATIC CARE
  1109. Guidelines for Pain Management During Neonatal Circumcision*
  1110. PHARMACOLOGIC INTERVENTIONS
  1111. Use of Topical Anesthetic
  1112. Use of Dorsal Penile Nerve Block or Ring Block
  1113. Acetaminophen
  1114. Oral Sucrose
  1115. NONPHARMACOLOGIC INTERVENTIONS (TO ACCOMPANY PRECEDING PHARMACOLOGIC INTERVENTIONS)
  1116. FIG. 8-13 Proper positioning of infant in Circumstraint.
  1117. CULTURAL AWARENESS
  1118. Circumcision
  1119. PROVIDE OPTIMAL NUTRITION
  1120. Human Milk
  1121. Breastfeeding
  1122. BOX 8-5 Ten Steps to Successful Breastfeeding
  1123. FIG. 8-14 Simultaneous breastfeeding of twins.
  1124. FIG. 8-15 The tongue is under the areola, with the tip of the nipple at the back of the wide-open mouth.
  1125. NURSINGALERT
  1126. Bottle Feeding
  1127. NURSINGTIP
  1128. NURSINGALERT
  1129. Commercially Prepared Formulas
  1130. Preparation of Formula
  1131. NURSINGALERT
  1132. Alternate Milk Products
  1133. Feeding Schedules
  1134. Feeding Behavior
  1135. PROMOTE PARENT-INFANT BONDING (ATTACHMENT)
  1136. Infant Behavior
  1137. BOX 8-6 How to Make the Infant’s World More Exciting*
  1138. Maternal Attachment
  1139. FIG. 8-16 En face position between parent and infant can be significant in attachment process.
  1140. Paternal Engrossment
  1141. FIG. 8-17 A desire to hold the infant and participate in caregiving activities is an indication of paternal engrossment.
  1142. Siblings
  1143. FIG. 8-18 Sibling visitation shortly after birth can facilitate the attachment process.
  1144. Multiple Births and Subsequent Children
  1145. FIG. 8-19 Newborn twins are placed in same bed during newborn transition period.
  1146. PREPARE FOR DISCHARGE AND HOME CARE
  1147. FAMILY-CENTERED CARE
  1148. Early Newborn Discharge Checklist
  1149. COMMUNITY FOCUS
  1150. Early Newborn Discharge Checklist
  1151. Feeding
  1152. Elimination
  1153. Circumcision
  1154. Color
  1155. Cord
  1156. Newborn screening
  1157. Vital signs
  1158. Activity
  1159. Home visit or primary practitioner visit
  1160. COMMUNITY FOCUS
  1161. Newborn Home Care After Early Discharge*
  1162. Wet diapers
  1163. Breastfeeding
  1164. Formula feeding
  1165. Circumcision
  1166. Stools
  1167. Color
  1168. Activity
  1169. Jaundice
  1170. Cord
  1171. Vital signs
  1172. Position of sleep
  1173. NURSINGALERT
  1174. KEY POINTS
  1175. References
  1176. Chapter 9 Health Problems of Newborns
  1177. LEARNING OBJECTIVES
  1178. RELATED TOPICS and ADDITIONAL RESOURCES
  1179. IN TEXT
  1180. BIRTH INJURIES
  1181. SOFT-TISSUE INJURY
  1182. HEAD TRAUMA
  1183. Caput Succedaneum
  1184. Cephalhematoma
  1185. FIG. 9-1 A, Caput succedaneum. B, Cephalhematoma. C, Subgaleal hemorrhage.
  1186. Subgaleal Hemorrhage
  1187. Nursing Care Management
  1188. FRACTURES
  1189. NURSINGALERT
  1190. NURSINGALERT
  1191. Nursing Care Management
  1192. PARALYSIS
  1193. Facial Paralysis
  1194. Brachial Palsy
  1195. FIG. 9-2 A, Paralysis of right side of face 15 minutes after forceps delivery. Absence of movement on affected side is especially noticeable when infant cries. B, The same infant 24 hours later.
  1196. Phrenic Nerve Paralysis
  1197. FIG. 9-3 Left-sided brachial plexus (Erb) palsy. Note extended, internally rotated arm and pronated wrist on affected side.
  1198. Nursing Care Management
  1199. COMMON PROBLEMS IN THE NEWBORN
  1200. ERYTHEMA TOXICUM NEONATORUM
  1201. CANDIDIASIS
  1202. Oral Candidiasis
  1203. FIG. 9-4 Oral candidiasis (thrush).
  1204. NURSINGALERT
  1205. Nursing Care Management
  1206. HERPES
  1207. Nursing Care Management
  1208. BIRTHMARKS
  1209. FIG. 9-5 A, Port-wine stain. B, Strawberry hemangioma.
  1210. Nursing Care Management
  1211. NURSING CARE OF THE HIGH-RISK NEWBORN AND FAMILY
  1212. IDENTIFICATION OF HIGH-RISK NEWBORNS
  1213. Classification of High-Risk Newborns
  1214. BOX 9-2 Psychologic Tasks of Parents of a High-Risk Infant
  1215. BOX 9-1 Classification of High-Risk Infants
  1216. CLASSIFICATION ACCORDING TO SIZE
  1217. Low-birth-weight (LBW) infant
  1218. Very low–birth-weight (VLBW) infant
  1219. Extremely low–birth-weight (ELBW) infant
  1220. Appropriate-for-gestational-age (AGA) infant
  1221. Small-for-date (SFD) or small-for-gestational-age (SGA) infant
  1222. Intrauterine growth restriction (IUGR)
  1223. Symmetric IUGR
  1224. Asymmetric IUGR
  1225. Large-for-gestational-age (LGA) infant
  1226. CLASSIFICATION ACCORDING TO GESTATIONAL AGE
  1227. Preterm (premature) infant
  1228. Full-term infant
  1229. Postterm (postmature) infant
  1230. Near-term (late-preterm) infant
  1231. CLASSIFICATION ACCORDING TO MORTALITY
  1232. Live birth
  1233. Fetal death
  1234. Neonatal death
  1235. Perinatal mortality
  1236. CARE OF HIGH-RISK NEWBORNS
  1237. Systematic Assessment
  1238. nursingcareguidelines
  1239. Physical Assessment
  1240. GENERAL ASSESSMENT
  1241. RESPIRATORY ASSESSMENT
  1242. CARDIOVASCULAR ASSESSMENT
  1243. GASTROINTESTINAL ASSESSMENT
  1244. GENITOURINARY ASSESSMENT
  1245. NEUROLOGIC-MUSCULOSKELETAL ASSESSMENT
  1246. TEMPERATURE
  1247. SKIN ASSESSMENT
  1248. Monitoring Physiologic Data
  1249. TABLE 9-1 Blood Pressure Ranges in Different Weight Groups of Healthy Preterm Infants*
  1250. Respiratory Support
  1251. Thermoregulation
  1252. nursingprocess
  1253. The High-Risk Newborn and Family
  1254. ASSESSMENT
  1255. DIAGNOSIS (PROBLEM IDENTIFICATION)
  1256. PLANNING
  1257. IMPLEMENTATION
  1258. EVALUATION
  1259. FIG. 9-6 Nurse caring for infant in a radiant warmer.
  1260. FIG. 9-7 Infant under plastic wrap, which produces a draft-free environment.
  1261. Protection from Infection
  1262. Hydration
  1263. NURSINGALERT
  1264. NURSINGALERT
  1265. Nutrition
  1266. Breastfeeding.
  1267. Nipple Feeding.
  1268. NURSINGALERT
  1269. FIG. 9-8 Nipple feeding the preterm infant. A, Infant is first brought to a quiet alert state in preparation for feeding. B, After readiness is demonstrated, infant is nipple fed.
  1270. Gavage Feeding.
  1271. NURSINGALERT
  1272. NURSINGALERT
  1273. Feeding Resistance
  1274. Energy Conservation
  1275. FAMILY FOCUS
  1276. Feeding Resistance
  1277. Skin Care
  1278. FIG. 9-9 A, Preterm infant slowly transitioned to prone position on prone roll. B, Preterm infant positioned on prone roll.
  1279. nursingcareguidelines
  1280. Neonatal Skin Care
  1281. GENERAL SKIN CARE
  1282. Assessment
  1283. Bathing
  1284. Initial Bath
  1285. Routine
  1286. Emollients
  1287. Adhesives
  1288. Antiseptic Agents
  1289. Transepidermal Water Loss (TEWL)
  1290. SKIN BREAKDOWN
  1291. Prevention
  1292. Treating Skin Breakdown
  1293. Treating Diaper Dermatitis
  1294. OTHER SKIN CARE CONCERNS
  1295. Use of Substances on Skin
  1296. Use of Thermal Devices
  1297. Use of Fluid Therapy and Hemodynamic Monitoring
  1298. Administration of Medications
  1299. Developmental Outcome
  1300. FIG. 9-10 Father providing skin-to-skin (kangaroo) care.
  1301. TABLE 9-2 Signs of Stress or Fatigue in Neonates
  1302. nursingcareguidelines
  1303. Developmental Interventions
  1304. GENERAL GUIDELINES
  1305. TACTILE
  1306. AUDITORY
  1307. VESTIBULAR
  1308. OLFACTORY
  1309. GUSTATORY
  1310. VISUAL
  1311. Family Support and Involvement
  1312. Facilitating Parent-Infant Relationships
  1313. FIG. 9-11 Father interacting with newborn receiving intensive care.
  1314. FIG. 9-12 Mother and father interacting with their preterm infant.
  1315. FIG. 9-13 Father feeding preterm infant.
  1316. Siblings.
  1317. FIG. 9-14 Siblings visiting in the NICU.
  1318. Support Groups.
  1319. Discharge Planning and Home Care
  1320. COMMUNITY FOCUS
  1321. COMMUNITY FOCUS
  1322. Preterm and Near-Term Infant Car Seat Evaluation
  1323. ETHICAL CASE STUDY
  1324. Preterm Infant
  1325. ETHICAL DECISION MAKING MODEL
  1326. Evaluate the Issue
  1327. Treat All Involved with Respect
  1328. Hear All Sides
  1329. Initiate Action
  1330. Consider the Outcome
  1331. Neonatal Loss
  1332. Baptism.
  1333. BOX 9-3 Etiology of Preterm Birth
  1334. MATERNAL FACTORS
  1335. FACTORS RELATED TO PREGNANCY
  1336. FETAL FACTORS
  1337. UNKNOWN FACTORS
  1338. HIGH RISK RELATED TO DYSMATURITY
  1339. PRETERM INFANTS
  1340. Diagnostic Evaluation
  1341. FIG. 9-15 Clinical and neurologic examinations comparing preterm and full-term infants. Clinical and neurologic examinations comparing preterm and full-term infants.
  1342. Therapeutic Management
  1343. Nursing Care Management
  1344. POSTTERM INFANTS
  1345. HIGH RISK RELATED TO PHYSIOLOGIC FACTORS
  1346. HYPERBILIRUBINEMIA
  1347. TABLE 9-3 Comparison of Major Types of Unconjugated Hyperbilirubinemia*
  1348. Pathophysiology
  1349. Diagnostic Evaluation
  1350. FIG. 9-16 A, Nomogram for designation of risk in 2840 well newborns at 36 or more weeks of gestational age with birth weight of 2000 g (4.4 pounds) or more, or 35 or more weeks of gestational age and birth weight of 2500 g (5.5 pounds) or more, based on the hour-specific serum bilirubin values. (This nomogram should not be used to represent the natural history of neonatal hyperbilirubinemia.) B, Guidelines for phototherapy in hospitalized infants of 35 or more weeks’ gestation.
  1351. Complications.
  1352. Therapeutic Management
  1353. FIG. 9-17 A, Infant receiving phototherapy; note nested boundaries for comfort and eye protection.B, Newborn laying on BiliBlanket, which may be used with overhead lights to provide intensive phototherapy.
  1354. nursingprocess
  1355. The Newborn with Jaundice
  1356. ASSESSMENT
  1357. DIAGNOSIS (PROBLEM IDENTIFICATION)
  1358. PLANNING
  1359. IMPLEMENTATION
  1360. EVALUATION
  1361. Prognosis.
  1362. Nursing Care Management
  1363. NURSINGALERT
  1364. NURSINGTIP
  1365. Phototherapy.
  1366. Family Support.
  1367. FAMILY FOCUS
  1368. Phototherapy and Parent-Infant Interaction
  1369. Discharge Planning and Home Care.
  1370. CRITICAL THINKING EXERCISE
  1371. Jaundice
  1372. QUESTIONS
  1373. HEMOLYTIC DISEASE OF THE NEWBORN
  1374. Blood Incompatibility
  1375. Rh Incompatibility (Isoimmunization).
  1376. FIG. 9-18 Development of maternal sensitization to Rh antigens. A, Fetal Rh-positive erythrocytes enter maternal system. Maternal anti-Rh antibodies are formed. B, Anti-Rh antibodies cross placenta and attack fetal erythrocytes.
  1377. TABLE 9-4 Potential Maternal-Fetal ABO Incompatibilities
  1378. ABO Incompatibility.
  1379. Clinical Manifestations
  1380. Diagnostic Evaluation
  1381. Therapeutic Management
  1382. Prevention of Rh Isoimmunization.
  1383. NURSINGALERT
  1384. Intrauterine Transfusion.
  1385. Exchange Transfusion.
  1386. Prognosis.
  1387. Nursing Care Management
  1388. NURSINGALERT
  1389. Family Support.
  1390. METABOLIC COMPLICATIONS
  1391. RESPIRATORY DISTRESS SYNDROME
  1392. Pathophysiology
  1393. TABLE 9-5 Metabolic Complications
  1394. BOX 9-4 Clinical Manifestations of Respiratory Distress Syndrome
  1395. MATERNAL FACTORS
  1396. Diagnostic Evaluation
  1397. Therapeutic Management
  1398. FIG. 9-19 Criteria for evaluating respiratory distress.
  1399. TABLE 9-6 Common Methods for Assisted Ventilation in Neonatal Respiratory Distress
  1400. Prevention.
  1401. Prognosis.
  1402. Nursing Care Management
  1403. NURSINGALERT
  1404. RESPIRATORY COMPLICATIONS
  1405. nursingcareplan
  1406. The High-Risk Infant with Respiratory Distress Syndrome
  1407. TABLE 9-7 Respiratory Complications
  1408. CARDIOVASCULAR COMPLICATIONS
  1409. TABLE 9-8 Cardiovascular and Hematologic Complications
  1410. CEREBRAL COMPLICATIONS
  1411. TABLE 9-9 Sensory and Neurologic Complications
  1412. NEONATAL SEIZURES
  1413. BOX 9-5 Causes of Neonatal Seizures
  1414. METABOLIC
  1415. TOXIC
  1416. PRENATAL INFECTIONS
  1417. POSTNATAL INFECTIONS
  1418. TRAUMA AT BIRTH
  1419. MALFORMATIONS
  1420. MISCELLANEOUS
  1421. Diagnostic Evaluation
  1422. Therapeutic Management
  1423. TABLE 9-10 Classifications of Neonatal Seizures
  1424. Nursing Care Management
  1425. HIGH RISK RELATED TO INFECTIOUS PROCESSES
  1426. SEPSIS
  1427. Diagnostic Evaluation
  1428. Prevention
  1429. Therapeutic Management
  1430. BOX 9-6 Manifestations of Neonatal Sepsis
  1431. GENERAL SIGNS
  1432. CIRCULATORY SYSTEM
  1433. RESPIRATORY SYSTEM
  1434. CENTRAL NERVOUS SYSTEM
  1435. GASTROINTESTINAL SYSTEM
  1436. HEMATOPOIETIC SYSTEM
  1437. Prognosis.
  1438. Nursing Care Management
  1439. NURSINGALERT
  1440. NECROTIZING ENTEROCOLITIS
  1441. Diagnostic Evaluation
  1442. Therapeutic Management
  1443. Prognosis.
  1444. Nursing Care Management
  1445. NURSINGTIP
  1446. BOX 9-7 Clinical Manifestations of Necrotizing Enterocolitis
  1447. NONSPECIFIC CLINICAL SIGNS
  1448. SPECIFIC SIGNS
  1449. HIGH RISK RELATED TO MATERNAL CONDITIONS
  1450. INFANTS OF DIABETIC MOTHERS
  1451. BOX 9-8 Clinical Manifestations of Infants of Diabetic Mothers
  1452. Therapeutic Management
  1453. Nursing Care Management
  1454. DRUG-EXPOSED INFANTS*
  1455. Clinical Manifestations
  1456. Diagnostic Evaluation
  1457. EVIDENCE-BASED PRACTICE
  1458. Glucose Water Feedings in the Newborn Period
  1459. ASK THE QUESTION
  1460. SEARCH FOR EVIDENCE
  1461. Search Strategies
  1462. Databases Used
  1463. CRITICALLY ANALYZE THE EVIDENCE
  1464. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  1465. References
  1466. Therapeutic Management
  1467. BOX 9-9 Signs of Withdrawal in the Neonate
  1468. NEUROLOGIC
  1469. GASTROINTESTINAL
  1470. AUTONOMIC
  1471. MISCELLANEOUS
  1472. Prognosis.
  1473. Nursing Care Management
  1474. Alcohol Exposure
  1475. Cocaine Exposure
  1476. Therapeutic Management.
  1477. Nursing Care Management.
  1478. Methamphetamine Exposure
  1479. Marijuana Exposure
  1480. MATERNAL INFECTIONS
  1481. TABLE 9-11 Infections Acquired from Mother Before, During, or After Birth*
  1482. Nursing Care Management
  1483. CONGENITAL ANOMALIES*
  1484. BOX 9-10 Assessment Clues to Genetic Disorders*
  1485. Major or minor birth defects (anomalies) and dysmorphic features
  1486. Growth abnormalities
  1487. Skeletal abnormalities
  1488. Vision or hearing problems
  1489. Metabolic disorders
  1490. Sexual development abnormalities
  1491. Skin disorders
  1492. GENETIC ETIOLOGY OF CONGENITAL ANOMALIES
  1493. Chromosomal Abnormalities
  1494. Single-Gene Defects
  1495. Multifactorial Inheritance
  1496. DEFECTS CAUSED BY CHEMICAL AGENTS
  1497. TABLE 9-12 Common Chromosomal Abnormalities
  1498. Nursing Care Management
  1499. FYI
  1500. INBORN ERRORS OF METABOLISM
  1501. TABLE 9-13 Congenital Effects of Maternal Alcohol Ingestion and Tobacco Smoking
  1502. CONGENITAL HYPOTHYROIDISM
  1503. BOX 9-11 Clinical Manifestations of Congenital Hypothyroidism
  1504. BIRTH*
  1505. AGES 6 TO 9 WEEKS†
  1506. OLDER CHILD
  1507. Diagnostic Evaluation
  1508. Therapeutic Management
  1509. Prognosis.
  1510. Nursing Care Management
  1511. FIG. 9-20 Metabolic error and consequences in phenylketonuria.
  1512. PHENYLKETONURIA
  1513. Diagnostic Evaluation*
  1514. NURSINGALERT
  1515. Therapeutic Management*
  1516. Prognosis.
  1517. Nursing Care Management
  1518. Family Support.†
  1519. GALACTOSEMIA
  1520. FAMILY FOCUS
  1521. Supporting Families
  1522. Diagnostic Evaluation
  1523. Therapeutic Management
  1524. Prognosis.
  1525. Nursing Care Management*
  1526. GENETIC EVALUATION AND COUNSELING
  1527. TABLE 9-14 Types of Genetic Testing
  1528. nursingcareguidelines
  1529. Common Indications for Referral
  1530. PSYCHOLOGIC ASPECTS OF GENETIC DISEASE
  1531. KEY POINTS
  1532. answers to CRITICAL THINKING EXERCISE
  1533. Supporting Families
  1534. JAUNDICE
  1535. References
  1536. UNIT FOUR INFANCY
  1537. Interactive Review — Unit Four
  1538. Chapter 10 Health Promotion of the Infant and Family
  1539. LEARNING OBJECTIVES
  1540. RELATED TOPICS and ADDITIONAL RESOURCES
  1541. IN TEXT
  1542. PROMOTING OPTIMAL GROWTH AND DEVELOPMENT
  1543. Biologic Development
  1544. Proportional Changes
  1545. Maturation of Systems
  1546. Fine Motor Development
  1547. Gross Motor Development
  1548. FIG. 10-1 Crude pincer grasp at 8 to 10 months.
  1549. NURSINGALERT
  1550. NURSINGALERT
  1551. FIG. 10-2 Head control while pulled to sitting position. A, Complete head lag at 1 month. B, Partial head lag at 2 months. C, Almost no head lag at 4 months.
  1552. FIG. 10-3 Head control while prone. A, Infant momentarily lifts head at 1 month. B, Infant lifts head and chest 90 degrees and bears weight on forearms at 4 months. C, Infant lifts heaD, chest, and upper abdomen and can bear weight on hands at 6 months. Note how this position facilitates turning from abdomen to back.
  1553. FIG. 10-4 Parachute reflex.
  1554. NURSINGALERT
  1555. Psychosocial Development: Developing a Sense of Trust (Erikson)
  1556. Cognitive Development: Sensorimotor Phase (Piaget)
  1557. FIG. 10-5 Development of sitting. A, Back is completely roundeD, and infant has no ability to sit upright at 1 month. B, At 2 months, infant exhibits more control; back is still roundeD, but infant can try to pull up with some head control. C, Back is rounded only in lumbar areA, and infant is able to sit erect with good head control at 4 months. D, Infant can sit alonE, leaning on hands for support, at 7 months. E, Infant sits without support at 8 months. Note the transferring of objects that occurs at 7 months.
  1558. FIG. 10-6 Development of locomotion. A, Infant bears full weight on feet by 7 months. B, Infant can maneuver from sitting to kneeling position. C, Infant can stand holding onto furniture at 9 months. D, While standing, infant takes deliberate step at 10 months. E, Infant crawls with abdomen on floor and pulls self forward at about 7 months, and then, F, creeps on hands and knees at 9 months.
  1559. FIG. 10-7 Nine-month-old is able to find hidden object under pillow.
  1560. Development of Body Image
  1561. FIG. 10-8 Nine-month-old infant enjoying own image in mirror.
  1562. Social Development
  1563. Attachment
  1564. FIG. 10-9 Infancy is an important time for attachment to significant others.
  1565. NURSINGALERT
  1566. Language Development
  1567. FAMILY FOCUS
  1568. Child’s Developing Language Skills
  1569. Play
  1570. TABLE 10-1 Play During Infancy
  1571. TEMPERAMENT
  1572. Childrearing Practices Related to Temperament
  1573. COPING WITH CONCERNS RELATEDTO NORMAL GROWTH AND DEVELOPMENT
  1574. Separation and Stranger Fear
  1575. Alternate Child Care Arrangements
  1576. TABLE 10-2 Growth and Development During Infancy
  1577. Limit Setting and Discipline
  1578. Thumb Sucking and Use of a Pacifier
  1579. Teething
  1580. NURSINGTIP
  1581. FIG. 10-10 Sequence of eruption of primary teeth. *Range represents ±1 standard deviation, or 67% of subjects studied.
  1582. NURSINGALERT
  1583. Infant Shoes
  1584. PROMOTING OPTIMAL HEALTH DURING INFANCY
  1585. NUTRITION
  1586. The First 6 Months
  1587. NURSINGALERT
  1588. NURSINGALERT
  1589. NURSINGALERT
  1590. NURSINGALERT
  1591. NURSINGALERT
  1592. The Second 6 Months
  1593. Selection and Preparation of Solid Foods
  1594. Introduction of Solid Foods
  1595. FAMILY-CENTERED CARE
  1596. Feeding During the First Year
  1597. BIRTH TO 6 MONTHS (BREASTFEEDING OR BOTTLE FEEDING)
  1598. Breastfeeding
  1599. Formula
  1600. AGE 6 TO 12 MONTHS (SOLID FOODS)
  1601. Cereal-Start at 4 to 6 Months of Age
  1602. Fruits and Vegetables-Start at 6 to 8 Months of Age
  1603. Meat, Fish, and Poultry-Start at 8 to 10 Months of Age
  1604. Eggs and Cheese-Start at 12 Months of Age
  1605. Weaning
  1606. SLEEP AND ACTIVITY
  1607. Sleep Problems
  1608. TABLE 10-3 Selected Sleep Disturbances During Infancy and Early Childhood
  1609. CULTURAL AWARENESS
  1610. The Family Bed
  1611. DENTAL HEALTH
  1612. COMMUNITY FOCUS
  1613. Keeping Current on Vaccine Recommendations
  1614. IMMUNIZATIONS
  1615. Schedule for Immunizations
  1616. Recommendations for Routine Immunizations
  1617. FIG. 10-11 Recommended immunization schedules for persons aged 0 to 6 years (A) and 7 to 18 years (B)-United States, 2008. (From Centers for Disease Control and Prevention: Recommended immunization schedules for persons aged 0-18 years-United States, 2008. MMWR 56[51 and 52]:Q1-Q4, 2007.) Recommended immunization schedules for persons aged 0 to 6 years (A) and 7 to 18 years (B)-United States, 2008.
  1618. FIG. 10-12 Catch-up immunization schedule for persons aged 4 months to 18 years who start late or who are more than 1 month behind.
  1619. FIG. 10-13 Convertible seat in forward-facing position for older infants and toddlers.
  1620. TABLE 10-4 Recommended Immunization Schedules: Canada, 2006
  1621. TABLE 10-5 Guide to Tetanus Prophylaxis in Routine Wound Management
  1622. NURSINGALERT
  1623. Recommendations for Selected Immunizations
  1624. Reactions
  1625. Contraindications and Precautions
  1626. Administration
  1627. TABLE 10-6 Contraindications and Precautions to Vaccinationsa
  1628. ATRAUMATIC CARE
  1629. Immunizations
  1630. FAMILY-CENTERED CARE
  1631. Communicating with Parents About Immunizations
  1632. TABLE 10-7 Product Brand Names for Principal Childhood Vaccine Types
  1633. COMMUNITY FOCUS
  1634. Improving Immunization Rates Among Children and Adolescents
  1635. INJURY PREVENTION
  1636. Aspiration of Foreign Objects
  1637. BOX 10-1 Injury Prevention During Infancy
  1638. BIRTH TO 4 MONTHS
  1639. Major Developmental Accomplishments
  1640. Injury Prevention
  1641. Aspiration
  1642. Burns
  1643. Suffocation and Drowning
  1644. Motor Vehicles
  1645. Falls
  1646. Poisoning
  1647. Bodily Damage
  1648. AGE 4 TO 7 MONTHS
  1649. Major Developmental Accomplishments
  1650. Injury Prevention
  1651. Aspiration
  1652. Suffocation
  1653. Burns
  1654. Falls
  1655. Motor Vehicles
  1656. Poisoning
  1657. Bodily Damage
  1658. AGE 8 TO 12 MONTHS
  1659. Major Developmental Accomplishments
  1660. Injury Prevention
  1661. Aspiration
  1662. Bodily Damage
  1663. Falls
  1664. Suffocation and Drowning
  1665. Poisoning
  1666. Burns
  1667. Suffocation
  1668. NURSINGALERT
  1669. Motor Vehicle Injuries
  1670. NURSINGALERT
  1671. NURSINGALERT
  1672. Falls
  1673. Poisoning
  1674. Burns
  1675. Drowning
  1676. Bodily Damage
  1677. Nurse’s Role in Injury Prevention
  1678. FAMILY-CENTERED CARE
  1679. Child Safety Home Checklist
  1680. SAFETY: FIRE, ELECTRICAL, BURNS
  1681. SAFETY: SUFFOCATION AND ASPIRATION
  1682. SAFETY: POISONING
  1683. SAFETY: FALLS
  1684. SAFETY: BODILY INJURY
  1685. FAMILY-CENTERED CARE
  1686. Guidance During Infant’s First Year
  1687. FIRST 6 MONTHS
  1688. SECOND 6 MONTHS
  1689. ANTICIPATORY GUIDANCE’CARE OF FAMILIES
  1690. KEY POINTS
  1691. References
  1692. Chapter 11 Health Problems of Infants
  1693. LEARNING OBJECTIVES
  1694. RELATED TOPICS and ADDITIONAL RESOURCES
  1695. IN TEXT
  1696. NUTRITIONAL DISORDERS
  1697. VITAMIN IMBALANCES
  1698. COMPLEMENTARY AND ALTERNATIVE MEDICINE
  1699. MINERAL IMBALANCES
  1700. VEGETARIAN DIETS
  1701. NURSING CARE MANAGEMENT
  1702. FIG. 11-5 Placement of electrodes or belt for apnea monitoring. In small infants, one fingerbreadth may be used.
  1703. BOX 11-1 Factors That Affect Iron Absorption
  1704. INCREASE
  1705. DECREASE
  1706. BOX 11-2 MyPyramid: Sample Serving Sizes
  1707. Grain group
  1708. Vegetable group
  1709. Fruit group
  1710. Milk group
  1711. Meat group
  1712. PROTEIN-ENERGY MALNUTRITION
  1713. FIG. 11-1 MyPyramid for Kids.
  1714. Kwashiorkor
  1715. Marasmus
  1716. Therapeutic Management
  1717. Nursing Care Management
  1718. FOOD SENSITIVITY
  1719. BOX 11-3 Hyperallergenic Foods and Sources
  1720. Nuts*
  1721. Eggs*
  1722. Wheat*
  1723. Legumes
  1724. Fish or shellfish*
  1725. Soy*
  1726. Chocolate
  1727. Milk
  1728. Buckwheat
  1729. Pork, chicken
  1730. Strawberries, melon, pineapple
  1731. Corn
  1732. Citrus fruits
  1733. Tomatoes
  1734. Spices
  1735. nursingcareguidelines
  1736. Preventing Atopy in Children
  1737. IDENTIFY CHILDREN AT RISK
  1738. PRENATAL PRECAUTIONS (LAST TRIMESTER)
  1739. POSTNATAL PRECAUTIONS
  1740. ENVIRONMENTAL CONTROL
  1741. NURSINGALERT
  1742. Cow’s Milk Allergy
  1743. Diagnostic Evaluation.
  1744. BOX 11-4 Common Clinical Manifestations of Cow’s Milk Sensitivity
  1745. GASTROINTESTINAL
  1746. RESPIRATORY
  1747. OTHER SIGNS AND SYMPTOMS
  1748. Therapeutic Management.
  1749. Nursing Care Management.
  1750. Lactose Intolerance
  1751. FAMILY-CENTERED CARE
  1752. Controlling Symptoms of Lactose Intolerance
  1753. Nursing Care Management.
  1754. TABLE 11-1 Vitamins and Their Nutritional Significance*
  1755. TABLE 11-2 Minerals and Their Nutritional Significance*
  1756. FEEDING DIFFICULTIES
  1757. REGURGITATION AND ‘SPITTING UP’
  1758. PAROXYSMAL ABDOMINAL PAIN (COLIC)
  1759. Therapeutic Management
  1760. Nursing Care Management
  1761. GROWTH FAILURE (FAILURE TO THRIVE)
  1762. FAMILY-CENTERED CARE
  1763. Managing the Colicky Infant
  1764. FIG. 11-2 The ‘colic carry’ may be comforting to an infant with colic.
  1765. Diagnostic Evaluation
  1766. Therapeutic Management
  1767. Prognosis
  1768. Nursing Care Management
  1769. BOX 11-5 Clinical Manifestations of Failure to Thrive
  1770. FIG. 11-3 A consistent nurse is important in developing trust in infants with failure to thrive.
  1771. nursingcareguidelines
  1772. Feeding Children with Failure to Thrive
  1773. Provide a primary core of staff to feed the child.
  1774. Provide a quiet, unstimulating atmosphere.
  1775. Maintain a calm, even temperament throughout the meal.
  1776. Talk to the child by giving directions about eating.
  1777. Be persistent.
  1778. Maintain a face-to-face posture with the child when possible.
  1779. Introduce new foods slowly.
  1780. Follow the child’s rhythm of feeding.
  1781. Develop a structured routine.
  1782. POSITIONAL PLAGIOCEPHALY
  1783. Diagnostic Evaluation
  1784. Therapeutic Management
  1785. Nursing Care Management
  1786. FIG. 11-4 A, Plagiocephaly. B, Helmet used to correct plagiocephaly.
  1787. DISORDERS OF UNKNOWN ETIOLOGY
  1788. SUDDEN INFANT DEATH SYNDROME
  1789. Etiology
  1790. TABLE 11-3 Epidemiology of Sudden Infant Death Syndrome (SIDS)
  1791. Nursing Care Management
  1792. NURSINGALERT
  1793. Finding the Infant.
  1794. Arriving at the Emergency Department.
  1795. Returning Home.
  1796. APNEA AND APPARENT LIFE-THREATENING EVENT
  1797. Diagnostic Evaluation
  1798. Therapeutic Management
  1799. FAMILY-CENTERED CARE
  1800. Using Apnea Monitors
  1801. Nursing Care Management
  1802. NURSINGALERT
  1803. Family Support.
  1804. KEY POINTS
  1805. References
  1806. UNIT FIVE EARLY CHILDHOOD
  1807. Interactive Review — Unit Five
  1808. Chapter 12 Health Promotion of the Toddler and Family
  1809. LEARNING OBJECTIVES
  1810. RELATED TOPICS and ADDITIONAL RESOURCES
  1811. IN TEXT
  1812. PROMOTING OPTIMAL GROWTH AND DEVELOPMENT
  1813. Biologic Development
  1814. Proportional Changes
  1815. Sensory Changes
  1816. Maturation of Systems
  1817. Gross and Fine Motor Development
  1818. Psychosocial Development
  1819. Developing a Sense of Autonomy (Erikson)
  1820. Cognitive Development: Sensorimotor and Preoperational Phase (Piaget)
  1821. Tertiary Circular Reactions.
  1822. FIG. 12-1 Toddlers begin socializing with significant others such as siblings as a part of development.
  1823. FIG. 12-2 Domestic mimicry is common during toddlerhood.
  1824. Invention of New Means Through Mental Combinations.
  1825. Preoperational Phase.
  1826. SPIRITUAL DEVELOPMENT
  1827. BOX 12-1 Characteristics of Preoperational Thought
  1828. DEVELOPMENT OF BODY IMAGE
  1829. DEVELOPMENT OF GENDER IDENTITY
  1830. SOCIAL DEVELOPMENT
  1831. FIG. 12-3 Transitional objects, such as a warm and fuzzy stuffed animal, are sources of security to a toddler.
  1832. Language
  1833. Personal-Social Behavior
  1834. Play
  1835. FIG. 12-4 Young children enjoy dressing up.
  1836. NURSINGALERT
  1837. COPING WITH CONCERNS RELATED TO NORMAL GROWTH AND DEVELOPMENT
  1838. Toilet Training
  1839. nursingcareguidelines
  1840. Assessing Toilet Training Readiness
  1841. PHYSICAL READINESS
  1842. MENTAL READINESS
  1843. PSYCHOLOGIC READINESS
  1844. PARENTAL READINESS
  1845. TABLE 12-1 Growth and Development During the Toddler Years
  1846. NURSINGALERT
  1847. FIG. 12-5 A, Sitting in reverse fashion on a regular toilet provides additional security to a young child. B, Children may begin toilet training sitting on a small potty chair.
  1848. Sibling Rivalry
  1849. FIG. 12-6 To minimize sibling rivalry, parents should include the toddler during caregiving activities.
  1850. Temper Tantrums
  1851. Negativism
  1852. Regression
  1853. PROMOTING OPTIMAL HEALTHDURING TODDLERHOOD
  1854. Nutrition
  1855. Nutritional Counseling
  1856. BOX 12-2 Sample Menu for Toddlers Based on MyPyramid for Kids*
  1857. BREAKFAST
  1858. SNACK
  1859. LUNCH
  1860. SNACK
  1861. DINNER
  1862. SNACK
  1863. TOTAL (PER DAY)
  1864. NURSINGTIP
  1865. Dietary Guidelines
  1866. SLEEP AND ACTIVITY
  1867. Dental Health
  1868. Regular Dental Examinations
  1869. Removal of Plaque
  1870. FIG. 12-7 Young children can participate in toothbrushing, but parents need to brush all of the child’s teeth thoroughly.
  1871. NURSINGTIP
  1872. FIG. 12-8 The most effective cleaning of teeth is done by parents.
  1873. Fluoride
  1874. TABLE 12-2 Fluoride Supplementation*
  1875. Low-Cariogenic Diet
  1876. FIG. 12-9 Nursing caries.
  1877. Injury Prevention
  1878. TABLE 12-3 Injury Prevention During Early Childhood
  1879. Motor Vehicle Injuries
  1880. FIG. 12-10 A, Automobile booster seat. Note placement of shoulder strap (away from neck and face). B, Locking clip used with free-sliding lap/shoulder belt to keep the belt in a tight-holding position.
  1881. Car Restraints.
  1882. FAMILY-CENTERED CARE
  1883. Using Car Safety Restraints
  1884. FIG. 12-11 LATCH (Lower Anchors and Tethers for Children) universal child safety seat system. A, Flexible two-point attachment with top tether. B, Rigid two-point attachment with top tether. C, Top tether.
  1885. Other Car-Related Injuries.
  1886. Drowning
  1887. Burns
  1888. FIG. 12-12 Special plastic caps in electrical sockets prevent young fingers from exploring dangerous areas.
  1889. FIG. 12-13 Children are most likely to ingest substances that are on their level, such as cleaning agents stored under sinks, rat poison, plants, or diaper pail deodorants.
  1890. Poisoning
  1891. Falls
  1892. Aspiration and Suffocation
  1893. Bodily Damage
  1894. Terrorism and Violence
  1895. Anticipatory Guidance–Care of Families
  1896. KEY POINTS
  1897. FAMILY-CENTERED CARE
  1898. Guidance During Toddler Years
  1899. AGES 12 TO 18 MONTHS
  1900. AGES 18 TO 24 MONTHS
  1901. AGES 24 TO 36 MONTHS
  1902. References
  1903. Chapter 13 Health Promotion of the Preschooler and Family
  1904. LEARNING OBJECTIVES
  1905. RELATED TOPICS and ADDITIONAL RESOURCES
  1906. IN TEXT
  1907. PROMOTING OPTIMAL GROWTH AND DEVELOPMENT
  1908. BIOLOGIC DEVELOPMENT
  1909. Gross and Fine Motor Skills
  1910. PSYCHOSOCIAL DEVELOPMENT
  1911. Developing a Sense of Initiative (Erikson)
  1912. FIG. 13-1 A 4-year-old child has sufficient balance to stand or hop on one foot.
  1913. CULTURAL AWARENESS
  1914. Learning Sociocultural Mores
  1915. COGNITIVE DEVELOPMENT
  1916. Preoperational Phase (Piaget)
  1917. NURSINGALERT
  1918. MORAL DEVELOPMENT
  1919. Preconventional or Premoral Level (Kohlberg)
  1920. SPIRITUAL DEVELOPMENT
  1921. DEVELOPMENT OF BODY IMAGE
  1922. DEVELOPMENT OF SEXUALITY
  1923. SOCIAL DEVELOPMENT
  1924. Language
  1925. Personal-Social Behavior
  1926. FIG. 13-2 Preschool children enjoy friends and often use non-verbal messages to communicate.
  1927. Play
  1928. FIG. 13-3 Most preschoolers are able to dress themselves but need help with more difficult items of clothing.
  1929. FIG. 13-4 Preschoolers enjoy play activities that promote motor skills such as jumping and running. Water play is an exciting activity for preschoolers.
  1930. FIG. 13-5 Imaginative and imitative play is typical of pre-schoolers.
  1931. COPING WITH CONCERNS RELATED TO NORMAL GROWTH AND DEVELOPMENT
  1932. Preschool and Kindergarten Experience
  1933. FIG. 13-6 Thorough hand washing is the single most effective method of preventing infection.
  1934. Sex Education
  1935. TABLE 13-1 Growth and Development During Preschool Years
  1936. Fears
  1937. Stress
  1938. Aggression
  1939. Speech Problems
  1940. PROMOTING OPTIMAL HEALTH DURING THE PRESCHOOL YEARS*
  1941. NUTRITION
  1942. NURSINGALERT
  1943. FIG. 13-7 Preschool-age children enjoy helping adults and are more likely to try new foods if they can assist in the preparation.
  1944. SLEEP AND ACTIVITY
  1945. TABLE 13-2 Comparison of Nightmares to Sleep Terrors
  1946. Sleep Problems
  1947. DENTAL HEALTH
  1948. INJURY PREVENTION
  1949. ANTICIPATORY GUIDANCE—CARE OF FAMILIES
  1950. FAMILY-CENTERED CARE
  1951. Guidance During Preschool Years
  1952. AGE 3 YEARS
  1953. AGE 4 YEARS
  1954. AGE 5 YEARS
  1955. KEY POINTS
  1956. References
  1957. Chapter 14 Health Problems of Toddlers and Preschoolers
  1958. LEARNING OBJECTIVES
  1959. RELATED TOPICS and ADDITIONAL RESOURCES
  1960. IN TEXT
  1961. INFECTIOUS DISORDERS
  1962. COMMUNICABLE DISEASES
  1963. TABLE 14-1 Communicable Diseases of Childhood
  1964. FIG. 14-1 Chickenpox (varicella). A, Progression of disease. B, Simultaneous stages of lesions in chickenpox. C, Clinical view.
  1965. FIG. 14-2 Erythema infectiosum.
  1966. FIG. 14-3 Roseola infantum.
  1967. FIG. 14-4 Measles (rubeola). A, Progression of disease. B, Exanthem first appears at the hairline and spreads from head to toe over 3 days. C, Measles ultimately involves the palms and soles.
  1968. FIG. 14-5 Rubella (German measles). A, Progression of rash. B, Clinical view.
  1969. FIG. 14-6 Scarlet fever.
  1970. Nursing Care Management
  1971. nursingprocess: The Child with Communicable Disease
  1972. ASSESSMENT
  1973. DIAGNOSIS (PROBLEM IDENTIFICATION)
  1974. PLANNING
  1975. IMPLEMENTATION
  1976. EVALUATION
  1977. Prevent Spread.
  1978. NURSINGALERT
  1979. Prevent Complications.
  1980. NURSINGALERT
  1981. NURSINGALERT
  1982. Provide Comfort.
  1983. NURSINGALERT
  1984. Support Child and Family.
  1985. NURSINGALERT
  1986. CONJUNCTIVITIS
  1987. BOX 14-1 Clinical Manifestations of Conjunctivitis
  1988. BACTERIAL CONJUNCTIVITIS (“PINK EYE”)
  1989. VIRAL CONJUNCTIVITIS
  1990. ALLERGIC CONJUNCTIVITIS
  1991. CONJUNCTIVITIS CAUSED BY FOREIGN BODY
  1992. Therapeutic Management
  1993. Nursing Care Management
  1994. NURSINGALERT
  1995. STOMATITIS
  1996. FIG. 14-7 Primary gingivostomatitis.
  1997. Therapeutic Management
  1998. Nursing Care Management
  1999. NURSINGALERT
  2000. INTESTINAL PARASITIC DISEASES
  2001. GENERAL NURSING CARE MANAGEMENT
  2002. GIARDIASIS
  2003. TABLE 14-2 Selected Intestinal Parasites
  2004. COMMUNITY FOCUS
  2005. Preventing Intestinal Parasitic Disease
  2006. BOX 14-2 Clinical Manifestations of Giardiasis
  2007. Therapeutic Management
  2008. Nursing Care Management
  2009. FIG. 14-8 Prevention of giardiasis, especially in daycare centers, requires sanitary practices during diaper changes, such as discarding paper diapers in a covered receptacle, changing paper covers on the diaper-changing surface, and having facilities for hand washing nearby. NOTE: Soiled cloth diapers and clothing should be stored in a plastic bag for transport home.
  2010. ENTEROBIASIS (PINWORMS)
  2011. Diagnostic Evaluation
  2012. BOX 14-3 Clinical Manifestations of Pinworms
  2013. Therapeutic Management
  2014. Nursing Care Management
  2015. INGESTION OF INJURIOUS AGENTS
  2016. NURSINGALERT
  2017. BOX 14-4 Poisonous and Nonpoisonous Plants
  2018. POISONOUS PLANTS (TOXIC PARTS)
  2019. NONPOISONOUS PLANTS
  2020. PRINCIPLES OF EMERGENCY TREATMENT
  2021. CRITICAL THINKING EXERCISE
  2022. Poisoning
  2023. QUESTIONS
  2024. emergencytreatment
  2025. Poisoning
  2026. BOX 14-5 Selected Poisonings in Children
  2027. CORROSIVES (STRONG ACIDS OR ALKALIS)
  2028. Clinical Manifestations
  2029. Comments
  2030. Treatment
  2031. HYDROCARBONS
  2032. Clinical Manifestations
  2033. Comments
  2034. Treatment
  2035. ACETAMINOPHEN
  2036. Clinical Manifestations
  2037. Comments
  2038. Treatment
  2039. ASPIRIN (ACETYLSALICYLIC ACID [ASA])
  2040. Clinical Manifestations
  2041. Comments
  2042. Treatment
  2043. IRON
  2044. Clinical Manifestations
  2045. Comments
  2046. Treatment
  2047. PLANTS
  2048. Clinical Manifestations
  2049. Comments
  2050. Treatment
  2051. Assessment
  2052. Gastric Decontamination
  2053. NURSINGALERT
  2054. EVIDENCE-BASED PRACTICE
  2055. Gastric Lavage in Children
  2056. Curt Roberts and Danna Salinas
  2057. ASK THE QUESTION
  2058. SEARCH FOR EVIDENCE
  2059. Search Strategies
  2060. Databases Used
  2061. CRITICALLY ANALYZE THE EVIDENCE
  2062. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  2063. References
  2064. Prevention of Recurrence
  2065. FAMILY FOCUS
  2066. Poisoning
  2067. HEAVY METAL POISONING
  2068. NURSINGALERT
  2069. COMMUNITY FOCUS
  2070. Poison Prevention
  2071. LEAD POISONING
  2072. BOX 14-6 Sources of Lead*
  2073. Causes of Lead Poisoning
  2074. CULTURAL AWARENESS
  2075. Sources of Lead
  2076. Pathophysiology and Clinical Manifestations
  2077. FIG. 14-9 Main effects of lead on body systems.
  2078. NURSINGALERT
  2079. Diagnostic Evaluation
  2080. Anticipatory Guidance
  2081. Screening for Lead Poisoning
  2082. Therapeutic Management
  2083. Chelation Therapy.
  2084. COMMUNITY FOCUS
  2085. Reducing Blood Lead Levels
  2086. Prognosis.
  2087. Nursing Care Management
  2088. ATRAUMATIC CARE
  2089. Lead Chelation Therapy
  2090. NURSINGALERT
  2091. NURSINGALERT
  2092. CHILD MALTREATMENT
  2093. CHILD NEGLECT
  2094. Types of Neglect
  2095. EMOTIONAL ABUSE
  2096. PHYSICAL ABUSE
  2097. Shaken Baby Syndrome
  2098. NURSINGALERT
  2099. Munchausen Syndrome by Proxy
  2100. Factors Predisposing to Physical Abuse
  2101. Parental Characteristics.
  2102. Characteristics of the Child.
  2103. Environmental Characteristics.
  2104. SEXUAL ABUSE
  2105. Characteristics of Abusers and Victims
  2106. Initiation and Perpetuation of Sexual Abuse
  2107. BOX 14-7 Methods Used to Pressure Children into Sexual Activity
  2108. NURSING CARE OF THE MALTREATED CHILD
  2109. NURSINGALERT
  2110. nursingcareguidelines
  2111. Talking with Children Who Reveal Abuse
  2112. BOX 14-8 Warning Signs of Abuse
  2113. BOX 14-9 Clinical Manifestations of Potential Child Maltreatment
  2114. PHYSICAL NEGLECT
  2115. Suggestive Physical Findings
  2116. Suggestive Behaviors
  2117. EMOTIONAL ABUSE AND NEGLECT
  2118. Suggestive Physical Findings
  2119. Suggestive Behaviors
  2120. PHYSICAL ABUSE
  2121. Suggestive Physical Findings
  2122. Suggestive Behaviors
  2123. SEXUAL ABUSE
  2124. Suggestive Physical Findings
  2125. Suggestive Behaviors
  2126. Caregiver-Child Interaction
  2127. History and Interview
  2128. Child Physical Abuse.
  2129. Neglect and Emotional Abuse.
  2130. Sexual Abuse.
  2131. NURSINGALERT
  2132. Physical Assessment
  2133. Child Physical Abuse.
  2134. NURSINGALERT
  2135. Neglect and Emotional Abuse.
  2136. Sexual Abuse.
  2137. Nursing Care Management
  2138. Protect Child from Further Abuse.
  2139. NURSINGALERT
  2140. nursingprocess: The Child Who Is Maltreated
  2141. ASSESSMENT
  2142. DIAGNOSIS (PROBLEM IDENTIFICATION)
  2143. PLANNING
  2144. IMPLEMENTATION
  2145. EVALUATION
  2146. Support Child.
  2147. Support Family.
  2148. nursingcareguidelines
  2149. Recording Assessment Data in Suspected Abuse
  2150. HISTORY OF INJURY
  2151. PHYSICAL EXAMINATION
  2152. Plan for Discharge.
  2153. Prevent Abuse.
  2154. nursingcareplan: The Child Who Is Maltreated
  2155. FAMILY-CENTERED CARE
  2156. Preventing or Dealing with Sexual Abuse of Children
  2157. KEY POINTS
  2158. answers to CRITIAL THINKING EXERCISE
  2159. POISONING
  2160. REFERENCES
  2161. UNIT SIX MIDDLE CHILDHOOD AND ADOLESCENCE
  2162. Interactive Review — Unit Six
  2163. Chapter 15 Health Promotion of the School-Age Child and Family
  2164. LEARNING OBJECTIVES
  2165. RELATED TOPICS and ADDITIONAL RESOURCES
  2166. IN TEXT
  2167. PROMOTING OPTIMAL GROWTH AND DEVELOPMENT
  2168. BIOLOGIC DEVELOPMENT
  2169. Proportional Changes
  2170. Maturation of Systems
  2171. FIG. 15-1 Middle childhood is the stage of development when deciduous teeth are shed.
  2172. Prepubescence
  2173. PSYCHOSOCIAL DEVELOPMENT: DEVELOPING A SENSE OF INDUSTRY (ERIKSON)
  2174. FIG. 15-2 School-age children are motivated to complete tasks working alone.
  2175. COGNITIVE DEVELOPMENT (PIAGET)
  2176. MORAL DEVELOPMENT (KOHLBERG)
  2177. FIG. 15-3 Common examples that demonstrate the child’s ability to conserve (ages are only approximate).
  2178. SPIRITUAL DEVELOPMENT
  2179. CULTURAL AWARENESS
  2180. Religious Orientation
  2181. SOCIAL DEVELOPMENT
  2182. Social Relationships and Cooperation
  2183. FIG. 15-4 School-age children enjoy engaging in activities with a “best friend.”
  2184. Clubs and Peer Groups.
  2185. Relationships with Families
  2186. Play
  2187. Rules and Rituals.
  2188. Team Play.
  2189. Quiet Games and Activities.
  2190. FIG. 15-5 Selecting a book with the assistance of an adult.
  2191. FIG. 15-6 School-age children take pride in learning new skills.
  2192. Ego Mastery.
  2193. DEVELOPING A SELF-CONCEPT
  2194. Developing a Body Image
  2195. COPING WITH CONCERNS RELATED TO NORMAL GROWTH AND DEVELOPMENT
  2196. School Experience
  2197. Teachers.
  2198. Parents.
  2199. Latchkey Children
  2200. FAMILY-CENTERED CARE
  2201. Helping Children in School
  2202. GENERAL GUIDELINES
  2203. SPECIFIC GUIDELINES
  2204. Limit Setting and Discipline
  2205. Dishonest Behavior
  2206. TABLE 15-1 Growth and Development During School-Age Years
  2207. Stress and Fear
  2208. NURSINGALERT
  2209. PROMOTING OPTIMAL HEALTH DURING THE SCHOOL YEARS
  2210. NUTRITION
  2211. SLEEP AND REST
  2212. EXERCISE AND ACTIVITY
  2213. FIG. 15-7 The activities engaged in by school-age children vary according to interest and opportunity. A, Little League competitors. B, Playing tug-of-war.
  2214. Sports
  2215. Acquisition of Skills
  2216. DENTAL HEALTH
  2217. FIG. 15-8 Sequence of eruption of secondary teeth.
  2218. Dental Problems
  2219. emergencytreatment
  2220. Avulsed Permanent Tooth
  2221. TO REIMPLANT TOOTH
  2222. IF RELUCTANT TO REIMPLANT TOOTH
  2223. SEX EDUCATION
  2224. Nurse’s Role in Sex Education
  2225. SCHOOL HEALTH
  2226. INJURY PREVENTION
  2227. FIG. 15-9 The right size bike is important; the child should be able to sit on the bike and place the balls of both feet on the ground. The foot should comfortably reach and manipulate the pedal in the down position. Wearing a protective helmet is mandatory. The helmet should be positioned so it sits low on the forehead and parallel to the ground when the head is held upright. It should not rock back and forth or shift from side to side. The strap should fasten securely under the chin.
  2228. FAMILY-CENTERED CARE
  2229. Bicycle Safety
  2230. ANTICIPATORY GUIDANCE—CARE OF FAMILIES
  2231. FAMILY-CENTERED CARE
  2232. Skateboard and In-Line Skate Safety
  2233. TABLE 15-2 Injury Prevention During School-Age Years
  2234. FAMILY-CENTERED CARE
  2235. Guidance During School Years
  2236. AGE 6 YEARS
  2237. AGES 7 TO 10 YEARS
  2238. AGES 11 TO 12 YEARS
  2239. HEALTH GUIDANCE
  2240. KEY POINTS
  2241. References
  2242. Chapter 16 Health Promotion of the Adolescent and Family
  2243. LEARNING OBJECTIVES
  2244. RELATED TOPICS and ADDITIONAL RESOURCES
  2245. IN TEXT
  2246. PROMOTING OPTIMAL GROWTH AND DEVELOPMENT
  2247. BIOLOGIC DEVELOPMENT
  2248. CULTURAL AWARENESS
  2249. The Adolescent Years
  2250. Hormonal Changes of Puberty
  2251. Sexual Maturation
  2252. Sexual Maturation in Girls.
  2253. Sexual Maturation in Boys.
  2254. BOX 16-1 Usual Sequence of Maturational Changes
  2255. GIRLS
  2256. BOYS
  2257. Physical Growth
  2258. FIG. 16-1 Development of breasts in girls—average age span, 9 to 13½ years. Stage 1 (prepubertal—elevation of papilla only) is not shown.
  2259. Sex Differences in General Growth Patterns.
  2260. FIG. 16-2 Growth in pubic hair in girls—average age span for stages 2 through 5: 9 to 13½ years.
  2261. FIG. 16-3 Developmental stages of secondary sex characteristics and genital development in boys—average age span, 9½ to 14 years.
  2262. Physiologic Changes
  2263. PSYCHOSOCIAL DEVELOPMENT: DEVELOPING A SENSE OF IDENTITY (ERIKSON)
  2264. Group Identity.
  2265. Individual Identity.
  2266. CRITICAL THINKING EXERCISE
  2267. Discussing the Future
  2268. QUESTIONS
  2269. Sex-Role Identity.
  2270. Emotionality.
  2271. COGNITIVE DEVELOPMENT (PIAGET)
  2272. MORAL DEVELOPMENT (KOHLBERG)
  2273. SPIRITUAL DEVELOPMENT
  2274. SOCIAL DEVELOPMENT
  2275. Relationships with Parents
  2276. Relationships with Peers
  2277. FAMILY FOCUS
  2278. Communication with Adolescents: The Art of Listening
  2279. Peer Group.
  2280. FIG. 16-4 Teenagers like to gather in small groups.
  2281. Best Friends.
  2282. Interests and Activities
  2283. FIG. 16-5 The cell phone allows adolescents to talk for hours with peers.
  2284. ADOLESCENT SEXUALITY
  2285. FIG. 16-6 Heterosexual relationships are important for most adolescents.
  2286. CRITICAL THINKING EXERCISE
  2287. Discussing Sexual Orientation with Adolescents
  2288. QUESTIONS
  2289. DEVELOPMENT OF SELF-CONCEPT AND BODY IMAGE
  2290. Responses to Puberty
  2291. TABLE 16-1 Growth and Development During Adolescence
  2292. PROMOTING OPTIMAL HEALTH DURING ADOLESCENCE
  2293. nursingcareguidelines
  2294. Interviewing Adolescents
  2295. CRITICAL THINKING EXERCISE
  2296. Respecting Privacy
  2297. QUESTIONS
  2298. IMMUNIZATIONS
  2299. NUTRITION
  2300. Eating Habits and Behavior
  2301. FIG. 16-7 Snacking on empty calories is common among adolescents, especially during inactivity.
  2302. Nursing Care Management
  2303. SLEEP AND REST
  2304. EXERCISE AND ACTIVITY
  2305. FIG. 16-8 Adolescents should be encouraged to participate in activities that contribute to lifelong physical fitness.
  2306. DENTAL HEALTH
  2307. PERSONAL CARE
  2308. Vision
  2309. Hearing
  2310. Posture
  2311. Body Art
  2312. Tanning
  2313. STRESS REDUCTION
  2314. FIG. 16-9 Adolescents use being alone as a method of coping with stress. Health care professionals need to assess whether this indicates clinical depression.
  2315. BOX 16-2 Areas of Stress in Adolescence
  2316. SEXUALITY EDUCATION AND GUIDANCE
  2317. BOX 16-3 Injury Prevention During Adolescence
  2318. DEVELOPMENTAL ABILITIES RELATED TO RISK OF INJURY
  2319. INJURY PREVENTION
  2320. Motor or Nonmotor Vehicles
  2321. Drowning
  2322. Burns
  2323. Poisoning
  2324. Falls
  2325. Bodily Damage
  2326. INJURY PREVENTION
  2327. Motor Vehicle—Related Injuries
  2328. Other Vehicle Injuries.
  2329. Firearms
  2330. Nonpowder Firearms.
  2331. Sports Injuries
  2332. Nursing Care Management
  2333. ANTICIPATORY GUIDANCE—CARE OF FAMILIES
  2334. FAMILY-CENTERED CARE
  2335. Guidance During Adolescence
  2336. ENCOURAGE PARENTS TO:
  2337. BE AWARE THAT ADOLESCENTS:
  2338. FAMILY FOCUS
  2339. Family Rules for Adolescents
  2340. KEY POINTS
  2341. answers to CRITIAL THINKING EXERCISE
  2342. DISCUSSING THE FUTURE
  2343. DISCUSSING SEXUAL ORIENTATION WITH ADOLESCENTS
  2344. RESPECTING PRIVACY
  2345. References
  2346. Chapter 17 Health Problems of School-Age Children and Adolescents
  2347. LEARNING OBJECTIVES
  2348. RELATED TOPICS and ADDITIONAL RESOURCES
  2349. IN TEXT
  2350. PROBLEMS RELATED TO ELIMINATION
  2351. ENURESIS
  2352. Nursing Care Management
  2353. ENCOPRESIS
  2354. Nursing Care Management
  2355. FAMILY FOCUS
  2356. Helping Families Understand Encopresis
  2357. HEALTH PROBLEMS RELATED TO SPORTS PARTICIPATION
  2358. OVERUSE SYNDROMES
  2359. FIG. 17-1 Football is an example of a strenuous collision sport.
  2360. Stress Fractures
  2361. Therapeutic Management
  2362. NURSE’S ROLE IN SPORTS FOR CHILDREN AND ADOLESCENTS
  2363. ALTERED GROWTH AND MATURATION
  2364. Nursing Care Management
  2365. SEX CHROMOSOME DISORDERS
  2366. Turner Syndrome
  2367. Klinefelter Syndrome
  2368. TABLE 17-1 Common Sex Chromosome Disorders
  2369. Nursing Care Management
  2370. DISORDERS RELATED TO THE REPRODUCTIVE SYSTEM
  2371. AMENORRHEA
  2372. DYSMENORRHEA
  2373. Therapeutic Management
  2374. Nursing Care Management
  2375. VAGINITIS
  2376. DISORDERS OF THE MALE REPRODUCTIVE SYSTEM
  2377. Nursing Care Management
  2378. CRITICAL THINKING EXERCISE
  2379. Testicular Self-Examination
  2380. QUESTIONS
  2381. GYNECOMASTIA
  2382. Nursing Care Management
  2383. HEALTH PROBLEMS RELATED TO SEXUALITY
  2384. ADOLESCENT PREGNANCY
  2385. Nursing Care Management
  2386. CONTRACEPTION
  2387. TABLE 17-2 Advantages and Disadvantages of Contraceptive Methods in Adolescents
  2388. Nursing Care Management
  2389. SEXUALLY TRANSMITTED DISEASES
  2390. Therapeutic Management
  2391. Nursing Care Management
  2392. PELVIC INFLAMMATORY DISEASE
  2393. TABLE 17-3 Selected Sexually Transmitted Diseases*
  2394. SEXUAL ASSAULT (RAPE)
  2395. BOX 17-1 Definitions of Sexual Assaults
  2396. Diagnostic Evaluation
  2397. BOX 17-2 Clinical Manifestations of Rape Victims
  2398. MAY DISPLAY A VARIETY OF EMOTIONS AND BEHAVIORS:
  2399. EVIDENCE OF PHYSICAL FORCE FROM:
  2400. MEDICAL EXAMINATION PROVIDES EVIDENCE OF:
  2401. NURSINGALERT
  2402. Therapeutic Management
  2403. FAMILY FOCUS
  2404. Supporting the Rape Victim’s Parents
  2405. Rape Trauma Syndrome
  2406. Nursing Care Management
  2407. EATING DISORDERS
  2408. OBESITY
  2409. FIG. 17-2 Complex relationships in obesity.
  2410. Etiology and Pathophysiology
  2411. Diagnostic Evaluation
  2412. Therapeutic Management
  2413. Nursing Care Management
  2414. nursingprocess: The Child or Adolescent Who Is Overweight or Obese
  2415. ASSESSMENT
  2416. DIAGNOSIS (PROBLEM IDENTIFICATION)
  2417. PLANNING
  2418. IMPLEMENTATION
  2419. EVALUATION
  2420. Nutritional Counseling.
  2421. Behavioral Therapy.
  2422. Group Involvement.
  2423. Family Involvement.
  2424. Physical Activity.
  2425. BOX 17-3 Helpful Suggestions to Promote Healthy Eating Habits
  2426. Prevention.
  2427. ANOREXIA NERVOSA AND BULIMIA NERVOSA
  2428. Etiology and Pathophysiology
  2429. BOX 17-4 Clinical Manifestations of Anorexia Nervosa
  2430. Diagnostic Evaluation
  2431. BOX 17-6 Diagnostic Criteria for Bulimia
  2432. BOX 17-5 Diagnostic Criteria for Anorexia Nervosa
  2433. Therapeutic Management
  2434. Nutrition Therapy.
  2435. Psychotherapy.
  2436. Pharmacologic Therapy.
  2437. Nursing Care Management
  2438. CRITICAL THINKING EXERCISE
  2439. Anorexia Nervosa
  2440. QUESTIONS
  2441. DISORDERS WITH BEHAVIORAL COMPONENTS
  2442. ATTENTION DEFICIT HYPERACTIVITY DISORDER AND LEARNING DISABILITY
  2443. Diagnostic Evaluation
  2444. Therapeutic Management
  2445. BOX 17-7 Diagnostic Criteria for Attention Deficit Hyperactivity Disorder
  2446. Pharmacologic Therapy.
  2447. Behavioral Therapy.
  2448. Environmental Manipulation.
  2449. CRITICAL THINKING EXERCISE
  2450. Attention Deficit Hyperactivity Disorder
  2451. QUESTIONS
  2452. Appropriate Classroom Placement.
  2453. FAMILY FOCUS
  2454. A Child’s Perception of Taking Ritalin at School
  2455. Prognosis.
  2456. Nursing Care Management
  2457. POSTTRAUMATIC STRESS DISORDER
  2458. Nursing Care Management
  2459. SCHOOL PHOBIA
  2460. Nursing Care Management
  2461. RECURRENT ABDOMINAL PAIN
  2462. Nursing Care Management
  2463. CONVERSION REACTION
  2464. Nursing Care Management
  2465. CHILDHOOD DEPRESSION
  2466. BOX 17-8 Characteristics of Children with Depression
  2467. BEHAVIOR
  2468. INTERNAL STATES
  2469. PHYSIOLOGY
  2470. Nursing Care Management
  2471. CHILDHOOD SCHIZOPHRENIA
  2472. Nursing Care Management
  2473. SERIOUS HEALTH PROBLEMS OF LATER CHILDHOOD AND ADOLESCENCE
  2474. SUBSTANCE ABUSE
  2475. Motivation
  2476. Types of Drugs Abused
  2477. Tobacco.
  2478. COMMUNITY FOCUS
  2479. Early Sexual Maturation, Alcohol, and Cigarettes
  2480. Etiology.
  2481. Smokeless Tobacco.
  2482. Nursing Care Management.
  2483. COMMUNITY FOCUS
  2484. Nonsmoking Strategies
  2485. Alcohol.
  2486. Cocaine.
  2487. Narcotics.
  2488. Central Nervous System Depressants.
  2489. Central Nervous System Stimulants.
  2490. Mind-Altering Drugs.
  2491. Nursing Care Management Related to Therapeutic Management
  2492. Acute Care.
  2493. Long-Term Management.
  2494. Family Support.
  2495. Prevention.
  2496. SUICIDE
  2497. NURSINGALERT
  2498. Etiology
  2499. Methods
  2500. NURSINGALERT
  2501. COMMUNITY FOCUS
  2502. Suicide, Sexual Identity, and Sexual Orientation
  2503. BOX 17-9 Warning Signs of Suicide
  2504. Motivation
  2505. Diagnostic Evaluation
  2506. Therapeutic Management
  2507. NURSINGALERT
  2508. Nursing Care Management
  2509. NURSINGALERT
  2510. KEY POINTS
  2511. answers to CRITIAL THINKING EXERCISE
  2512. TESTICULAR SELF-EXAMINATION
  2513. ANOREXIA NERVOSA
  2514. ATTENTION DEFICIT HYPERACTIVITY DISORDER
  2515. References
  2516. UNIT SEVEN THE CHILD AND FAMILY WITH SPECIAL NEEDS
  2517. Interactive Review — Unit Seven
  2518. Chapter 18 Chronic Illness, Disability, or End-of-Life Care for the Child and Family
  2519. LEARNING OBJECTIVES
  2520. RELATED TOPICS and ADDITIONAL RESOURCES
  2521. IN TEXT
  2522. PERSPECTIVES ON THE CARE OF CHILDREN WITH SPECIAL NEEDS
  2523. SCOPE OF THE PROBLEM
  2524. TRENDS IN CARE
  2525. Developmental Focus
  2526. BOX 18-1 Common Terms Regarding Children with Special Needs
  2527. Family-Centered Care
  2528. Family–Health Care Provider Communication
  2529. Establishing Therapeutic Relationships
  2530. The Role of Culture in Family-Centered Care
  2531. Shared Decision Making
  2532. BOX 18-2 Facilitating Shared Decision Making
  2533. Normalization
  2534. Managed Care
  2535. THE FAMILY OF THE CHILD WITH SPECIAL NEEDS
  2536. BOX 18-3 Adaptive Tasks of Parents Having Children with Chronic Conditions
  2537. IMPACT OF THE CHILD’s CHRONIC ILLNESS OR DISABILITY
  2538. BOX 18-4 Anticipated Parental Stress Points
  2539. Parents
  2540. Parental Roles.
  2541. Mother-Father Differences.
  2542. Single-Parent Families.
  2543. Siblings
  2544. FAMILY FOCUS
  2545. Reflection of an Older Brother
  2546. BOX 18-5 Supporting Siblings of Children with Special Needs
  2547. PROMOTE HEALTHY SIBLING RELATIONSHIPS
  2548. HELP SIBLINGS COPE
  2549. INVOLVE SIBLINGS
  2550. COPING WITH ONGOING STRESS AND PERIODIC CRISES
  2551. Concurrent Stresses Within the Family
  2552. Coping Mechanisms
  2553. Parental Empowerment
  2554. ASSISTING FAMILY MEMBERS IN MANAGING THEIR FEELINGS
  2555. nursingcareguidelines
  2556. Assessing Coping Behaviors
  2557. APPROACH BEHAVIORS
  2558. AVOIDANCE BEHAVIORS
  2559. Shock and Denial
  2560. Adjustment
  2561. Reintegration and Acknowledgment
  2562. BOX 18-6 Characteristics of Parental Overprotection
  2563. ESTABLISHING A SUPPORT SYSTEM
  2564. BOX 18-7 Concept of Functional Burden
  2565. IMPACT OF THE CHILD WITH SPECIAL NEEDS
  2566. FAMILY RESOURCES AND ABILITY TO COPE
  2567. THE CHILD WITH SPECIAL NEEDS
  2568. DEVELOPMENTAL ASPECTS
  2569. FIG. 18-1 Children with any type of impairment should have the opportunity to develop their skills.
  2570. BOX 18-8 Coping Patterns Used by Children with Special Needs
  2571. COPING MECHANISMS
  2572. FIG. 18-2 Periods of sadness and anger are appropriate in the child’s adjustment to a chronic illness or disability, especially during exacerbations of the disorder.
  2573. Hopefulness
  2574. Health Education and Self-Care
  2575. nursingprocess
  2576. The Child with Special Needs
  2577. ASSESSMENT
  2578. DIAGNOSIS (PROBLEM IDENTIFICATION)
  2579. PLANNING
  2580. IMPLEMENTATION
  2581. EVALUATION
  2582. RESPONSES TO PARENTAL BEHAVIOR
  2583. TYPE OF ILLNESS OR DISABILITY
  2584. NURSING CARE OF THE FAMILY AND CHILD WITH SPECIAL NEEDS
  2585. ASSESSMENT
  2586. TABLE 18-1 Assessment of Factors Affecting Family Adjustment
  2587. FAMILY FOCUS
  2588. Identifying Family Needs
  2589. PROVIDE SUPPORT AT THE TIME OF DIAGNOSIS
  2590. FIG. 18-3 Informing session should take place in a private, comfortable setting free of distractions and interruptions.
  2591. NURSINGTIP
  2592. SUPPORT FAMILY’S COPING METHODS
  2593. Parents
  2594. nursingcareguidelines
  2595. Situations Requiring Special Consideration
  2596. CONGENITAL ANOMALY
  2597. COGNITIVE IMPAIRMENT
  2598. PHYSICAL DISABILITY
  2599. CHRONIC ILLNESS
  2600. MULTIPLE DISABILITIES
  2601. TERMINAL ILLNESS
  2602. nursingcareguidelines
  2603. Developing Successful Parent-Professional Partnerships
  2604. nursingcareguidelines
  2605. Encouraging Expression of Emotion
  2606. Parent-to-Parent Support
  2607. Advocate for Empowerment
  2608. The Child
  2609. nursingcareguidelines
  2610. Promoting Normalization
  2611. Siblings
  2612. EDUCATE ABOUT THE DISORDER AND GENERAL HEALTH CARE
  2613. Activities of Daily Living
  2614. Safe Transportation
  2615. Primary Health Care
  2616. PROMOTE NORMAL DEVELOPMENT
  2617. Early Childhood
  2618. FIG. 18-4 A modified tricycle with block pedals, self-adhesive straps for support, and modified seat and handle bars can help a child with disabilities gain mobility.
  2619. TABLE 18-2 Developmental Effects of Chronic Illness or Disability on Children
  2620. School Age
  2621. FIG. 18-5 Children with special needs should continue their schooling as soon as their condition permits.
  2622. Adolescence
  2623. ESTABLISH REALISTIC FUTURE GOALS
  2624. PERSPECTIVES ON THE CARE OF CHILDREN AT THE END OF LIFE
  2625. PRINCIPLES OF PALLIATIVE CARE
  2626. DECISION MAKING AT THE END OF LIFE
  2627. Ethical Considerations in End-of-LifeDecision Making
  2628. EVIDENCE-BASED PRACTICE
  2629. Pediatric Pain and Symptom Management at the End of Life
  2630. ASK THE QUESTION
  2631. SEARCH FOR EVIDENCE
  2632. Search Strategies
  2633. Databases Used
  2634. CRITICALLY ANALYZE THE EVIDENCE
  2635. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  2636. References
  2637. Physician–Health Care Team Decision Making
  2638. Parental Decision Making
  2639. The Dying Child
  2640. FAMILY FOCUS
  2641. Family of the Dying Child
  2642. TABLE 18-3 Children’s Understanding of and Reactions to Death
  2643. Treatment Options for Terminally Ill Children
  2644. Hospital.
  2645. Home Care.
  2646. Hospice Care.
  2647. NURSING CARE OF THE CHILD AND FAMILY AT THE END OF LIFE
  2648. FEAR OF PAIN AND SUFFERING
  2649. nursingcareplan The Child Who Is Terminally Ill or Dying
  2650. Pain and Symptom Management
  2651. BOX 18-9 Ethical Principle of Double Effect
  2652. Parents’ and Siblings’ Need for Education and Support
  2653. FEAR OF DYING ALONE OR OF NOT BEING PRESENT WHEN THE CHILD DIES
  2654. FEAR OF ACTUAL DEATH
  2655. Home Deaths
  2656. FIG. 18-6 For the dying child there is no greater comfort than the security and closeness of a parent.
  2657. BOX 18-10 Physical Signs of Approaching Death
  2658. Hospital Deaths
  2659. FAMILY FOCUS
  2660. Children Need to Say Good-Bye
  2661. ORGAN OR TISSUE DONATION AND AUTOPSY
  2662. GRIEF AND MOURNING
  2663. Parental Grief
  2664. Sibling Grief
  2665. nursingcareguidelines
  2666. Supporting Grieving Families*
  2667. GENERAL
  2668. AT THE TIME OF DEATH
  2669. POSTDEATH
  2670. Nurses’ Reactions to Caring for Dying Children
  2671. FAMILY FOCUS
  2672. A Dying Child: A Nurse’s Perspective
  2673. KEY POINTS
  2674. References
  2675. Chapter 19 Impact of Cognitive or Sensory Impairment on the Child and Family
  2676. LEARNING OBJECTIVES
  2677. RELATED TOPICS and ADDITIONAL RESOURCES
  2678. IN TEXT
  2679. COGNITIVE IMPAIRMENT
  2680. GENERAL CONCEPTS
  2681. Diagnosis and Classification
  2682. BOX 19-2 Early Behavioral Signs Suggestive of Cognitive Impairment
  2683. BOX 19-1 Dimensions of Care for the Intellectually Disabled
  2684. Dimension I
  2685. Dimension II
  2686. Dimension III
  2687. Dimension IV
  2688. TABLE 19-1 Classification of Cognitive Impairment
  2689. Etiology
  2690. NURSING CARE OF CHILDREN WITH IMPAIRED COGNITIVE FUNCTION
  2691. Educate Child and Family.
  2692. FIG. 19-1 A push panel allows a child with cognitive impairment to turn a computer on and off.
  2693. Teach Child Self-Care Skills.
  2694. nursingcareplan The Child with Impaired Cognitive Function
  2695. Promote Child’s Optimal Development.
  2696. Encourage Play and Exercise.
  2697. FIG. 19-2 Placing an attractive object outside the child’s reach encourages crawling movements.
  2698. FIG. 19-3 A manual switch allows a child with cognitive impairment to play with a battery-operated toy.
  2699. FIG. 19-4 A favorite toy provides stimulation for a young child.
  2700. FIG. 19-5 A child with cognitive and physical impairments can activate electronic/communication equipment by moving a device near her head.
  2701. Provide Means of Communication.
  2702. Establish Discipline.
  2703. Encourage Socialization.
  2704. Provide Information on Sexuality.
  2705. Help Family Adjust to Future Care.
  2706. Care for Child During Hospitalization.
  2707. Assist in Measures to Prevent Cognitive Impairment
  2708. DOWN SYNDROME
  2709. Etiology
  2710. Diagnostic Evaluation
  2711. FIG. 19-6 Down syndrome in an infant. Note small, square head with upward slant to eyes, flat nasal bridge, protruding tongue, mottled skin, and hypotonia.
  2712. BOX 19-3 Clinical Manifestations of Down Syndrome
  2713. HEAD AND EYES
  2714. NOSE AND EARS
  2715. MOUTH AND NECK
  2716. CHEST AND HEART
  2717. ABDOMEN AND GENITALIA
  2718. HANDS AND FEET
  2719. MUSCULOSKELETON AND SKIN
  2720. OTHER
  2721. Therapeutic Management
  2722. NURSINGALERT
  2723. Prognosis.
  2724. Nursing Care Management
  2725. Support Family at Time of Diagnosis.
  2726. Assist Family in Preventing Physical Problems.
  2727. ETHICAL CASE STUDY Child with Down Syndrome
  2728. ETHICAL DECISION MAKING MODEL
  2729. Evaluate the Issue
  2730. Treat All Involved with Respect
  2731. Hear All Sides
  2732. Initiate Action
  2733. Consider the Outcome
  2734. CRITICAL THINKING EXERCISE
  2735. Diagnosis of Down Syndrome
  2736. QUESTIONS
  2737. Assist in Prenatal Diagnosis and Genetic Counseling.
  2738. FRAGILE X SYNDROME
  2739. Clinical Manifestations
  2740. Therapeutic Management
  2741. BOX 19-4 Clinical Manifestations of Fragile X Syndrome
  2742. PHYSICAL FEATURES
  2743. BEHAVIORAL FEATURES
  2744. Prognosis.
  2745. Nursing Care Management
  2746. SENSORY IMPAIRMENT
  2747. HEARING IMPAIRMENT
  2748. Definition and Classification
  2749. Etiology.
  2750. Pathology.
  2751. TABLE 19-2 Intensity of Sounds Expressed in Decibels
  2752. Symptom Severity.
  2753. Therapeutic Management
  2754. Conductive Hearing Loss.
  2755. TABLE 19-3 Classification of Hearing Loss Based on Symptom Severity
  2756. NURSINGTIP
  2757. FIG. 19-7 On-the-body hearing aids are convenient for young children, such as this child with severe bilateral hearing loss. Note eye patching for strabismus.
  2758. NURSINGALERT
  2759. Sensorineural Hearing Loss.
  2760. BOX 19-5 Clinical Manifestations of Hearing Impairment
  2761. INFANTS
  2762. CHILDREN
  2763. Nursing Care Management
  2764. Infancy.
  2765. Childhood.
  2766. NURSINGALERT
  2767. Lipreading.
  2768. Cued Speech.
  2769. Sign Language.
  2770. Speech Language Therapy.
  2771. Additional Aids.
  2772. nursingcareguidelines
  2773. Facilitating Lipreading
  2774. Socialization.
  2775. Support Child and Family.
  2776. Care for Child During Hospitalization.
  2777. CRITICAL THINKING EXERCISE
  2778. Hearing Impairment
  2779. QUESTIONS
  2780. Assist in Measures to Prevent Hearing Impairment.
  2781. NURSINGALERT
  2782. VISUAL IMPAIRMENT
  2783. Definition and Classification
  2784. Etiology
  2785. BOX 19-6 Types of Visual Impairment
  2786. REFRACTIVE ERRORS
  2787. Myopia
  2788. Nearsightedness
  2789. Pathophysiology
  2790. Clinical Manifestations
  2791. Treatment
  2792. Hyperopia
  2793. Farsightedness
  2794. Pathophysiology
  2795. Clinical Manifestations
  2796. Treatment
  2797. Astigmatism
  2798. Pathophysiology
  2799. Clinical Manifestations
  2800. Treatment
  2801. Anisometropia
  2802. Pathophysiology
  2803. Clinical Manifestations
  2804. Treatment
  2805. AMBLYOPIA
  2806. Lazy eye
  2807. Pathophysiology
  2808. Clinical Manifestations
  2809. Treatment
  2810. STRABISMUS
  2811. ‘Squint’
  2812. Esotropia
  2813. Exotropia
  2814. Pathophysiology
  2815. Clinical Manifestations
  2816. Treatment
  2817. CATARACTS
  2818. Pathophysiology
  2819. Clinical Manifestations
  2820. Treatment
  2821. GLAUCOMA
  2822. Pathophysiology
  2823. Clinical Manifestations
  2824. Treatment
  2825. Trauma.
  2826. emergencytreatment
  2827. Eye Injuries
  2828. FOREIGN OBJECT
  2829. CHEMICAL BURNS
  2830. ULTRAVIOLET BURNS
  2831. HEMATOMA (‘BLACK EYE’)
  2832. PENETRATING INJURIES
  2833. Infections.
  2834. Nursing Care Management
  2835. Infancy.
  2836. NURSINGALERT
  2837. Childhood.
  2838. Promote Parent-Child Attachment.
  2839. Promote Child’s Optimal Development.
  2840. Development and Independence.
  2841. Play and Socialization.
  2842. Education.
  2843. Care for the Child During Hospitalization.
  2844. Assist in Measures to Prevent Visual Impairment.
  2845. NURSINGALERT
  2846. DEAF-BLIND CHILDREN
  2847. RETINOBLASTOMA
  2848. Diagnostic Evaluation
  2849. BOX 19-7 Clinical Manifestations of Retinoblastoma
  2850. FIG. 19-8 White reflex. Whitish appearance of lens is produced as light falls on tumor mass in left eye.
  2851. Therapeutic Management
  2852. Prognosis.
  2853. FIG. 19-9 The same infant with left prosthetic eye.
  2854. Nursing Care Management
  2855. AUTISM SPECTRUM DISORDERS
  2856. Etiology
  2857. Clinical Manifestations and Diagnostic Evaluation
  2858. NURSINGTIP
  2859. EVIDENCE-BASED PRACTICE
  2860. Thimerosal-Containing Vaccines and Autism Spectrum Disorders
  2861. ASK THE QUESTION
  2862. SEARCH FOR EVIDENCE
  2863. Search Strategies
  2864. Databases Used
  2865. CRITICALLY ANALYZE THE EVIDENCE
  2866. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  2867. References
  2868. BOX 19-8 Diagnostic Criteria for Autistic Disorder
  2869. Prognosis
  2870. Nursing Care Management
  2871. Family Support.
  2872. KEY POINTS
  2873. answers to CRITIAL THINKING EXERCISE
  2874. DIAGNOSIS OF DOWN SYNDROME
  2875. HEARING IMPAIRMENT
  2876. References
  2877. Chapter 20 Family-Centered Home Care
  2878. LEARNING OBJECTIVES
  2879. RELATED TOPICS and ADDITIONAL RESOURCES
  2880. IN TEXT
  2881. GENERAL CONCEPTS OF HOME CARE
  2882. HOME CARE TRENDS
  2883. EVIDENCE-BASED PRACTICE
  2884. Home Care Decreases Length of Hospital Stay
  2885. ASK THE QUESTION
  2886. SEARCH FOR EVIDENCE
  2887. Search Strategies
  2888. Databases Used
  2889. CRITICALLY ANALYZE THE EVIDENCE
  2890. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  2891. References
  2892. EFFECTIVE HOME CARE
  2893. BOX 20-1 Intermittent Skilled Nursing
  2894. HEALTH CARE NEED
  2895. INTERVENTION
  2896. BOX 20-2 Services Necessary to Support Effective Home Care
  2897. DISCHARGE PLANNING AND SELECTION OF A HOME CARE AGENCY
  2898. BOX 20-3 Characteristics of a High-Quality Pediatric Home Care Agency
  2899. NURSINGTIP
  2900. NURSINGTIP
  2901. BOX 20-4 Assessment for Technology-Dependent Home Care
  2902. FAMILY CARE PROVIDERS
  2903. PRIMARY CARE PROVIDER
  2904. HOME CARE SUPPORT
  2905. HOME PHYSICAL ENVIRONMENT
  2906. EMERGENCY PREPAREDNESS
  2907. FIG. 20-1 An essential aspect of preparation for home care is the arrangement of equipment and supplies.
  2908. BOX 20-5 Critical Home Care Referral Information
  2909. CARE COORDINATION (CASE MANAGEMENT)
  2910. BOX 20-6 Care Coordination for Children with Special Health Care Needs
  2911. ROLE OF THE NURSE, TRAINING, AND STANDARDS OF CARE
  2912. FIG. 20-2 The nurse in the home care setting requires expertise to care for a child who is technology dependent.
  2913. BOX 20-7 Qualities of a Pediatric Home Care Nurse
  2914. BOX 20-8 Selected Resources for Home Care
  2915. FAMILY-CENTERED HOME CARE
  2916. DIVERSITY IN HOME CARE
  2917. FAMILY FOCUS
  2918. Developing Relationships with Culturally Diverse Families
  2919. NURSINGTIP
  2920. PARENT-PROFESSIONAL COLLABORATION
  2921. CRITICAL THINKING EXERCISE
  2922. Family-Centered Home Care and Conflicts
  2923. QUESTIONS
  2924. NURSINGALERT
  2925. FAMILY FOCUS
  2926. Knowledgeable Parents
  2927. THE NURSING PROCESS
  2928. BOX 20-9 Sample Family Assessment Questions
  2929. NURSINGTIP
  2930. FAMILY FOCUS
  2931. What I Learned About Home Care
  2932. PROMOTION OF OPTIMUM DEVELOPMENT, SELF-CARE, AND EDUCATION
  2933. nursingcareguidelines
  2934. Negotiating ‘House Rules’ for Home Care
  2935. HOUSE RULES
  2936. CHILD
  2937. SIBLINGS
  2938. NURSING
  2939. CRITICAL THINKING EXERCISE
  2940. Maintaining Therapeutic Boundaries
  2941. QUESTIONS
  2942. BOX 20-10 Incorporating Developmental Support into the Home Care Plan
  2943. OUTCOME CRITERIA
  2944. INTERVENTION
  2945. SAFETY ISSUES IN THE HOME
  2946. NURSINGTIP
  2947. NURSINGTIP
  2948. FAMILY-TO-FAMILY SUPPORT
  2949. KEY POINTS
  2950. answers to CRITIAL THINKING EXERCISE
  2951. FAMILY-CENTERED HOME CARE AND CONFLICTS
  2952. MAINTAINING THERAPEUTIC BOUNDARIES
  2953. References
  2954. UNIT EIGHT IMPACT OF HOSPITALIZATION ON THE CHILD AND FAMILY
  2955. Interactive Review — Unit Eight
  2956. Chapter 21 Family-Centered Care of the Child During Illness and Hospitalization
  2957. LEARNING OBJECTIVES
  2958. RELATED TOPICS and ADDITIONAL RESOURCES
  2959. IN TEXT
  2960. STRESSORS OF HOSPITALIZATION AND CHILDREN’S REACTIONS
  2961. SEPARATION ANXIETY
  2962. FIG. 21-1 In the protest phase of separation anxiety, children cry loudly and are inconsolable in their grief for the parent.
  2963. FIG. 21-2 During the despair phase of separation anxiety, children are sad, lonely, and uninterested in food and play.
  2964. BOX 21-1 Manifestations of Separation Anxiety in Young Children
  2965. PHASE OF PROTEST
  2966. PHASE OF DESPAIR
  2967. PHASE OF DETACHMENT
  2968. FIG. 21-3 Young children may appear withdrawn and sad even in the presence of a parent.
  2969. Early Childhood
  2970. Later Childhood and Adolescence
  2971. LOSS OF CONTROL
  2972. Infants
  2973. Toddlers
  2974. Preschoolers
  2975. School-Age Children
  2976. Adolescents
  2977. EFFECTS OF HOSPITALIZATION ON THE CHILD
  2978. Individual Risk Factors
  2979. Changes in the Pediatric Population.
  2980. BOX 21-2 Posthospital Behaviors in Children
  2981. YOUNG CHILDREN
  2982. OLDER CHILDREN
  2983. BOX 21-3 Risk Factors That Increase Children’s Vulnerability to the Stresses of Hospitalization
  2984. Beneficial Effects of Hospitalization
  2985. STRESSORS AND REACTIONS OF THE FAMILY OF THE CHILD WHO IS HOSPITALIZED
  2986. PARENTAL REACTIONS
  2987. SIBLING REACTIONS
  2988. BOX 21-4 Factors Affecting Parents’ Reactions to Their Child’s Illness
  2989. ALTERED FAMILY ROLES
  2990. NURSING CARE OF THE CHILD WHO IS HOSPITALIZED
  2991. PREPARATION FOR HOSPITALIZATION
  2992. FYI
  2993. Admission Assessment
  2994. Preparing Child for Admission
  2995. CRITICAL THINKING EXERCISE
  2996. Complementary and Alternative Medicine
  2997. QUESTIONS
  2998. BOX 21-5 Nursing Admission History According to Functional Health Patterns*
  2999. HEALTH PERCEPTION–HEALTH MANAGEMENT PATTERN
  3000. NUTRITION-METABOLIC PATTERN
  3001. ELIMINATION PATTERN
  3002. SLEEP-REST PATTERN
  3003. ACTIVITY-EXERCISE PATTERN
  3004. COGNITIVE-PERCEPTUAL PATTERN
  3005. SELF-PERCEPTION–SELF-CONCEPT PATTERN
  3006. SELF-PERCEPTION–SELF-CONCEPT PATTERN–cont’d
  3007. ROLE-RELATIONSHIP PATTERN
  3008. SEXUALITY-REPRODUCTIVE PATTERN
  3009. COPING-STRESS TOLERANCE PATTERN
  3010. VALUE-BELIEF PATTERN
  3011. BOX 21-6 Complementary Medicine Practices and Examples
  3012. Nutrition, diet, and lifestyle or behavioral health changes
  3013. Mind-body control therapies
  3014. Traditional and ethnomedicine therapies
  3015. Structural manipulation and energetic therapies
  3016. Pharmacologic and biologic therapies
  3017. Bioelectromagnetic therapies
  3018. FIG. 21-4 The initial admission procedures give the nurse an opportunity to get to know the child and to assess the child’s understanding of the hospital experience.
  3019. BOX 21-7 Guidelines for Admission
  3020. PREADMISSION
  3021. ADMISSION
  3022. NURSING INTERVENTIONS
  3023. Preventing or Minimizing Separation
  3024. ETHICAL CASE STUDY Maternal Absence During Infant Hospitalization
  3025. ETHICAL DECISION MAKING MODEL
  3026. Evaluate the Issue
  3027. Treat All Involved with Respect
  3028. Hear All Sides
  3029. Initiate Action
  3030. Consider the Outcome
  3031. FIG. 21-5 When parents cannot visit, other significant persons can provide comfort to the hospitalized child.
  3032. FIG. 21-6 For extended hospitalizations children enjoy having projects with other patients to occupy time.
  3033. Minimizing Loss of Control
  3034. Promoting Freedom of Movement.
  3035. Maintaining Child’s Routine.
  3036. FIG. 21-7 Time structuring is an effective strategy for normalizing the hospital environment and increasing the child’s sense of control.
  3037. NURSINGTIP
  3038. Encouraging Independence.
  3039. Promoting Understanding.
  3040. BOX 21-8 Bill of Rights for Children and Teens
  3041. Preventing or Minimizing Fear of Bodily Injury
  3042. Providing Developmentally Appropriate Activities
  3043. NURSINGTIP
  3044. Providing Opportunities for Play and Expressive Activities
  3045. FIG. 21-8 Play materials for children in the hospital need to be appropriate for their age, interests, and limitations.
  3046. BOX 21-9 Functions of Play in the Hospital
  3047. Diversional Activities.
  3048. Toys.
  3049. NURSINGTIP
  3050. Expressive Activities.
  3051. FIG. 21-9 Drawing and painting are excellent media for expression.
  3052. Creative Expression.
  3053. Dramatic Play.
  3054. NURSINGTIP
  3055. Maximizing Potential Benefits of Hospitalization
  3056. CRITICAL THINKING EXERCISE
  3057. Playroom and Hospital Procedures
  3058. QUESTIONS
  3059. Fostering Parent-Child Relationships.
  3060. Providing Educational Opportunities.
  3061. Promoting Self-Mastery.
  3062. Providing Socialization.
  3063. NURSING CARE OF THE FAMILY
  3064. FIG. 21-10 Placing children of the same age-group with similar illnesses near each other on the unit is both psychologically and medically supportive.
  3065. SUPPORTING FAMILY MEMBERS
  3066. FAMILY-CENTERED CARE
  3067. Supporting Siblings During Hospitalization
  3068. PROVIDING INFORMATION
  3069. ENCOURAGING PARENT PARTICIPATION
  3070. PREPARING FOR DISCHARGE AND HOME CARE
  3071. CARE OF THE CHILD AND FAMILY IN SPECIAL HOSPITAL SITUATIONS
  3072. AMBULATORY OR OUTPATIENT SETTING
  3073. NURSINGTIP
  3074. FAMILY-CENTERED CARE
  3075. Discharge from Ambulatory Settings
  3076. ISOLATION
  3077. NURSINGTIP
  3078. EMERGENCY ADMISSION
  3079. BOX 21-10 Guidelines for Special Hospital Admission*
  3080. EMERGENCY ADMISSION
  3081. ADMISSION TO INTENSIVE CARE UNIT (ICU)
  3082. INTENSIVE CARE UNIT
  3083. FIG. 21-11 Parental presence during hospitalization provides emotional support for the child and increases the parent’s sense of empowerment in the caregiver role.
  3084. BOX 21-11 Neonatal or Pediatric Intensive Care Unit Stressors for the Child and Family
  3085. PHYSICAL STRESSORS
  3086. ENVIRONMENTAL STRESSORS
  3087. PSYCHOLOGIC STRESSORS
  3088. SOCIAL STRESSORS
  3089. FAMILY FOCUS
  3090. Artists as Partners in Care
  3091. KEY POINTS
  3092. answers to CRITIAL THINKING EXERCISE
  3093. COMPLEMENTARY AND ALTERNATIVE MEDICINE
  3094. PLAYROOM AND HOSPITAL PROCEDURES
  3095. References
  3096. Chapter 22 Pediatric Variations of Nursing Interventions
  3097. LEARNING OBJECTIVES
  3098. RELATED TOPICS and ADDITIONAL RESOURCES
  3099. IN TEXT
  3100. GENERAL CONCEPTS RELATED TO PEDIATRIC PROCEDURES
  3101. INFORMED CONSENT
  3102. Requirements for Obtaining Informed Consent
  3103. EVIDENCE-BASED PRACTICE
  3104. Informed Consent and Assent in Children
  3105. ASK THE QUESTION
  3106. SEARCH FOR EVIDENCE
  3107. Search Strategies
  3108. Databases Used
  3109. CRITICALLY ANALYZE THE EVIDENCE
  3110. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  3111. References
  3112. Eligibility for Giving Informed Consent
  3113. Informed Consent of Parents or Legal Guardians
  3114. Evidence of Consent.
  3115. Informed Consent of Mature and Emancipated Minors.
  3116. Treatment Without Parental Consent.
  3117. Adolescents, Consent, and Confidentiality.
  3118. Informed Consent and Parental Right to the Child’s Medical Chart.
  3119. PREPARATION FOR DIAGNOSTIC AND THERAPEUTIC PROCEDURES
  3120. Psychologic Preparation
  3121. BOX 22-1 General Guidelines for Preparing Children for Procedures
  3122. NURSINGTIP
  3123. Establish Trust and Provide Support.
  3124. Parental Presence and Support.
  3125. BOX 22-2 Age-Specific Preparation of Children for Procedures Based on Developmental Characteristics
  3126. INFANT: DEVELOPING A SENSE OF TRUST AND SENSORIMOTOR THOUGHT
  3127. Attachment to Parent
  3128. Stranger Anxiety
  3129. Sensorimotor Phase of Learning
  3130. Increased Muscle Control
  3131. Memory for Past Experiences
  3132. Imitation of Gestures
  3133. TODDLER: DEVELOPING A SENSE OF AUTONOMY AND SENSORIMOTOR TO PREOPERATIONAL THOUGHT
  3134. Egocentric Thought
  3135. Negative Behavior
  3136. Animism
  3137. Limited Language Skills
  3138. Limited Concept of Time
  3139. Striving for Independence
  3140. PRESCHOOLER: DEVELOPING INITIATIVE AND PREOPERATIONAL THOUGHT
  3141. Egocentric
  3142. Increased Language Skills
  3143. Limited Concept of Time and Frustration Tolerance
  3144. Illness and Hospitalization Viewed as Punishment
  3145. Animism
  3146. Fears of Bodily Harm, Intrusion, and Castration
  3147. Striving for Initiative
  3148. SCHOOL-AGE CHILD: DEVELOPING INDUSTRY AND CONCRETE THOUGHT
  3149. Increased Language Skills; Interest in Acquiring Knowledge
  3150. Improved Concept of Time
  3151. Increased Self-Control
  3152. Striving for Industry
  3153. Developing Relationships with Peers
  3154. ADOLESCENT: DEVELOPING IDENTITY AND ABSTRACT THOUGHT
  3155. Increasing Abstract Thought and Reasoning
  3156. Conscious of Appearance
  3157. Concerned More with Present Than with Future
  3158. Striving for Independence
  3159. Developing Peer Relationships and Group Identity
  3160. Provide an Explanation.
  3161. nursingcareguidelines
  3162. Selecting Nonthreatening Words or Phrases
  3163. NURSINGTIP
  3164. Physical Preparation.
  3165. Performance of the Procedure
  3166. NURSINGTIP
  3167. Expect Success.
  3168. Involve the Child.
  3169. Provide Distraction.
  3170. NURSINGTIP
  3171. Allow Expression of Feelings.
  3172. FIG. 22-1 Playing with hospital equipment provides children with the opportunity to play out fears and concerns.
  3173. Postprocedural Support
  3174. Encourage Expression of Feelings.
  3175. Provide Positive Reinforcement.
  3176. Use of Play in Procedures
  3177. NURSINGTIP
  3178. SURGICAL PROCEDURES
  3179. Preoperative Care
  3180. BOX 22-3 Play Activities for Specific Procedures
  3181. FLUID INTAKE
  3182. DEEP BREATHING
  3183. RANGE OF MOTION AND USE OF EXTREMITIES
  3184. SOAKS
  3185. INJECTIONS
  3186. AMBULATION
  3187. EXTENDING ENVIRONMENT (e.g., FOR PATIENTS IN TRACTION)
  3188. FIG. 22-2 Parental presence during induction of anesthesia can minimize child’s and parents’ anxiety during the preoperative period.
  3189. TABLE 22-1 Fasting Recommendations to Reduce the Risk of Pulmonary Aspiration*
  3190. Preoperative Sedation.
  3191. Postoperative Care
  3192. nursingcareguidelines
  3193. Postoperative Care
  3194. NURSINGTIP
  3195. TABLE 22-2 Potential Causes of Postoperative Vital Sign Alterations in Children
  3196. COMPLIANCE
  3197. Compliance Strategies
  3198. BOX 22-4 Factors That Positively Influence Compliance
  3199. INDIVIDUAL AND FAMILY FACTORS
  3200. CARE SETTING FACTORS
  3201. TREATMENT FACTORS
  3202. nursingcareguidelines
  3203. Effective Teaching of Family Members
  3204. NURSINGTIP
  3205. GENERAL HYGIENE AND CARE
  3206. MAINTAINING HEALTHY SKIN*
  3207. nursingcareguidelines
  3208. Skin Care
  3209. BATHING
  3210. ORAL HYGIENE
  3211. HAIR CARE
  3212. NURSINGTIP
  3213. FEEDING THE SICK CHILD
  3214. nursingcareguidelines
  3215. Feeding the Sick Child
  3216. CONTROLLING ELEVATED TEMPERATURES
  3217. Fever
  3218. Hyperthermia
  3219. FAMILY TEACHING AND HOME CARE
  3220. FAMILY-CENTERED CARE
  3221. The Child with Fever
  3222. CALL THE OFFICE IMMEDIATELY IF:
  3223. CALL WITHIN 24 HOURS IF:
  3224. SAFETY
  3225. ENVIRONMENTAL FACTORS
  3226. FIG. 22-3 To prevent needlestick injuries, used needles (and other sharp instruments) are not capped or broken and are disposed of in a rigid, puncture-resistant container located near the site of use. Note placement of the container to prevent children’s access to the contents.
  3227. Toy Safety
  3228. FIG. 22-4 Nurse maintains hand contact when back is turned.
  3229. Preventing Falls
  3230. INFECTION CONTROL
  3231. BOX 22-5 Types of Precautions and Patients Requiring Them
  3232. STANDARD PRECAUTIONS
  3233. AIRBORNE PRECAUTIONS
  3234. DROPLET PRECAUTIONS
  3235. CONTACT PRECAUTIONS
  3236. NURSINGALERT
  3237. NURSINGALERT
  3238. TRANSPORTING INFANTS AND CHILDREN
  3239. RESTRAINING METHODS AND THERAPEUTIC HOLDING
  3240. FIG. 22-5 Transporting infants. A, Infant’s thigh firmly grasped in nurse’s hand. B, Football hold. C, Back supported.
  3241. FIG. 22-6 Therapeutic holding of child for extremity venipuncture with parental assistance.
  3242. Jacket Restraint
  3243. Mummy Restraint or Swaddle
  3244. Arm and Leg Restraints
  3245. FIG. 22-7 Application of mummy restraint. A, Infant placed on folded corner of blanket and one corner of blanket brought across body and secured beneath body. B, Second corner brought across body and secured, and lower corner folded and tucked or pinned in place; modified mummy restraint with chest uncovered.
  3246. Elbow Restraint
  3247. POSITIONING FOR PROCEDURES
  3248. Femoral Venipuncture
  3249. FIG. 22-8 Restraining infant for femoral venipuncture.
  3250. Extremity Venipuncture
  3251. Lumbar Puncture
  3252. FIG. 22-9 Child in side-lying position for lumbar puncture.
  3253. ATRAUMATIC CARE
  3254. Lumbar Puncture and Bone Marrow Test
  3255. NURSINGALERT
  3256. Bone Marrow Aspiration or Biopsy
  3257. COLLECTION OF SPECIMENS
  3258. URINE SPECIMENS
  3259. NURSINGTIP
  3260. FIG. 22-10 Application of urine collection bag. A, On female infants, adhesive portion is applied to exposed and dried perineum first. B, Bag adheres firmly around perineal area to prevent urine leakage.
  3261. FYI
  3262. NURSINGTIP
  3263. Clean-Catch Specimens
  3264. FYI
  3265. Twenty-Four-Hour Collection
  3266. Bladder Catheterization and Other Techniques
  3267. TABLE 22-3 Straight Catheter or Foley Catheter*
  3268. NURSINGALERT
  3269. EVIDENCE-BASED PRACTICE
  3270. Use of Lidocaine Lubricant for Urethral Catheterization
  3271. ASK THE QUESTION
  3272. SEARCH FOR EVIDENCE
  3273. Search Strategies
  3274. Databases Used
  3275. CRITICALLY ANALYZE THE EVIDENCE
  3276. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  3277. References
  3278. CULTURAL AWARENESS
  3279. Bladder Catheterization
  3280. STOOL SPECIMENS
  3281. NURSINGTIP
  3282. BLOOD SPECIMENS
  3283. NURSINGTIP
  3284. NURSINGALERT
  3285. EVIDENCE-BASED PRACTICE
  3286. Obtaining Blood Specimens from Central Venous Catheters in Children
  3287. ASK THE QUESTION
  3288. SEARCH FOR EVIDENCE
  3289. Search Strategies
  3290. Databases Used
  3291. CRITICALLY ANALYZE THE EVIDENCE
  3292. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  3293. References
  3294. FIG. 22-11 Puncture site (colored stippled area) on sole of infant’s foot.
  3295. ATRAUMATIC CARE
  3296. Guidelines for Skin and Vessel Punctures
  3297. FOR REDUCTION OF PAIN ASSOCIATED WITH HEEL, FINGER, VENOUS, OR ARTERIAL PUNCTURES
  3298. FOR MULTIPLE BLOOD SAMPLES
  3299. FOR HEEL LANCING IN NEWBORNS
  3300. RESPIRATORY SECRETION SPECIMENS
  3301. ADMINISTRATION OF MEDICATION
  3302. DETERMINATION OF DRUG DOSAGE
  3303. Checking Dosage
  3304. Identification
  3305. ORAL ADMINISTRATION
  3306. Preparation
  3307. ATRAUMATIC CARE
  3308. Encouraging a Child’s Acceptance of Oral Medication
  3309. Administration
  3310. NURSINGTIP
  3311. INTRAMUSCULAR ADMINISTRATION
  3312. Selecting the Syringe and Needle
  3313. FIG. 22-12 Nurse partially restrains child for easy and comfortable administration of oral medication.
  3314. Determining the Site
  3315. Administration
  3316. TABLE 22-4 Intramuscular Injection Sites in Children
  3317. FIG. 22-13 Holding small child for intramuscular injection. Note how nurse isolates and stabilizes muscle.
  3318. nursingcareguidelines
  3319. Intramuscular Administration of Medication
  3320. SUBCUTANEOUS AND INTRADERMAL ADMINISTRATION
  3321. EVIDENCE-BASED PRACTICE
  3322. Medication Safety and Insulin Therapy
  3323. ASK THE QUESTION
  3324. SEARCH FOR EVIDENCE
  3325. Search Strategies
  3326. Databases Used
  3327. CRITICALLY ANALYZE THE EVIDENCE
  3328. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  3329. References
  3330. NURSINGTIP
  3331. INTRAVENOUS ADMINISTRATION
  3332. Peripheral Intermittent Infusion Device
  3333. Central Venous Access Device
  3334. NURSINGALERT
  3335. EVIDENCE-BASED PRACTICE
  3336. Normal Saline or Heparinized Saline Flush Solution in Pediatric Intravenous Lines
  3337. ASK THE QUESTION
  3338. SEARCH FOR EVIDENCE
  3339. Search Strategies
  3340. Databases Used
  3341. CRITICALLY ANALYZE THE EVIDENCE
  3342. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  3343. References
  3344. TABLE 22-5 Comparison of Long-Term Central Venous Access Devices
  3345. NURSINGALERT
  3346. FIG. 22-14 Venous access devices. A, Blood being drawn from a central venous catheter. B, Child with external central venous catheter. C, Child with implanted port with Huber needle in place. D, Side view of implanted port.
  3347. TABLE 22-6 Flush Guidelines
  3348. EVIDENCE-BASED PRACTICE
  3349. Central Venous Catheter Site Care
  3350. ASK THE QUESTIONS
  3351. SEARCH FOR EVIDENCE
  3352. Search Strategies
  3353. Databases Used
  3354. CRITICALLY ANALYZE THE EVIDENCE
  3355. Dressing Protocol.
  3356. Skin Antisepsis.
  3357. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  3358. References
  3359. NURSINGTIP
  3360. NURSINGALERT
  3361. NASOGASTRIC, OROGASTRIC, OR GASTROSTOMY ADMINISTRATION
  3362. RECTAL ADMINISTRATION
  3363. OPTIC, OTIC, AND NASAL ADMINISTRATION
  3364. nursingcareguidelines
  3365. Nasogastric, Orogastric, or Gastrostomy Medication Administration in Children
  3366. NURSINGTIP
  3367. FIG. 22-15 Administering eye drops.
  3368. NURSINGALERT
  3369. FIG. 22-16 Proper position for instilling nose drops.
  3370. FAMILY TEACHING AND HOME CARE
  3371. NURSINGTIP
  3372. NURSINGTIP
  3373. MAINTAINING FLUID BALANCE
  3374. MEASUREMENT OF INTAKE AND OUTPUT
  3375. NURSINGTIP
  3376. Special Needs When the Child Is NPO
  3377. NURSINGTIP
  3378. PARENTERAL FLUID THERAPY
  3379. Site and Equipment
  3380. NURSINGTIP
  3381. FIG. 22-17 Preferred sites for venous access in infants.
  3382. FIG. 22-18 Transilluminator: low-heat light-emitting diode (LED) light placed on the skin to illuminate veins; an opening allows cannulation of vein.
  3383. EVIDENCE-BASED PRACTICE
  3384. Use of Transillumination Devices in Obtaining Vascular Access
  3385. ASK THE QUESTION
  3386. SEARCH FOR EVIDENCE
  3387. Search Strategies
  3388. Databases Used
  3389. CRITICALLY ANALYZE THE EVIDENCE
  3390. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  3391. References
  3392. Safety Catheters and Needleless Systems
  3393. FIG. 22-19 Interlink intravenous access systems. A, Blue spike syringe. B, Preslit injection port (needleless). C, Blunt plastic cannula syringe. D, Lever lock cannula. E, Threaded lock cannula.
  3394. NURSINGALERT
  3395. Infusion Pumps
  3396. Securement of a Peripheral Intravenous Line
  3397. FIG. 22-20 StatLock securement devices enhance peripheral intravenous line dwell time and decrease phlebitis.
  3398. FIG. 22-21 I.V. House used to protect intravenous site.
  3399. NURSINGALERT
  3400. EVIDENCE-BASED PRACTICE
  3401. Peripheral Intravenous Site Care
  3402. ASK THE QUESTION
  3403. SEARCH FOR EVIDENCE
  3404. Search Strategies
  3405. Databases Used
  3406. CRITICALLY ANALYZE THE EVIDENCE
  3407. Site Preparation.
  3408. Site Dressing.
  3409. Stabilization or Securement Devices.
  3410. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  3411. References
  3412. Removal of a Peripheral Intravenous Line
  3413. NURSINGALERT
  3414. EVIDENCE-BASED PRACTICE
  3415. Frequency of Changing Intravenous Administration Sets
  3416. ASK THE QUESTION
  3417. SEARCH FOR EVIDENCE
  3418. Search Strategies
  3419. Databases Used
  3420. CRITICALLY ANALYZE THE EVIDENCE
  3421. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  3422. References
  3423. Complications
  3424. NURSINGALERT
  3425. NURSINGALERT
  3426. PROCEDURES FOR MAINTAINING RESPIRATORY FUNCTION
  3427. INHALATION THERAPY
  3428. Oxygen Therapy
  3429. FIG. 22-22 Oxygen administered to infant by means of a plastic hood. Note oxygen analyzer (blue machine).
  3430. FIG. 22-23 The tent provides a comfortable method for oxygen administration.
  3431. NURSINGALERT
  3432. NURSINGALERT
  3433. Oxygen Toxicity.
  3434. Monitoring Oxygen Therapy
  3435. FIG. 22-24 Oximeter sensor on great toe. Note that sensor is positioned with light-emitting diode opposite photodetector. Cord is secured to foot to minimize movement of sensor.
  3436. NURSINGALERT
  3437. NURSINGTIP
  3438. Aerosol Therapy
  3439. BRONCHIAL (POSTURAL) DRAINAGE
  3440. CHEST PHYSICAL THERAPY
  3441. ARTIFICIAL VENTILATION
  3442. Artificial Airways
  3443. Tracheostomy
  3444. Suctioning.
  3445. FIG. 22-25 Bronchial drainage positions for all major segments of child. For each position, model of tracheobronchial tree is projected beside child to show segmental bronchus (red) being drained and pathway of secretions out of bronchus. Drainage platform is horizontal unless otherwise noted. Red area on child’s chest indicates area to be cupped or vibrated by therapist. A, Apical segment of right upper lobe and apical subsegment of apical-posterior segment of left upper lobe. B, Posterior segment of right upper lobe and posterior subsegment of apical-posterior segment of left upper lobe. C, Anterior segments of both upper lobes. Child should be rotated slightly away from side being drained. D, Superior segments of both lower lobes. E, Posterior basal segments of both lower lobes. F, Lateral basal segments of right lower lobe. Left lateral basal segment would be drained by mirror image of this position (right side down). G, Anterior basal segment of left lower lobe. Right anterior basal segment would be drained by mirror image of this position (left side down). H, Medial and lateral segments of right middle lobe. I, Lingular segments (superior and inferior) of left upper lobe (homologue of right middle lobe). (From Chernick V, editor: Kendig’s disorders of the respiratory tract of children, ed 6, Philadelphia, 1998, Saunders.)
  3446. FIG. 22-26 A, Cupped hand position for percussion. B, Device for infant percussion.
  3447. NURSINGALERT
  3448. FYI
  3449. FIG. 22-27 Silastic pediatric tracheostomy tube and obturator.
  3450. FIG. 22-28 Tracheostomy suctioning. A, Insertion, port open. B, Withdrawal, port occluded. Note that catheter is inserted just slightly beyond end of tracheostomy tube.
  3451. NURSINGALERT
  3452. EVIDENCE-BASED PRACTICE
  3453. Normal Saline Instillation Before Suctioning–Helpful or Harmful?
  3454. ASK THE QUESTION
  3455. SEARCH FOR EVIDENCE
  3456. Search Strategies
  3457. Databases Used
  3458. CRITICALLY ANALYZE THE EVIDENCE
  3459. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  3460. References
  3461. Routine Care.
  3462. FIG. 22-29 Tracheostomy ties are snug but allow one finger to be inserted.
  3463. Emergency Care: Tube Occlusion and Accidental Decannulation.
  3464. NURSINGALERT
  3465. PROCEDURES RELATED TO ALTERNATIVE FEEDING TECHNIQUES
  3466. NURSINGALERT
  3467. GAVAGE FEEDING
  3468. ATRAUMATIC CARE
  3469. Reducing the Distress of Nasogastric Tube Insertion
  3470. FIG. 22-30 Gavage feeding. A, Measuring tube for orogastric feeding from tip of nose to earlobe and to midpoint between end of xiphoid process and umbilicus. B, Inserting tube.
  3471. TABLE 22-7 Recommended Minimum Insertion Lengths for Orogastric Tubes in Very Low–Birth-Weight Infants
  3472. NURSINGALERT
  3473. GASTROSTOMY FEEDING
  3474. nursingcareguidelines
  3475. Nasogastric Tube Feedings in Children
  3476. EVIDENCE-BASED PRACTICE
  3477. Assessing Correct Placement of Nasogastric or Orogastric Tubes in Children
  3478. ASK THE QUESTION
  3479. SEARCH FOR EVIDENCE
  3480. Search Strategies
  3481. Databases Used
  3482. CRITICALLY ANALYZE THE EVIDENCE
  3483. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  3484. References
  3485. FIG. 22-31 Appearance of healthy granulation tissue around stoma.
  3486. NASODUODENAL AND NASOJEJUNAL TUBES
  3487. TOTAL PARENTERAL NUTRITION
  3488. FIG. 22-32 Child with skin-level gastrostomy device (MIC-KEY), which provides for secure attachment of extension tubing to gastrostomy opening.
  3489. FAMILY TEACHING AND HOME CARE
  3490. PROCEDURES RELATED TO ELIMINATION
  3491. ENEMA
  3492. NURSINGTIP
  3493. nursingcareguidelines
  3494. Administration of Enemas to Children
  3495. FYI
  3496. OSTOMIES
  3497. FAMILY TEACHING AND HOME CARE
  3498. KEY POINTS
  3499. References
  3500. UNIT NINE THE CHILD WITH PROBLEMS RELATED TO THE TRANSFER OF OXYGEN AND NUTRIENTS
  3501. Interactive Review — Unit Nine
  3502. Chapter 23 The Child with Respiratory Dysfunction
  3503. LEARNING OBJECTIVES
  3504. RELATED TOPICS and ADDITIONAL RESOURCES
  3505. IN TEXT
  3506. RESPIRATORY INFECTION
  3507. Etiology and Characteristics
  3508. Infectious Agents.
  3509. Age.
  3510. Size.
  3511. Resistance.
  3512. Seasonal Variations.
  3513. Clinical Manifestations
  3514. Nursing Care Management
  3515. Ease Respiratory Efforts.
  3516. BOX 23-1 Signs and Symptoms Associated with Respiratory Tract Infections in Infants and Small Children
  3517. FEVER
  3518. POOR FEEDING AND ANOREXIA
  3519. VOMITING
  3520. DIARRHEA
  3521. ABDOMINAL PAIN
  3522. NASAL BLOCKAGE
  3523. NASAL DISCHARGE
  3524. COUGH
  3525. RESPIRATORY SOUNDS
  3526. SORE THROAT
  3527. MENINGISMUS
  3528. BOX 23-2 Components for Assessing Respiratory Function
  3529. RESPIRATIONS
  3530. OTHER OBSERVATIONS
  3531. nursingprocess: The Child with Acute Respiratory Tract Infection
  3532. ASSESSMENT
  3533. DIAGNOSES (PROBLEM IDENTIFICATION)
  3534. PLANNING
  3535. IMPLEMENTATION
  3536. EVALUATION
  3537. Promote Rest.
  3538. Promote Comfort.
  3539. Prevent Spread of Infection.
  3540. Reduce Body Temperature.
  3541. NURSINGALERT
  3542. Promote Hydration.
  3543. Provide Nutrition.
  3544. Family Support and Home Care.
  3545. UPPER RESPIRATORY TRACT INFECTIONS
  3546. NASOPHARYNGITIS
  3547. Therapeutic Management
  3548. nursingcareplan: The Child with Acute Respiratory Tract Infection
  3549. BOX 23-3 Clinical Manifestations of Nasopharyngitis and Pharyngitis
  3550. NASOPHARYNGITIS
  3551. Younger Child
  3552. Older Child
  3553. Physical Assessment Signs
  3554. PHARYNGITIS
  3555. Younger Child
  3556. Older Child
  3557. Physical Assessment Signs
  3558. Younger Child
  3559. Older Child
  3560. Prevention.
  3561. Nursing Care Management
  3562. BOX 23-4 Early Evidence of Respiratory Complications
  3563. Family Support.
  3564. PHARYNGITIS
  3565. FIG. 23-1 Tonsillitis and pharyngitis.
  3566. Clinical Manifestations
  3567. Diagnostic Evaluation
  3568. Therapeutic Management
  3569. Nursing Care Management
  3570. TONSILLITIS
  3571. Pathophysiology
  3572. FIG. 23-2 Location of various tonsillar masses.
  3573. Etiology
  3574. Clinical Manifestations
  3575. Therapeutic Management
  3576. Nursing Care Management
  3577. NURSINGALERT
  3578. Family Support and Home Care.
  3579. INFLUENZA
  3580. Clinical Manifestations
  3581. Therapeutic Management
  3582. Prevention.
  3583. Nursing Care Management
  3584. OTITIS MEDIA
  3585. Etiology
  3586. BOX 23-5 Standard Terminology for Otitis Media
  3587. Pathophysiology
  3588. Diagnostic Evaluation
  3589. BOX 23-6 Clinical Manifestations of Otitis Media
  3590. ACUTE OTITIS MEDIA
  3591. Infant or Very Young Child
  3592. Older Child
  3593. CHRONIC OTITIS MEDIA
  3594. Therapeutic Management
  3595. Prevention.
  3596. Nursing Care Management
  3597. INFECTIOUS MONONUCLEOSIS
  3598. Etiology and Pathophysiology
  3599. Diagnostic Tests
  3600. Therapeutic Management
  3601. BOX 23-7 Clinical Manifestations of Infectious Mononucleosis
  3602. EARLY SIGNS
  3603. ACUTE DISEASE
  3604. Cardinal Features
  3605. Common Features
  3606. Prognosis.
  3607. Nursing Care Management
  3608. NURSINGALERT
  3609. TABLE 23-1 Comparison of Croup Syndromes
  3610. CROUP SYNDROMES
  3611. ACUTE EPIGLOTTITIS
  3612. Clinical Manifestations
  3613. NURSINGALERT
  3614. NURSINGALERT
  3615. Therapeutic Management
  3616. Nursing Care Management
  3617. NURSINGALERT
  3618. CRITICAL THINKING EXERCISE
  3619. Croup Syndrome
  3620. QUESTIONS
  3621. ACUTE LARYNGITIS
  3622. Therapeutic Management and Nursing Care Management
  3623. ACUTE LARYNGOTRACHEOBRONCHITIS
  3624. BOX 23-8 Progression of Symptoms in Laryngotracheobronchitis
  3625. STAGE I
  3626. STAGE II
  3627. STAGE III
  3628. STAGE IV
  3629. Therapeutic Management
  3630. Nursing Care Management
  3631. NURSINGALERT
  3632. ACUTE SPASMODIC LARYNGITIS
  3633. Therapeutic Management and Nursing Care Management
  3634. BACTERIAL TRACHEITIS
  3635. Therapeutic Management and Nursing Care Management
  3636. INFECTIONS OF THE LOWER AIRWAYS
  3637. TABLE 23-2 Comparison of Conditions Affecting the Bronchi
  3638. BRONCHITIS
  3639. RESPIRATORY SYNCYTIAL VIRUS AND BRONCHIOLITIS
  3640. Pathophysiology
  3641. Clinical Manifestations
  3642. Diagnostic Evaluation
  3643. Therapeutic Management
  3644. BOX 23-9 Signs and Symptoms of Respiratory Syncytial Virus
  3645. INITIAL
  3646. WITH PROGRESSION OF ILLNESS
  3647. SEVERE ILLNESS
  3648. Prevention of RSV Infection
  3649. NURSINGALERT
  3650. Nursing Care Management
  3651. PNEUMONIAS
  3652. BOX 23-10 General Signs of Pneumonia
  3653. Viral Pneumonia
  3654. Primary Atypical Pneumonia
  3655. Severe Acute Respiratory Syndrome
  3656. Nursing Care Management.
  3657. Avian Influenza Virus
  3658. Bacterial Pneumonia
  3659. Complications.
  3660. Prognosis.
  3661. Prevention.
  3662. Nursing Care Management
  3663. FIG. 23-3 Child placed in semierect position is often more comfortable, and this position enhances diaphragmatic expansion.
  3664. OTHER INFECTIONS OF THE RESPIRATORY TRACT
  3665. PERTUSSIS (WHOOPING COUGH)
  3666. TUBERCULOSIS
  3667. BOX 23-11 Clinical Manifestations of Tuberculosis
  3668. Diagnostic Evaluation
  3669. BOX 23-12 Tuberculin Skin Test (TST) Recommendations for Infants, Children, and Adolescents*
  3670. CHILDREN FOR WHOM IMMEDIATE TST IS INDICATED
  3671. CHILDREN WHO SHOULD HAVE ANNUAL TST‡
  3672. CHILDREN WHO SOME EXPERTS RECOMMEND SHOULD BE TESTED EVERY 2 TO 3 YEARS
  3673. CHILDREN WHO SOME EXPERTS RECOMMEND SHOULD BE CONSIDERED FOR TST AT 4 TO 6 AND 11 TO 16 YEARS
  3674. CHILDREN AT INCREASED RISK FOR PROGRESSION OF INFECTION TO DISEASE
  3675. BOX 23-13 Definition of Positive Tuberculin Skin Test (TST) Results in Infants, Children, and Adolescents*
  3676. INDURATION ≥5 mm
  3677. INDURATION ≥10 mm
  3678. INDURATION ≥15 mm
  3679. Therapeutic Management
  3680. Prognosis.
  3681. Prevention.
  3682. Nursing Care Management
  3683. PULMONARY DYSFUNCTION CAUSED BY NONINFECTIOUS IRRITANTS
  3684. FOREIGN BODY ASPIRATION
  3685. Diagnostic Evaluation
  3686. Therapeutic Management
  3687. Nursing Care Management
  3688. NURSINGALERT
  3689. Prevention.
  3690. ASPIRATION PNEUMONIA
  3691. Nursing Care Management
  3692. ACUTE RESPIRATORY DISTRESS SYNDROME/ACUTE LUNG INJURY
  3693. Prognosis.
  3694. Nursing Care Management
  3695. SMOKE INHALATION INJURY
  3696. NURSINGALERT
  3697. Therapeutic Management
  3698. Nursing Care Management
  3699. ENVIRONMENTAL TOBACCO SMOKE EXPOSURE
  3700. Nursing Care Management
  3701. LONG-TERM RESPIRATORY DYSFUNCTION
  3702. ASTHMA
  3703. FAMILY-CENTERED CARE
  3704. Decreasing Childhood Exposure to Environmental Tobacco Smoke
  3705. BOX 23-14 Asthma Severity Classification in Children: Ages 0 to 11*
  3706. STEP 5 OR 6: SEVERE PERSISTENT ASTHMA
  3707. STEP 3 OR 4: MODERATE PERSISTENT ASTHMA
  3708. STEP 2: MILD PERSISTENT ASTHMA
  3709. STEP 1: INTERMITTENT ASTHMA
  3710. Etiology
  3711. BOX 23-15 Triggers Tending to Precipitate or Aggravate Asthmatic Exacerbations
  3712. Pathophysiology
  3713. FIG. 23-4 Mechanisms of obstruction in asthma.
  3714. Diagnostic Evaluation
  3715. NURSINGALERT
  3716. BOX 23-16 Clinical Manifestations of Asthma
  3717. COUGH
  3718. RESPIRATORY-RELATED SIGNS
  3719. CHEST
  3720. WITH REPEATED EPISODES
  3721. nursingcareguidelines
  3722. Interpreting Peak Expiratory Flow Rates*
  3723. Therapeutic Management
  3724. FAMILY-CENTERED CARE
  3725. “Allergy-Proofing” the Home and Community
  3726. Allergen Control.
  3727. Drug Therapy.
  3728. Exercise.
  3729. Chest Physical Therapy.
  3730. Hyposensitization.
  3731. Prognosis.
  3732. Status Asthmaticus.
  3733. NURSINGALERT
  3734. Nursing Care Management
  3735. Avoid Allergens.
  3736. NURSINGALERT
  3737. Relieve Bronchospasm.
  3738. nursingcareplan: The Child with Asthma
  3739. FIG. 23-5 Child using metered-dose inhaler with spacer and face mask.
  3740. FAMILY-CENTERED CARE
  3741. Use of a Peak Expiratory Flow Meter
  3742. FAMILY-CENTERED CARE
  3743. Use of a Metered-Dose Inhaler*
  3744. STEPS FOR CHECKING HOW MUCH MEDICINE IS IN THE CANISTER
  3745. STEPS FOR USING THE INHALER
  3746. NURSINGALERT
  3747. Provide Acute Asthma Care.
  3748. FIG. 23-6 Child with asthma is allowed play activity as tolerated.
  3749. Support Child or Adolescent and Family.
  3750. FIG. 23-7 Children with asthma may take a nebulized aerosol treatment with (A) a mask or (B) mouthpiece.
  3751. CYSTIC FIBROSIS
  3752. Pathophysiology
  3753. FIG. 23-8 Various effects of exocrine gland dysfunction in cystic fibrosis.
  3754. BOX 23-17 Clinical Manifestations of Cystic Fibrosis
  3755. MECONIUM ILEUS*
  3756. GASTROINTESTINAL MANIFESTATIONS
  3757. PULMONARY MANIFESTATIONS
  3758. Diagnostic Evaluation
  3759. Therapeutic Management
  3760. Management of Pulmonary Problems.
  3761. FIG. 23-9 Child using Flutter mucus clearance device.
  3762. NURSINGALERT
  3763. Management of Gastrointestinal Problems.
  3764. Management of Endocrine Problems.
  3765. Prognosis.
  3766. Nursing Care Management
  3767. Hospital Care.
  3768. Home Care.
  3769. Family Support.
  3770. ETHICAL CASE STUDY: Cystic Fibrosis and End-of-Life Care
  3771. ETHICAL DECISION MAKING MODEL
  3772. Evaluate the Issue
  3773. Treat All Involved with Respect
  3774. Hear All Sides
  3775. Initiate Action
  3776. Consider the Outcome
  3777. Transition to Adulthood.
  3778. OBSTRUCTIVE SLEEP-DISORDERED BREATHING
  3779. RESPIRATORY EMERGENCY
  3780. RESPIRATORY FAILURE
  3781. Diagnostic Evaluation
  3782. Therapeutic Management
  3783. BOX 23-18 Clinical Manifestations of Respiratory Failure
  3784. CARDINAL SIGNS
  3785. EARLY BUT LESS OBVIOUS SIGNS
  3786. SIGNS OF MORE SEVERE HYPOXIA
  3787. Nursing Care Management
  3788. CARDIOPULMONARY RESUSCITATION
  3789. Resuscitation Procedure
  3790. Open the Airway.
  3791. Give Breaths.
  3792. Pulse Check.
  3793. FIG. 23-10 Summary of basic life support maneuvers for infants, children, and adults (newborn-neonatal information not included). CPR, Cardiopulmonary resuscitation; HCP, maneuvers used only by health care provider; AED, automated external defibrillator.
  3794. FIG. 23-11 Open airway using the head tilt—chin lift maneuver and check breathing.
  3795. FIG. 23-12 Mouth-to—mouth and nose breathing for infant.
  3796. FIG. 23-13 Locating brachial pulse in infant.
  3797. FIG. 23-14 Combining chest compressions with breathing in infant.
  3798. Chest Compression.
  3799. FIG. 23-15 Chest compressions in child: one hand for smaller child (A) and two hands for larger child (B).
  3800. Medications.
  3801. FIG. 23-16 Relief of foreign body obstruction in infant. A, Back blows. B, Chest thrusts.
  3802. TABLE 23-3 Drugs for Pediatric Cardiopulmonary Resuscitation
  3803. AIRWAY OBSTRUCTION
  3804. NURSINGALERT
  3805. Infants
  3806. FIG. 23-17 Abdominal thrusts in standing child for relief of foreign body obstruction.
  3807. Children
  3808. FIG. 23-18 Recovery position for child after respiratory emergency.
  3809. KEY POINTS
  3810. answers to CRITIAL THINKING EXERCISE
  3811. CROUP SYNDROME
  3812. References
  3813. Chapter 24 The Child with Gastrointestinal Dysfunction
  3814. LEARNING OBJECTIVES
  3815. RELATED TOPICS and ADDITIONAL RESOURCES
  3816. IN TEXT
  3817. GASTROINTESTINAL DYSFUNCTION
  3818. DEHYDRATION
  3819. Water Balance in Infants
  3820. Body Surface Area.
  3821. BOX 24-1 Clinical Manifestations of Gastrointestinal Dysfunction in Children
  3822. Basal Metabolic Rate.
  3823. Kidney Function.
  3824. Fluid Requirements.
  3825. BOX 24-2 Daily Maintenance Fluid Requirements
  3826. Types of Dehydration
  3827. Diagnostic Evaluation
  3828. TABLE 24-1 Evaluating Extent of Dehydration
  3829. Therapeutic Management
  3830. Nursing Care Management
  3831. Intake and Output.
  3832. DISORDERS OF MOTILITY
  3833. DIARRHEA
  3834. Etiology
  3835. TABLE 24-2 Infectious Causes of Acute Diarrhea
  3836. Pathophysiology
  3837. Diagnostic Evaluation
  3838. Therapeutic Management
  3839. BOX 24-3 Model for Rehydration
  3840. Prevention
  3841. NURSINGALERT
  3842. Nursing Care Management
  3843. CRITICAL THINKING EXERCISE
  3844. Diarrhea
  3845. QUESTIONS
  3846. nursingprocess: The Child with Diarrhea
  3847. ASSESSMENT
  3848. DIAGNOSIS (PROBLEM IDENTIFICATION)
  3849. PLANNING
  3850. IMPLEMENTATION
  3851. EVALUATION
  3852. Prevention.
  3853. NURSINGALERT
  3854. CONSTIPATION
  3855. Newborn Period
  3856. Infancy
  3857. Childhood
  3858. CRITICAL THINKING EXERCISE
  3859. Constipation
  3860. QUESTIONS
  3861. Nursing Care Management
  3862. BOX 24-4 High-Fiber Foods
  3863. BREAD, GRAINS
  3864. VEGETABLES
  3865. FRUITS
  3866. MISCELLANEOUS
  3867. HIRSCHSPRUNG DISEASE
  3868. Pathophysiology
  3869. FIG. 24-1 Hirschsprung disease.
  3870. BOX 24-5 Clinical Manifestations of Hirschsprung Disease
  3871. NEWBORN PERIOD
  3872. INFANCY
  3873. CHILDHOOD
  3874. Diagnostic Evaluation
  3875. Therapeutic Management
  3876. Prognosis.
  3877. Nursing Care Management
  3878. Preoperative Care.
  3879. Postoperative Care.
  3880. Discharge Care.
  3881. VOMITING
  3882. Therapeutic Management
  3883. Nursing Care Management
  3884. GASTROESOPHAGEAL REFLUX
  3885. BOX 24-6 Clinical Manifestations and Complications of Gastroesophageal Reflux
  3886. SYMPTOMS IN INFANTS
  3887. SYMPTOMS IN CHILDREN
  3888. COMPLICATIONS
  3889. Pathophysiology
  3890. Diagnostic Evaluation
  3891. Therapeutic Management
  3892. FIG. 24-2 Nissen fundoplication sutures passing through esophageal musculature.
  3893. Nursing Care Management
  3894. FUNCTIONAL ABDOMINAL PAIN DISORDERS
  3895. Etiology
  3896. Pathophysiology
  3897. Diagnostic Evaluation
  3898. Therapeutic Management
  3899. Nursing Care Management
  3900. INFLAMMATORY DISORDERS
  3901. ACUTE APPENDICITIS
  3902. Etiology
  3903. Pathophysiology
  3904. Diagnostic Evaluation
  3905. BOX 24-7 Clinical Manifestations of Appendicitis
  3906. NURSINGALERT
  3907. Therapeutic Management
  3908. Ruptured Appendix.
  3909. Prognosis.
  3910. Nursing Care Management
  3911. NURSINGALERT
  3912. Postoperative Care.
  3913. MECKEL DIVERTICULUM
  3914. nursingcareplan The Child with Appendicitis
  3915. Pathophysiology
  3916. Diagnostic Evaluation
  3917. Therapeutic Management
  3918. Prognosis.
  3919. BOX 24-8 Clinical Manifestations of Meckel Diverticulum
  3920. ABDOMINAL PAIN
  3921. BLOODY STOOLS*
  3922. SOMETIMES
  3923. Nursing Care Management
  3924. INFLAMMATORY BOWEL DISEASE
  3925. Etiology
  3926. TABLE 24-3 Clinical Manifestations of Inflammatory Bowel Diseases
  3927. Pathophysiology of Ulcerative Colitis
  3928. Pathophysiology of Crohn Disease
  3929. Diagnostic Evaluation
  3930. Therapeutic Management
  3931. Medical Treatment.
  3932. Nutritional Support.
  3933. Surgical Treatment.
  3934. Prognosis.
  3935. Nursing Care Management
  3936. CRITICAL THINKING EXERCISE
  3937. Inflammatory Bowel Disease
  3938. QUESTIONS
  3939. Family Support.
  3940. PEPTIC ULCER DISEASE
  3941. Etiology
  3942. Pathophysiology
  3943. Diagnostic Evaluation
  3944. BOX 24-9 Characteristics of Peptic Ulcers
  3945. NEONATES
  3946. INFANTS TO 3-YEAR-OLD CHILDREN
  3947. 2- TO 6-YEAR-OLD CHILDREN
  3948. CHILDREN 6 YEARS AND OLDER
  3949. Therapeutic Management
  3950. Prognosis.
  3951. Nursing Care Management
  3952. HEPATIC DISORDERS
  3953. ACUTE HEPATITIS
  3954. Etiology
  3955. Hepatitis A.
  3956. Hepatitis B.
  3957. TABLE 24-4 Comparison of Types A, B, and C Hepatitis
  3958. Hepatitis C.
  3959. Hepatitis D.
  3960. Hepatitis E.
  3961. Hepatitis G.
  3962. Diagnostic Evaluation
  3963. Pathophysiology
  3964. Therapeutic Management
  3965. Prevention.
  3966. Prognosis.
  3967. Nursing Care Management
  3968. CIRRHOSIS
  3969. Therapeutic Management
  3970. Prognosis.
  3971. FAMILY FOCUS
  3972. End-Stage Liver Disease
  3973. Nursing Care Management
  3974. BILIARY ATRESIA
  3975. Etiology and Pathophysiology
  3976. Diagnostic Evaluation
  3977. BOX 24-10 Clinical Manifestations of Extrahepatic Biliary Atresia
  3978. Therapeutic Management
  3979. Prognosis.
  3980. ETHICAL CASE STUDY: Liver Transplant
  3981. ETHICAL DECISION MAKING MODEL
  3982. Treat All Involved with Respect
  3983. Hear All Sides
  3984. Initiate Action
  3985. Consider the Outcome
  3986. Nursing Care Management
  3987. STRUCTURAL DEFECTS
  3988. CLEFT LIP OR CLEFT PALATE
  3989. Etiology
  3990. FIG. 24-3 Variations in clefts of lip and palate at birth. A, Notch in vermilion border. B, Unilateral cleft lip and palate. C, Bilateral cleft lip and palate. D, Cleft palate.
  3991. Pathophysiology
  3992. Diagnostic Evaluation
  3993. Therapeutic Management
  3994. Surgical Correction of Cleft Lip.
  3995. Surgical Correction of Cleft Palate.
  3996. Prognosis.
  3997. Nursing Care Management
  3998. Feeding.
  3999. Preoperative Care.
  4000. Postoperative Care for Cleft Lip.
  4001. Postoperative Care of Cleft Palate.
  4002. NURSINGALERT
  4003. Long-Term Care.
  4004. ESOPHAGEAL ATRESIA WITH TRACHEOESOPHAGEAL FISTULA
  4005. Etiology
  4006. Pathophysiology
  4007. FIG. 24-4 A-E, Five most common types of esophageal atresia and tracheoesophageal fistula.
  4008. nursingprocess: The Child with a Cleft Lip or Cleft Palate
  4009. ASSESSMENT
  4010. DIAGNOSIS (PROBLEM IDENTIFICATION)
  4011. PLANNING
  4012. IMPLEMENTATION
  4013. EVALUATION
  4014. Diagnostic Evaluation
  4015. BOX 24-11 Clinical Manifestations of Tracheoesophageal Fistula
  4016. Therapeutic Management
  4017. Prognosis.
  4018. Nursing Care Management
  4019. NURSINGALERT
  4020. Postoperative Care.
  4021. Special Problems.
  4022. HERNIAS
  4023. OBSTRUCTIVE DISORDERS
  4024. HYPERTROPHIC PYLORIC STENOSIS
  4025. Pathophysiology
  4026. Diagnostic Evaluation
  4027. TABLE 24-5 Summary Outline of Hernias
  4028. BOX 24-12 Clinical Manifestations of Mechanical/Paralytic Intestinal Obstruction
  4029. Therapeutic Management
  4030. Prognosis.
  4031. Nursing Care Management
  4032. Preoperative Care.
  4033. FIG. 24-5 Hypertrophic pyloric stenosis. A, Enlarged muscular area nearly obliterates pyloric channel. B, Longitudinal surgical division of muscle down to submucosa establishes adequate passageway.
  4034. BOX 24-13 Clinical Manifestations of Hypertrophic Pyloric Stenosis
  4035. Postoperative Care.
  4036. INTUSSUSCEPTION
  4037. FIG. 24-6 Ileocolic intussusception.
  4038. Pathophysiology
  4039. NURSINGALERT
  4040. Diagnostic Evaluation
  4041. BOX 24-14 Clinical Manifestations of Intussusception
  4042. Therapeutic Management
  4043. Prognosis.
  4044. Nursing Care Management
  4045. NURSINGALERT
  4046. MALROTATION AND VOLVULUS
  4047. Diagnostic Evaluation
  4048. Therapeutic Management
  4049. Nursing Care Management
  4050. ANORECTAL MALFORMATIONS
  4051. Diagnostic Evaluation
  4052. TABLE 24-6 Classification of Anorectal Malformations
  4053. Therapeutic Management
  4054. Nursing Care Management
  4055. Family Support, Discharge Planning, and Home Care.
  4056. MALABSORPTION SYNDROMES
  4057. CELIAC DISEASE
  4058. Pathophysiology
  4059. Diagnostic Evaluation
  4060. BOX 24-15 Clinical Manifestations of Celiac Disease
  4061. IMPAIRED FAT ABSORPTION
  4062. IMPAIRED NUTRIENT ABSORPTION
  4063. BEHAVIORAL CHANGES
  4064. CELIAC CRISIS*
  4065. Therapeutic Management
  4066. Prognosis.
  4067. Nursing Care Management
  4068. SHORT-BOWEL SYNDROME
  4069. Therapeutic Management
  4070. Prognosis.
  4071. Nursing Care Management
  4072. KEY POINTS
  4073. answers to CRITIAL THINKING EXERCISE
  4074. DIARRHEA
  4075. CONSTIPATION
  4076. INFLAMMATORY BOWEL DISEASE
  4077. References
  4078. UNIT TEN THE CHILD WITH PROBLEMS RELATED TO THE PRODUCTION AND CIRCULATION OF BLOOD
  4079. Interactive Review — Unit Ten
  4080. Chapter 25 The Child with Cardiovascular Dysfunction
  4081. LEARNING OBJECTIVES
  4082. RELATED TOPICS and ADDITIONAL RESOURCES
  4083. IN TEXT
  4084. CARDIOVASCULAR DYSFUNCTION
  4085. History and Physical Examination
  4086. Inspection
  4087. Palpation and Percussion
  4088. Auscultation
  4089. Diagnostic Evaluation
  4090. TABLE 25-1 Procedures for Cardiac Diagnosis
  4091. Electrocardiogram.
  4092. NURSINGTIP
  4093. Echocardiography.
  4094. Cardiac Catheterization.
  4095. TABLE 25-2 Current Interventional Cardiac Catheterization Procedures in Children
  4096. Nursing Care Management
  4097. Preprocedural Care.
  4098. Postprocedural Care.
  4099. NURSINGALERT
  4100. CONGENITAL HEART DISEASE
  4101. FAMILY-CENTERED CARE
  4102. After Cardiac Catheterization
  4103. CRITICAL THINKING EXERCISE
  4104. Cardiac Catheterization
  4105. QUESTIONS
  4106. FIG. 25-1 Changes in circulation at birth. A,Prenatal circulation. B, Postnatal circulation. Arrows indicate direction of blood flow. Although four pulmonary veins enter the LA, for simplicity this diagram shows only two. RA, Right atrium; LA, left atrium; RV, right ventricle; LV, left ventricle.
  4107. CIRCULATORY CHANGES AT BIRTH
  4108. ALTERED HEMODYNAMICS
  4109. CLASSIFICATION OF DEFECTS
  4110. FIG. 25-2 Comparison of acyanotic-cyanotic and hemodynamic classification systems of congenital heart disease.
  4111. Defects with Increased Pulmonary Blood Flow
  4112. Obstructive Defects
  4113. Defects with Decreased Pulmonary Blood Flow
  4114. BOX 25-1 Defects with Increased Pulmonary Blood Flow
  4115. ATRIAL SEPTAL DEFECT
  4116. VENTRICULAR SEPTAL DEFECT
  4117. ATRIOVENTRICULAR CANAL DEFECT
  4118. PATENT DUCTUS ARTERIOSUS
  4119. FIG. 25-3 Hemodynamics in defects with increased pulmonary blood flow. See Fig. 25-1 for abbreviations.
  4120. FIG. 25-4 Obstruction to ventricular ejection can occur at the valvular level (shown), below the valve (subvalvular), or above the valve (supravalvular). Pulmonary stenosis is shown here. Ao, Aorta; PA, pulmonary artery. See Fig. 25-1 for additional abbreviations.
  4121. FIG. 25-5 Hemodynamic defects with decreased pulmonary blood flow. See Fig. 25-1 for abbreviations.
  4122. Mixed Defects
  4123. BOX 25-2 Obstructive Defects
  4124. COARCTATION OF THE AORTA
  4125. AORTIC STENOSIS
  4126. Valvular Aortic Stenosis
  4127. Subvalvular Aortic Stenosis
  4128. PULMONIC STENOSIS
  4129. BOX 25-3 Defects with Decreased Pulmonary Blood Flow
  4130. TETRALOGY OF FALLOT
  4131. TRICUSPID ATRESIA
  4132. BOX 25-4 Mixed Defects
  4133. TRANSPOSITION OF THE GREAT ARTERIES, OR TRANSPOSITION OF THE GREAT VESSELS
  4134. TOTAL ANOMALOUS PULMONARY VENOUS CONNECTION
  4135. TRUNCUS ARTERIOSUS
  4136. HYPOPLASTIC LEFT HEART SYNDROME
  4137. CLINICAL CONSEQUENCES OF CONGENITAL HEART DISEASE
  4138. CONGESTIVE HEART FAILURE
  4139. FIG. 25-6 Pathophysiology of congestive heart failure. ADH, Antidiuretic hormone.
  4140. Pathophysiology
  4141. BOX 25-5 Clinical Manifestations of Congestive Heart Failure
  4142. IMPAIRED MYOCARDIAL FUNCTION
  4143. PULMONARY CONGESTION
  4144. SYSTEMIC VENOUS CONGESTION
  4145. Diagnostic Evaluation
  4146. Therapeutic Management
  4147. Improve Cardiac Function.
  4148. NURSINGALERT
  4149. Remove Accumulated Fluid and Sodium.
  4150. NURSINGALERT
  4151. Decrease Cardiac Demands.
  4152. Improve Tissue Oxygenation.
  4153. TABLE 25-3 Diuretics Used in Congestive Heart Failure
  4154. NURSINGALERT
  4155. Nursing Care Management
  4156. Assist in Measures to Improve Cardiac Function.
  4157. BOX 25-6 Common Signs of Digoxin Toxicity in Children
  4158. GASTROINTESTINAL
  4159. CARDIAC
  4160. nursingprocess
  4161. The Child with Congestive Heart Failure
  4162. ASSESSMENT
  4163. DIAGNOSIS (PROBLEM IDENTIFICATION)
  4164. PLANNING
  4165. IMPLEMENTATION
  4166. EVALUATION
  4167. nursingcareplan
  4168. The Child with Congestive Heart Failure (CHF)
  4169. NURSINGALERT
  4170. FAMILY-CENTERED CARE
  4171. Administering Digoxin
  4172. Monitor Afterload Reduction.
  4173. CRITICAL THINKING EXERCISE
  4174. Digoxin Toxicity
  4175. QUESTIONS
  4176. Decrease Cardiac Demands.
  4177. Reduce Respiratory Distress.
  4178. Maintain Nutritional Status.
  4179. Assist in Measures to Promote Fluid Loss.
  4180. NURSINGTIP
  4181. Support Child and Family.
  4182. HYPOXEMIA
  4183. Clinical Manifestations
  4184. FIG. 25-7 Clubbing of the fingers.
  4185. Therapeutic Management
  4186. CRITICAL THINKING EXERCISE
  4187. Hypercyanotic Spell
  4188. QUESTIONS
  4189. Nursing Care Management
  4190. FIG. 25-8 Infant held in knee-chest position.
  4191. nursingcareguidelines
  4192. Treating Hypercyanotic Spells
  4193. TABLE 25-4 Selected Shunt Procedures for Children with Cardiac Defects
  4194. FIG. 25-9 Schematic diagram of cardiac shunts.
  4195. NURSINGALERT
  4196. NURSING CARE OF THE FAMILY AND CHILD WITH CONGENITAL HEART DISEASE
  4197. HELP FAMILY ADJUST TO THE DISORDER
  4198. FAMILY FOCUS
  4199. Diagnosis of Heart Disease
  4200. EDUCATE FAMILY ABOUT THE DISORDER
  4201. HELP FAMILIES MANAGE THE ILLNESS AT HOME
  4202. PREPARE CHILD AND FAMILY FOR INVASIVE PROCEDURES
  4203. PROVIDE POSTOPERATIVE CARE
  4204. Observe Vital Signs
  4205. BOX 25-7 Selected Complications After Cardiac Surgery and Treatment Approaches
  4206. CARDIAC
  4207. RESPIRATORY
  4208. NEUROLOGIC
  4209. INFECTIOUS DISEASE
  4210. HEMATOLOGIC
  4211. OTHER
  4212. Maintain Respiratory Status
  4213. NURSINGALERT
  4214. NURSINGALERT
  4215. Monitor Fluids
  4216. NURSINGALERT
  4217. Provide Rest and Progressive Activity
  4218. Provide Comfort and Emotional Support
  4219. FAMILY-CENTERED CARE
  4220. Topics to Include in Discharge Teaching After Cardiac Surgery
  4221. PLAN FOR DISCHARGE AND HOME CARE
  4222. ACQUIRED CARDIOVASCULAR DISORDERS
  4223. BACTERIAL (INFECTIVE) ENDOCARDITIS
  4224. Pathophysiology
  4225. Diagnostic Evaluation
  4226. Therapeutic Management
  4227. Nursing Care Management
  4228. BOX 25-8 Clinical Manifestations of Infective Endocarditis
  4229. BOX 25-9 Cardiac Conditions Associated with the Highest Risk of Adverse Outcome from Endocarditis
  4230. nursingcareguidelines
  4231. Diagnosis of Initial Attack of Rheumatic Fever (Jones Criteria, 1992 Update)*
  4232. MAJOR MANIFESTATIONS
  4233. Carditis
  4234. Polyarthritis
  4235. Erythema Marginatum
  4236. Chorea (St. Vitus Dance, Sydenham Chorea)
  4237. Subcutaneous Nodes
  4238. MINOR MANIFESTATIONS
  4239. Clinical Findings
  4240. Laboratory Findings
  4241. SUPPORTING EVIDENCE OF ANTECEDENT GROUP A STREPTOCOCCAL INFECTION
  4242. RHEUMATIC FEVER
  4243. Etiology
  4244. Diagnostic Evaluation
  4245. Therapeutic Management
  4246. Nursing Care Management
  4247. HYPERLIPIDEMIA (HYPERCHOLESTEROLEMIA)
  4248. TABLE 25-5 Classification of Cholesterol Levels in Children from Families with a History of Heart Disease
  4249. Diagnostic Evaluation
  4250. Therapeutic Management
  4251. EVIDENCE-BASED PRACTICE
  4252. Cholesterol Screening for Children
  4253. ASK THE QUESTION
  4254. SEARCH FOR EVIDENCE
  4255. Search Strategies
  4256. Databases Used
  4257. CRITICALLY ANALYZE THE EVIDENCE
  4258. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  4259. References
  4260. Nursing Care Management
  4261. CARDIAC DYSRHYTHMIAS
  4262. Diagnostic Evaluation
  4263. Bradydysrhythmias.
  4264. Tachydysrhythmias.
  4265. PULMONARY ARTERY HYPERTENSION
  4266. Clinical Manifestations
  4267. Therapeutic Management
  4268. CARDIOMYOPATHY
  4269. Therapeutic Management
  4270. Nursing Care Management
  4271. HEART TRANSPLANTATION
  4272. Nursing Care Management
  4273. VASCULAR DYSFUNCTION
  4274. SYSTEMIC HYPERTENSION
  4275. Etiology
  4276. Diagnostic Evaluation
  4277. BOX 25-10 Clinical Manifestations of Hypertension
  4278. ADOLESCENTS AND OLDER CHILDREN
  4279. INFANTS OR YOUNG CHILDREN
  4280. Therapeutic Management
  4281. Nursing Care Management
  4282. KAWASAKI DISEASE (MUCOCUTANEOUS LYMPH NODE SYNDROME)
  4283. BOX 25-11 Diagnostic Criteria for Kawasaki Disease
  4284. Pathophysiology
  4285. Clinical Manifestations
  4286. Cardiac Involvement.
  4287. Therapeutic Management
  4288. Prognosis.
  4289. Nursing Care Management
  4290. Discharge Teaching.
  4291. SHOCK
  4292. Pathophysiology
  4293. BOX 25-12 Types of Shock
  4294. HYPOVOLEMIC
  4295. Characteristics
  4296. Most Frequent Causes
  4297. DISTRIBUTIVE
  4298. Characteristics
  4299. Most Frequent Causes
  4300. CARDIOGENIC
  4301. Characteristic
  4302. Most Frequent Causes
  4303. BOX 25-13 Clinical Manifestations of Shock
  4304. COMPENSATED
  4305. DECOMPENSATED
  4306. IRREVERSIBLE
  4307. Diagnostic Evaluation
  4308. Therapeutic Management
  4309. Ventilatory Support.
  4310. Cardiovascular Support.
  4311. Nursing Care Management
  4312. NURSINGALERT
  4313. ANAPHYLAXIS
  4314. emergencytreatment
  4315. Shock
  4316. VENTILATION
  4317. FLUID ADMINISTRATION
  4318. CARDIOVASCULAR SUPPORT
  4319. GENERAL SUPPORT
  4320. IN ADDITION:
  4321. Septic Shock
  4322. Anaphylaxis
  4323. NURSINGALERT
  4324. Clinical Manifestations
  4325. Therapeutic Management
  4326. Nursing Care Management
  4327. SEPTIC SHOCK
  4328. BOX 25-14 Definitions of Systemic Inflammatory Response Syndrome, Infection, Sepsis, and Severe Sepsis
  4329. TABLE 25-6 Age-Specific Vital Signs and Laboratory Variables in Septic Shock*
  4330. TOXIC SHOCK SYNDROME
  4331. Diagnostic Evaluation
  4332. Therapeutic Management
  4333. Nursing Care Management
  4334. BOX 25-15 Criteria for Definition of Toxic Shock Syndrome
  4335. KEY POINTS
  4336. answers to CRITIAL THINKING EXERCISE
  4337. CARDIAC CATHETERIZATION
  4338. DIGOXIN TOXICITY
  4339. HYPERCYANOTIC SPELL
  4340. References
  4341. Chapter 26 The Child with Hematologic or Immunologic Dysfunction
  4342. LEARNING OBJECTIVES
  4343. RELATED TOPICS and ADDITIONAL RESOURCES
  4344. IN TEXT
  4345. HEMATOLOGIC AND IMMUNOLOGIC DYSFUNCTION
  4346. FYI
  4347. RED BLOOD CELL DISORDERS
  4348. ANEMIA
  4349. Classification
  4350. Consequences of Anemia
  4351. TABLE 26-1 Tests Performed as Part of the Complete Blood Cell Count
  4352. FIG. 26-1 Classifications of anemias. AIHA, Autoimmune hemolytic anemia; ALL, acute lymphoid leukemia; CMV, cytomegalovirus; DIC, disseminated intravascular coagulation; G6PD, glucose-6-phosphate dehydrogenase; ITP, idiopathic thrombocytopenic purpura.
  4353. BOX 26-1 Red Blood Cell Morphology
  4354. SIZE (CELL SIZE)
  4355. SHAPE (CELL SHAPE)
  4356. COLOR (CELL STAINING CHARACTERISTICS)
  4357. Diagnostic Evaluation
  4358. Therapeutic Management
  4359. Nursing Care Management
  4360. Prepare Child and Family for Laboratory Tests.
  4361. NURSINGTIP
  4362. Red blood cells
  4363. White blood cells
  4364. Platelets
  4365. Plasma
  4366. Decrease Tissue Oxygen Needs.
  4367. NURSINGALERT
  4368. Prevent Complications.
  4369. IRON DEFICIENCY ANEMIA
  4370. Pathophysiology
  4371. Therapeutic Management
  4372. Prognosis.
  4373. Nursing Care Management
  4374. NURSINGTIP
  4375. Diet.
  4376. SICKLE CELL ANEMIA
  4377. Pathophysiology
  4378. FIG. 26-2 Differences between effects of normal (A) and sickled (B) red blood cells on circulation with related complications. CVA, Cerebrovascular accident.
  4379. BOX 26-2 Clinical Manifestations of Sickle Cell Anemia
  4380. GENERAL
  4381. VASOOCCLUSIVE CRISIS
  4382. SEQUESTRATION CRISIS
  4383. EFFECTS OF CHRONIC VASOOCCLUSIVE PHENOMENA
  4384. Heart
  4385. Lungs
  4386. Kidneys
  4387. Liver
  4388. Spleen
  4389. Eyes
  4390. Extremities
  4391. Central nervous system
  4392. Clinical Manifestations
  4393. Diagnostic Evaluation
  4394. Therapeutic Management
  4395. ETHICAL CASE STUDY Sickle Cell Disease
  4396. ETHICAL DECISION MAKING MODEL
  4397. Evaluate the Issue
  4398. Treat All Involved with Respect
  4399. Hear All Sides
  4400. Initiate Action
  4401. Consider the Outcome
  4402. EVIDENCE-BASED PRACTICE
  4403. Sickle Cell Anemia and Penicillin Prophylaxis
  4404. ASK THE QUESTION
  4405. SEARCH FOR EVIDENCE
  4406. Search Strategies
  4407. Databases Used
  4408. CRITICALLY ANALYZE THE EVIDENCE
  4409. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  4410. References
  4411. NURSINGALERT
  4412. Prognosis.
  4413. Nursing Care Management
  4414. Educate Family and Child.
  4415. NURSINGTIP
  4416. FAMILY FOCUS
  4417. Fear of Addiction
  4418. Promote Supportive Therapies During Crises.
  4419. NURSINGALERT
  4420. Recognize Other Complications.
  4421. NURSINGALERT
  4422. Support Family.
  4423. β-THALASSEMIA (COOLEY ANEMIA)
  4424. Pathophysiology
  4425. BOX 26-3 Clinical Manifestations of b-Thalassemia
  4426. ANEMIA (BEFORE DIAGNOSIS)
  4427. PROGRESSIVE ANEMIA
  4428. OTHER FEATURES
  4429. BONE CHANGES (OLDER CHILDREN IF UNTREATED)
  4430. Diagnostic Evaluation
  4431. Therapeutic Management
  4432. NURSINGALERT
  4433. Prognosis.
  4434. Nursing Care Management
  4435. APLASTIC ANEMIA
  4436. Etiology
  4437. Diagnostic Evaluation
  4438. Therapeutic Management
  4439. BOX 26-4 Common Causes of Acquired Aplastic Anemia
  4440. Nursing Care Management
  4441. DEFECTS IN HEMOSTASIS
  4442. HEMOPHILIA
  4443. Pathophysiology
  4444. BOX 26-5 Clinical Manifestations of Hemophilia
  4445. Diagnostic Evaluation
  4446. Therapeutic Management
  4447. Prognosis.
  4448. Nursing Care Management
  4449. Prevent Bleeding.
  4450. Recognize and Control Bleeding.
  4451. Prevent Crippling Effects of Bleeding.
  4452. Support Family and Prepare for Home Care.
  4453. IDIOPATHIC THROMBOCYTOPENIC PURPURA
  4454. BOX 26-6 Clinical Manifestations of Idiopathic Thrombocytopenic Purpura
  4455. Diagnostic Evaluation
  4456. Therapeutic Management
  4457. BOX 26-7 Criteria for Anti-D Antibody Therapy
  4458. NURSINGALERT
  4459. Prognosis.
  4460. Nursing Care Management
  4461. FIG. 26-3 Effects of disseminated intravascular coagulation. RBC, Red blood cell.
  4462. DISSEMINATED INTRAVASCULAR COAGULATION
  4463. Pathophysiology
  4464. Diagnostic Evaluation
  4465. BOX 26-8 Clinical Manifestations of Disseminated Intravascular Coagulation
  4466. Therapeutic Management
  4467. Nursing Care Management
  4468. EPISTAXIS (NOSEBLEEDING)
  4469. Nursing Care Management
  4470. emergencytreatment
  4471. Epistaxis
  4472. NEOPLASTIC DISORDERS
  4473. Leukemias
  4474. Classification
  4475. Morphology.
  4476. Pathophysiology
  4477. TABLE 26-2 Pathology and Related Clinical Manifestations of Leukemia
  4478. Diagnostic Evaluation
  4479. Therapeutic Management
  4480. Hematopoietic Stem Cell Transplantation.
  4481. Prognosis
  4482. Late Effects of Treatment
  4483. Nursing Care Management
  4484. Prepare Child and Family for Diagnostic and Therapeutic Procedures.
  4485. Relieve Pain.
  4486. nursingcareplan
  4487. The Child with Cancer
  4488. Prevent Complications of Myelosuppression.
  4489. Infection
  4490. NURSINGALERT
  4491. nursingcareguidelines
  4492. Calculating the Absolute Neutrophil Count
  4493. EXAMPLE:
  4494. Hemorrhage
  4495. Anemia
  4496. Use Precautions in Administering and Handling Chemotherapeutic Agents.
  4497. NURSINGALERT
  4498. NURSINGALERT
  4499. Manage Problems of Drug Toxicity.
  4500. Nausea and Vomiting
  4501. Anorexia
  4502. Mucosal Ulceration
  4503. NURSINGALERT
  4504. Neuropathy
  4505. Hemorrhagic Cystitis
  4506. NURSINGALERT
  4507. Alopecia
  4508. NURSINGTIP
  4509. Moon Face
  4510. Mood Changes
  4511. Provide Emotional Support.
  4512. Lymphomas
  4513. HODGKIN DISEASE
  4514. FIG. 26-4 Main areas of lymphadenopathy and organ involvement in Hodgkin disease.
  4515. Therapeutic Management
  4516. Prognosis.
  4517. Nursing Care Management
  4518. NON-HODGKIN LYMPHOMA
  4519. Diagnostic Evaluation
  4520. Therapeutic Management
  4521. Prognosis.
  4522. Nursing Care Management
  4523. IMMUNOLOGIC DEFICIENCY DISORDERS
  4524. HUMAN IMMUNODEFICIENCY VIRUS INFECTION AND ACQUIRED IMMUNODEFICIENCY SYNDROME
  4525. Epidemiology
  4526. Etiology
  4527. Pathophysiology
  4528. Clinical Manifestations
  4529. Diagnostic Evaluation
  4530. BOX 26-9 Common Clinical Manifestations of Human Immunodeficiency Virus Infection in Children
  4531. BOX 26-10 Common Defining Conditions for Acquired Immunodeficiency Syndrome in Children
  4532. Therapeutic Management
  4533. TABLE 26-3 Pediatric HIV Infection Classification*
  4534. TABLE 26-4 Immunologic Categories Based on Age-Specific CD4 T-Lymphocyte Counts and Percent of Total Lymphocytes
  4535. Prognosis.
  4536. Nursing Care Management
  4537. FAMILY FOCUS
  4538. Caregivers and the Infant with Human Immunodeficiency Virus Infection
  4539. nursingprocess
  4540. The Child with Human Immunodeficiency Virus Infection
  4541. ASSESSMENT
  4542. DIAGNOSIS (PROBLEM IDENTIFICATION)
  4543. PLANNING
  4544. IMPLEMENTATION
  4545. EVALUATION
  4546. SEVERE COMBINED IMMUNODEFICIENCY DISEASE
  4547. Therapeutic Management
  4548. Nursing Care Management
  4549. WISKOTT-ALDRICH SYNDROME
  4550. Nursing Care Management
  4551. TECHNOLOGIC MANAGEMENT OF HEMATOLOGIC AND IMMUNOLOGIC DISORDERS
  4552. BLOOD TRANSFUSION THERAPY
  4553. TABLE 26-5 Nursing Care of the Child Receiving Blood Transfusions
  4554. HEMATOPOIETIC STEM CELL TRANSPLANTATION
  4555. Nursing Care Management
  4556. APHERESIS
  4557. FAMILY FOCUS
  4558. The Decision for a Hematopoietic Stem Cell Transplant
  4559. Nursing Care Management
  4560. KEY POINTS
  4561. References
  4562. UNIT ELEVEN THE CHILD WITH A DISTURBANCE OF REGULATORY MECHANISMS
  4563. Interactive Review — Unit Eleven
  4564. Chapter 27 The Child with Genitourinary Dysfunction
  4565. LEARNING OBJECTIVES
  4566. RELATED TOPICS and ADDITIONAL RESOURCES
  4567. IN TEXT
  4568. GENITOURINARY DYSFUNCTION
  4569. Clinical Manifestations
  4570. Laboratory Tests
  4571. Nursing Care Management
  4572. GENITOURINARY TRACT DISORDERS AND DEFECTS
  4573. Urinary Tract Infection
  4574. Classification
  4575. Etiology
  4576. Anatomic and Physical Factors.
  4577. TABLE 27-1 Radiologic and Other Tests of Urinary System Function
  4578. TABLE 27-2 Urine Tests of Renal Function
  4579. TABLE 27-3 Blood Tests of Renal Function
  4580. FYI
  4581. Altered Urine and Bladder Chemistry.
  4582. Diagnostic Evaluation
  4583. NURSINGALERT
  4584. BOX 27-1 Clinical Manifestations of Urinary Tract Disorders or Disease
  4585. NEONATAL PERIOD (BIRTH TO 1 MONTH)
  4586. INFANCY (1 TO 24 MONTHS)
  4587. CHILDHOOD (2 TO 14 YEARS)
  4588. Therapeutic Management
  4589. Vesicoureteral Reflux.
  4590. Prognosis.
  4591. Nursing Care Management
  4592. NURSINGTIP
  4593. Prevention.
  4594. nursingcareguidelines
  4595. Prevention of Urinary Tract Infection
  4596. FACTORS PREDISPOSING TO DEVELOPMENT
  4597. MEASURES OF PREVENTION
  4598. CRITICAL THINKING EXERCISE
  4599. Urinary Tract Infection and Constipation
  4600. QUESTIONS
  4601. OBSTRUCTIVE UROPATHY
  4602. FIG. 27-1 Major sites of urinary tract obstruction.
  4603. Nursing Care Management
  4604. EXTERNAL DEFECTS
  4605. Psychologic Problems Related to Genital Surgery
  4606. TABLE 27-4 Defects of the Genitourinary Tract
  4607. Nursing Care Management
  4608. GLOMERULAR DISEASE
  4609. NEPHROTIC SYNDROME
  4610. FIG. 27-2 Sequence of events in nephrotic syndrome. ADH, Antidiuretic hormone.
  4611. Pathophysiology
  4612. Diagnostic Evaluation
  4613. BOX 27-2 Clinical Manifestations of Nephrotic Syndrome
  4614. Therapeutic Management
  4615. Prognosis.
  4616. Nursing Care Management
  4617. NURSINGTIP
  4618. Family Support and Home Care.
  4619. ACUTE GLOMERULONEPHRITIS
  4620. Etiology
  4621. BOX 27-3 Clinical Manifestations of Acute Poststreptococcal Glomerulonephritis
  4622. Pathophysiology
  4623. Diagnostic Evaluation
  4624. Therapeutic Management
  4625. Prognosis.
  4626. Nursing Care Management
  4627. MISCELLANEOUS RENAL DISORDERS
  4628. HEMOLYTIC UREMIC SYNDROME
  4629. BOX 27-4 Clinical Manifestations of Hemolytic Uremic Syndrome
  4630. BOX 27-5 Clinical Manifestations of Wilms Tumor
  4631. Pathophysiology
  4632. Diagnostic Evaluation
  4633. Therapeutic Management
  4634. Prognosis.
  4635. Nursing Care Management
  4636. WILMS TUMOR
  4637. Etiology
  4638. Diagnostic Evaluation
  4639. NURSINGALERT
  4640. BOX 27-6 Staging of Wilms Tumor
  4641. Stage I
  4642. Stage II
  4643. Stage III
  4644. Stage IV
  4645. Stage V
  4646. Therapeutic Management
  4647. Prognosis.
  4648. Nursing Care Management
  4649. Preoperative Care.
  4650. Postoperative Care.
  4651. Family Support.
  4652. NURSINGALERT
  4653. RENAL FAILURE
  4654. ACUTE RENAL FAILURE
  4655. Pathophysiology
  4656. Diagnostic Evaluation
  4657. BOX 27-7 Clinical Manifestations of Acute Renal Failure
  4658. NURSINGALERT
  4659. NURSINGALERT
  4660. Therapeutic Management
  4661. Complications.
  4662. Prognosis.
  4663. Nursing Care Management
  4664. Family Support.
  4665. nursingcareplan: The Child with Acute Renal Dysfunction
  4666. CHRONIC RENAL FAILURE
  4667. Pathophysiology
  4668. Diagnostic Evaluation
  4669. Therapeutic Management
  4670. BOX 27-8 Clinical Manifestations of Chronic Renal Failure
  4671. Prognosis.
  4672. Nursing Care Management
  4673. FAMILY FOCUS
  4674. Family Priorities
  4675. TECHNOLOGIC MANAGEMENT OF RENAL FAILURE
  4676. DIALYSIS
  4677. NURSINGALERT
  4678. TRANSPLANTATION
  4679. FIG. 27-3 Diversional activities help lessen the boredom children can experience during hemodialysis.
  4680. NURSINGALERT
  4681. KEY POINTS
  4682. answers to CRITIAL THINKING EXERCISE
  4683. URINARY TRACT INFECTION AND CONSTIPATION
  4684. References
  4685. Chapter 28 The Child with Cerebral Dysfunction
  4686. LEARNING OBJECTIVES
  4687. RELATED TOPICS and ADDITIONAL RESOURCES
  4688. IN TEXT
  4689. CEREBRAL DYSFUNCTION
  4690. GENERAL ASPECTS
  4691. INCREASED INTRACRANIAL PRESSURE
  4692. BOX 28-1 Clinical Manifestations of Increased Intracranial Pressure in Infants and Children
  4693. INFANTS
  4694. CHILDREN
  4695. PERSONALITY AND BEHAVIORAL SIGNS
  4696. LATE SIGNS
  4697. BOX 28-2 Levels of Consciousness
  4698. ALTERED STATES OF CONSCIOUSNESS
  4699. Levels of Consciousness
  4700. Coma Assessment
  4701. FIG. 28-1 Pediatric coma scale.
  4702. NURSINGALERT
  4703. NEUROLOGIC EXAMINATION
  4704. Vital Signs
  4705. Skin
  4706. Eyes
  4707. FIG. 28-2 Variations in pupil size with altered states of consciousness. A, Ipsilateral pupillary constriction with slight ptosis. B, Bilateral small pupils. C, Midposition, light fixed to all stimuli. D, Bilateral dilated and fixed pupils. E, Dilated pupils, left eye abducted with ptosis. F, Pinpoint pupils.
  4708. NURSINGALERT
  4709. NURSINGALERT
  4710. NURSINGALERT
  4711. Motor Function
  4712. FIG. 28-3 A, Flexion posturing. B, Extension posturing.
  4713. Posturing
  4714. Reflexes
  4715. NURSINGALERT
  4716. SPECIAL DIAGNOSTIC PROCEDURES
  4717. TABLE 28-1 Neurologic Diagnostic Procedures
  4718. NURSING CARE OF THE UNCONSCIOUS CHILD
  4719. NURSINGALERT
  4720. RESPIRATORY MANAGEMENT
  4721. NURSINGALERT
  4722. INTRACRANIAL PRESSURE MONITORING
  4723. NURSINGALERT
  4724. NURSINGALERT
  4725. CRITICAL THINKING EXERCISE
  4726. Hydrocephalus
  4727. QUESTIONS
  4728. Nursing Activities
  4729. NURSINGALERT
  4730. Suctioning
  4731. NUTRITION AND HYDRATION
  4732. Altered Pituitary Secretion
  4733. MEDICATIONS
  4734. THERMOREGULATION
  4735. ELIMINATION
  4736. HYGIENIC CARE
  4737. NURSINGALERT
  4738. POSITIONING AND EXERCISE
  4739. STIMULATION
  4740. Regaining Consciousness
  4741. FAMILY SUPPORT
  4742. CEREBRAL TRAUMA
  4743. HEAD INJURY
  4744. Etiology
  4745. Pathophysiology
  4746. FIG. 28-4 Mechanical distortion of cranium during closed head injury. A, Preinjury contour of skull. B, Immediate postinjury contour of skull. C, Torn subdural vessels. D, Shearing forces. E, Trauma from contact with floor of cranium.
  4747. Concussion.
  4748. FIG. 28-5 A, Epidural (extradural) hematoma and compression of temporal lobe through tentorial hiatus. B, Subdural hematoma.
  4749. Contusion and Laceration.
  4750. Fractures.
  4751. Complications
  4752. NURSINGALERT
  4753. Epidural Hemorrhage.
  4754. Subdural Hemorrhage.
  4755. BOX 28-3 Clinical Manifestations of Acute Head Injury
  4756. MINOR INJURY
  4757. SIGNS OF PROGRESSION
  4758. SEVERE INJURY
  4759. ASSOCIATED SIGNS
  4760. NURSINGALERT
  4761. Cerebral Edema.
  4762. NURSINGALERT
  4763. Diagnostic Evaluation
  4764. NURSINGALERT
  4765. Initial Assessment.
  4766. NURSINGALERT
  4767. NURSINGALERT
  4768. NURSINGALERT
  4769. emergencytreatment
  4770. Head Injury
  4771. Special Tests.
  4772. Posttraumatic Syndromes.
  4773. Therapeutic Management
  4774. FAMILY FOCUS
  4775. Maintaining Contact
  4776. Surgical Therapy.
  4777. Prognosis.
  4778. Nursing Care Management
  4779. NURSINGALERT
  4780. Family Support.
  4781. Rehabilitation.
  4782. Prevention.
  4783. NEAR-DROWNING
  4784. Pathophysiology
  4785. Therapeutic Management
  4786. BOX 28-4 Clinical Manifestations of Near-Drowning
  4787. CATEGORY A
  4788. CATEGORY B
  4789. CATEGORY C
  4790. NURSINGALERT
  4791. Prognosis.
  4792. Nursing Care Management
  4793. nursingcareguidelines
  4794. Establishing Brain Death in Children
  4795. Prevention.
  4796. NERVOUS SYSTEM TUMORS
  4797. BRAIN TUMORS
  4798. Diagnostic Evaluation
  4799. Therapeutic Management
  4800. Prognosis.
  4801. Nursing Care Management
  4802. Prevent Postoperative Complications.
  4803. NURSINGALERT
  4804. NURSINGALERT
  4805. NURSINGALERT
  4806. NURSINGALERT
  4807. Support Child and Family.
  4808. NEUROBLASTOMA
  4809. Diagnostic Evaluation
  4810. Therapeutic Management
  4811. Prognosis.
  4812. Nursing Care Management
  4813. INTRACRANIAL INFECTIONS
  4814. BACTERIAL MENINGITIS
  4815. Pathophysiology
  4816. Clinical Manifestations
  4817. EVIDENCE-BASED PRACTICE
  4818. Children with Bacterial Meningitis and Preventive Vaccines
  4819. ASK THE QUESTION
  4820. SEARCH FOR EVIDENCE
  4821. Search Strategies
  4822. Databases Used
  4823. CRITICALLY ANALYZE THE EVIDENCE
  4824. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  4825. References
  4826. NURSINGALERT
  4827. Diagnostic Evaluation
  4828. BOX 28-5 Clinical Manifestations of Bacterial Meningitis
  4829. CHILDREN AND ADOLESCENTS
  4830. INFANTS AND YOUNG CHILDREN
  4831. NEONATES: SPECIFIC SIGNS
  4832. NEONATES: NONSPECIFIC SIGNS THAT MAY BE PRESENT
  4833. Therapeutic Management
  4834. Drugs.
  4835. Nonspecific Measures.
  4836. Prognosis.
  4837. Prevention.
  4838. NURSINGALERT
  4839. NURSINGALERT
  4840. Nursing Care Management
  4841. Family Support.
  4842. NONBACTERIAL (ASEPTIC) MENINGITIS
  4843. ENCEPHALITIS
  4844. Etiology
  4845. TABLE 28-2 Variation of Cerebrospinal Fluid Analysis in Bacterial and Viral Meningitis
  4846. Diagnostic Evaluation
  4847. BOX 28-6 Clinical Manifestations of Encephalitis
  4848. ONSET: SUDDEN OR GRADUAL
  4849. SEVERE CASES
  4850. Therapeutic Management
  4851. Nursing Care Management
  4852. RABIES
  4853. BOX 28-7 Clinical Manifestations of Rabies
  4854. INITIAL SIGNS
  4855. EXCITEMENT PHASE
  4856. SEVERE SPASM OF RESPIRATORY MUSCLES*
  4857. NURSINGALERT
  4858. Therapeutic Management
  4859. Nursing Care Management
  4860. REYE SYNDROME
  4861. BOX 28-8 Staging Criteria for Reye Syndrome
  4862. Therapeutic Management
  4863. Prognosis.
  4864. Nursing Care Management
  4865. SEIZURE DISORDERS†
  4866. EPILEPSY
  4867. Etiology
  4868. Pathophysiology
  4869. BOX 28-9 Etiology of Seizures in Children
  4870. NONRECURRENT (ACUTE)
  4871. RECURRENT (CHRONIC)
  4872. Seizure Classification and Clinical Manifestations
  4873. Diagnostic Evaluation
  4874. BOX 28-10 Classification and Clinical Manifestations of Seizures
  4875. PARTIAL SEIZURES
  4876. Simple Partial Seizures with Motor Signs
  4877. Simple Partial Seizures with Sensory Signs
  4878. Complex Partial Seizures (Psychomotor Seizures)
  4879. GENERALIZED SEIZURES
  4880. Tonic-Clonic Seizures (Formerly Known as Grand Mal)
  4881. Tonic Phase
  4882. Clonic Phase
  4883. Status Epilepticus
  4884. Postictal State
  4885. Absence Seizures (Formerly Called Petit Mal or Lapses)
  4886. Atonic and Akinetic Seizures (Also Known as Drop Attacks)
  4887. Myoclonic Seizures
  4888. Infantile Spasms
  4889. TABLE 28-3 Comparison of Simple Partial, Complex Partial, and Absence Seizures
  4890. Therapeutic Management
  4891. Drug Therapy.
  4892. NURSINGALERT
  4893. Ketogenic Diet.
  4894. Vagus Nerve Stimulation.
  4895. Surgical Therapy.
  4896. Status Epilepticus.
  4897. NURSINGALERT
  4898. Prognosis
  4899. Nursing Care Management
  4900. BOX 28-11 General Observations: The Child During a Seizure
  4901. OBSERVATIONS DURING SEIZURE
  4902. General Description
  4903. Onset
  4904. Behavior
  4905. Movement
  4906. Face
  4907. Eyes
  4908. Respiratory Effort
  4909. Other
  4910. POSTICTAL OBSERVATIONS
  4911. nursingprocess
  4912. The Child with Seizures
  4913. ASSESSMENT
  4914. DIAGNOSIS (PROBLEM IDENTIFICATION)
  4915. PLANNING
  4916. INTERVENTIONS
  4917. EVALUATION
  4918. nursingcareplan: The Child with Seizure Disorder
  4919. emergencytreatment
  4920. Seizures
  4921. TONIC-CLONIC SEIZURE
  4922. During the Seizure
  4923. After the Seizure
  4924. COMPLEX PARTIAL SEIZURE
  4925. During the Seizure
  4926. After the Seizure
  4927. CALL EMERGENCY MEDICAL SERVICES IF
  4928. NURSINGALERT
  4929. Long-Term Care
  4930. BOX 28-12 Seizure Precautions
  4931. NURSINGALERT
  4932. Triggering Factors.
  4933. FEBRILE SEIZURES
  4934. NURSINGALERT
  4935. CEREBRAL MALFORMATIONS
  4936. CRANIAL DEFORMITIES
  4937. Prognosis.
  4938. Nursing Care Management
  4939. FAMILY FOCUS
  4940. Blood Donation
  4941. HYDROCEPHALUS
  4942. Pathophysiology
  4943. FIG. 28-6 Hydrocephalus: a block in flow of cerebrospinal fluid. A, Patent cerebrospinal fluid circulation. B, Enlarged lateral and third ventricles caused by obstruction of circulation—stenosis of aqueduct of Sylvius.
  4944. Diagnostic Evaluation
  4945. Therapeutic Management
  4946. BOX 28-13 Clinical Manifestations of Hydrocephalus
  4947. INFANCY (EARLY)
  4948. INFANCY (LATER)
  4949. INFANCY (GENERAL)
  4950. CHILDHOOD
  4951. FIG. 28-7 Ventriculoperitoneal shunt. Catheter is threaded beneath the skin.
  4952. Prognosis.
  4953. Nursing Care Management
  4954. NURSINGALERT
  4955. Postoperative Care.
  4956. NURSINGALERT
  4957. Family Support.
  4958. KEY POINTS
  4959. answers to CRITIAL THINKING EXERCISE
  4960. HYDROCEPHALUS
  4961. References
  4962. Chapter 29 The Child with Endocrine Dysfunction
  4963. LEARNING OBJECTIVES
  4964. RELATED TOPICS and ADDITIONAL RESOURCES
  4965. IN TEXT
  4966. DISORDERS OF PITUITARY FUNCTION
  4967. NURSINGALERT
  4968. HYPOPITUITARISM
  4969. BOX 29-1 Clinical Manifestations of Hypopituitarism
  4970. TABLE 29-1 Hormones and Their Function
  4971. Diagnostic Evaluation
  4972. BOX 29-2 Evaluating the Growth Curve
  4973. BOX 29-3 Bone Age for Evaluating Growth Disorders
  4974. Therapeutic Management
  4975. Nursing Care Management
  4976. Child and Family Support.
  4977. NURSINGTIP
  4978. PITUITARY HYPERFUNCTION
  4979. Diagnostic Evaluation
  4980. Therapeutic Management
  4981. Nursing Care Management
  4982. PRECOCIOUS PUBERTY
  4983. BOX 29-4 Causes of Precocious Puberty
  4984. CENTRAL PRECOCIOUS PUBERTY
  4985. PERIPHERAL PRECOCIOUS PUBERTY
  4986. INCOMPLETE PRECOCIOUS PUBERTY
  4987. Therapeutic Management
  4988. Nursing Care Management
  4989. DIABETES INSIPIDUS
  4990. NURSINGALERT
  4991. Diagnostic Evaluation
  4992. NURSINGALERT
  4993. Therapeutic Management
  4994. NURSINGTIP
  4995. Nursing Care Management
  4996. SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE
  4997. Nursing Care Management
  4998. NURSINGALERT
  4999. DISORDERS OF THYROID FUNCTION
  5000. JUVENILE HYPOTHYROIDISM
  5001. BOX 29-5 Clinical Manifestations of Juvenile Hypothyroidism
  5002. Nursing Care Management
  5003. GOITER
  5004. Nursing Care Management
  5005. NURSINGALERT
  5006. LYMPHOCYTIC THYROIDITIS
  5007. BOX 29-6 Clinical Manifestations of Lymphocytic Thyroiditis
  5008. ENLARGED THYROID GLAND
  5009. TRACHEAL COMPRESSION
  5010. HYPERTHYROIDISM (POSSIBLE)
  5011. Diagnostic Evaluation
  5012. Therapeutic Management
  5013. Nursing Care Management
  5014. HYPERTHYROIDISM
  5015. Diagnostic Evaluation
  5016. Therapeutic Management
  5017. BOX 29-7 Clinical Manifestations of Hyperthyroidism (Graves Disease)
  5018. CARDINAL SIGNS
  5019. PHYSICAL SIGNS
  5020. THYROID STORM
  5021. Nursing Care Management
  5022. NURSINGALERT
  5023. NURSINGALERT
  5024. DISORDERS OF PARATHYROID FUNCTION
  5025. HYPOPARATHYROIDISM
  5026. BOX 29-8 Clinical Manifestations of Hypoparathyroidism
  5027. PSEUDOHYPOPARATHYROIDISM
  5028. IDIOPATHIC HYPOPARATHYROIDISM
  5029. BOTH TYPES
  5030. Diagnostic Evaluation
  5031. Therapeutic Management
  5032. Nursing Care Management
  5033. HYPERPARATHYROIDISM
  5034. BOX 29-9 Clinical Manifestations of Hyperparathyroidism
  5035. GASTROINTESTINAL
  5036. CENTRAL NERVOUS SYSTEM
  5037. NEUROMUSCULAR
  5038. SKELETAL
  5039. RENAL
  5040. Diagnostic Evaluation
  5041. Therapeutic Management
  5042. Nursing Care Management
  5043. DISORDERS OF ADRENAL FUNCTION
  5044. ACUTE ADRENOCORTICAL INSUFFICIENCY
  5045. Diagnostic Evaluation
  5046. BOX 29-10 Clinical Manifestations of Acute Adrenocortical Insufficiency
  5047. EARLY SYMPTOMS
  5048. GENERALIZED HEMORRHAGIC MANIFESTATIONS (WATERHOUSE-FRIDERICHSEN SYNDROME)
  5049. SHOCKLIKE STATE
  5050. NEWBORN
  5051. Therapeutic Management
  5052. Nursing Care Management
  5053. NURSINGALERT
  5054. NURSINGTIP
  5055. CHRONIC ADRENOCORTICAL INSUFFICIENCY (ADDISON DISEASE)
  5056. Therapeutic Management
  5057. BOX 29-11 Clinical Manifestations of Chronic Adrenocortical Insufficiency
  5058. NEUROLOGIC SYMPTOMS
  5059. PIGMENTARY CHANGES
  5060. GASTROINTESTINAL SYMPTOMS
  5061. CIRCULATORY SYMPTOMS
  5062. HYPOGLYCEMIA
  5063. OTHER SIGNS (SEEN IN SOME CHILDREN)
  5064. Nursing Care Management
  5065. BOX 29-12 Etiology of Cushing Syndrome
  5066. Pituitary
  5067. Adrenal
  5068. Ectopic
  5069. Iatrogenic
  5070. Food dependent
  5071. CUSHING SYNDROME
  5072. FIG. 29-1 Characteristics of Cushing syndrome.
  5073. Clinical Manifestations
  5074. Diagnostic Evaluation
  5075. Therapeutic Management
  5076. Nursing Care Management
  5077. NURSINGALERT
  5078. CONGENITAL ADRENAL HYPERPLASIA
  5079. Diagnostic Evaluation
  5080. Therapeutic Management
  5081. Nursing Care Management
  5082. NURSINGALERT
  5083. PHEOCHROMOCYTOMA
  5084. Diagnostic Evaluation
  5085. Therapeutic Management
  5086. Nursing Care Management
  5087. NURSINGALERT
  5088. DISORDERS OF PANCREATIC HORMONE SECRETION: DIABETES MELLITUS
  5089. TABLE 29-2 Characteristics of Type 1 and Type 2 Diabetes Mellitus
  5090. Pathophysiology
  5091. BOX 29-13 Clinical Manifestations of Type 1 Diabetes Mellitus
  5092. Ketoacidosis.
  5093. Long-Term Complications
  5094. NURSINGALERT
  5095. Diagnostic Evaluation
  5096. Therapeutic Management
  5097. Insulin Therapy.
  5098. Insulin Preparations
  5099. NURSINGALERT
  5100. Dosage
  5101. BOX 29-14 Types of Insulin
  5102. Methods of Administration
  5103. Monitoring.
  5104. Blood Glucose
  5105. Glycosylated Hemoglobin
  5106. Urine
  5107. NURSINGALERT
  5108. Nutrition.
  5109. TABLE 29-3 Plasma Blood Glucose and Hemoglobin A1c Goals for Type 1 Diabetes Mellitus by Age-Group
  5110. Exercise.
  5111. Hypoglycemia.
  5112. NURSINGALERT
  5113. TABLE 29-4 Comparison of Manifestations of Hypoglycemia and Hyperglycemia
  5114. NURSINGALERT
  5115. Morning Hyperglycemia.
  5116. Illness Management.
  5117. Therapeutic Management of Diabetic Ketoacidosis
  5118. Fluid and Electrolyte Therapy.
  5119. NURSINGALERT
  5120. NURSINGALERT
  5121. Nursing Care Management
  5122. EVIDENCE-BASED PRACTICE
  5123. Hospital Admission or Outpatient Care for Children Newly Diagnosed with Type 1 Diabetes Mellitus
  5124. ASK THE QUESTION
  5125. SEARCH FOR EVIDENCE
  5126. Search Strategies
  5127. Databases Used
  5128. CRITICALLY ANALYZE THE EVIDENCE
  5129. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  5130. References
  5131. Hospital Management.
  5132. Child and Family Education.
  5133. nursingprocess
  5134. The Child with Diabetes Mellitus
  5135. ASSESSMENT
  5136. DIAGNOSIS (PROBLEM IDENTIFICATION)
  5137. PLANNING
  5138. IMPLEMENTATION
  5139. EVALUATION
  5140. Medical Identification.
  5141. Nature of Diabetes.
  5142. Meal Planning.
  5143. nursingcareplan
  5144. The Child with Diabetes Mellitus
  5145. Traveling.
  5146. Insulin.
  5147. Injection Procedure.
  5148. FIG. 29-2 School-age children are able to administer their own insulin.
  5149. TABLE 29-5 Onset and Duration of Action Related to Injection Site
  5150. Continuous Subcutaneous Insulin Infusion
  5151. Monitoring.
  5152. FIG. 29-3 Child using finger-stick device to obtain blood sample.
  5153. ATRAUMATIC CARE
  5154. Minimizing Pain of Blood Glucose Monitoring
  5155. NURSINGALERT
  5156. FIG. 29-4 Child using blood glucose monitor and reagent strips to test blood for glucose.
  5157. Urine Testing
  5158. Signs of Hyperglycemia.
  5159. Signs of Hypoglycemia.
  5160. emergencytreatment
  5161. Hypoglycemia
  5162. MILD REACTION—ADRENERGIC SYMPTOMS
  5163. MODERATE REACTION—NEUROGLYCOPENIC SYMPTOMS
  5164. SEVERE REACTION—UNRESPONSIVE, UNCONSCIOUS, OR SEIZURES
  5165. NOCTURNAL REACTION
  5166. Hygiene.
  5167. Exercise.
  5168. NURSINGALERT
  5169. Record Keeping.
  5170. Self-Management
  5171. Child or Adolescent and Family Support.
  5172. NURSINGTIP
  5173. CRITICAL THINKING EXERCISE
  5174. Type 1 Diabetes Mellitus
  5175. QUESTIONS
  5176. KEY POINTS
  5177. answers to CRITIAL THINKING EXERCISE
  5178. TYPE 1 DIABETES MELLITUS
  5179. References
  5180. Chapter 30 The Child with Integumentary Dysfunction
  5181. LEARNING OBJECTIVES
  5182. RELATED TOPICS and ADDITIONAL RESOURCES
  5183. IN TEXT
  5184. INTEGUMENTARY DYSFUNCTION
  5185. SKIN LESIONS
  5186. Skin of Younger Children
  5187. Pathophysiology of Dermatitis
  5188. Diagnostic Evaluation
  5189. History and Subjective Symptoms.
  5190. Objective Findings.
  5191. Types of Lesions.
  5192. Laboratory Studies.
  5193. WOUNDS
  5194. Epidermal Injuries
  5195. Injury to Deeper Tissues
  5196. Process of Wound Healing
  5197. FIG. 30-1 Primary skin lesions.
  5198. FIG. 30-2 Secondary skin lesions.
  5199. TABLE 30-1 Factors That Delay Wound Healing
  5200. Factors That Influence Healing
  5201. GENERAL THERAPEUTIC MANAGEMENT
  5202. TABLE 30-2 Common Wound Care Products
  5203. Dressings
  5204. Topical Therapy
  5205. NURSINGALERT
  5206. Topical Corticosteroid Therapy.
  5207. Other Topical Therapies.
  5208. Systemic Therapy
  5209. NURSING CARE MANAGEMENT
  5210. NURSINGALERT
  5211. Wound Care
  5212. NURSINGALERT
  5213. NURSINGALERT
  5214. Relief of Symptoms
  5215. Topical Therapy
  5216. NURSINGALERT
  5217. HOME CARE AND FAMILY SUPPORT
  5218. INFECTIONS OF THE SKIN
  5219. BACTERIAL INFECTIONS
  5220. TABLE 30-3 Bacterial Infections
  5221. Nursing Care Management
  5222. FIG. 30-3 Impetigo contagiosa.
  5223. FIG. 30-4 Cellulitis of cheek from puncture wound.
  5224. VIRAL INFECTIONS
  5225. TABLE 30-4 Viral Infections
  5226. DERMATOPHYTOSES (FUNGAL INFECTIONS)
  5227. Nursing Care Management
  5228. TABLE 30-5 Dermatophytoses (Fungal Infections)
  5229. SYSTEMIC MYCOTIC (FUNGAL) INFECTIONS
  5230. FIG. 30-5 A, Tinea capitis. B, Tinea corporis. Both infections are caused by Microsporum canis, the “kitten” or “puppy” fungus.
  5231. TABLE 30-6 Systemic Mycoses
  5232. SKIN DISORDERS RELATED TO CHEMICAL OR PHYSICAL CONTACTS
  5233. CONTACT DERMATITIS
  5234. Nursing Care Management
  5235. POISON IVY, OAK, AND SUMAC
  5236. Therapeutic Management
  5237. Nursing Care Management
  5238. FIG. 30-6 Poison ivy.
  5239. FIG. 30-7 Poison ivy lesions. Note “streaked” blisters surrounding one large blister.
  5240. Prevention.
  5241. CRITICAL THINKING EXERCISE
  5242. Poison Ivy
  5243. QUESTIONS
  5244. DRUG REACTIONS
  5245. NURSINGALERT
  5246. Nursing Care Management
  5247. FOREIGN BODIES
  5248. SKIN DISORDERS RELATED TO ANIMAL CONTACTS
  5249. Arthropod Bites and Stings
  5250. TABLE 30-7 Skin Lesions Caused by Arthropods
  5251. FIG. 30-8 Brown recluse spider bite. Note central necrosis surrounded by purplish area and blisters.
  5252. SCABIES
  5253. Nursing Care Management
  5254. BOX 29-1 Clinical Manifestations of Scabies
  5255. LESION
  5256. DISTRIBUTION
  5257. PEDICULOSIS CAPITIS
  5258. Diagnostic Evaluation
  5259. BOX 30-2 Clinical Manifestations of Pediculosis
  5260. DISTRIBUTION
  5261. FIG. 30-9 A, Empty nit case. B, Viable nits.
  5262. Therapeutic Management
  5263. Nursing Care Management
  5264. Prevention.
  5265. TABLE 30-8 Eruptions Caused by Rickettsiae
  5266. COMMUNITY FOCUS
  5267. Preventing the Spread and Recurrence of Pediculosis
  5268. EVIDENCE-BASED PRACTICE
  5269. No-Nit School Policies
  5270. ASK THE QUESTION
  5271. SEARCH FOR EVIDENCE
  5272. Search Strategies
  5273. Databases Used
  5274. CRITICALLY ANALYZE THE EVIDENCE
  5275. APPLY THE EVIDENCE: NURSING IMPLICATIONS
  5276. References
  5277. RICKETTSIAL DISEASES
  5278. LYME DISEASE
  5279. Diagnostic Evaluation
  5280. Therapeutic Management
  5281. FIG. 30-10 Lyme disease. Note annular red rings in erythema chronicum migrans.
  5282. Nursing Care Management
  5283. Mammal Bites and Scratches
  5284. PET AND WILD ANIMAL BITES
  5285. Therapeutic Management
  5286. Nursing Care Management
  5287. HUMAN BITES
  5288. CAT SCRATCH DISEASE
  5289. COMMUNITY FOCUS
  5290. Animal Safety
  5291. MISCELLANEOUS SKIN DISORDERS
  5292. SKIN DISORDERS ASSOCIATED WITH SPECIFIC AGE-GROUPS
  5293. DIAPER DERMATITIS
  5294. Pathophysiology and Clinical Manifestations
  5295. Nursing Care Management
  5296. TABLE 30-9 Miscellaneous Skin Disorders
  5297. FIG. 30-11 Irritant diaper dermatitis. Note sharply demarcated edges.
  5298. FIG. 30-12 Candidiasis of diaper area. Note beefy red central erythema with satellite pustules.
  5299. FAMILY-CENTERED CARE
  5300. Controlling Diaper Rash
  5301. ATOPIC DERMATITIS (ECZEMA)
  5302. BOX 30-3 Clinical Manifestations of Atopic Dermatitis
  5303. DISTRIBUTION OF LESIONS
  5304. APPEARANCE OF LESIONS
  5305. Infantile Form
  5306. Childhood Form
  5307. Adolescent or Adult Form
  5308. OTHER PHYSICAL MANIFESTATIONS
  5309. FIG. 30-13 Infantile atopic dermatitis with oozing and crusting of lesions.
  5310. Therapeutic Management
  5311. Nursing Care Management
  5312. NURSINGALERT
  5313. Family Support.
  5314. nursingcareguidelines
  5315. Preventing Atopy in Children
  5316. IDENTIFY CHILDREN AT RISK
  5317. PRENATAL PRECAUTIONS (LAST TRIMESTER)
  5318. POSTNATAL PRECAUTIONS
  5319. ENVIRONMENTAL CONTROL
  5320. SEBORRHEIC DERMATITIS
  5321. Nursing Care Management
  5322. ACNE
  5323. Pathophysiology
  5324. FIG. 30-14 Acne vulgaris. A, Comedones with a few inflammatory pustules. B, Papulopustular acne.
  5325. Therapeutic Management
  5326. General Measures.
  5327. Cleansing.
  5328. Medications.
  5329. Nursing Care Management
  5330. THERMAL INJURY
  5331. BURNS
  5332. Characteristics of Burn Injury
  5333. Type of Injury.
  5334. Extent of Injury.
  5335. Depth of Injury.
  5336. FIG. 30-15 Estimation of distribution of burns in children. A, Children from birth to age 5 years. B, Older children.
  5337. FIG. 30-16 Classification of burn depth.
  5338. FIG. 30-17 Superficial partial-thickness burns on an African-American child. A, Blisters intact. B, Blisters removed.
  5339. Severity of Injury.
  5340. Inhalation Injury.
  5341. FIG. 30-18 Bottom to top: Deep partial-thickness burn (red area); full-thickness burn (white area); full-thickness burn with eschar (brown area).
  5342. FIG. 30-19 Full-thickness burn with muscle and fascia involved.
  5343. TABLE 30-10 Severity Grading System Adopted by the American Burn Association
  5344. Pathophysiology
  5345. Complications.
  5346. Wound Sepsis.
  5347. Therapeutic Management
  5348. Emergency Care.
  5349. Stop the Burning Process.
  5350. emergencytreatment
  5351. Burns
  5352. MINOR BURNS
  5353. MAJOR BURNS
  5354. Assess the Victim’s Condition.
  5355. Cover the Burn.
  5356. Transport the Child to Medical Aid.
  5357. Provide Reassurance.
  5358. Minor Burns.
  5359. Major Burns.
  5360. Fluid Replacement Therapy.
  5361. Nutrition.
  5362. Medication.
  5363. Management of the Burn Wound.
  5364. Primary Excision.
  5365. Débridement.
  5366. Topical Antimicrobial Agents.
  5367. Biologic Skin Coverings.
  5368. TABLE 30-11 Comparison of Common Topical Preparations
  5369. Permanent Skin Coverings.
  5370. Sheet Graft.
  5371. Mesh Graft.
  5372. FIG. 30-20 Removal of split-thickness skin graft with a dermatome.
  5373. FIG. 30-21 Sheet graft.
  5374. Cultured Epithelium.
  5375. Prognosis.
  5376. Nursing Care Management
  5377. Acute Phase.
  5378. FIG. 30-22 Mesh graft.
  5379. NURSINGALERT
  5380. Management and Rehabilitative Phases.
  5381. NURSINGALERT
  5382. Comfort Management.
  5383. Care of the Burn Wound.
  5384. ATRAUMATIC CARE
  5385. Reducing the Stress of Burn Care Procedures
  5386. Nutrition.
  5387. Prevention of Complications
  5388. Acute Care.
  5389. Long-Term Care.
  5390. FIG. 30-23 Extensive scars from flame burn.
  5391. FIG. 30-24 Child in elasticized (Jobst) garment and “airplane” splints.
  5392. Psychosocial Support of the Child.
  5393. Psychosocial Support of the Family.
  5394. Prevention of Burn Injury.
  5395. SUNBURN
  5396. Nursing Care Management
  5397. NURSINGALERT
  5398. COLD INJURY
  5399. KEY POINTS
  5400. answers to CRITIAL THINKING EXERCISE
  5401. POISON IVY
  5402. References
  5403. UNIT TWELVE THE CHILD WITH A PROBLEM THAT INTERFERES WITH PHYSICAL MOBILITY
  5404. Interactive Review — Unit Twelve
  5405. Chapter 31 The Child with Musculoskeletal or Articular Dysfunction
  5406. LEARNING OBJECTIVES
  5407. RELATED TOPICS and ADDITIONAL RESOURCES
  5408. IN TEXT
  5409. THE IMMOBILIZED CHILD
  5410. IMMOBILIZATION
  5411. Physiologic Effects of Immobilization
  5412. TABLE 31-1 Summary of Physical Effects of Immobilization*
  5413. Psychologic Effects of Immobilization
  5414. FAMILY FOCUS
  5415. Immobilization and Self-Esteem
  5416. Effect on Families
  5417. Nursing Care Management
  5418. Family Support and Home Care.
  5419. TRAUMATIC INJURY
  5420. SOFT-TISSUE INJURY
  5421. Contusions
  5422. FIG. 31-1 Sites of injuries to bones, joints, and soft tissues.
  5423. Dislocations
  5424. Sprains
  5425. Strains
  5426. Therapeutic Management
  5427. NURSINGTIP
  5428. FRACTURES
  5429. Epiphyseal (or Physeal) Injuries
  5430. Types of Fractures
  5431. BOX 31-1 Types of Fractures in Children
  5432. NURSINGALERT
  5433. Bone Healing and Remodeling
  5434. FIG. 31-2 Types of fractures in children.
  5435. Diagnostic Evaluation
  5436. NURSINGALERT
  5437. BOX 31-2 Clinical Manifestations of a Fracture
  5438. Therapeutic Management
  5439. emergencytreatment
  5440. Fracture
  5441. Nursing Care Management
  5442. NURSINGALERT
  5443. THE CHILD IN A CAST
  5444. The Cast
  5445. Cast Application.
  5446. Nursing Care Management
  5447. NURSINGALERT
  5448. NURSINGALERT
  5449. FAMILY-CENTERED CARE
  5450. Cast Care
  5451. FIG. 31-3 Spica cast with hip abductor. Note casts on doll as well.
  5452. Cast Removal.
  5453. FIG. 31-4 Young children usually adapt well to a cast but often fear the removal.
  5454. THE CHILD IN TRACTION
  5455. Purposes of Traction
  5456. FIG. 31-5 Application of traction to maintain bone alignment.
  5457. Types of Traction (General)
  5458. BOX 31-3 Types of Traction
  5459. Upper Extremity Traction
  5460. Lower Extremity Traction
  5461. FIG. 31-6 Buck extension traction.
  5462. FIG. 31-7 Ninety-ninety traction.
  5463. Cervical Traction
  5464. FIG. 31-8 A, Halo vest. B, Crutchfield tong traction.
  5465. Nursing Care Management
  5466. NURSINGALERT
  5467. nursingcareguidelines: Traction Care
  5468. UNDERSTAND THERAPY
  5469. MAINTAIN TRACTION
  5470. MAINTAIN ALIGNMENT
  5471. SKIN TRACTION
  5472. SKELETAL TRACTION
  5473. PREVENT SKIN BREAKDOWN
  5474. PREVENT COMPLICATIONS
  5475. NURSINGTIP
  5476. NURSINGALERT
  5477. DISTRACTION
  5478. External Fixation
  5479. Nursing Care Management
  5480. FIG. 31-9 Child with Ilizarov external fixator during physical therapy on parallel bars.
  5481. AMPUTATION
  5482. NURSINGALERT
  5483. Nursing Care Management
  5484. CONGENITAL DEFECTS
  5485. DEVELOPMENTAL DYSPLASIA OF THE HIP
  5486. Pathophysiology
  5487. Diagnostic Evaluation
  5488. CULTURAL AWARENESS
  5489. Developmental Dysplasia of the Hip
  5490. FIG. 31-10 Configuration and relationship of structures in developmental dysplasia of the hip.
  5491. FIG. 31-11 Signs of developmental dysplasia of the hip. A, Asymmetry of gluteal and thigh folds with shortening of the thigh (Galeazzi sign). B, Limited hip abduction, as seen in flexion (Ortolani test). C, Apparent shortening of the femur, as indicated by the level of the knees in flexion (Allis sign). D, Ortolani test with femoral head moving in and out of acetabulum (in infants 1 to 2 months old). E, Positive Trendelenburg sign with lordosis (if child is weight bearing).
  5492. BOX 31-4 Clinical Manifestations of Developmental Dysplasia of the Hip
  5493. INFANT
  5494. OLDER INFANT AND CHILD
  5495. NURSINGALERT
  5496. Therapeutic Management
  5497. FIG. 31-12 Child in Pavlik harness.
  5498. Newborn to Age 6 Months.
  5499. Ages 6 to 18 Months.
  5500. Older Child.
  5501. Nursing Care Management
  5502. NURSINGALERT
  5503. CONGENITAL CLUBFOOT
  5504. FIG. 31-13 Bilateral congenital talipes equinovarus (congenital clubfoot) in 2-month-old infant.
  5505. Classification
  5506. Diagnostic Evaluation
  5507. Therapeutic Management
  5508. FIG. 31-14 Feet casted for correction of bilateral talipes equinovarus.
  5509. Nursing Care Management
  5510. METATARSUS ADDUCTUS (VARUS)
  5511. Nursing Care Management
  5512. SKELETAL LIMB DEFICIENCY
  5513. Pathophysiology
  5514. Therapeutic Management
  5515. Nursing Care Management
  5516. OSTEOGENESIS IMPERFECTA
  5517. BOX 31-5 Classification of Osteogenesis Imperfecta
  5518. Therapeutic Management
  5519. Nursing Care Management
  5520. NURSINGALERT
  5521. ACQUIRED DEFECTS
  5522. LEGG-CALVÉ-PERTHES DISEASE
  5523. Pathophysiology
  5524. BOX 31-6 Radiographic Stages of Legg-Calvé-Perthes Disease
  5525. Clinical Manifestations and Diagnostic Evaluation
  5526. Therapeutic Management
  5527. FAMILY FOCUS
  5528. Legg-Calvé-Perthes Disease
  5529. Nursing Care Management
  5530. SLIPPED CAPITAL FEMORAL EPIPHYSIS
  5531. Pathophysiology
  5532. Diagnostic Evaluation
  5533. Therapeutic Management
  5534. BOX 31-7 Clinical Manifestations of Slipped Capital Femoral Epiphysis
  5535. Nursing Care Management
  5536. KYPHOSIS AND LORDOSIS
  5537. FIG. 31-15 Defects of spinal column. A, Normal spine. B, Kyphosis. C, Lordosis. D, Normal spine in balance. E, Mild scoliosis in balance. F, Severe scoliosis not in balance. G, Rib hump and flank asymmetry seen in flexion caused by rotary component.
  5538. IDIOPATHIC SCOLIOSIS
  5539. Diagnostic Evaluation
  5540. NURSINGALERT
  5541. Therapeutic Management
  5542. Bracing and Exercise.
  5543. FIG. 31-16 A, Standard thoracolumbosacral orthotic (TLSO) brace for idiopathic scoliosis. Brace may be decorated to make it more acceptable to adolescents. B, Variation of a standard TLSO brace that fastens in the back to provide needed support. C, Posterior view of same brace.
  5544. Surgical Management.
  5545. Nursing Care Management
  5546. Preoperative Care.
  5547. Postoperative Care.
  5548. INFECTIONS OF BONES AND JOINTS
  5549. OSTEOMYELITIS
  5550. Pathophysiology
  5551. Diagnostic Evaluation
  5552. BOX 31-8 Clinical Manifestations of Acute Osteomyelitis
  5553. GENERAL MANIFESTATIONS
  5554. LOCAL MANIFESTATIONS
  5555. Therapeutic Management
  5556. Nursing Care Management
  5557. SEPTIC ARTHRITIS
  5558. Therapeutic Management and Nursing Care Management
  5559. SKELETAL TUBERCULOSIS
  5560. Nursing Care Management
  5561. BONE AND SOFT-TISSUE TUMORS
  5562. GENERAL CONCEPTS: BONE TUMORS
  5563. Diagnostic Evaluation
  5564. BOX 31-9 Clinical Manifestations of Bone Tumors
  5565. OSTEOSARCOMA
  5566. Therapeutic Management
  5567. Nursing Care Management
  5568. EWING SARCOMA (PRIMITIVE NEUROECTODERMAL TUMOR)
  5569. Therapeutic Management
  5570. Nursing Care Management
  5571. RHABDOMYOSARCOMA
  5572. Diagnostic Evaluation
  5573. BOX 31-10 Clinical Manifestations of Rhabdomyosarcoma According to Tumor Site
  5574. CENTRAL NERVOUS SYSTEM
  5575. ORBIT
  5576. NASOPHARYNX
  5577. PARANASAL SINUSES
  5578. MIDDLE EAR
  5579. RETROPERITONEAL AREA (USUALLY A “SILENT” TUMOR)
  5580. PERINEUM
  5581. EXTREMITY
  5582. Therapeutic Management
  5583. Nursing Care Management
  5584. DISORDERS OF JOINTS
  5585. JUVENILE IDIOPATHIC ARTHRITIS (JUVENILE RHEUMATOID ARTHRITIS)
  5586. Pathophysiology
  5587. Clinical Manifestations
  5588. Classification of Juvenile Idiopathic Arthritis
  5589. Diagnostic Evaluation
  5590. Therapeutic Management
  5591. Medications.
  5592. Tumor Necrosis Factor Inhibition.
  5593. Physical and Occupational Therapy.
  5594. Nursing Care Management
  5595. Relieve Pain.
  5596. Promote General Health.
  5597. Facilitate Compliance.
  5598. Encourage Heat and Exercise.
  5599. NURSINGTIP
  5600. Support Child and Family.
  5601. SYSTEMIC LUPUS ERYTHEMATOSUS
  5602. BOX 31-11 Clinical Manifestations of Systemic Lupus Erythematosus Related to Tissues Involved
  5603. BOX 31-12 Diagnostic Criteria for Systemic Lupus Erythematosus
  5604. Clinical Manifestations and Diagnostic Evaluation
  5605. Therapeutic Management
  5606. Nursing Care Management
  5607. KEY POINTS
  5608. References
  5609. Chapter 32 The Child with Neuromuscular or Muscular Dysfunction
  5610. LEARNING OBJECTIVES
  5611. RELATED TOPICS and ADDITIONAL RESOURCES
  5612. IN TEXT
  5613. CONGENITAL NEUROMUSCULAR OR MUSCULAR DISORDERS
  5614. CEREBRAL PALSY
  5615. Pathophysiology
  5616. BOX 32-1 Clinical Classification of Cerebral Palsy
  5617. SPASTIC (PYRAMIDAL)
  5618. DYSKINETIC (NONSPASTIC, EXTRAPYRAMIDAL)
  5619. ATAXIC (NONSPASTIC, EXTRAPYRAMIDAL)
  5620. MIXED TYPE
  5621. BOX 32-2 Clinical Signs and Symptoms of Cerebral Palsy
  5622. SPASTIC TYPE
  5623. DYSKINETIC TYPE
  5624. ATAXIC TYPE
  5625. OTHER MANIFESTATIONS
  5626. Diagnostic Evaluation
  5627. BOX 32-3 Early Signs of Cerebral Palsy
  5628. Therapeutic Management
  5629. FIG. 32-1 Mobilization device for child.
  5630. FIG. 32-2 Bike walker used to provide mobility and to enhance leg muscle strength.
  5631. Prognosis.
  5632. NURSINGALERT
  5633. Nursing Care Management
  5634. nursingprocess
  5635. The Child with Cerebral Palsy
  5636. ASSESSMENT
  5637. DIAGNOSIS (PROBLEM IDENTIFICATION)
  5638. PLANNING
  5639. IMPLEMENTATION
  5640. EVALUATION
  5641. FIG. 32-3 Manual jaw control provided anteriorly.
  5642. FIG. 32-4 Manual jaw control provided from the side.
  5643. Support Family.
  5644. FAMILY FOCUS
  5645. The Reality of Acceptance of Cerebral Palsy
  5646. Support Hospitalized Child.
  5647. SPINA BIFIDA (MYELOMENINGOCELE)
  5648. Pathophysiology
  5649. FIG. 32-5 Midline defects of osseous spine with varying degrees of neural herniations.
  5650. Diagnostic Evaluation
  5651. FIG. 32-6 A, Myelomeningocele with intact sac. B, Myelomeningocele with ruptured sac.
  5652. BOX 32-4 Significant Neural Tube Defects
  5653. Prenatal Detection.
  5654. BOX 32-5 Clinical Manifestations of Spina Bifida
  5655. SPINA BIFIDA CYSTICA
  5656. SPINA BIFIDA OCCULTA
  5657. Therapeutic Management
  5658. Infancy.
  5659. Orthopedic Considerations.
  5660. Management of Genitourinary Function.
  5661. Bowel Control.
  5662. Prognosis.
  5663. Prevention.
  5664. NURSINGALERT
  5665. Nursing Care Management
  5666. Care of the Myelomeningocele Sac.
  5667. NURSINGTIP
  5668. NURSINGALERT
  5669. NURSINGALERT
  5670. Prevent Complications.
  5671. Provide Postoperative Care.
  5672. Support Family and Educate About Home Care.
  5673. Latex Allergy
  5674. BOX 32-6 Medical Conditions Associated with Risk of Latex Allergy
  5675. nursingcareguidelines
  5676. Identifying Latex Allergy
  5677. NURSINGALERT
  5678. BOX 32-7 Selected Items Possibly Containing Latex Modified from Spina Bifida Association of America Fact Sheet: Latex in the hospital environment items and home and community items, Washington, DC, 2003, The Association.*
  5679. MEDICAL ITEMS
  5680. HOME AND COMMUNITY ITEMS
  5681. SPINAL MUSCULAR ATROPHY, TYPE 1 (WERDNIG-HOFFMANN DISEASE)
  5682. Diagnostic Evaluation and Therapeutic Management
  5683. Prognosis.
  5684. BOX 32-8 Clinical Manifestations of Spinal Muscular Atrophy (SMA)
  5685. TYPE 1 (WERDNIG-HOFFMANN DISEASE)
  5686. TYPE 2 (INTERMEDIATE SMA)
  5687. TYPE 3 (KUGELBERG-WELANDER SYNDROME; MILD SMA)
  5688. Nursing Care Management
  5689. SPINAL MUSCULAR ATROPHY, TYPE 3 (KUGELBERG-WELANDER DISEASE)
  5690. Therapeutic Management and Nursing Care Management
  5691. MUSCULAR DYSTROPHIES
  5692. DUCHENNE (PSEUDOHYPERTROPHIC) MUSCULAR DYSTROPHY
  5693. FIG. 32-7 Initial muscle groups involved in muscular dystrophies. A, Pseudohypertrophic. B, Fascioscapulohumeral. C, Limb girdle.
  5694. FIG. 32-8 Child with Duchenne muscular dystrophy attains standing posture by kneeling, then gradually pushing his torso upright (with knees straight) by “walking” his hands up his legs (Gower sign). Note marked lordosis in upright position.
  5695. BOX 32-9 Characteristics of Duchenne Muscular Dystrophy
  5696. BOX 32-10 Clinical Manifestations of Duchenne Muscular Dystrophy
  5697. Diagnostic Evaluation
  5698. Therapeutic Management
  5699. Nursing Care Management
  5700. ACQUIRED NEUROMUSCULAR DISORDERS
  5701. GUILLAIN-BARRÉ SYNDROME (INFECTIOUS POLYNEURITIS)
  5702. Pathophysiology
  5703. Diagnostic Evaluation
  5704. Therapeutic Management
  5705. BOX 32-11 Clinical Manifestations of Guillain-Barré Syndrome
  5706. INITIAL SYMPTOMS
  5707. OTHER MANIFESTATIONS
  5708. Course and Prognosis.
  5709. Nursing Care Management
  5710. TETANUS
  5711. Pathophysiology
  5712. Therapeutic Management
  5713. BOX 32-12 Clinical Manifestations of Tetanus
  5714. INITIAL SYMPTOMS
  5715. PROGRESSIVE INVOLVEMENT
  5716. OTHER ASPECTS
  5717. Nursing Care Management
  5718. BOTULISM
  5719. BOX 32-13 Clinical Manifestations of Botulism
  5720. GENERAL SIGNS
  5721. INFANT BOTULISM*
  5722. Infant Botulism
  5723. NURSINGALERT
  5724. Nursing Care Management
  5725. SPINAL CORD INJURIES
  5726. Mechanisms of Injury
  5727. Therapeutic Management
  5728. Nursing Care Management
  5729. NURSINGALERT
  5730. FIG. 32-9 Wheelchair allows adolescent mobility and independence.
  5731. KEY POINTS
  5732. References
  5733. APPENDIX A Developmental/Sensory Assessment
  5734. Developmental/Sensory Assessment
  5735. FIG. A-1 A, Denver II. B, Directions for administration of numbered items on Denver II.
  5736. FIG. A-2 A, Denver Articulation Screening Examination (DASE) for children 2½ to 6 years of age. B, Percentile rank.
  5737. FIG. A-3 Denver Eye Screening Test.
  5738. SNELLEN SCREENING*
  5739. Preparation
  5740. FIG. A-4 Snellen chart. A, Letter (alphabet) chart. B, Symbol E chart.
  5741. PROCEDURE
  5742. RECORDING AND REFERRAL
  5743. APPENDIX B Growth Measurements
  5744. Growth Measurements
  5745. Height and Weight Measurements for Boys
  5746. FIG. B-1 ▪ Weight-for-age percentiles, boys, birth to 36 months, CDC growth charts: United States.
  5747. FIG. B-2 ▪ Length-for-age percentiles, boys, birth to 36 months, CDC growth charts: United States.
  5748. FIG. B-3 ▪ Weight-for-length percentiles, boys, birth to 36 months, CDC growth charts: United States.
  5749. FIG. B-4 ▪ Head circumference—for-age percentiles, boys, birth to 36 months, CDC growth charts: United States.
  5750. FIG. B-5 ▪ Weight-for-age percentiles, boys, 2 to 20 years, CDC growth charts: United States.
  5751. FIG. B-6 ▪ Stature-for-age percentiles, boys, 2 to 20 years, CDC growth charts: United States.
  5752. FIG. B-7 ▪ Weight-for-stature percentiles, boys, CDC growth charts: United States.
  5753. FIG. B-8 ▪ Body mass index—for-age percentiles, boys, 2 to 20 years, CDC growth charts: United States.
  5754. Height and Weight Measurements for Girls
  5755. FIG. B-9 ▪ Weight-for-age percentiles, girls, birth to 36 months, CDC growth charts: United States.
  5756. FIG. B-10 ▪ Length-for-age percentiles, girls, birth to 36 months, CDC growth charts: United States.
  5757. FIG. B-11 ▪ Weight-for-length percentiles, girls, birth to 36 months, CDC growth charts: United States.
  5758. FIG. B-12 ▪ Head circumference—for-age percentiles, girls, birth to 36 months, CDC growth charts: United States.
  5759. FIG. B-13 ▪ Weight-for-age percentiles, girls, 2 to 20 years, CDC growth charts: United States.
  5760. FIG. B-14 ▪ Stature-for-age percentiles, girls, 2 to 20 years, CDC growth charts: United States.
  5761. FIG. B-15 ▪ Weight-for-stature percentiles, girls, CDC growth charts: United States.
  5762. FIG. B-16 ▪ Body mass index—for-age percentiles, girls, 2 to 20 years, CDC growth charts: United States.
  5763. Growth Standards of Healthy Chinese Children
  5764. Percentiles for Triceps Skinfold
  5765. Percentiles of Upper Arm Circumference
  5766. APPENDIX C Common Laboratory Tests
  5767. Common Laboratory Tests
  5768. Common Laboratory Tests and Tests Results*
  5769. Common Laboratory Tests and Tests Results*
  5770. Abbreviations Used in Laboratory Tests
  5771. Prefixes Denoting Decimal Factors
  5772. Appendix D NANDA International-Approved Nursing Diagnoses 2007-2008
  5773. NANDA International-Approved Nursing Diagnoses 2007-2008
  5774. APPENDIX E Translations of Wong-Baker FACES Pain Rating Scale*
  5775. Translations of Wong-Baker FACES Pain Rating Scale*
  5776. Brief Word Instructions (Above)
  5777. Original Instructions
  5778. English.
  5779. Spanish.
  5780. French.
  5781. Italian.
  5782. Portuguese.
  5783. Romanian.
  5784. Bosnian.
  5785. German.
  5786. Vietnamese
  5787. Japanese
  5788. Chinese
  5789. APPENDIX F Spanish-English Translations
  5790. Spanish-English Translations
  5791. APPENDIX G Dietary Reference Intakes
  5792. Dietary Reference Intakes
  5793. Recommended Dietary Allowances (RDA) and Adequate Intake (AI)a of Major Nutrients
  5794. Recommended Dietary Allowances (RDA) and Adequate Intake (AI)a of Major Nutrients
  5795. Estimated Safe and Adequate Daily Dietary Intakes of Selected Vitamins and Minerals*
  5796. Estimated Safe and Adequate Daily Dietary Intakes of Selected Vitamins and Minerals*
  5797. Estimated Sodium, Chloride, and Potassium Minimum Requirements of Healthy Persons*
  5798. Estimated Sodium, Chloride, and Potassium Minimum Requirements of Healthy Persons*
  5799. Median Heights and Weights and Estimated Energy Requirements (EERs*)
  5800. Median Heights and Weights and Estimated Energy Requirements (EERs*)
  5801. Contents in Brief
  5802. Contents in Brief
  5803. Companion CD
  5804. ANATOMY REVIEWS
  5805. ANIMATIONS
  5806. CASE STUDIES
  5807. CRITICAL THINKING EXERCISES
  5808. NCLEX REVIEW QUESTIONS
  5809. PEDIATRIC ASSESSMENT VIDEO CLIPS
  5810. Blood Pressure (BP) Levels for Boys by Age and Height Percentile
  5811. Blood Pressure (BP) Levels for Girls by Age and Height Percentile
  5812. Centigrade to Fahrenheit Temperature Conversions
  5813. Normal Temperatures in Children
  5814. Normal Heart Rates for Infants and Children
  5815. Normal Respiratory Rates for Children

 

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