This is completed downloadable of Test Bank for Wong’s Essentials of Pediatric Nursing, 8th Edition: Marilyn J. Hockenberry
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Table of Content:
- ORGANIZATION OF THE BOOK
- UNIFYING PRINCIPLES
- The Family as the Unit of Care
- An Integrated Approach to Development
- Focus on Wellness and Illness: Child, Family, and Community
- SpecialFeatures
- FAMILY-CENTERED CARE
- EVIDENCE-BASED PRACTICE
- COMMUNITY FOCUS
- CRITICAL THINKING EXERCISES
- nursing process
- CULTURAL AWARENESS
- ATRAUMATIC CARE
- FYI
- nursingcareplans
- FAMILY FOCUS
- ETHICAL CASE STUDY
- NURSINGALERT
- NURSINGTIP
- nursingcareguidlines
- emergencytreatment
- Nursing Care
- Culturally Competent Care
- The Critical Role of Research and Evidence-Based Practice
- CANADIAN CONTENT
- TEACHING/LEARNING PACKAGE
- AVAILABLE FOR PURCHASE
- ACKNOWLEDGMENTS
- Interactive Review — Essentials of Pediatric Nursing
- UNIT ONE CHILDREN, THEIR FAMILIES, AND THE NURSE
- Interactive Review — Unit One
- Chapter 1 Perspectives of Pediatric Nursing
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- HEALTH CARE FOR CHILDREN
- BOX 1-1 Healthy People 2010
- GOALS
- LEADING HEALTH INDICATORS
- HEALTH PROMOTION
- NUTRITION
- DENTAL CARE
- IMMUNIZATIONS
- CHILDHOOD HEALTH PROBLEMS
- OBESITY AND TYPE 2 DIABETES
- CHILDHOOD INJURIES
- FIG. 1-1 The American culture’s intake of high-caloric fatty foods contributes to obesity in children.
- TABLE 1-1 Mortality from Leading Types of Unintentional Injuries, United States, 1997 (Rate Per 100,000 Population in Each Age-Group)
- 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.
- BOX 1-2 Childhood Injuries: Risk Factors
- Developmental characteristics
- Cognitive characteristics (age specific)
- Young child
- 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.
- FIG. 1-4 Improper use of firearms is the fourth leading cause of death from injury in children 5 to 14 years of age.
- FIG. 1-5 Mechanical suffocation is the leading cause of death from injury in infants.
- 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.
- VIOLENCE
- COMMUNITY FOCUS
- Violence in Children
- SUBSTANCE ABUSE
- MENTAL HEALTH PROBLEMS
- MORTALITY
- INFANT MORTALITY
- 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)
- CHILDHOOD MORTALITY
- 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)
- TABLE 1-4 Five Leading Causes of Death in Children in the United States: Selected Age Intervals, 2005 (Rate Per 100,000 Population)
- MORBIDITY
- CHILDHOOD MORBIDITY
- THE ART OF PEDIATRIC NURSING
- PHILOSOPHY OF CARE
- FAMILY-CENTERED CARE
- BOX 1-3 Key Elements of Family-Centered Care
- ATRAUMATIC CARE
- ROLE OF THE PEDIATRIC NURSE
- THERAPEUTIC RELATIONSHIP
- FAMILY ADVOCACY AND CARING
- nursingcareguidelines
- Exploring Your Relationships with Children and Families
- NEGATIVE ACTIONS
- POSITIVE ACTIONS
- DISEASE PREVENTION AND HEALTH PROMOTION
- BOX 1-4 United Nations’ Declaration of the Rights of the Child
- HEALTH TEACHING
- SUPPORT AND COUNSELING
- COORDINATION AND COLLABORATION
- ETHICAL DECISION MAKING
- BOX 1-5 American Nurses Association Standard 12: Ethics
- MEASUREMENT CRITERIA
- RESEARCH
- CRITICAL THINKING AND THE PROCESS OF NURSING CHILDREN AND FAMILIES
- CRITICAL THINKING
- EVIDENCE-BASED PRACTICE
- TABLE 1-5 The Nursing Process and Evidence-Based Practice
- BOX 1-6 Evidence-Based Practice Template
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- REFERENCES
- NURSING PROCESS
- BOX 1-7 Nursing Process
- Assessment
- Nursing Diagnosis
- BOX 1-8 Classification Systems for Nursing Diagnoses
- HUMAN RESPONSE PATTERNS
- FUNCTIONAL HEALTH PATTERNS
- TAXONOMY II DOMAINS
- FAMILY FOCUS
- Using Defining Characteristics to Select an Appropriate Nursing Diagnosis
- Planning
- Implementation
- Evaluation
- Documentation
- nursingcareguidelines
- Documentation of Nursing Care
- KEY POINTS
- References
- Chapter 2 Community-Based Nursing Care of the Child and Family
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- NURSING IN THE COMMUNITY
- COMMUNITY CONCEPTS
- COMMUNITY
- Community Health Nursing
- Roles and Functions
- BOX 2-1 Evolving Role of the Pediatric Nurse: Natural and Man-Made Disasters
- Preparedness and planning
- NURSINGALERT
- DEMOGRAPHY
- EPIDEMIOLOGY
- Distribution of Disease, Injury, or Illness
- Epidemiologic Triangle
- Levels of Prevention
- FIG. 2-1 The epidemiologic triangle.
- BOX 2-2 Frequently Used Mortality and Morbidity Rates
- CRUDE BIRTH RATE
- CRUDE DEATH RATE
- CAUSE-SPECIFIC DEATH RATE
- AGE-SPECIFIC DEATH RATE
- INCIDENCE OF DISEASE
- PREVALENCE OF DISEASE
- Screening
- ECONOMICS
- EVIDENCE-BASED PRACTICE
- Acanthosis Nigricans and the Risk of Type 2 Diabetes in Children
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- COMMUNITY NURSING PROCESS
- BOX 2-3 The Community Nursing Process
- COMMUNITY NEEDS ASSESSMENT AND DIAGNOSIS
- NURSINGTIP
- COMMUNITY PLANNING
- COMMUNITY IMPLEMENTATION
- COMMUNITY EVALUATION
- BOX 2-4 An Example of Community Assessment and Planning
- COMMUNITY NEEDS ASSESSMENT AND DIAGNOSIS
- PLANNING
- IMPLEMENTATION AND EVALUATION
- KEY POINTS
- References
- INTERNET RESOURCES
- Chapter 3 Family Influences on Child Health Promotion
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- GENERAL CONCEPTS
- DEFINITION OF FAMILY
- NURSINGALERT
- FAMILY THEORIES
- Family Systems Theory
- TABLE 3-1 Summary of Family Theories and Applications
- Family Stress Theory
- Developmental Theory
- FAMILY NURSING INTERVENTIONS
- BOX 3-1 Duvall’s Developmental Stages of the Family
- STAGE I-MARRIAGE AND AN INDEPENDENT HOME: THE JOINING OF FAMILIES
- STAGE II-FAMILIES WITH INFANTS
- STAGE III-FAMILIES WITH PRESCHOOLERS
- STAGE IV-FAMILIES WITH SCHOOLCHILDREN
- STAGE V-FAMILIES WITH TEENAGERS
- STAGE VI-FAMILIES AS LAUNCHING CENTERS
- STAGE VII-MIDDLE-AGED FAMILIES
- STAGE VIII-AGING FAMILIES
- BOX 3-2 Family Nursing Interventions
- FAMILY STRUCTURE AND FUNCTION
- FAMILY STRUCTURE
- Traditional Nuclear Family
- Nuclear Family
- FIG. 3-1 Children benefit from interaction with grandparents, who sometimes assume the parenting role.
- Blended Family
- Extended Family
- Single-Parent Family
- Binuclear Family
- Polygamous Family
- Communal Family
- Gay/Lesbian Family
- FAMILY STRENGTHS AND FUNCTIONING STYLE
- BOX 3-3 Qualities of Strong Families
- FAMILY ROLES AND RELATIONSHIPS
- PARENTAL ROLES
- ROLE LEARNING
- Family Size and Configuration
- FIG. 3-2 Family structure promotes strong relationships among its members.
- Sibling Interactions
- Spacing of Children.
- Sibling Functions.
- FIG. 3-3 Older school-age children often enjoy taking responsibility for the care of a younger sibling.
- More Active Sibling Relationships.
- Ordinal Position
- The Only Child.
- Multiple Births
- BOX 3-4 Influence of Ordinal Position on Children
- FIRSTBORN CHILDREN
- MIDDLE CHILDREN
- YOUNGEST CHILDREN
- ONLY CHILDREN
- FIG. 3-4 Fraternal twins.
- BOX 3-5 Characteristics of Twins
- MONOZYGOTIC (MZ) OR IDENTICAL TWINS
- DIZYGOTIC (DZ) OR FRATERNAL TWINS
- Parental Adjustment.
- PARENTING
- MOTIVATION FOR PARENTHOOD
- PREPARATION FOR PARENTHOOD
- TRANSITION TO PARENTHOOD
- Parental Factors Affecting Transition to Parenthood
- Parental Age.
- FIG. 3-5 Fathers who assume care of their children may feel more comfortable and successful in their parenting role.
- Father Involvement.
- Parenting Education.
- FIG. 3-6 Quality time spent with a child is essential to a family’s health and well-being.
- Support Systems.
- FIG. 3-7 Learning new roles together as a mother and father can enhance parenting relationships.
- PARENTING BEHAVIORS
- Parental Styles of Control
- LIMIT SETTING AND DISCIPLINE
- Minimizing Misbehavior
- FAMILY-CENTERED CARE
- Minimizing Misbehavior
- General Guidelines for Implementing Discipline
- Types of Discipline
- FAMILY-CENTERED CARE
- Implementing Discipline
- NURSINGALERT
- FIG. 3-8 Time-out is an excellent disciplinary strategy for young children.
- SPECIAL PARENTING SITUATIONS
- FAMILY-CENTERED CARE
- Using Time-Out
- PARENTING THE ADOPTED CHILD
- FIG. 3-9 An older sister lovingly embraces her adopted sister.
- Issues of Origin
- CRITICAL THINKING EXERCISE
- Parenting the Adopted Child
- QUESTIONS
- Adolescence
- Cross-Racial and International Adoption
- NURSINGALERT
- PARENTING AND DIVORCE
- BOX 3-6 Stages of the Divorce Process
- ACUTE PHASE
- TRANSITIONAL PHASE
- STABILIZING PHASE
- Impact of Divorce on Children
- BOX 3-7 Feelings and Behaviors of Children Related to Divorce
- INFANCY
- EARLY PRESCHOOL CHILDREN (AGES 2 TO 3 YEARS)
- LATER PRESCHOOL CHILDREN (AGES 3 TO 5 YEARS)
- EARLY SCHOOL-AGE CHILDREN (AGES 5 TO 6 YEARS)
- MIDDLE SCHOOL-AGE CHILDREN (AGES 6 TO 8 YEARS)
- LATER SCHOOL-AGE CHILDREN (AGES 9 TO 12 YEARS)
- ADOLESCENTS (AGES 12 TO 18 YEARS)
- Age- and Sex-Related Responses to Divorce.
- Telling the Children.
- Custody and Parenting Partnerships
- SINGLE PARENTING
- Single Fathers
- PARENTING IN RECONSTITUTED FAMILIES
- PARENTING IN DUAL-EARNER FAMILIES
- Working Mothers
- FOSTER PARENTING
- ACCOMMODATING CONTEMPORARY PARENTING SITUATIONS
- EVIDENCE-BASED PRACTICE
- Daycare for Preschool Children
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- KEY POINTS
- answers to CRITICAL THINKING EXERCISE
- PARENTING THE ADOPTED CHILD
- References
- Chapter 4 Social, Cultural, and Religious Influences on Child Health Promotion
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- CULTURE
- FIG. 4-1 Ethnicity is an individual’s association with shared cultural, social, and linguistic heritage.
- SOCIAL ROLES
- Self-Esteem and Culture
- SUBCULTURAL INFLUENCES
- FIG. 4-2 Teenagers from different cultural backgrounds interact within the larger culture.
- Ethnicity
- Socioeconomic Class
- Poverty
- Homelessness
- Migrant Farmworker Families
- Immigrant Children
- Religion
- Schools
- FIG. 4-3 Soon after an infant is born, many families have special religious ceremonies.
- Communities
- Peer Cultures
- THE CHILD AND FAMILY IN NORTH AMERICA
- Minority-Group Membership
- CULTURAL AWARENESS
- Overview of Race and Hispanic Origin in Census 2000
- NURSINGALERT
- NURSINGALERT
- CRITICAL THINKING EXERCISE
- Reducing Cultural Shock
- QUESTIONS
- CULTURAL SHOCK AND CULTURAL COMPETENCE
- NURSINGALERT
- CULTURAL AND RELIGIOUS INFLUENCES ON HEALTH CARE
- SUSCEPTIBILITY TO HEALTH PROBLEMS
- Hereditary Factors
- Physical Characteristics.
- Socioeconomic Factors
- Poverty.
- Homelessness.
- Migrant Farmworker Families.
- Immigrant Families.
- CULTURAL CUSTOMS
- NURSINGTIP
- Cultural Relativism
- Relationships with Health Care Providers
- FIG. 4-4 A father with his hospitalized child.
- NURSINGALERT
- Communication.
- NURSINGTIP
- Food Customs
- nursingcareguidelines
- Culturally Sensitive Interactions
- NONVERBAL STRATEGIES
- VERBAL STRATEGIES
- FIG. 4-5 Food customs outside the home can differ significantly from traditional cultural practices
- HEALTH BELIEFS AND PRACTICES
- Health Beliefs
- Natural Forces.
- Supernatural Forces.
- Imbalance of Forces.
- Health Practices
- BOX 4-1 Cultural Practices Possibly Considered Abusive by the Dominant Culture
- BOX 4-2 BELIEF Framework for Integrating Culture and Spirituality into the Nursing Assessment
- NURSINGALERT
- RELIGIOUS BELIEFS
- IMPORTANCE OF CULTURE AND RELIGION TO NURSES
- TABLE 4-1 Religious Beliefs That May Affect Nursing Care
- BOX 4-3 Exploring Your Cultural Competence: ASKED Model of Cultural Competence
- NURSINGALERT
- TABLE 4-2 Broad Cultural Characteristics Related to Health Care of Children and Families
- KEY POINTS
- answer to CRITICAL THINKING EXERCISE
- REDUCING CULTURAL SHOCK
- References
- Chapter 5 Developmental Influences on Child Health Promotion
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- GROWTH AND DEVELOPMENT
- FOUNDATIONS OF GROWTH AND DEVELOPMENT
- Stages of Development
- Patterns of Growth and Development
- Directional Trends.
- FIG. 5-1 Directional trends in growth.
- BOX 5-1 Developmental Age Periods
- PRENATAL PERIOD–CONCEPTION TO BIRTH
- INFANCY PERIOD–BIRTH TO 12 MONTHS
- EARLY CHILDHOOD–1 TO 6 YEARS
- MIDDLE CHILDHOOD–6 TO 11 OR 12 YEARS
- LATER CHILDHOOD–11 TO 19 YEARS
- Sequential Trends.
- Developmental Pace.
- FYI
- Sensitive Periods.
- Individual Differences
- BIOLOGIC GROWTH AND PHYSICAL DEVELOPMENT
- External Proportions
- 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.
- FIG. 5-3 Changes in body proportions occur dramatically during childhood.
- TABLE 5-1 General Trends in Height and Weight Gain During Childhood
- Biologic Determinants of Growth and Development
- NURSINGTIP
- Skeletal Growth and Maturation
- Neurologic Maturation
- Lymphoid Tissues
- Development of Organ Systems
- TABLE 5-2 Dietary Reference Intake for Calories and Protein Throughout Adolescence*
- PHYSIOLOGIC CHANGES
- Metabolism
- FYI
- Temperature
- Sleep and Rest
- BOX 5-2 Attributes of Temperament
- TEMPERAMENT
- BOX 5-3 Activities to Promote Mastery Motivation
- Significance of Temperament
- DEVELOPMENT OF PERSONALITY AND MENTAL FUNCTION
- THEORETIC FOUNDATIONS OF PERSONALITY DEVELOPMENT
- Psychosexual Development (Freud)
- TABLE 5-3 Summary of Personality, Cognitive, and Moral Development Theories
- Psychosocial Development (Erikson)
- FIG. 5-4 The stage of initiative is characterized by physical activity and imagination while children explore the physical world around them.
- THEORETIC FOUNDATIONS OF MENTAL DEVELOPMENT
- Cognitive Development (Piaget)
- Language Development
- Moral Development (Kohlberg)
- Spiritual Development (Fowler)
- DEVELOPMENT OF SELF-CONCEPT
- Body Image
- Self-Esteem
- ROLE OF PLAY IN DEVELOPMENT
- CLASSIFICATION OF PLAY
- CONTENT OF PLAY
- FIG. 5-5 Children derive pleasure from handling raw materials.
- 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.
- SOCIAL CHARACTER OF PLAY
- FIG. 5-7 Parallel play.
- FIG. 5-8 Associative play.
- FIG. 5-9 Cooperative play.
- FUNCTIONS OF PLAY
- Sensorimotor Development
- Intellectual Development
- Socialization
- Creativity
- Self-Awareness
- Therapeutic Value
- Moral Value
- FIG. 5-10 Play is therapeutic at any age and provides a means for release of tension and stress.
- TOYS
- Toy Safety
- SELECTED FACTORS THAT INFLUENCE DEVELOPMENT
- HEREDITY
- NEUROENDOCRINE FACTORS
- FAMILY-CENTERED CARE
- Toy Safety*
- SELECTION
- SUPERVISION
- MAINTENANCE
- STORAGE
- COMMUNITY FOCUS
- Healthy Food Choices
- NUTRITION
- INTERPERSONAL RELATIONSHIPS
- FIG. 5-11 Peers become increasingly important as children develop friendships outside the family group.
- SOCIOECONOMIC LEVEL
- DISEASE
- ENVIRONMENTAL HAZARDS
- COMMUNITY FOCUS
- Sun Protection Basics
- STRESS IN CHILDHOOD
- Coping
- INFLUENCE OF THE MASS MEDIA
- Reading Materials
- Movies
- Television
- FYI
- BOX 5-4 Factors That Encourage Learning or Performing Television-Influenced Behaviors
- BOX 5-5 Five Important Ideas to Teach Children and Adolescents About Television
- NURSINGTIP
- Video Games
- FAMILY-CENTERED CARE
- Television Viewing
- Internet
- DEVELOPMENTAL ASSESSMENT
- DENVER II
- BOX 5-6 Denver II Scoring
- INTERPRETATION OF DENVER II SCORES
- INTERPRETATION OF TEST
- RECOMMENDATIONS FOR REFERRAL FOR SUSPECT AND UNTESTABLE RESULTS
- DENVER II PRESCREENING DEVELOPMENTAL QUESTIONNAIRE
- KEY POINTS
- References
- UNIT TWO ASSESSMENT OF THE CHILD AND FAMILY
- Interactive Review — Unit Two
- Chapter 6 Communication and Physical Assessment of the Child
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- GUIDELINES FOR COMMUNICATION AND INTERVIEWING
- ESTABLISHING A SETTING FOR COMMUNICATION
- Appropriate Introduction
- Assurance of Privacy and Confidentiality
- FIG. 6-1 Child plays while nurse interviews parent.
- NURSINGALERT
- COMPUTER PRIVACY AND APPLICATIONS IN NURSING
- TELEPHONE TRIAGE AND COUNSELING
- NURSINGALERT
- BOX 6-1 Telephone Triage Guidelines
- RESOURCES FOR TELEPHONE TRIAGE PROTOCOLS
- COMMUNICATING WITH FAMILIES
- COMMUNICATING WITH PARENTS
- Encouraging the Parent to Talk
- Directing the Focus
- Listening and Cultural Awareness
- Using Silence
- Being Empathic
- Providing Anticipatory Guidance
- NURSINGTIP
- Avoiding Blocks to Communication
- Communicating with Families Through an Interpreter
- BOX 6-2 Blocks to Communication
- COMMUNICATION BARRIERS (NURSE)
- SIGNS OF INFORMATION OVERLOAD (PATIENT)
- nursingcareguidelines
- Using an Interpreter
- NURSINGALERT
- COMMUNICATING WITH CHILDREN
- Communication Related to Development of Thought Processes
- FIG. 6-2 Nurse assumes position at child’s level.
- BOX 6-3 Characteristics of Communicative Development in Young Children
- PERLOCUTIONARY STAGE (0 TO 8-9 MONTHS)
- EMERGING ILLOCUTIONARY STAGE (8-9 TO 12-15 MONTHS)
- CONVENTIONAL ILLOCUTIONARY—EMERGING LOCUTIONARY STAGE (12-15 TO 18-24 MONTHS)
- nursingcareguidelines
- Communicating with Children
- FIG. 6-3 A young child may take the expression ‘a little stick in the arm’ literally.
- nursingcareguidelines
- Communicating with Adolescents
- BUILD A FOUNDATION
- COMMUNICATE EFFECTIVELY
- NURSINGALERT
- COMMUNICATION TECHNIQUES
- Play
- BOX 6-4 Creative Communication Techniques with Children
- VERBAL TECHNIQUES
- ‘I’ Messages
- Third-Person Technique
- Facilitative Response
- Storytelling
- Mutual Storytelling
- Bibliotherapy
- Dreams
- ‘What If’ Questions
- Three Wishes
- Rating Game
- Word Association Game
- Sentence Completion
- Pros and Cons
- NONVERBAL TECHNIQUES
- Writing
- Drawing
- Guidelines for Evaluating Drawings
- Magic
- Play
- HISTORY TAKING
- PERFORMING A HEALTH HISTORY
- Identifying Information
- Chief Complaint
- BOX 6-5 Outline of a Pediatric Health History
- Identifying information
- Chief complaint (CC)
- Present illness (PI)
- Past history (PH)
- Review of systems (ROS)
- Family medical history
- Psychosocial history
- Sexual history
- Family history
- Nutritional assessment
- Present Illness
- nursingcareguidelines
- Analyzing the Symptom: Pain
- TYPE
- LOCATION
- SEVERITY
- DURATION
- INFLUENCING FACTORS
- History
- NURSINGALERT
- nursingcareguidelines
- Taking an Allergy History
- NURSINGALERT
- BOX 6-6 Habits to Explore During a Health Interview
- BOX 6-7 Anticipatory Guidance’Sexuality
- AGES 12 TO 14 YEARS
- AGES 15 TO 18 YEARS
- Sexual History
- Family Medical History
- Family Structure
- nursingcareguidelines
- Initiating a Comprehensive Family Assessment
- NURSINGALERT
- Psychosocial History
- BOX 6-8 Family Assessment Interview
- GENERAL GUIDELINES
- STRUCTURAL ASSESSMENT AREAS
- Family Composition
- Home and Community Environment
- Occupation and Education of Family Members
- Cultural and Religious Traditions
- FUNCTIONAL ASSESSMENT AREAS
- Family Interactions and Roles
- Power, Decision Making, and Problem Solving
- Communication
- Expression of Feelings and Individuality
- Review of Systems
- NUTRITIONAL ASSESSMENT
- DIETARY INTAKE
- nursingcareguidelines
- Review of Systems
- BOX 6-9 Nutrition Assessment
- DIETARY HISTORY
- ADDITIONAL QUESTIONS FOR INFANTS
- CULTURAL AWARENESS
- Food Practices
- CLINICAL EXAMINATION
- TABLE 6-1 Clinical Assessment of Nutritional Status
- EVALUATION OF NUTRITIONAL ASSESSMENT
- GENERAL APPROACHES TOWARD EXAMINING THE CHILD
- SEQUENCE OF THE EXAMINATION
- PREPARATION OF THE CHILD
- nursingcareguidelines
- Performing Pediatric Physical Examination
- FIG. 6-4 Using paper-doll technique to prepare child for physical examination.
- FIG. 6-5 Preparing children for physical examination.
- TABLE 6-2 Age-Specific Approaches to Physical Examination During Childhood
- 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.
- PHYSICAL EXAMINATION
- GROWTH MEASUREMENTS
- Growth Charts
- NURSINGALERT
- NURSINGALERT
- Length
- Height
- 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.
- NURSINGTIPS
- Weight
- FIG. 6-8 Measurement of head, chest, and abdominal circumference and crown-to-heel (recumbent) length.
- FIG. 6-9 Measurement of height.
- FIG. 6-10 A, Infant on scale. B, Toddler on scale. Note presence of nurse to prevent falls.
- Skinfold Thickness and Arm Circumference
- Head Circumference
- PHYSIOLOGIC MEASUREMENTS
- BOX 6-10 Fever in Infants and Children
- BOX 6-11 Recommended Temperature Screening Routes in Infants and Children
- BIRTH TO 2 YEARS
- 2 TO 5 YEARS
- OVER 5 YEARS
- ATRAUMATIC CARE
- Reducing Young Children’s Fears
- Temperature
- BOX 6-12 Alternative Temperature Measurement Sitesfor the Ill Child
- SKIN
- URINARY BLADDER
- PULMONARY ARTERY
- ESOPHAGEAL SITE
- NASOPHARYNGEAL SITE
- TABLE 6-3 Temperature Measurement Locations for Infants and Children
- NURSINGALERT
- NURSINGALERT
- Pulse
- BOX 6-13 Types of Thermometers Used to Measure Temperature in Infants and Children
- ELECTRONIC THERMOMETER
- INFRARED THERMOMETER
- EAR-BASED TEMPERATURE SENSOR
- EAR SENSOR (LIGHTOUCH LTX)
- AXILLARY SENSOR (LIGHTOUCH LTN)
- DIGITAL THERMOMETER
- LIQUID CRYSTAL SKIN CONTACT THERMOMETER (CHEMICAL DOT THERMOMETER)
- EVIDENCE-BASED PRACTICE
- Temperature Measurement in Pediatrics
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- TABLE 6-4 Grading of Pulses
- Respiration
- Blood Pressure
- TABLE 6-5 Normative Dinamap Blood Pressure Values (Systolic/Diastolic; Mean Arterial Pressure in Parentheses)
- 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.
- FIG. 6-12 Sites for measuring blood pressure. A, Upper arm. B, Lower arm or forearm. C, Thigh. D, Calf or ankle.
- TABLE 6-6 Recommended Dimensions for Blood Pressure Cuff Bladders
- TABLE 6-7 Differences in Oscillometric Systolic Blood Pressure Between Arm and Lower Extremity Sites in Normal Children
- NURSINGALERT
- NURSINGALERT
- nursingcareguidelines
- Using the Blood Pressure Tables
- NURSINGALERT
- GENERAL APPEARANCE
- SKIN
- Accessory Structures
- TABLE 6-8 Differences in Color Changes of Racial Groups
- FIG. 6-13 Examples of flexion creases on palm. A, Normal. B, Transpalmar crease.
- LYMPH NODES
- HEAD AND NECK
- NURSINGALERT
- NURSINGALERT
- FIG. 6-14 Location of superficial lymph nodes. Arrows indicate directional flow of lymph.
- NURSINGALERT
- EYES
- Inspection of External Structures
- FIG. 6-15 External structures of eye.
- Inspection of Internal Structures
- FIG. 6-16 Structures of fundus.
- NURSINGALERT
- Vision Testing
- 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.
- 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.
- NURSINGALERT
- NURSINGALERT
- EARS
- Inspection of External Structures
- FIG. 6-19 Ear alignment.
- Inspection of Internal Structures
- ATRAUMATIC CARE
- Reducing Distress from Otoscopy in Young Children
- FIG. 6-20 Position for restraining child (A) and infant (B) during otoscopic examination.
- FIG. 6-21 Positioning head by tilting it toward opposite shoulder for full view of tympanic membrane.
- FIG. 6-22 Landmarks of tympanic membrane with ‘clock’ superimposed.
- FIG. 6-23 Positioning for visualizing eardrum in infant (A) and in child older than 3 years of age (B).
- NURSINGALERT
- Auditory Testing
- NOSE
- Inspection of External Structures
- FIG. 6-24 External landmarks and internal structures of nose.
- TABLE 6-9 Audiologic Tests for Infants and Children
- Inspection of Internal Structures
- MOUTH AND THROAT
- FIG. 6-25 A, Encouraging child to cooperate. B, Positioning child for examination of mouth.
- ATRAUMATIC CARE
- Encouraging Opening the Mouth for Examination
- Inspection of Internal Structures
- FIG. 6-26 Interior structures of mouth.
- FIG. 6-27 Rib cage.
- CHEST
- FIG. 6-28 Imaginary landmarks of chest. A, Anterior. B, Right lateral. C, Posterior.
- FIG. 6-29 Movement of chest during respiration.
- FIG. 6-30 Location of lobes of lungs within thoracic cavity.
- LUNGS
- BOX 6-14 Classification of Normal Breath Sounds
- VESICULAR BREATH SOUNDS
- BRONCHOVESICULAR BREATH SOUNDS
- BRONCHIAL BREATH SOUNDS
- nursingcareguidelines
- Effective Auscultation
- Auscultation
- ATRAUMATIC CARE
- Encouraging Deep Breaths
- BOX 6-15 Various Patterns of Respiration
- HEART
- FIG. 6-31 Position of heart within thorax.
- NURSINGALERT
- Auscultation
- FIG. 6-32 Location of pulses.
- NURSINGALERT
- TABLE 6-10 Sequence of Auscultating Heart Sounds*
- FIG. 6-33 Direction of heart sounds for anatomic valve sites and areas (circled) for auscultation.
- NURSINGTIP
- TABLE 6-11 Grading of the Intensity of Heart Murmurs
- ABDOMEN
- FIG. 6-34 Location of structures in abdomen.
- Inspection
- FIG. 6-35 Location of hernias.
- NURSINGALERT
- NURSINGTIP
- ATRAUMATIC CARE
- Promoting Relaxation During Abdominal Palpation
- Auscultation
- Palpation
- FIG. 6-36 Palpating femoral pulses.
- NURSINGALERT
- NURSINGALERT
- GENITALIA
- FIG. 6-37 Major structures of genitalia in uncircumcised postpubertal male.
- Male Genitalia
- 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.
- Female Genitalia
- FIG. 6-39 External structures of genitalia in postpubertal female. Labia are spread to reveal deeper structures.
- NURSINGALERT
- ANUS
- BACK AND EXTREMITIES
- Spine
- NURSINGALERT
- Extremities
- Joints
- FIG. 6-40 Bowleg.
- FIG. 6-41 Knock-knee.
- Muscles
- NEUROLOGIC ASSESSMENT
- Cerebellar Function
- BOX 6-16 Tests for Cerebellar Function
- Finger-to-nose test
- Heel-to-shin test
- Romberg test
- Reflexes
- Cranial Nerves
- 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.
- 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.
- 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.
- 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).
- 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.
- TABLE 6-12 Assessment of Cranial Nerves
- KEY POINTS
- References
- Chapter 7 Pain Assessment and Management in Children
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- PAIN ASSESSMENT
- BOX 7-1 Developmental Characteristics of Children’s Responses to Pain
- YOUNG INFANT
- OLDER INFANT
- YOUNG CHILD
- SCHOOL-AGE CHILD
- ADOLESCENT
- BEHAVIORAL MEASURES
- FIG. 7-1 Full, robust crying of preterm infant after heel stick.
- FIG. 7-2 The face of pain after heel stick. Note eye squeeze, brow bulge, nasolabial furrow, and widespread mouth.
- TABLE 7-1 Selected Behavioral Pain Assessment Scales for Young Children
- PHYSIOLOGIC MEASURES
- SELF-REPORT MEASURES
- TABLE 7-2 Pain Rating Scales for Children
- MULTIDIMENSIONAL MEASURES
- 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.
- BOX 7-2 Manifestations of Acute Pain in the Neonate
- PHYSIOLOGIC RESPONSES
- Vital signs
- Oxygenation
- Skin
- Laboratory evidence of metabolic or endocrine changes
- Other observations
- BEHAVIORAL RESPONSES
- Vocalizations
- Facial expression
- Body movements and posture
- Changes in state
- PAIN ASSESSMENT IN SPECIFIC POPULATIONS
- PAIN IN NEONATES
- CHILDREN WITH COMMUNICATION AND COGNITIVE IMPAIRMENT
- TABLE 7-3 Pain Assessment Scales for Infants
- FIG. 7-4 Non-communicating Children’s Pain Checklist.
- CULTURAL ISSUES IN PAIN ASSESSMENT
- CHILDREN WITH CHRONIC ILLNESS AND COMPLEX PAIN
- PAIN MANAGEMENT
- NONPHARMACOLOGIC MANAGEMENT
- nursingcareguidelines
- Nonpharmacologic Strategies for Pain Management
- GENERAL STRATEGIES
- SPECIFIC STRATEGIES
- DISTRACTION
- Relaxation
- Guided Imagery
- Positive Self-Talk
- Thought Stopping
- Behavioral Contracting
- Informal
- Formal
- FIG. 7-5 Sucking following oral sucrose can enhance analgesia before a heel stick in a preterm infant.
- EVIDENCE-BASED PRACTICE
- Reduction of Minor Procedural Pain in Infants
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- Venipuncture Versus Heel Lance for Blood Sampling.
- Glucose vs EMLA Cream for Venipuncture in Neonates
- Sucrose for Minor Painful Procedures (Heel Lance and Venipuncture)
- Sucrose Compared with Glucose for Analgesia for Minor Pain (Heel Stick)
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- Sucrose
- Glucose
- Topical Anesthetics
- References
- FIG. 7-6 Mother using kangaroo hold with her newborn infant. Note placement of the infant directly on the mother’s skin.
- COMPLEMENTARY PAIN MEDICINE
- PHARMACOLOGIC MANAGEMENT
- TABLE 7-4 Nonsteroidal Antiinflammatory Drugs (NSAIDs) Approved for Children*
- TABLE 7-5 Dosage of Selected Opioids for Children
- TABLE 7-6 Coanalgesic Adjuvant Drugs
- NURSINGALERT
- Patient-Controlled Analgesia
- TABLE 7-7 Management of Opioid Side Effects
- TABLE 7-8 Equianalgesia of Selected Analgesics
- BOX 7-3 Routes and Methods of Analgesic Drug Administration
- ORAL
- SUBLINGUAL, BUCCAL, OR TRANSMUCOSAL
- Actiq
- INTRAVENOUS (IV) (BOLUS)
- IV (CONTINUOUS)
- SUBCUTANEOUS (SC) (CONTINUOUS)
- PATIENT-CONTROLLED ANALGESIA (PCA)
- FAMILY-CONTROLLED ANALGESIA
- NURSE-ACTIVATED ANALGESIA
- INTRAMUSCULAR
- INTRANASAL
- INTRADERMAL
- TOPICAL OR TRANSDERMAL
- RECTAL
- REGIONAL NERVE BLOCK
- INHALATION
- EPIDURAL OR INTRATHECAL
- FIG. 7-7 Nurse programming a patient-controlled analgesia pump to administer analgesia.
- Epidural Analgesia
- TABLE 7-9 Suggested Intravenous Patient-Controlled Analgesia Opioid Infusion Orders
- FIG. 7-8 Epidural analgesia catheter placement.
- FIG. 7-9 Dressing covering site of epidural catheter.
- Transmucosal and Transdermal Analgesia
- FIG. 7-10 LMX is an effective analgesic before intravenous insertion or blood draw.
- EVIDENCE-BASED PRACTICE
- EMLA Versus LMX for Pain Reduction During Peripheral Intravenous Access in Children
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- FIG. 7-11 The LidoSite system delivers analgesia quickly to the intravenous site.
- EVIDENCE-BASED PRACTICE
- Lidocaine Iontophoresis for Pain Reduction During Peripheral Intravenous Access in Children
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- EVIDENCE-BASED PRACTICE
- Buffered Lidocaine for Pain Reduction During Peripheral Intravenous Access in Children
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- Buffered Lidocaine
- References
- Timing of Analgesia
- BOX 7-4 Side Effects of Opioids
- GENERAL
- SIGNS OF TOLERANCE
- SIGNS OF WITHDRAWAL SYNDROME IN PATIENTS WITH PHYSICAL DEPENDENCE
- Initial Signs of Withdrawal
- Later Signs of Withdrawal
- Monitoring Side Effects
- nursingcareguidelines
- Managing Opioid-Induced Respiratory Depression
- IF RESPIRATIONS ARE DEPRESSED
- IF PATIENT CANNOT BE AROUSED OR IS APNEIC
- COMMUNITY FOCUS
- Fear of Opioid Addiction
- Evaluation of Effectiveness of Pain Regimen
- FIG. 7-12 Weaning flow sheet to monitor opioid weaning in neonates.
- PAINFUL AND INVASIVE PROCEDURES
- POSTOPERATIVE PAIN
- RECURRENT HEADACHES IN CHILDREN
- RECURRENT ABDOMINAL PAIN IN CHILDREN
- CANCER PAIN IN CHILDREN
- PAIN AND SEDATION IN END-OF-LIFE CARE
- KEY POINTS
- References
- UNIT THREE THE NEWBORN
- Interactive Review — Unit Three
- Chapter 8 Health Promotion of the Newborn and Family
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- ADJUSTMENT TO EXTRAUTERINE LIFE
- IMMEDIATE ADJUSTMENTS
- Respiratory System
- Circulatory System
- PHYSIOLOGIC STATUS OF OTHER SYSTEMS
- Thermoregulation
- Hematopoietic System
- Fluid and Electrolyte Balance
- Gastrointestinal System
- BOX 8-1 Change in Stooling Patterns of Newborns
- MECONIUM
- MILK STOOL
- Renal System
- Integumentary System
- Musculoskeletal System
- Defenses Against Infection
- Endocrine System
- Neurologic System
- Sensory Functions
- Vision.
- Hearing.
- Smell.
- Taste.
- Touch.
- NURSING CARE OF THE NEWBORN AND FAMILY
- ASSESSMENT
- Initial Assessment: Apgar Scoring
- 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.
- TABLE 8-1 Infant Evaluation at Birth—Apgar Scoring System
- Clinical Assessment of Gestational Age
- Weight Related to Gestational Age.
- BOX 8-2 Tests Used in Assessing Gestational Age
- Posture
- Square window
- Arm recoil
- Popliteal angle
- Scarf sign
- Heel to ear
- FIG. 8-2 Three infants, same gestational age, weight 600, 1400, and 2750 g, respectively, from left to right.
- General Measurements.
- FIG. 8-3 Measurement of infant length.
- FIG. 8-4 Mother taking axillary temperature with digital thermometer.
- FIG. 8-5 Measurement of blood pressure using oscillometry.
- NURSINGALERT
- General Appearance.
- Skin.
- Head.
- NURSINGTIP
- FIG. 8-6 A, Location of sutures and fontanels. B, Palpating anterior fontanel.
- 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.
- Eyes.
- NURSINGTIP
- Ears.
- Nose.
- Mouth and Throat.
- Neck.
- Chest.
- Lungs.
- Heart.
- NURSINGTIP
- Abdomen.
- NURSINGALERT
- Female Genitalia.
- Male Genitalia.
- Back and Rectum.
- NURSINGALERT
- Extremities.
- Neurologic System.
- Transitional Assessment: Periods of Reactivity
- FIG. 8-8 A, Plantar or grasp reflex. B, Babinski reflex. 1, Direction of stroke. 2, Dorsiflexion of big toe. 3, Fanning of toes.
- TABLE 8-2 Assessment of Reflexes in the Newborn
- FIG. 8-9 Moro reflex.
- Behavioral Assessment
- FIG. 8-10 Tonic neck reflex.
- FIG. 8-11 Crawl reflex.
- TABLE 8-3 States of Sleep and Activity
- BOX 8-3 Clusters of Neonatal Behaviors in Brazelton Neonatal Behavioral Assessment Scale
- Habituation
- Orientation
- Motor performance
- Range of state
- Regulation of state
- Autonomic stability
- Reflexes
- Patterns of Sleep and Activity.
- nursingcareguidelines
- Violence in Children
- nursingcareguidelines
- Physical Examination of the Newborn
- Cry.
- Assessment of Attachment Behaviors
- Physical Assessment
- MAINTAIN A PATENT AIRWAY
- nursingprocess
- The Healthy Newborn and Family
- ASSESSMENT
- DIAGNOSIS (PROBLEM IDENTIFICATION)
- PLANNING
- IMPLEMENTATION
- EVALUATION
- TABLE 8-4 Physical Assessment of the Newborn
- NURSINGALERT
- NURSINGALERT
- MAINTAIN A STABLE BODY TEMPERATURE
- PROTECT FROM INFECTION AND INJURY
- Identification
- Eye Care
- nursingcareguidelines
- Ophthalmia Neonatorum Prophylaxis
- NURSINGTIP
- Vitamin K Administration
- Hepatitis B Vaccine Administration
- Newborn Screening for Disease
- Universal Newborn Hearing Screening
- ATRAUMATIC CARE
- Heel Punctures
- Bathing
- FIG. 8-12 Bath time is an excellent opportunity for parents to learn about their newborn.
- Care of the Umbilicus
- NURSINGALERT
- Circumcision
- BOX 8-4 Risks and Benefits of Neonatal Circumcision
- RISKS
- BENEFITS
- ATRAUMATIC CARE
- Guidelines for Pain Management During Neonatal Circumcision*
- PHARMACOLOGIC INTERVENTIONS
- Use of Topical Anesthetic
- Use of Dorsal Penile Nerve Block or Ring Block
- Acetaminophen
- Oral Sucrose
- NONPHARMACOLOGIC INTERVENTIONS (TO ACCOMPANY PRECEDING PHARMACOLOGIC INTERVENTIONS)
- FIG. 8-13 Proper positioning of infant in Circumstraint.
- CULTURAL AWARENESS
- Circumcision
- PROVIDE OPTIMAL NUTRITION
- Human Milk
- Breastfeeding
- BOX 8-5 Ten Steps to Successful Breastfeeding
- FIG. 8-14 Simultaneous breastfeeding of twins.
- FIG. 8-15 The tongue is under the areola, with the tip of the nipple at the back of the wide-open mouth.
- NURSINGALERT
- Bottle Feeding
- NURSINGTIP
- NURSINGALERT
- Commercially Prepared Formulas
- Preparation of Formula
- NURSINGALERT
- Alternate Milk Products
- Feeding Schedules
- Feeding Behavior
- PROMOTE PARENT-INFANT BONDING (ATTACHMENT)
- Infant Behavior
- BOX 8-6 How to Make the Infant’s World More Exciting*
- Maternal Attachment
- FIG. 8-16 En face position between parent and infant can be significant in attachment process.
- Paternal Engrossment
- FIG. 8-17 A desire to hold the infant and participate in caregiving activities is an indication of paternal engrossment.
- Siblings
- FIG. 8-18 Sibling visitation shortly after birth can facilitate the attachment process.
- Multiple Births and Subsequent Children
- FIG. 8-19 Newborn twins are placed in same bed during newborn transition period.
- PREPARE FOR DISCHARGE AND HOME CARE
- FAMILY-CENTERED CARE
- Early Newborn Discharge Checklist
- COMMUNITY FOCUS
- Early Newborn Discharge Checklist
- Feeding
- Elimination
- Circumcision
- Color
- Cord
- Newborn screening
- Vital signs
- Activity
- Home visit or primary practitioner visit
- COMMUNITY FOCUS
- Newborn Home Care After Early Discharge*
- Wet diapers
- Breastfeeding
- Formula feeding
- Circumcision
- Stools
- Color
- Activity
- Jaundice
- Cord
- Vital signs
- Position of sleep
- NURSINGALERT
- KEY POINTS
- References
- Chapter 9 Health Problems of Newborns
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- BIRTH INJURIES
- SOFT-TISSUE INJURY
- HEAD TRAUMA
- Caput Succedaneum
- Cephalhematoma
- FIG. 9-1 A, Caput succedaneum. B, Cephalhematoma. C, Subgaleal hemorrhage.
- Subgaleal Hemorrhage
- Nursing Care Management
- FRACTURES
- NURSINGALERT
- NURSINGALERT
- Nursing Care Management
- PARALYSIS
- Facial Paralysis
- Brachial Palsy
- 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.
- Phrenic Nerve Paralysis
- FIG. 9-3 Left-sided brachial plexus (Erb) palsy. Note extended, internally rotated arm and pronated wrist on affected side.
- Nursing Care Management
- COMMON PROBLEMS IN THE NEWBORN
- ERYTHEMA TOXICUM NEONATORUM
- CANDIDIASIS
- Oral Candidiasis
- FIG. 9-4 Oral candidiasis (thrush).
- NURSINGALERT
- Nursing Care Management
- HERPES
- Nursing Care Management
- BIRTHMARKS
- FIG. 9-5 A, Port-wine stain. B, Strawberry hemangioma.
- Nursing Care Management
- NURSING CARE OF THE HIGH-RISK NEWBORN AND FAMILY
- IDENTIFICATION OF HIGH-RISK NEWBORNS
- Classification of High-Risk Newborns
- BOX 9-2 Psychologic Tasks of Parents of a High-Risk Infant
- BOX 9-1 Classification of High-Risk Infants
- CLASSIFICATION ACCORDING TO SIZE
- Low-birth-weight (LBW) infant
- Very low–birth-weight (VLBW) infant
- Extremely low–birth-weight (ELBW) infant
- Appropriate-for-gestational-age (AGA) infant
- Small-for-date (SFD) or small-for-gestational-age (SGA) infant
- Intrauterine growth restriction (IUGR)
- Symmetric IUGR
- Asymmetric IUGR
- Large-for-gestational-age (LGA) infant
- CLASSIFICATION ACCORDING TO GESTATIONAL AGE
- Preterm (premature) infant
- Full-term infant
- Postterm (postmature) infant
- Near-term (late-preterm) infant
- CLASSIFICATION ACCORDING TO MORTALITY
- Live birth
- Fetal death
- Neonatal death
- Perinatal mortality
- CARE OF HIGH-RISK NEWBORNS
- Systematic Assessment
- nursingcareguidelines
- Physical Assessment
- GENERAL ASSESSMENT
- RESPIRATORY ASSESSMENT
- CARDIOVASCULAR ASSESSMENT
- GASTROINTESTINAL ASSESSMENT
- GENITOURINARY ASSESSMENT
- NEUROLOGIC-MUSCULOSKELETAL ASSESSMENT
- TEMPERATURE
- SKIN ASSESSMENT
- Monitoring Physiologic Data
- TABLE 9-1 Blood Pressure Ranges in Different Weight Groups of Healthy Preterm Infants*
- Respiratory Support
- Thermoregulation
- nursingprocess
- The High-Risk Newborn and Family
- ASSESSMENT
- DIAGNOSIS (PROBLEM IDENTIFICATION)
- PLANNING
- IMPLEMENTATION
- EVALUATION
- FIG. 9-6 Nurse caring for infant in a radiant warmer.
- FIG. 9-7 Infant under plastic wrap, which produces a draft-free environment.
- Protection from Infection
- Hydration
- NURSINGALERT
- NURSINGALERT
- Nutrition
- Breastfeeding.
- Nipple Feeding.
- NURSINGALERT
- 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.
- Gavage Feeding.
- NURSINGALERT
- NURSINGALERT
- Feeding Resistance
- Energy Conservation
- FAMILY FOCUS
- Feeding Resistance
- Skin Care
- FIG. 9-9 A, Preterm infant slowly transitioned to prone position on prone roll. B, Preterm infant positioned on prone roll.
- nursingcareguidelines
- Neonatal Skin Care
- GENERAL SKIN CARE
- Assessment
- Bathing
- Initial Bath
- Routine
- Emollients
- Adhesives
- Antiseptic Agents
- Transepidermal Water Loss (TEWL)
- SKIN BREAKDOWN
- Prevention
- Treating Skin Breakdown
- Treating Diaper Dermatitis
- OTHER SKIN CARE CONCERNS
- Use of Substances on Skin
- Use of Thermal Devices
- Use of Fluid Therapy and Hemodynamic Monitoring
- Administration of Medications
- Developmental Outcome
- FIG. 9-10 Father providing skin-to-skin (kangaroo) care.
- TABLE 9-2 Signs of Stress or Fatigue in Neonates
- nursingcareguidelines
- Developmental Interventions
- GENERAL GUIDELINES
- TACTILE
- AUDITORY
- VESTIBULAR
- OLFACTORY
- GUSTATORY
- VISUAL
- Family Support and Involvement
- Facilitating Parent-Infant Relationships
- FIG. 9-11 Father interacting with newborn receiving intensive care.
- FIG. 9-12 Mother and father interacting with their preterm infant.
- FIG. 9-13 Father feeding preterm infant.
- Siblings.
- FIG. 9-14 Siblings visiting in the NICU.
- Support Groups.
- Discharge Planning and Home Care
- COMMUNITY FOCUS
- COMMUNITY FOCUS
- Preterm and Near-Term Infant Car Seat Evaluation
- ETHICAL CASE STUDY
- Preterm Infant
- ETHICAL DECISION MAKING MODEL
- Evaluate the Issue
- Treat All Involved with Respect
- Hear All Sides
- Initiate Action
- Consider the Outcome
- Neonatal Loss
- Baptism.
- BOX 9-3 Etiology of Preterm Birth
- MATERNAL FACTORS
- FACTORS RELATED TO PREGNANCY
- FETAL FACTORS
- UNKNOWN FACTORS
- HIGH RISK RELATED TO DYSMATURITY
- PRETERM INFANTS
- Diagnostic Evaluation
- FIG. 9-15 Clinical and neurologic examinations comparing preterm and full-term infants. Clinical and neurologic examinations comparing preterm and full-term infants.
- Therapeutic Management
- Nursing Care Management
- POSTTERM INFANTS
- HIGH RISK RELATED TO PHYSIOLOGIC FACTORS
- HYPERBILIRUBINEMIA
- TABLE 9-3 Comparison of Major Types of Unconjugated Hyperbilirubinemia*
- Pathophysiology
- Diagnostic Evaluation
- 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.
- Complications.
- Therapeutic Management
- 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.
- nursingprocess
- The Newborn with Jaundice
- ASSESSMENT
- DIAGNOSIS (PROBLEM IDENTIFICATION)
- PLANNING
- IMPLEMENTATION
- EVALUATION
- Prognosis.
- Nursing Care Management
- NURSINGALERT
- NURSINGTIP
- Phototherapy.
- Family Support.
- FAMILY FOCUS
- Phototherapy and Parent-Infant Interaction
- Discharge Planning and Home Care.
- CRITICAL THINKING EXERCISE
- Jaundice
- QUESTIONS
- HEMOLYTIC DISEASE OF THE NEWBORN
- Blood Incompatibility
- Rh Incompatibility (Isoimmunization).
- 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.
- TABLE 9-4 Potential Maternal-Fetal ABO Incompatibilities
- ABO Incompatibility.
- Clinical Manifestations
- Diagnostic Evaluation
- Therapeutic Management
- Prevention of Rh Isoimmunization.
- NURSINGALERT
- Intrauterine Transfusion.
- Exchange Transfusion.
- Prognosis.
- Nursing Care Management
- NURSINGALERT
- Family Support.
- METABOLIC COMPLICATIONS
- RESPIRATORY DISTRESS SYNDROME
- Pathophysiology
- TABLE 9-5 Metabolic Complications
- BOX 9-4 Clinical Manifestations of Respiratory Distress Syndrome
- MATERNAL FACTORS
- Diagnostic Evaluation
- Therapeutic Management
- FIG. 9-19 Criteria for evaluating respiratory distress.
- TABLE 9-6 Common Methods for Assisted Ventilation in Neonatal Respiratory Distress
- Prevention.
- Prognosis.
- Nursing Care Management
- NURSINGALERT
- RESPIRATORY COMPLICATIONS
- nursingcareplan
- The High-Risk Infant with Respiratory Distress Syndrome
- TABLE 9-7 Respiratory Complications
- CARDIOVASCULAR COMPLICATIONS
- TABLE 9-8 Cardiovascular and Hematologic Complications
- CEREBRAL COMPLICATIONS
- TABLE 9-9 Sensory and Neurologic Complications
- NEONATAL SEIZURES
- BOX 9-5 Causes of Neonatal Seizures
- METABOLIC
- TOXIC
- PRENATAL INFECTIONS
- POSTNATAL INFECTIONS
- TRAUMA AT BIRTH
- MALFORMATIONS
- MISCELLANEOUS
- Diagnostic Evaluation
- Therapeutic Management
- TABLE 9-10 Classifications of Neonatal Seizures
- Nursing Care Management
- HIGH RISK RELATED TO INFECTIOUS PROCESSES
- SEPSIS
- Diagnostic Evaluation
- Prevention
- Therapeutic Management
- BOX 9-6 Manifestations of Neonatal Sepsis
- GENERAL SIGNS
- CIRCULATORY SYSTEM
- RESPIRATORY SYSTEM
- CENTRAL NERVOUS SYSTEM
- GASTROINTESTINAL SYSTEM
- HEMATOPOIETIC SYSTEM
- Prognosis.
- Nursing Care Management
- NURSINGALERT
- NECROTIZING ENTEROCOLITIS
- Diagnostic Evaluation
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- NURSINGTIP
- BOX 9-7 Clinical Manifestations of Necrotizing Enterocolitis
- NONSPECIFIC CLINICAL SIGNS
- SPECIFIC SIGNS
- HIGH RISK RELATED TO MATERNAL CONDITIONS
- INFANTS OF DIABETIC MOTHERS
- BOX 9-8 Clinical Manifestations of Infants of Diabetic Mothers
- Therapeutic Management
- Nursing Care Management
- DRUG-EXPOSED INFANTS*
- Clinical Manifestations
- Diagnostic Evaluation
- EVIDENCE-BASED PRACTICE
- Glucose Water Feedings in the Newborn Period
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- Therapeutic Management
- BOX 9-9 Signs of Withdrawal in the Neonate
- NEUROLOGIC
- GASTROINTESTINAL
- AUTONOMIC
- MISCELLANEOUS
- Prognosis.
- Nursing Care Management
- Alcohol Exposure
- Cocaine Exposure
- Therapeutic Management.
- Nursing Care Management.
- Methamphetamine Exposure
- Marijuana Exposure
- MATERNAL INFECTIONS
- TABLE 9-11 Infections Acquired from Mother Before, During, or After Birth*
- Nursing Care Management
- CONGENITAL ANOMALIES*
- BOX 9-10 Assessment Clues to Genetic Disorders*
- Major or minor birth defects (anomalies) and dysmorphic features
- Growth abnormalities
- Skeletal abnormalities
- Vision or hearing problems
- Metabolic disorders
- Sexual development abnormalities
- Skin disorders
- GENETIC ETIOLOGY OF CONGENITAL ANOMALIES
- Chromosomal Abnormalities
- Single-Gene Defects
- Multifactorial Inheritance
- DEFECTS CAUSED BY CHEMICAL AGENTS
- TABLE 9-12 Common Chromosomal Abnormalities
- Nursing Care Management
- FYI
- INBORN ERRORS OF METABOLISM
- TABLE 9-13 Congenital Effects of Maternal Alcohol Ingestion and Tobacco Smoking
- CONGENITAL HYPOTHYROIDISM
- BOX 9-11 Clinical Manifestations of Congenital Hypothyroidism
- BIRTH*
- AGES 6 TO 9 WEEKS†
- OLDER CHILD
- Diagnostic Evaluation
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- FIG. 9-20 Metabolic error and consequences in phenylketonuria.
- PHENYLKETONURIA
- Diagnostic Evaluation*
- NURSINGALERT
- Therapeutic Management*
- Prognosis.
- Nursing Care Management
- Family Support.†
- GALACTOSEMIA
- FAMILY FOCUS
- Supporting Families
- Diagnostic Evaluation
- Therapeutic Management
- Prognosis.
- Nursing Care Management*
- GENETIC EVALUATION AND COUNSELING
- TABLE 9-14 Types of Genetic Testing
- nursingcareguidelines
- Common Indications for Referral
- PSYCHOLOGIC ASPECTS OF GENETIC DISEASE
- KEY POINTS
- answers to CRITICAL THINKING EXERCISE
- Supporting Families
- JAUNDICE
- References
- UNIT FOUR INFANCY
- Interactive Review — Unit Four
- Chapter 10 Health Promotion of the Infant and Family
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- PROMOTING OPTIMAL GROWTH AND DEVELOPMENT
- Biologic Development
- Proportional Changes
- Maturation of Systems
- Fine Motor Development
- Gross Motor Development
- FIG. 10-1 Crude pincer grasp at 8 to 10 months.
- NURSINGALERT
- NURSINGALERT
- 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.
- 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.
- FIG. 10-4 Parachute reflex.
- NURSINGALERT
- Psychosocial Development: Developing a Sense of Trust (Erikson)
- Cognitive Development: Sensorimotor Phase (Piaget)
- 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.
- 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.
- FIG. 10-7 Nine-month-old is able to find hidden object under pillow.
- Development of Body Image
- FIG. 10-8 Nine-month-old infant enjoying own image in mirror.
- Social Development
- Attachment
- FIG. 10-9 Infancy is an important time for attachment to significant others.
- NURSINGALERT
- Language Development
- FAMILY FOCUS
- Child’s Developing Language Skills
- Play
- TABLE 10-1 Play During Infancy
- TEMPERAMENT
- Childrearing Practices Related to Temperament
- COPING WITH CONCERNS RELATEDTO NORMAL GROWTH AND DEVELOPMENT
- Separation and Stranger Fear
- Alternate Child Care Arrangements
- TABLE 10-2 Growth and Development During Infancy
- Limit Setting and Discipline
- Thumb Sucking and Use of a Pacifier
- Teething
- NURSINGTIP
- FIG. 10-10 Sequence of eruption of primary teeth. *Range represents ±1 standard deviation, or 67% of subjects studied.
- NURSINGALERT
- Infant Shoes
- PROMOTING OPTIMAL HEALTH DURING INFANCY
- NUTRITION
- The First 6 Months
- NURSINGALERT
- NURSINGALERT
- NURSINGALERT
- NURSINGALERT
- NURSINGALERT
- The Second 6 Months
- Selection and Preparation of Solid Foods
- Introduction of Solid Foods
- FAMILY-CENTERED CARE
- Feeding During the First Year
- BIRTH TO 6 MONTHS (BREASTFEEDING OR BOTTLE FEEDING)
- Breastfeeding
- Formula
- AGE 6 TO 12 MONTHS (SOLID FOODS)
- Cereal-Start at 4 to 6 Months of Age
- Fruits and Vegetables-Start at 6 to 8 Months of Age
- Meat, Fish, and Poultry-Start at 8 to 10 Months of Age
- Eggs and Cheese-Start at 12 Months of Age
- Weaning
- SLEEP AND ACTIVITY
- Sleep Problems
- TABLE 10-3 Selected Sleep Disturbances During Infancy and Early Childhood
- CULTURAL AWARENESS
- The Family Bed
- DENTAL HEALTH
- COMMUNITY FOCUS
- Keeping Current on Vaccine Recommendations
- IMMUNIZATIONS
- Schedule for Immunizations
- Recommendations for Routine Immunizations
- 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.
- 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.
- FIG. 10-13 Convertible seat in forward-facing position for older infants and toddlers.
- TABLE 10-4 Recommended Immunization Schedules: Canada, 2006
- TABLE 10-5 Guide to Tetanus Prophylaxis in Routine Wound Management
- NURSINGALERT
- Recommendations for Selected Immunizations
- Reactions
- Contraindications and Precautions
- Administration
- TABLE 10-6 Contraindications and Precautions to Vaccinationsa
- ATRAUMATIC CARE
- Immunizations
- FAMILY-CENTERED CARE
- Communicating with Parents About Immunizations
- TABLE 10-7 Product Brand Names for Principal Childhood Vaccine Types
- COMMUNITY FOCUS
- Improving Immunization Rates Among Children and Adolescents
- INJURY PREVENTION
- Aspiration of Foreign Objects
- BOX 10-1 Injury Prevention During Infancy
- BIRTH TO 4 MONTHS
- Major Developmental Accomplishments
- Injury Prevention
- Aspiration
- Burns
- Suffocation and Drowning
- Motor Vehicles
- Falls
- Poisoning
- Bodily Damage
- AGE 4 TO 7 MONTHS
- Major Developmental Accomplishments
- Injury Prevention
- Aspiration
- Suffocation
- Burns
- Falls
- Motor Vehicles
- Poisoning
- Bodily Damage
- AGE 8 TO 12 MONTHS
- Major Developmental Accomplishments
- Injury Prevention
- Aspiration
- Bodily Damage
- Falls
- Suffocation and Drowning
- Poisoning
- Burns
- Suffocation
- NURSINGALERT
- Motor Vehicle Injuries
- NURSINGALERT
- NURSINGALERT
- Falls
- Poisoning
- Burns
- Drowning
- Bodily Damage
- Nurse’s Role in Injury Prevention
- FAMILY-CENTERED CARE
- Child Safety Home Checklist
- SAFETY: FIRE, ELECTRICAL, BURNS
- SAFETY: SUFFOCATION AND ASPIRATION
- SAFETY: POISONING
- SAFETY: FALLS
- SAFETY: BODILY INJURY
- FAMILY-CENTERED CARE
- Guidance During Infant’s First Year
- FIRST 6 MONTHS
- SECOND 6 MONTHS
- ANTICIPATORY GUIDANCE’CARE OF FAMILIES
- KEY POINTS
- References
- Chapter 11 Health Problems of Infants
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- NUTRITIONAL DISORDERS
- VITAMIN IMBALANCES
- COMPLEMENTARY AND ALTERNATIVE MEDICINE
- MINERAL IMBALANCES
- VEGETARIAN DIETS
- NURSING CARE MANAGEMENT
- FIG. 11-5 Placement of electrodes or belt for apnea monitoring. In small infants, one fingerbreadth may be used.
- BOX 11-1 Factors That Affect Iron Absorption
- INCREASE
- DECREASE
- BOX 11-2 MyPyramid: Sample Serving Sizes
- Grain group
- Vegetable group
- Fruit group
- Milk group
- Meat group
- PROTEIN-ENERGY MALNUTRITION
- FIG. 11-1 MyPyramid for Kids.
- Kwashiorkor
- Marasmus
- Therapeutic Management
- Nursing Care Management
- FOOD SENSITIVITY
- BOX 11-3 Hyperallergenic Foods and Sources
- Nuts*
- Eggs*
- Wheat*
- Legumes
- Fish or shellfish*
- Soy*
- Chocolate
- Milk
- Buckwheat
- Pork, chicken
- Strawberries, melon, pineapple
- Corn
- Citrus fruits
- Tomatoes
- Spices
- nursingcareguidelines
- Preventing Atopy in Children
- IDENTIFY CHILDREN AT RISK
- PRENATAL PRECAUTIONS (LAST TRIMESTER)
- POSTNATAL PRECAUTIONS
- ENVIRONMENTAL CONTROL
- NURSINGALERT
- Cow’s Milk Allergy
- Diagnostic Evaluation.
- BOX 11-4 Common Clinical Manifestations of Cow’s Milk Sensitivity
- GASTROINTESTINAL
- RESPIRATORY
- OTHER SIGNS AND SYMPTOMS
- Therapeutic Management.
- Nursing Care Management.
- Lactose Intolerance
- FAMILY-CENTERED CARE
- Controlling Symptoms of Lactose Intolerance
- Nursing Care Management.
- TABLE 11-1 Vitamins and Their Nutritional Significance*
- TABLE 11-2 Minerals and Their Nutritional Significance*
- FEEDING DIFFICULTIES
- REGURGITATION AND ‘SPITTING UP’
- PAROXYSMAL ABDOMINAL PAIN (COLIC)
- Therapeutic Management
- Nursing Care Management
- GROWTH FAILURE (FAILURE TO THRIVE)
- FAMILY-CENTERED CARE
- Managing the Colicky Infant
- FIG. 11-2 The ‘colic carry’ may be comforting to an infant with colic.
- Diagnostic Evaluation
- Therapeutic Management
- Prognosis
- Nursing Care Management
- BOX 11-5 Clinical Manifestations of Failure to Thrive
- FIG. 11-3 A consistent nurse is important in developing trust in infants with failure to thrive.
- nursingcareguidelines
- Feeding Children with Failure to Thrive
- Provide a primary core of staff to feed the child.
- Provide a quiet, unstimulating atmosphere.
- Maintain a calm, even temperament throughout the meal.
- Talk to the child by giving directions about eating.
- Be persistent.
- Maintain a face-to-face posture with the child when possible.
- Introduce new foods slowly.
- Follow the child’s rhythm of feeding.
- Develop a structured routine.
- POSITIONAL PLAGIOCEPHALY
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- FIG. 11-4 A, Plagiocephaly. B, Helmet used to correct plagiocephaly.
- DISORDERS OF UNKNOWN ETIOLOGY
- SUDDEN INFANT DEATH SYNDROME
- Etiology
- TABLE 11-3 Epidemiology of Sudden Infant Death Syndrome (SIDS)
- Nursing Care Management
- NURSINGALERT
- Finding the Infant.
- Arriving at the Emergency Department.
- Returning Home.
- APNEA AND APPARENT LIFE-THREATENING EVENT
- Diagnostic Evaluation
- Therapeutic Management
- FAMILY-CENTERED CARE
- Using Apnea Monitors
- Nursing Care Management
- NURSINGALERT
- Family Support.
- KEY POINTS
- References
- UNIT FIVE EARLY CHILDHOOD
- Interactive Review — Unit Five
- Chapter 12 Health Promotion of the Toddler and Family
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- PROMOTING OPTIMAL GROWTH AND DEVELOPMENT
- Biologic Development
- Proportional Changes
- Sensory Changes
- Maturation of Systems
- Gross and Fine Motor Development
- Psychosocial Development
- Developing a Sense of Autonomy (Erikson)
- Cognitive Development: Sensorimotor and Preoperational Phase (Piaget)
- Tertiary Circular Reactions.
- FIG. 12-1 Toddlers begin socializing with significant others such as siblings as a part of development.
- FIG. 12-2 Domestic mimicry is common during toddlerhood.
- Invention of New Means Through Mental Combinations.
- Preoperational Phase.
- SPIRITUAL DEVELOPMENT
- BOX 12-1 Characteristics of Preoperational Thought
- DEVELOPMENT OF BODY IMAGE
- DEVELOPMENT OF GENDER IDENTITY
- SOCIAL DEVELOPMENT
- FIG. 12-3 Transitional objects, such as a warm and fuzzy stuffed animal, are sources of security to a toddler.
- Language
- Personal-Social Behavior
- Play
- FIG. 12-4 Young children enjoy dressing up.
- NURSINGALERT
- COPING WITH CONCERNS RELATED TO NORMAL GROWTH AND DEVELOPMENT
- Toilet Training
- nursingcareguidelines
- Assessing Toilet Training Readiness
- PHYSICAL READINESS
- MENTAL READINESS
- PSYCHOLOGIC READINESS
- PARENTAL READINESS
- TABLE 12-1 Growth and Development During the Toddler Years
- NURSINGALERT
- 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.
- Sibling Rivalry
- FIG. 12-6 To minimize sibling rivalry, parents should include the toddler during caregiving activities.
- Temper Tantrums
- Negativism
- Regression
- PROMOTING OPTIMAL HEALTHDURING TODDLERHOOD
- Nutrition
- Nutritional Counseling
- BOX 12-2 Sample Menu for Toddlers Based on MyPyramid for Kids*
- BREAKFAST
- SNACK
- LUNCH
- SNACK
- DINNER
- SNACK
- TOTAL (PER DAY)
- NURSINGTIP
- Dietary Guidelines
- SLEEP AND ACTIVITY
- Dental Health
- Regular Dental Examinations
- Removal of Plaque
- FIG. 12-7 Young children can participate in toothbrushing, but parents need to brush all of the child’s teeth thoroughly.
- NURSINGTIP
- FIG. 12-8 The most effective cleaning of teeth is done by parents.
- Fluoride
- TABLE 12-2 Fluoride Supplementation*
- Low-Cariogenic Diet
- FIG. 12-9 Nursing caries.
- Injury Prevention
- TABLE 12-3 Injury Prevention During Early Childhood
- Motor Vehicle Injuries
- 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.
- Car Restraints.
- FAMILY-CENTERED CARE
- Using Car Safety Restraints
- 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.
- Other Car-Related Injuries.
- Drowning
- Burns
- FIG. 12-12 Special plastic caps in electrical sockets prevent young fingers from exploring dangerous areas.
- 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.
- Poisoning
- Falls
- Aspiration and Suffocation
- Bodily Damage
- Terrorism and Violence
- Anticipatory Guidance–Care of Families
- KEY POINTS
- FAMILY-CENTERED CARE
- Guidance During Toddler Years
- AGES 12 TO 18 MONTHS
- AGES 18 TO 24 MONTHS
- AGES 24 TO 36 MONTHS
- References
- Chapter 13 Health Promotion of the Preschooler and Family
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- PROMOTING OPTIMAL GROWTH AND DEVELOPMENT
- BIOLOGIC DEVELOPMENT
- Gross and Fine Motor Skills
- PSYCHOSOCIAL DEVELOPMENT
- Developing a Sense of Initiative (Erikson)
- FIG. 13-1 A 4-year-old child has sufficient balance to stand or hop on one foot.
- CULTURAL AWARENESS
- Learning Sociocultural Mores
- COGNITIVE DEVELOPMENT
- Preoperational Phase (Piaget)
- NURSINGALERT
- MORAL DEVELOPMENT
- Preconventional or Premoral Level (Kohlberg)
- SPIRITUAL DEVELOPMENT
- DEVELOPMENT OF BODY IMAGE
- DEVELOPMENT OF SEXUALITY
- SOCIAL DEVELOPMENT
- Language
- Personal-Social Behavior
- FIG. 13-2 Preschool children enjoy friends and often use non-verbal messages to communicate.
- Play
- FIG. 13-3 Most preschoolers are able to dress themselves but need help with more difficult items of clothing.
- FIG. 13-4 Preschoolers enjoy play activities that promote motor skills such as jumping and running. Water play is an exciting activity for preschoolers.
- FIG. 13-5 Imaginative and imitative play is typical of pre-schoolers.
- COPING WITH CONCERNS RELATED TO NORMAL GROWTH AND DEVELOPMENT
- Preschool and Kindergarten Experience
- FIG. 13-6 Thorough hand washing is the single most effective method of preventing infection.
- Sex Education
- TABLE 13-1 Growth and Development During Preschool Years
- Fears
- Stress
- Aggression
- Speech Problems
- PROMOTING OPTIMAL HEALTH DURING THE PRESCHOOL YEARS*
- NUTRITION
- NURSINGALERT
- FIG. 13-7 Preschool-age children enjoy helping adults and are more likely to try new foods if they can assist in the preparation.
- SLEEP AND ACTIVITY
- TABLE 13-2 Comparison of Nightmares to Sleep Terrors
- Sleep Problems
- DENTAL HEALTH
- INJURY PREVENTION
- ANTICIPATORY GUIDANCE—CARE OF FAMILIES
- FAMILY-CENTERED CARE
- Guidance During Preschool Years
- AGE 3 YEARS
- AGE 4 YEARS
- AGE 5 YEARS
- KEY POINTS
- References
- Chapter 14 Health Problems of Toddlers and Preschoolers
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- INFECTIOUS DISORDERS
- COMMUNICABLE DISEASES
- TABLE 14-1 Communicable Diseases of Childhood
- FIG. 14-1 Chickenpox (varicella). A, Progression of disease. B, Simultaneous stages of lesions in chickenpox. C, Clinical view.
- FIG. 14-2 Erythema infectiosum.
- FIG. 14-3 Roseola infantum.
- 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.
- FIG. 14-5 Rubella (German measles). A, Progression of rash. B, Clinical view.
- FIG. 14-6 Scarlet fever.
- Nursing Care Management
- nursingprocess: The Child with Communicable Disease
- ASSESSMENT
- DIAGNOSIS (PROBLEM IDENTIFICATION)
- PLANNING
- IMPLEMENTATION
- EVALUATION
- Prevent Spread.
- NURSINGALERT
- Prevent Complications.
- NURSINGALERT
- NURSINGALERT
- Provide Comfort.
- NURSINGALERT
- Support Child and Family.
- NURSINGALERT
- CONJUNCTIVITIS
- BOX 14-1 Clinical Manifestations of Conjunctivitis
- BACTERIAL CONJUNCTIVITIS (“PINK EYE”)
- VIRAL CONJUNCTIVITIS
- ALLERGIC CONJUNCTIVITIS
- CONJUNCTIVITIS CAUSED BY FOREIGN BODY
- Therapeutic Management
- Nursing Care Management
- NURSINGALERT
- STOMATITIS
- FIG. 14-7 Primary gingivostomatitis.
- Therapeutic Management
- Nursing Care Management
- NURSINGALERT
- INTESTINAL PARASITIC DISEASES
- GENERAL NURSING CARE MANAGEMENT
- GIARDIASIS
- TABLE 14-2 Selected Intestinal Parasites
- COMMUNITY FOCUS
- Preventing Intestinal Parasitic Disease
- BOX 14-2 Clinical Manifestations of Giardiasis
- Therapeutic Management
- Nursing Care Management
- 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.
- ENTEROBIASIS (PINWORMS)
- Diagnostic Evaluation
- BOX 14-3 Clinical Manifestations of Pinworms
- Therapeutic Management
- Nursing Care Management
- INGESTION OF INJURIOUS AGENTS
- NURSINGALERT
- BOX 14-4 Poisonous and Nonpoisonous Plants
- POISONOUS PLANTS (TOXIC PARTS)
- NONPOISONOUS PLANTS
- PRINCIPLES OF EMERGENCY TREATMENT
- CRITICAL THINKING EXERCISE
- Poisoning
- QUESTIONS
- emergencytreatment
- Poisoning
- BOX 14-5 Selected Poisonings in Children
- CORROSIVES (STRONG ACIDS OR ALKALIS)
- Clinical Manifestations
- Comments
- Treatment
- HYDROCARBONS
- Clinical Manifestations
- Comments
- Treatment
- ACETAMINOPHEN
- Clinical Manifestations
- Comments
- Treatment
- ASPIRIN (ACETYLSALICYLIC ACID [ASA])
- Clinical Manifestations
- Comments
- Treatment
- IRON
- Clinical Manifestations
- Comments
- Treatment
- PLANTS
- Clinical Manifestations
- Comments
- Treatment
- Assessment
- Gastric Decontamination
- NURSINGALERT
- EVIDENCE-BASED PRACTICE
- Gastric Lavage in Children
- Curt Roberts and Danna Salinas
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- Prevention of Recurrence
- FAMILY FOCUS
- Poisoning
- HEAVY METAL POISONING
- NURSINGALERT
- COMMUNITY FOCUS
- Poison Prevention
- LEAD POISONING
- BOX 14-6 Sources of Lead*
- Causes of Lead Poisoning
- CULTURAL AWARENESS
- Sources of Lead
- Pathophysiology and Clinical Manifestations
- FIG. 14-9 Main effects of lead on body systems.
- NURSINGALERT
- Diagnostic Evaluation
- Anticipatory Guidance
- Screening for Lead Poisoning
- Therapeutic Management
- Chelation Therapy.
- COMMUNITY FOCUS
- Reducing Blood Lead Levels
- Prognosis.
- Nursing Care Management
- ATRAUMATIC CARE
- Lead Chelation Therapy
- NURSINGALERT
- NURSINGALERT
- CHILD MALTREATMENT
- CHILD NEGLECT
- Types of Neglect
- EMOTIONAL ABUSE
- PHYSICAL ABUSE
- Shaken Baby Syndrome
- NURSINGALERT
- Munchausen Syndrome by Proxy
- Factors Predisposing to Physical Abuse
- Parental Characteristics.
- Characteristics of the Child.
- Environmental Characteristics.
- SEXUAL ABUSE
- Characteristics of Abusers and Victims
- Initiation and Perpetuation of Sexual Abuse
- BOX 14-7 Methods Used to Pressure Children into Sexual Activity
- NURSING CARE OF THE MALTREATED CHILD
- NURSINGALERT
- nursingcareguidelines
- Talking with Children Who Reveal Abuse
- BOX 14-8 Warning Signs of Abuse
- BOX 14-9 Clinical Manifestations of Potential Child Maltreatment
- PHYSICAL NEGLECT
- Suggestive Physical Findings
- Suggestive Behaviors
- EMOTIONAL ABUSE AND NEGLECT
- Suggestive Physical Findings
- Suggestive Behaviors
- PHYSICAL ABUSE
- Suggestive Physical Findings
- Suggestive Behaviors
- SEXUAL ABUSE
- Suggestive Physical Findings
- Suggestive Behaviors
- Caregiver-Child Interaction
- History and Interview
- Child Physical Abuse.
- Neglect and Emotional Abuse.
- Sexual Abuse.
- NURSINGALERT
- Physical Assessment
- Child Physical Abuse.
- NURSINGALERT
- Neglect and Emotional Abuse.
- Sexual Abuse.
- Nursing Care Management
- Protect Child from Further Abuse.
- NURSINGALERT
- nursingprocess: The Child Who Is Maltreated
- ASSESSMENT
- DIAGNOSIS (PROBLEM IDENTIFICATION)
- PLANNING
- IMPLEMENTATION
- EVALUATION
- Support Child.
- Support Family.
- nursingcareguidelines
- Recording Assessment Data in Suspected Abuse
- HISTORY OF INJURY
- PHYSICAL EXAMINATION
- Plan for Discharge.
- Prevent Abuse.
- nursingcareplan: The Child Who Is Maltreated
- FAMILY-CENTERED CARE
- Preventing or Dealing with Sexual Abuse of Children
- KEY POINTS
- answers to CRITIAL THINKING EXERCISE
- POISONING
- REFERENCES
- UNIT SIX MIDDLE CHILDHOOD AND ADOLESCENCE
- Interactive Review — Unit Six
- Chapter 15 Health Promotion of the School-Age Child and Family
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- PROMOTING OPTIMAL GROWTH AND DEVELOPMENT
- BIOLOGIC DEVELOPMENT
- Proportional Changes
- Maturation of Systems
- FIG. 15-1 Middle childhood is the stage of development when deciduous teeth are shed.
- Prepubescence
- PSYCHOSOCIAL DEVELOPMENT: DEVELOPING A SENSE OF INDUSTRY (ERIKSON)
- FIG. 15-2 School-age children are motivated to complete tasks working alone.
- COGNITIVE DEVELOPMENT (PIAGET)
- MORAL DEVELOPMENT (KOHLBERG)
- FIG. 15-3 Common examples that demonstrate the child’s ability to conserve (ages are only approximate).
- SPIRITUAL DEVELOPMENT
- CULTURAL AWARENESS
- Religious Orientation
- SOCIAL DEVELOPMENT
- Social Relationships and Cooperation
- FIG. 15-4 School-age children enjoy engaging in activities with a “best friend.”
- Clubs and Peer Groups.
- Relationships with Families
- Play
- Rules and Rituals.
- Team Play.
- Quiet Games and Activities.
- FIG. 15-5 Selecting a book with the assistance of an adult.
- FIG. 15-6 School-age children take pride in learning new skills.
- Ego Mastery.
- DEVELOPING A SELF-CONCEPT
- Developing a Body Image
- COPING WITH CONCERNS RELATED TO NORMAL GROWTH AND DEVELOPMENT
- School Experience
- Teachers.
- Parents.
- Latchkey Children
- FAMILY-CENTERED CARE
- Helping Children in School
- GENERAL GUIDELINES
- SPECIFIC GUIDELINES
- Limit Setting and Discipline
- Dishonest Behavior
- TABLE 15-1 Growth and Development During School-Age Years
- Stress and Fear
- NURSINGALERT
- PROMOTING OPTIMAL HEALTH DURING THE SCHOOL YEARS
- NUTRITION
- SLEEP AND REST
- EXERCISE AND ACTIVITY
- 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.
- Sports
- Acquisition of Skills
- DENTAL HEALTH
- FIG. 15-8 Sequence of eruption of secondary teeth.
- Dental Problems
- emergencytreatment
- Avulsed Permanent Tooth
- TO REIMPLANT TOOTH
- IF RELUCTANT TO REIMPLANT TOOTH
- SEX EDUCATION
- Nurse’s Role in Sex Education
- SCHOOL HEALTH
- INJURY PREVENTION
- 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.
- FAMILY-CENTERED CARE
- Bicycle Safety
- ANTICIPATORY GUIDANCE—CARE OF FAMILIES
- FAMILY-CENTERED CARE
- Skateboard and In-Line Skate Safety
- TABLE 15-2 Injury Prevention During School-Age Years
- FAMILY-CENTERED CARE
- Guidance During School Years
- AGE 6 YEARS
- AGES 7 TO 10 YEARS
- AGES 11 TO 12 YEARS
- HEALTH GUIDANCE
- KEY POINTS
- References
- Chapter 16 Health Promotion of the Adolescent and Family
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- PROMOTING OPTIMAL GROWTH AND DEVELOPMENT
- BIOLOGIC DEVELOPMENT
- CULTURAL AWARENESS
- The Adolescent Years
- Hormonal Changes of Puberty
- Sexual Maturation
- Sexual Maturation in Girls.
- Sexual Maturation in Boys.
- BOX 16-1 Usual Sequence of Maturational Changes
- GIRLS
- BOYS
- Physical Growth
- 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.
- Sex Differences in General Growth Patterns.
- FIG. 16-2 Growth in pubic hair in girls—average age span for stages 2 through 5: 9 to 13½ years.
- FIG. 16-3 Developmental stages of secondary sex characteristics and genital development in boys—average age span, 9½ to 14 years.
- Physiologic Changes
- PSYCHOSOCIAL DEVELOPMENT: DEVELOPING A SENSE OF IDENTITY (ERIKSON)
- Group Identity.
- Individual Identity.
- CRITICAL THINKING EXERCISE
- Discussing the Future
- QUESTIONS
- Sex-Role Identity.
- Emotionality.
- COGNITIVE DEVELOPMENT (PIAGET)
- MORAL DEVELOPMENT (KOHLBERG)
- SPIRITUAL DEVELOPMENT
- SOCIAL DEVELOPMENT
- Relationships with Parents
- Relationships with Peers
- FAMILY FOCUS
- Communication with Adolescents: The Art of Listening
- Peer Group.
- FIG. 16-4 Teenagers like to gather in small groups.
- Best Friends.
- Interests and Activities
- FIG. 16-5 The cell phone allows adolescents to talk for hours with peers.
- ADOLESCENT SEXUALITY
- FIG. 16-6 Heterosexual relationships are important for most adolescents.
- CRITICAL THINKING EXERCISE
- Discussing Sexual Orientation with Adolescents
- QUESTIONS
- DEVELOPMENT OF SELF-CONCEPT AND BODY IMAGE
- Responses to Puberty
- TABLE 16-1 Growth and Development During Adolescence
- PROMOTING OPTIMAL HEALTH DURING ADOLESCENCE
- nursingcareguidelines
- Interviewing Adolescents
- CRITICAL THINKING EXERCISE
- Respecting Privacy
- QUESTIONS
- IMMUNIZATIONS
- NUTRITION
- Eating Habits and Behavior
- FIG. 16-7 Snacking on empty calories is common among adolescents, especially during inactivity.
- Nursing Care Management
- SLEEP AND REST
- EXERCISE AND ACTIVITY
- FIG. 16-8 Adolescents should be encouraged to participate in activities that contribute to lifelong physical fitness.
- DENTAL HEALTH
- PERSONAL CARE
- Vision
- Hearing
- Posture
- Body Art
- Tanning
- STRESS REDUCTION
- 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.
- BOX 16-2 Areas of Stress in Adolescence
- SEXUALITY EDUCATION AND GUIDANCE
- BOX 16-3 Injury Prevention During Adolescence
- DEVELOPMENTAL ABILITIES RELATED TO RISK OF INJURY
- INJURY PREVENTION
- Motor or Nonmotor Vehicles
- Drowning
- Burns
- Poisoning
- Falls
- Bodily Damage
- INJURY PREVENTION
- Motor Vehicle—Related Injuries
- Other Vehicle Injuries.
- Firearms
- Nonpowder Firearms.
- Sports Injuries
- Nursing Care Management
- ANTICIPATORY GUIDANCE—CARE OF FAMILIES
- FAMILY-CENTERED CARE
- Guidance During Adolescence
- ENCOURAGE PARENTS TO:
- BE AWARE THAT ADOLESCENTS:
- FAMILY FOCUS
- Family Rules for Adolescents
- KEY POINTS
- answers to CRITIAL THINKING EXERCISE
- DISCUSSING THE FUTURE
- DISCUSSING SEXUAL ORIENTATION WITH ADOLESCENTS
- RESPECTING PRIVACY
- References
- Chapter 17 Health Problems of School-Age Children and Adolescents
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- PROBLEMS RELATED TO ELIMINATION
- ENURESIS
- Nursing Care Management
- ENCOPRESIS
- Nursing Care Management
- FAMILY FOCUS
- Helping Families Understand Encopresis
- HEALTH PROBLEMS RELATED TO SPORTS PARTICIPATION
- OVERUSE SYNDROMES
- FIG. 17-1 Football is an example of a strenuous collision sport.
- Stress Fractures
- Therapeutic Management
- NURSE’S ROLE IN SPORTS FOR CHILDREN AND ADOLESCENTS
- ALTERED GROWTH AND MATURATION
- Nursing Care Management
- SEX CHROMOSOME DISORDERS
- Turner Syndrome
- Klinefelter Syndrome
- TABLE 17-1 Common Sex Chromosome Disorders
- Nursing Care Management
- DISORDERS RELATED TO THE REPRODUCTIVE SYSTEM
- AMENORRHEA
- DYSMENORRHEA
- Therapeutic Management
- Nursing Care Management
- VAGINITIS
- DISORDERS OF THE MALE REPRODUCTIVE SYSTEM
- Nursing Care Management
- CRITICAL THINKING EXERCISE
- Testicular Self-Examination
- QUESTIONS
- GYNECOMASTIA
- Nursing Care Management
- HEALTH PROBLEMS RELATED TO SEXUALITY
- ADOLESCENT PREGNANCY
- Nursing Care Management
- CONTRACEPTION
- TABLE 17-2 Advantages and Disadvantages of Contraceptive Methods in Adolescents
- Nursing Care Management
- SEXUALLY TRANSMITTED DISEASES
- Therapeutic Management
- Nursing Care Management
- PELVIC INFLAMMATORY DISEASE
- TABLE 17-3 Selected Sexually Transmitted Diseases*
- SEXUAL ASSAULT (RAPE)
- BOX 17-1 Definitions of Sexual Assaults
- Diagnostic Evaluation
- BOX 17-2 Clinical Manifestations of Rape Victims
- MAY DISPLAY A VARIETY OF EMOTIONS AND BEHAVIORS:
- EVIDENCE OF PHYSICAL FORCE FROM:
- MEDICAL EXAMINATION PROVIDES EVIDENCE OF:
- NURSINGALERT
- Therapeutic Management
- FAMILY FOCUS
- Supporting the Rape Victim’s Parents
- Rape Trauma Syndrome
- Nursing Care Management
- EATING DISORDERS
- OBESITY
- FIG. 17-2 Complex relationships in obesity.
- Etiology and Pathophysiology
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- nursingprocess: The Child or Adolescent Who Is Overweight or Obese
- ASSESSMENT
- DIAGNOSIS (PROBLEM IDENTIFICATION)
- PLANNING
- IMPLEMENTATION
- EVALUATION
- Nutritional Counseling.
- Behavioral Therapy.
- Group Involvement.
- Family Involvement.
- Physical Activity.
- BOX 17-3 Helpful Suggestions to Promote Healthy Eating Habits
- Prevention.
- ANOREXIA NERVOSA AND BULIMIA NERVOSA
- Etiology and Pathophysiology
- BOX 17-4 Clinical Manifestations of Anorexia Nervosa
- Diagnostic Evaluation
- BOX 17-6 Diagnostic Criteria for Bulimia
- BOX 17-5 Diagnostic Criteria for Anorexia Nervosa
- Therapeutic Management
- Nutrition Therapy.
- Psychotherapy.
- Pharmacologic Therapy.
- Nursing Care Management
- CRITICAL THINKING EXERCISE
- Anorexia Nervosa
- QUESTIONS
- DISORDERS WITH BEHAVIORAL COMPONENTS
- ATTENTION DEFICIT HYPERACTIVITY DISORDER AND LEARNING DISABILITY
- Diagnostic Evaluation
- Therapeutic Management
- BOX 17-7 Diagnostic Criteria for Attention Deficit Hyperactivity Disorder
- Pharmacologic Therapy.
- Behavioral Therapy.
- Environmental Manipulation.
- CRITICAL THINKING EXERCISE
- Attention Deficit Hyperactivity Disorder
- QUESTIONS
- Appropriate Classroom Placement.
- FAMILY FOCUS
- A Child’s Perception of Taking Ritalin at School
- Prognosis.
- Nursing Care Management
- POSTTRAUMATIC STRESS DISORDER
- Nursing Care Management
- SCHOOL PHOBIA
- Nursing Care Management
- RECURRENT ABDOMINAL PAIN
- Nursing Care Management
- CONVERSION REACTION
- Nursing Care Management
- CHILDHOOD DEPRESSION
- BOX 17-8 Characteristics of Children with Depression
- BEHAVIOR
- INTERNAL STATES
- PHYSIOLOGY
- Nursing Care Management
- CHILDHOOD SCHIZOPHRENIA
- Nursing Care Management
- SERIOUS HEALTH PROBLEMS OF LATER CHILDHOOD AND ADOLESCENCE
- SUBSTANCE ABUSE
- Motivation
- Types of Drugs Abused
- Tobacco.
- COMMUNITY FOCUS
- Early Sexual Maturation, Alcohol, and Cigarettes
- Etiology.
- Smokeless Tobacco.
- Nursing Care Management.
- COMMUNITY FOCUS
- Nonsmoking Strategies
- Alcohol.
- Cocaine.
- Narcotics.
- Central Nervous System Depressants.
- Central Nervous System Stimulants.
- Mind-Altering Drugs.
- Nursing Care Management Related to Therapeutic Management
- Acute Care.
- Long-Term Management.
- Family Support.
- Prevention.
- SUICIDE
- NURSINGALERT
- Etiology
- Methods
- NURSINGALERT
- COMMUNITY FOCUS
- Suicide, Sexual Identity, and Sexual Orientation
- BOX 17-9 Warning Signs of Suicide
- Motivation
- Diagnostic Evaluation
- Therapeutic Management
- NURSINGALERT
- Nursing Care Management
- NURSINGALERT
- KEY POINTS
- answers to CRITIAL THINKING EXERCISE
- TESTICULAR SELF-EXAMINATION
- ANOREXIA NERVOSA
- ATTENTION DEFICIT HYPERACTIVITY DISORDER
- References
- UNIT SEVEN THE CHILD AND FAMILY WITH SPECIAL NEEDS
- Interactive Review — Unit Seven
- Chapter 18 Chronic Illness, Disability, or End-of-Life Care for the Child and Family
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- PERSPECTIVES ON THE CARE OF CHILDREN WITH SPECIAL NEEDS
- SCOPE OF THE PROBLEM
- TRENDS IN CARE
- Developmental Focus
- BOX 18-1 Common Terms Regarding Children with Special Needs
- Family-Centered Care
- Family–Health Care Provider Communication
- Establishing Therapeutic Relationships
- The Role of Culture in Family-Centered Care
- Shared Decision Making
- BOX 18-2 Facilitating Shared Decision Making
- Normalization
- Managed Care
- THE FAMILY OF THE CHILD WITH SPECIAL NEEDS
- BOX 18-3 Adaptive Tasks of Parents Having Children with Chronic Conditions
- IMPACT OF THE CHILD’s CHRONIC ILLNESS OR DISABILITY
- BOX 18-4 Anticipated Parental Stress Points
- Parents
- Parental Roles.
- Mother-Father Differences.
- Single-Parent Families.
- Siblings
- FAMILY FOCUS
- Reflection of an Older Brother
- BOX 18-5 Supporting Siblings of Children with Special Needs
- PROMOTE HEALTHY SIBLING RELATIONSHIPS
- HELP SIBLINGS COPE
- INVOLVE SIBLINGS
- COPING WITH ONGOING STRESS AND PERIODIC CRISES
- Concurrent Stresses Within the Family
- Coping Mechanisms
- Parental Empowerment
- ASSISTING FAMILY MEMBERS IN MANAGING THEIR FEELINGS
- nursingcareguidelines
- Assessing Coping Behaviors
- APPROACH BEHAVIORS
- AVOIDANCE BEHAVIORS
- Shock and Denial
- Adjustment
- Reintegration and Acknowledgment
- BOX 18-6 Characteristics of Parental Overprotection
- ESTABLISHING A SUPPORT SYSTEM
- BOX 18-7 Concept of Functional Burden
- IMPACT OF THE CHILD WITH SPECIAL NEEDS
- FAMILY RESOURCES AND ABILITY TO COPE
- THE CHILD WITH SPECIAL NEEDS
- DEVELOPMENTAL ASPECTS
- FIG. 18-1 Children with any type of impairment should have the opportunity to develop their skills.
- BOX 18-8 Coping Patterns Used by Children with Special Needs
- COPING MECHANISMS
- 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.
- Hopefulness
- Health Education and Self-Care
- nursingprocess
- The Child with Special Needs
- ASSESSMENT
- DIAGNOSIS (PROBLEM IDENTIFICATION)
- PLANNING
- IMPLEMENTATION
- EVALUATION
- RESPONSES TO PARENTAL BEHAVIOR
- TYPE OF ILLNESS OR DISABILITY
- NURSING CARE OF THE FAMILY AND CHILD WITH SPECIAL NEEDS
- ASSESSMENT
- TABLE 18-1 Assessment of Factors Affecting Family Adjustment
- FAMILY FOCUS
- Identifying Family Needs
- PROVIDE SUPPORT AT THE TIME OF DIAGNOSIS
- FIG. 18-3 Informing session should take place in a private, comfortable setting free of distractions and interruptions.
- NURSINGTIP
- SUPPORT FAMILY’S COPING METHODS
- Parents
- nursingcareguidelines
- Situations Requiring Special Consideration
- CONGENITAL ANOMALY
- COGNITIVE IMPAIRMENT
- PHYSICAL DISABILITY
- CHRONIC ILLNESS
- MULTIPLE DISABILITIES
- TERMINAL ILLNESS
- nursingcareguidelines
- Developing Successful Parent-Professional Partnerships
- nursingcareguidelines
- Encouraging Expression of Emotion
- Parent-to-Parent Support
- Advocate for Empowerment
- The Child
- nursingcareguidelines
- Promoting Normalization
- Siblings
- EDUCATE ABOUT THE DISORDER AND GENERAL HEALTH CARE
- Activities of Daily Living
- Safe Transportation
- Primary Health Care
- PROMOTE NORMAL DEVELOPMENT
- Early Childhood
- 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.
- TABLE 18-2 Developmental Effects of Chronic Illness or Disability on Children
- School Age
- FIG. 18-5 Children with special needs should continue their schooling as soon as their condition permits.
- Adolescence
- ESTABLISH REALISTIC FUTURE GOALS
- PERSPECTIVES ON THE CARE OF CHILDREN AT THE END OF LIFE
- PRINCIPLES OF PALLIATIVE CARE
- DECISION MAKING AT THE END OF LIFE
- Ethical Considerations in End-of-LifeDecision Making
- EVIDENCE-BASED PRACTICE
- Pediatric Pain and Symptom Management at the End of Life
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- Physician–Health Care Team Decision Making
- Parental Decision Making
- The Dying Child
- FAMILY FOCUS
- Family of the Dying Child
- TABLE 18-3 Children’s Understanding of and Reactions to Death
- Treatment Options for Terminally Ill Children
- Hospital.
- Home Care.
- Hospice Care.
- NURSING CARE OF THE CHILD AND FAMILY AT THE END OF LIFE
- FEAR OF PAIN AND SUFFERING
- nursingcareplan The Child Who Is Terminally Ill or Dying
- Pain and Symptom Management
- BOX 18-9 Ethical Principle of Double Effect
- Parents’ and Siblings’ Need for Education and Support
- FEAR OF DYING ALONE OR OF NOT BEING PRESENT WHEN THE CHILD DIES
- FEAR OF ACTUAL DEATH
- Home Deaths
- FIG. 18-6 For the dying child there is no greater comfort than the security and closeness of a parent.
- BOX 18-10 Physical Signs of Approaching Death
- Hospital Deaths
- FAMILY FOCUS
- Children Need to Say Good-Bye
- ORGAN OR TISSUE DONATION AND AUTOPSY
- GRIEF AND MOURNING
- Parental Grief
- Sibling Grief
- nursingcareguidelines
- Supporting Grieving Families*
- GENERAL
- AT THE TIME OF DEATH
- POSTDEATH
- Nurses’ Reactions to Caring for Dying Children
- FAMILY FOCUS
- A Dying Child: A Nurse’s Perspective
- KEY POINTS
- References
- Chapter 19 Impact of Cognitive or Sensory Impairment on the Child and Family
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- COGNITIVE IMPAIRMENT
- GENERAL CONCEPTS
- Diagnosis and Classification
- BOX 19-2 Early Behavioral Signs Suggestive of Cognitive Impairment
- BOX 19-1 Dimensions of Care for the Intellectually Disabled
- Dimension I
- Dimension II
- Dimension III
- Dimension IV
- TABLE 19-1 Classification of Cognitive Impairment
- Etiology
- NURSING CARE OF CHILDREN WITH IMPAIRED COGNITIVE FUNCTION
- Educate Child and Family.
- FIG. 19-1 A push panel allows a child with cognitive impairment to turn a computer on and off.
- Teach Child Self-Care Skills.
- nursingcareplan The Child with Impaired Cognitive Function
- Promote Child’s Optimal Development.
- Encourage Play and Exercise.
- FIG. 19-2 Placing an attractive object outside the child’s reach encourages crawling movements.
- FIG. 19-3 A manual switch allows a child with cognitive impairment to play with a battery-operated toy.
- FIG. 19-4 A favorite toy provides stimulation for a young child.
- FIG. 19-5 A child with cognitive and physical impairments can activate electronic/communication equipment by moving a device near her head.
- Provide Means of Communication.
- Establish Discipline.
- Encourage Socialization.
- Provide Information on Sexuality.
- Help Family Adjust to Future Care.
- Care for Child During Hospitalization.
- Assist in Measures to Prevent Cognitive Impairment
- DOWN SYNDROME
- Etiology
- Diagnostic Evaluation
- 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.
- BOX 19-3 Clinical Manifestations of Down Syndrome
- HEAD AND EYES
- NOSE AND EARS
- MOUTH AND NECK
- CHEST AND HEART
- ABDOMEN AND GENITALIA
- HANDS AND FEET
- MUSCULOSKELETON AND SKIN
- OTHER
- Therapeutic Management
- NURSINGALERT
- Prognosis.
- Nursing Care Management
- Support Family at Time of Diagnosis.
- Assist Family in Preventing Physical Problems.
- ETHICAL CASE STUDY Child with Down Syndrome
- ETHICAL DECISION MAKING MODEL
- Evaluate the Issue
- Treat All Involved with Respect
- Hear All Sides
- Initiate Action
- Consider the Outcome
- CRITICAL THINKING EXERCISE
- Diagnosis of Down Syndrome
- QUESTIONS
- Assist in Prenatal Diagnosis and Genetic Counseling.
- FRAGILE X SYNDROME
- Clinical Manifestations
- Therapeutic Management
- BOX 19-4 Clinical Manifestations of Fragile X Syndrome
- PHYSICAL FEATURES
- BEHAVIORAL FEATURES
- Prognosis.
- Nursing Care Management
- SENSORY IMPAIRMENT
- HEARING IMPAIRMENT
- Definition and Classification
- Etiology.
- Pathology.
- TABLE 19-2 Intensity of Sounds Expressed in Decibels
- Symptom Severity.
- Therapeutic Management
- Conductive Hearing Loss.
- TABLE 19-3 Classification of Hearing Loss Based on Symptom Severity
- NURSINGTIP
- 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.
- NURSINGALERT
- Sensorineural Hearing Loss.
- BOX 19-5 Clinical Manifestations of Hearing Impairment
- INFANTS
- CHILDREN
- Nursing Care Management
- Infancy.
- Childhood.
- NURSINGALERT
- Lipreading.
- Cued Speech.
- Sign Language.
- Speech Language Therapy.
- Additional Aids.
- nursingcareguidelines
- Facilitating Lipreading
- Socialization.
- Support Child and Family.
- Care for Child During Hospitalization.
- CRITICAL THINKING EXERCISE
- Hearing Impairment
- QUESTIONS
- Assist in Measures to Prevent Hearing Impairment.
- NURSINGALERT
- VISUAL IMPAIRMENT
- Definition and Classification
- Etiology
- BOX 19-6 Types of Visual Impairment
- REFRACTIVE ERRORS
- Myopia
- Nearsightedness
- Pathophysiology
- Clinical Manifestations
- Treatment
- Hyperopia
- Farsightedness
- Pathophysiology
- Clinical Manifestations
- Treatment
- Astigmatism
- Pathophysiology
- Clinical Manifestations
- Treatment
- Anisometropia
- Pathophysiology
- Clinical Manifestations
- Treatment
- AMBLYOPIA
- Lazy eye
- Pathophysiology
- Clinical Manifestations
- Treatment
- STRABISMUS
- ‘Squint’
- Esotropia
- Exotropia
- Pathophysiology
- Clinical Manifestations
- Treatment
- CATARACTS
- Pathophysiology
- Clinical Manifestations
- Treatment
- GLAUCOMA
- Pathophysiology
- Clinical Manifestations
- Treatment
- Trauma.
- emergencytreatment
- Eye Injuries
- FOREIGN OBJECT
- CHEMICAL BURNS
- ULTRAVIOLET BURNS
- HEMATOMA (‘BLACK EYE’)
- PENETRATING INJURIES
- Infections.
- Nursing Care Management
- Infancy.
- NURSINGALERT
- Childhood.
- Promote Parent-Child Attachment.
- Promote Child’s Optimal Development.
- Development and Independence.
- Play and Socialization.
- Education.
- Care for the Child During Hospitalization.
- Assist in Measures to Prevent Visual Impairment.
- NURSINGALERT
- DEAF-BLIND CHILDREN
- RETINOBLASTOMA
- Diagnostic Evaluation
- BOX 19-7 Clinical Manifestations of Retinoblastoma
- FIG. 19-8 White reflex. Whitish appearance of lens is produced as light falls on tumor mass in left eye.
- Therapeutic Management
- Prognosis.
- FIG. 19-9 The same infant with left prosthetic eye.
- Nursing Care Management
- AUTISM SPECTRUM DISORDERS
- Etiology
- Clinical Manifestations and Diagnostic Evaluation
- NURSINGTIP
- EVIDENCE-BASED PRACTICE
- Thimerosal-Containing Vaccines and Autism Spectrum Disorders
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- BOX 19-8 Diagnostic Criteria for Autistic Disorder
- Prognosis
- Nursing Care Management
- Family Support.
- KEY POINTS
- answers to CRITIAL THINKING EXERCISE
- DIAGNOSIS OF DOWN SYNDROME
- HEARING IMPAIRMENT
- References
- Chapter 20 Family-Centered Home Care
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- GENERAL CONCEPTS OF HOME CARE
- HOME CARE TRENDS
- EVIDENCE-BASED PRACTICE
- Home Care Decreases Length of Hospital Stay
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- EFFECTIVE HOME CARE
- BOX 20-1 Intermittent Skilled Nursing
- HEALTH CARE NEED
- INTERVENTION
- BOX 20-2 Services Necessary to Support Effective Home Care
- DISCHARGE PLANNING AND SELECTION OF A HOME CARE AGENCY
- BOX 20-3 Characteristics of a High-Quality Pediatric Home Care Agency
- NURSINGTIP
- NURSINGTIP
- BOX 20-4 Assessment for Technology-Dependent Home Care
- FAMILY CARE PROVIDERS
- PRIMARY CARE PROVIDER
- HOME CARE SUPPORT
- HOME PHYSICAL ENVIRONMENT
- EMERGENCY PREPAREDNESS
- FIG. 20-1 An essential aspect of preparation for home care is the arrangement of equipment and supplies.
- BOX 20-5 Critical Home Care Referral Information
- CARE COORDINATION (CASE MANAGEMENT)
- BOX 20-6 Care Coordination for Children with Special Health Care Needs
- ROLE OF THE NURSE, TRAINING, AND STANDARDS OF CARE
- FIG. 20-2 The nurse in the home care setting requires expertise to care for a child who is technology dependent.
- BOX 20-7 Qualities of a Pediatric Home Care Nurse
- BOX 20-8 Selected Resources for Home Care
- FAMILY-CENTERED HOME CARE
- DIVERSITY IN HOME CARE
- FAMILY FOCUS
- Developing Relationships with Culturally Diverse Families
- NURSINGTIP
- PARENT-PROFESSIONAL COLLABORATION
- CRITICAL THINKING EXERCISE
- Family-Centered Home Care and Conflicts
- QUESTIONS
- NURSINGALERT
- FAMILY FOCUS
- Knowledgeable Parents
- THE NURSING PROCESS
- BOX 20-9 Sample Family Assessment Questions
- NURSINGTIP
- FAMILY FOCUS
- What I Learned About Home Care
- PROMOTION OF OPTIMUM DEVELOPMENT, SELF-CARE, AND EDUCATION
- nursingcareguidelines
- Negotiating ‘House Rules’ for Home Care
- HOUSE RULES
- CHILD
- SIBLINGS
- NURSING
- CRITICAL THINKING EXERCISE
- Maintaining Therapeutic Boundaries
- QUESTIONS
- BOX 20-10 Incorporating Developmental Support into the Home Care Plan
- OUTCOME CRITERIA
- INTERVENTION
- SAFETY ISSUES IN THE HOME
- NURSINGTIP
- NURSINGTIP
- FAMILY-TO-FAMILY SUPPORT
- KEY POINTS
- answers to CRITIAL THINKING EXERCISE
- FAMILY-CENTERED HOME CARE AND CONFLICTS
- MAINTAINING THERAPEUTIC BOUNDARIES
- References
- UNIT EIGHT IMPACT OF HOSPITALIZATION ON THE CHILD AND FAMILY
- Interactive Review — Unit Eight
- Chapter 21 Family-Centered Care of the Child During Illness and Hospitalization
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- STRESSORS OF HOSPITALIZATION AND CHILDREN’S REACTIONS
- SEPARATION ANXIETY
- FIG. 21-1 In the protest phase of separation anxiety, children cry loudly and are inconsolable in their grief for the parent.
- FIG. 21-2 During the despair phase of separation anxiety, children are sad, lonely, and uninterested in food and play.
- BOX 21-1 Manifestations of Separation Anxiety in Young Children
- PHASE OF PROTEST
- PHASE OF DESPAIR
- PHASE OF DETACHMENT
- FIG. 21-3 Young children may appear withdrawn and sad even in the presence of a parent.
- Early Childhood
- Later Childhood and Adolescence
- LOSS OF CONTROL
- Infants
- Toddlers
- Preschoolers
- School-Age Children
- Adolescents
- EFFECTS OF HOSPITALIZATION ON THE CHILD
- Individual Risk Factors
- Changes in the Pediatric Population.
- BOX 21-2 Posthospital Behaviors in Children
- YOUNG CHILDREN
- OLDER CHILDREN
- BOX 21-3 Risk Factors That Increase Children’s Vulnerability to the Stresses of Hospitalization
- Beneficial Effects of Hospitalization
- STRESSORS AND REACTIONS OF THE FAMILY OF THE CHILD WHO IS HOSPITALIZED
- PARENTAL REACTIONS
- SIBLING REACTIONS
- BOX 21-4 Factors Affecting Parents’ Reactions to Their Child’s Illness
- ALTERED FAMILY ROLES
- NURSING CARE OF THE CHILD WHO IS HOSPITALIZED
- PREPARATION FOR HOSPITALIZATION
- FYI
- Admission Assessment
- Preparing Child for Admission
- CRITICAL THINKING EXERCISE
- Complementary and Alternative Medicine
- QUESTIONS
- BOX 21-5 Nursing Admission History According to Functional Health Patterns*
- HEALTH PERCEPTION–HEALTH MANAGEMENT PATTERN
- NUTRITION-METABOLIC PATTERN
- ELIMINATION PATTERN
- SLEEP-REST PATTERN
- ACTIVITY-EXERCISE PATTERN
- COGNITIVE-PERCEPTUAL PATTERN
- SELF-PERCEPTION–SELF-CONCEPT PATTERN
- SELF-PERCEPTION–SELF-CONCEPT PATTERN–cont’d
- ROLE-RELATIONSHIP PATTERN
- SEXUALITY-REPRODUCTIVE PATTERN
- COPING-STRESS TOLERANCE PATTERN
- VALUE-BELIEF PATTERN
- BOX 21-6 Complementary Medicine Practices and Examples
- Nutrition, diet, and lifestyle or behavioral health changes
- Mind-body control therapies
- Traditional and ethnomedicine therapies
- Structural manipulation and energetic therapies
- Pharmacologic and biologic therapies
- Bioelectromagnetic therapies
- 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.
- BOX 21-7 Guidelines for Admission
- PREADMISSION
- ADMISSION
- NURSING INTERVENTIONS
- Preventing or Minimizing Separation
- ETHICAL CASE STUDY Maternal Absence During Infant Hospitalization
- ETHICAL DECISION MAKING MODEL
- Evaluate the Issue
- Treat All Involved with Respect
- Hear All Sides
- Initiate Action
- Consider the Outcome
- FIG. 21-5 When parents cannot visit, other significant persons can provide comfort to the hospitalized child.
- FIG. 21-6 For extended hospitalizations children enjoy having projects with other patients to occupy time.
- Minimizing Loss of Control
- Promoting Freedom of Movement.
- Maintaining Child’s Routine.
- FIG. 21-7 Time structuring is an effective strategy for normalizing the hospital environment and increasing the child’s sense of control.
- NURSINGTIP
- Encouraging Independence.
- Promoting Understanding.
- BOX 21-8 Bill of Rights for Children and Teens
- Preventing or Minimizing Fear of Bodily Injury
- Providing Developmentally Appropriate Activities
- NURSINGTIP
- Providing Opportunities for Play and Expressive Activities
- FIG. 21-8 Play materials for children in the hospital need to be appropriate for their age, interests, and limitations.
- BOX 21-9 Functions of Play in the Hospital
- Diversional Activities.
- Toys.
- NURSINGTIP
- Expressive Activities.
- FIG. 21-9 Drawing and painting are excellent media for expression.
- Creative Expression.
- Dramatic Play.
- NURSINGTIP
- Maximizing Potential Benefits of Hospitalization
- CRITICAL THINKING EXERCISE
- Playroom and Hospital Procedures
- QUESTIONS
- Fostering Parent-Child Relationships.
- Providing Educational Opportunities.
- Promoting Self-Mastery.
- Providing Socialization.
- NURSING CARE OF THE FAMILY
- 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.
- SUPPORTING FAMILY MEMBERS
- FAMILY-CENTERED CARE
- Supporting Siblings During Hospitalization
- PROVIDING INFORMATION
- ENCOURAGING PARENT PARTICIPATION
- PREPARING FOR DISCHARGE AND HOME CARE
- CARE OF THE CHILD AND FAMILY IN SPECIAL HOSPITAL SITUATIONS
- AMBULATORY OR OUTPATIENT SETTING
- NURSINGTIP
- FAMILY-CENTERED CARE
- Discharge from Ambulatory Settings
- ISOLATION
- NURSINGTIP
- EMERGENCY ADMISSION
- BOX 21-10 Guidelines for Special Hospital Admission*
- EMERGENCY ADMISSION
- ADMISSION TO INTENSIVE CARE UNIT (ICU)
- INTENSIVE CARE UNIT
- 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.
- BOX 21-11 Neonatal or Pediatric Intensive Care Unit Stressors for the Child and Family
- PHYSICAL STRESSORS
- ENVIRONMENTAL STRESSORS
- PSYCHOLOGIC STRESSORS
- SOCIAL STRESSORS
- FAMILY FOCUS
- Artists as Partners in Care
- KEY POINTS
- answers to CRITIAL THINKING EXERCISE
- COMPLEMENTARY AND ALTERNATIVE MEDICINE
- PLAYROOM AND HOSPITAL PROCEDURES
- References
- Chapter 22 Pediatric Variations of Nursing Interventions
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- GENERAL CONCEPTS RELATED TO PEDIATRIC PROCEDURES
- INFORMED CONSENT
- Requirements for Obtaining Informed Consent
- EVIDENCE-BASED PRACTICE
- Informed Consent and Assent in Children
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- Eligibility for Giving Informed Consent
- Informed Consent of Parents or Legal Guardians
- Evidence of Consent.
- Informed Consent of Mature and Emancipated Minors.
- Treatment Without Parental Consent.
- Adolescents, Consent, and Confidentiality.
- Informed Consent and Parental Right to the Child’s Medical Chart.
- PREPARATION FOR DIAGNOSTIC AND THERAPEUTIC PROCEDURES
- Psychologic Preparation
- BOX 22-1 General Guidelines for Preparing Children for Procedures
- NURSINGTIP
- Establish Trust and Provide Support.
- Parental Presence and Support.
- BOX 22-2 Age-Specific Preparation of Children for Procedures Based on Developmental Characteristics
- INFANT: DEVELOPING A SENSE OF TRUST AND SENSORIMOTOR THOUGHT
- Attachment to Parent
- Stranger Anxiety
- Sensorimotor Phase of Learning
- Increased Muscle Control
- Memory for Past Experiences
- Imitation of Gestures
- TODDLER: DEVELOPING A SENSE OF AUTONOMY AND SENSORIMOTOR TO PREOPERATIONAL THOUGHT
- Egocentric Thought
- Negative Behavior
- Animism
- Limited Language Skills
- Limited Concept of Time
- Striving for Independence
- PRESCHOOLER: DEVELOPING INITIATIVE AND PREOPERATIONAL THOUGHT
- Egocentric
- Increased Language Skills
- Limited Concept of Time and Frustration Tolerance
- Illness and Hospitalization Viewed as Punishment
- Animism
- Fears of Bodily Harm, Intrusion, and Castration
- Striving for Initiative
- SCHOOL-AGE CHILD: DEVELOPING INDUSTRY AND CONCRETE THOUGHT
- Increased Language Skills; Interest in Acquiring Knowledge
- Improved Concept of Time
- Increased Self-Control
- Striving for Industry
- Developing Relationships with Peers
- ADOLESCENT: DEVELOPING IDENTITY AND ABSTRACT THOUGHT
- Increasing Abstract Thought and Reasoning
- Conscious of Appearance
- Concerned More with Present Than with Future
- Striving for Independence
- Developing Peer Relationships and Group Identity
- Provide an Explanation.
- nursingcareguidelines
- Selecting Nonthreatening Words or Phrases
- NURSINGTIP
- Physical Preparation.
- Performance of the Procedure
- NURSINGTIP
- Expect Success.
- Involve the Child.
- Provide Distraction.
- NURSINGTIP
- Allow Expression of Feelings.
- FIG. 22-1 Playing with hospital equipment provides children with the opportunity to play out fears and concerns.
- Postprocedural Support
- Encourage Expression of Feelings.
- Provide Positive Reinforcement.
- Use of Play in Procedures
- NURSINGTIP
- SURGICAL PROCEDURES
- Preoperative Care
- BOX 22-3 Play Activities for Specific Procedures
- FLUID INTAKE
- DEEP BREATHING
- RANGE OF MOTION AND USE OF EXTREMITIES
- SOAKS
- INJECTIONS
- AMBULATION
- EXTENDING ENVIRONMENT (e.g., FOR PATIENTS IN TRACTION)
- FIG. 22-2 Parental presence during induction of anesthesia can minimize child’s and parents’ anxiety during the preoperative period.
- TABLE 22-1 Fasting Recommendations to Reduce the Risk of Pulmonary Aspiration*
- Preoperative Sedation.
- Postoperative Care
- nursingcareguidelines
- Postoperative Care
- NURSINGTIP
- TABLE 22-2 Potential Causes of Postoperative Vital Sign Alterations in Children
- COMPLIANCE
- Compliance Strategies
- BOX 22-4 Factors That Positively Influence Compliance
- INDIVIDUAL AND FAMILY FACTORS
- CARE SETTING FACTORS
- TREATMENT FACTORS
- nursingcareguidelines
- Effective Teaching of Family Members
- NURSINGTIP
- GENERAL HYGIENE AND CARE
- MAINTAINING HEALTHY SKIN*
- nursingcareguidelines
- Skin Care
- BATHING
- ORAL HYGIENE
- HAIR CARE
- NURSINGTIP
- FEEDING THE SICK CHILD
- nursingcareguidelines
- Feeding the Sick Child
- CONTROLLING ELEVATED TEMPERATURES
- Fever
- Hyperthermia
- FAMILY TEACHING AND HOME CARE
- FAMILY-CENTERED CARE
- The Child with Fever
- CALL THE OFFICE IMMEDIATELY IF:
- CALL WITHIN 24 HOURS IF:
- SAFETY
- ENVIRONMENTAL FACTORS
- 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.
- Toy Safety
- FIG. 22-4 Nurse maintains hand contact when back is turned.
- Preventing Falls
- INFECTION CONTROL
- BOX 22-5 Types of Precautions and Patients Requiring Them
- STANDARD PRECAUTIONS
- AIRBORNE PRECAUTIONS
- DROPLET PRECAUTIONS
- CONTACT PRECAUTIONS
- NURSINGALERT
- NURSINGALERT
- TRANSPORTING INFANTS AND CHILDREN
- RESTRAINING METHODS AND THERAPEUTIC HOLDING
- FIG. 22-5 Transporting infants. A, Infant’s thigh firmly grasped in nurse’s hand. B, Football hold. C, Back supported.
- FIG. 22-6 Therapeutic holding of child for extremity venipuncture with parental assistance.
- Jacket Restraint
- Mummy Restraint or Swaddle
- Arm and Leg Restraints
- 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.
- Elbow Restraint
- POSITIONING FOR PROCEDURES
- Femoral Venipuncture
- FIG. 22-8 Restraining infant for femoral venipuncture.
- Extremity Venipuncture
- Lumbar Puncture
- FIG. 22-9 Child in side-lying position for lumbar puncture.
- ATRAUMATIC CARE
- Lumbar Puncture and Bone Marrow Test
- NURSINGALERT
- Bone Marrow Aspiration or Biopsy
- COLLECTION OF SPECIMENS
- URINE SPECIMENS
- NURSINGTIP
- 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.
- FYI
- NURSINGTIP
- Clean-Catch Specimens
- FYI
- Twenty-Four-Hour Collection
- Bladder Catheterization and Other Techniques
- TABLE 22-3 Straight Catheter or Foley Catheter*
- NURSINGALERT
- EVIDENCE-BASED PRACTICE
- Use of Lidocaine Lubricant for Urethral Catheterization
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- CULTURAL AWARENESS
- Bladder Catheterization
- STOOL SPECIMENS
- NURSINGTIP
- BLOOD SPECIMENS
- NURSINGTIP
- NURSINGALERT
- EVIDENCE-BASED PRACTICE
- Obtaining Blood Specimens from Central Venous Catheters in Children
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- FIG. 22-11 Puncture site (colored stippled area) on sole of infant’s foot.
- ATRAUMATIC CARE
- Guidelines for Skin and Vessel Punctures
- FOR REDUCTION OF PAIN ASSOCIATED WITH HEEL, FINGER, VENOUS, OR ARTERIAL PUNCTURES
- FOR MULTIPLE BLOOD SAMPLES
- FOR HEEL LANCING IN NEWBORNS
- RESPIRATORY SECRETION SPECIMENS
- ADMINISTRATION OF MEDICATION
- DETERMINATION OF DRUG DOSAGE
- Checking Dosage
- Identification
- ORAL ADMINISTRATION
- Preparation
- ATRAUMATIC CARE
- Encouraging a Child’s Acceptance of Oral Medication
- Administration
- NURSINGTIP
- INTRAMUSCULAR ADMINISTRATION
- Selecting the Syringe and Needle
- FIG. 22-12 Nurse partially restrains child for easy and comfortable administration of oral medication.
- Determining the Site
- Administration
- TABLE 22-4 Intramuscular Injection Sites in Children
- FIG. 22-13 Holding small child for intramuscular injection. Note how nurse isolates and stabilizes muscle.
- nursingcareguidelines
- Intramuscular Administration of Medication
- SUBCUTANEOUS AND INTRADERMAL ADMINISTRATION
- EVIDENCE-BASED PRACTICE
- Medication Safety and Insulin Therapy
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- NURSINGTIP
- INTRAVENOUS ADMINISTRATION
- Peripheral Intermittent Infusion Device
- Central Venous Access Device
- NURSINGALERT
- EVIDENCE-BASED PRACTICE
- Normal Saline or Heparinized Saline Flush Solution in Pediatric Intravenous Lines
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- TABLE 22-5 Comparison of Long-Term Central Venous Access Devices
- NURSINGALERT
- 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.
- TABLE 22-6 Flush Guidelines
- EVIDENCE-BASED PRACTICE
- Central Venous Catheter Site Care
- ASK THE QUESTIONS
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- Dressing Protocol.
- Skin Antisepsis.
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- NURSINGTIP
- NURSINGALERT
- NASOGASTRIC, OROGASTRIC, OR GASTROSTOMY ADMINISTRATION
- RECTAL ADMINISTRATION
- OPTIC, OTIC, AND NASAL ADMINISTRATION
- nursingcareguidelines
- Nasogastric, Orogastric, or Gastrostomy Medication Administration in Children
- NURSINGTIP
- FIG. 22-15 Administering eye drops.
- NURSINGALERT
- FIG. 22-16 Proper position for instilling nose drops.
- FAMILY TEACHING AND HOME CARE
- NURSINGTIP
- NURSINGTIP
- MAINTAINING FLUID BALANCE
- MEASUREMENT OF INTAKE AND OUTPUT
- NURSINGTIP
- Special Needs When the Child Is NPO
- NURSINGTIP
- PARENTERAL FLUID THERAPY
- Site and Equipment
- NURSINGTIP
- FIG. 22-17 Preferred sites for venous access in infants.
- FIG. 22-18 Transilluminator: low-heat light-emitting diode (LED) light placed on the skin to illuminate veins; an opening allows cannulation of vein.
- EVIDENCE-BASED PRACTICE
- Use of Transillumination Devices in Obtaining Vascular Access
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- Safety Catheters and Needleless Systems
- 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.
- NURSINGALERT
- Infusion Pumps
- Securement of a Peripheral Intravenous Line
- FIG. 22-20 StatLock securement devices enhance peripheral intravenous line dwell time and decrease phlebitis.
- FIG. 22-21 I.V. House used to protect intravenous site.
- NURSINGALERT
- EVIDENCE-BASED PRACTICE
- Peripheral Intravenous Site Care
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- Site Preparation.
- Site Dressing.
- Stabilization or Securement Devices.
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- Removal of a Peripheral Intravenous Line
- NURSINGALERT
- EVIDENCE-BASED PRACTICE
- Frequency of Changing Intravenous Administration Sets
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- Complications
- NURSINGALERT
- NURSINGALERT
- PROCEDURES FOR MAINTAINING RESPIRATORY FUNCTION
- INHALATION THERAPY
- Oxygen Therapy
- FIG. 22-22 Oxygen administered to infant by means of a plastic hood. Note oxygen analyzer (blue machine).
- FIG. 22-23 The tent provides a comfortable method for oxygen administration.
- NURSINGALERT
- NURSINGALERT
- Oxygen Toxicity.
- Monitoring Oxygen Therapy
- 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.
- NURSINGALERT
- NURSINGTIP
- Aerosol Therapy
- BRONCHIAL (POSTURAL) DRAINAGE
- CHEST PHYSICAL THERAPY
- ARTIFICIAL VENTILATION
- Artificial Airways
- Tracheostomy
- Suctioning.
- 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.)
- FIG. 22-26 A, Cupped hand position for percussion. B, Device for infant percussion.
- NURSINGALERT
- FYI
- FIG. 22-27 Silastic pediatric tracheostomy tube and obturator.
- 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.
- NURSINGALERT
- EVIDENCE-BASED PRACTICE
- Normal Saline Instillation Before Suctioning–Helpful or Harmful?
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- Routine Care.
- FIG. 22-29 Tracheostomy ties are snug but allow one finger to be inserted.
- Emergency Care: Tube Occlusion and Accidental Decannulation.
- NURSINGALERT
- PROCEDURES RELATED TO ALTERNATIVE FEEDING TECHNIQUES
- NURSINGALERT
- GAVAGE FEEDING
- ATRAUMATIC CARE
- Reducing the Distress of Nasogastric Tube Insertion
- 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.
- TABLE 22-7 Recommended Minimum Insertion Lengths for Orogastric Tubes in Very Low–Birth-Weight Infants
- NURSINGALERT
- GASTROSTOMY FEEDING
- nursingcareguidelines
- Nasogastric Tube Feedings in Children
- EVIDENCE-BASED PRACTICE
- Assessing Correct Placement of Nasogastric or Orogastric Tubes in Children
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- FIG. 22-31 Appearance of healthy granulation tissue around stoma.
- NASODUODENAL AND NASOJEJUNAL TUBES
- TOTAL PARENTERAL NUTRITION
- FIG. 22-32 Child with skin-level gastrostomy device (MIC-KEY), which provides for secure attachment of extension tubing to gastrostomy opening.
- FAMILY TEACHING AND HOME CARE
- PROCEDURES RELATED TO ELIMINATION
- ENEMA
- NURSINGTIP
- nursingcareguidelines
- Administration of Enemas to Children
- FYI
- OSTOMIES
- FAMILY TEACHING AND HOME CARE
- KEY POINTS
- References
- UNIT NINE THE CHILD WITH PROBLEMS RELATED TO THE TRANSFER OF OXYGEN AND NUTRIENTS
- Interactive Review — Unit Nine
- Chapter 23 The Child with Respiratory Dysfunction
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- RESPIRATORY INFECTION
- Etiology and Characteristics
- Infectious Agents.
- Age.
- Size.
- Resistance.
- Seasonal Variations.
- Clinical Manifestations
- Nursing Care Management
- Ease Respiratory Efforts.
- BOX 23-1 Signs and Symptoms Associated with Respiratory Tract Infections in Infants and Small Children
- FEVER
- POOR FEEDING AND ANOREXIA
- VOMITING
- DIARRHEA
- ABDOMINAL PAIN
- NASAL BLOCKAGE
- NASAL DISCHARGE
- COUGH
- RESPIRATORY SOUNDS
- SORE THROAT
- MENINGISMUS
- BOX 23-2 Components for Assessing Respiratory Function
- RESPIRATIONS
- OTHER OBSERVATIONS
- nursingprocess: The Child with Acute Respiratory Tract Infection
- ASSESSMENT
- DIAGNOSES (PROBLEM IDENTIFICATION)
- PLANNING
- IMPLEMENTATION
- EVALUATION
- Promote Rest.
- Promote Comfort.
- Prevent Spread of Infection.
- Reduce Body Temperature.
- NURSINGALERT
- Promote Hydration.
- Provide Nutrition.
- Family Support and Home Care.
- UPPER RESPIRATORY TRACT INFECTIONS
- NASOPHARYNGITIS
- Therapeutic Management
- nursingcareplan: The Child with Acute Respiratory Tract Infection
- BOX 23-3 Clinical Manifestations of Nasopharyngitis and Pharyngitis
- NASOPHARYNGITIS
- Younger Child
- Older Child
- Physical Assessment Signs
- PHARYNGITIS
- Younger Child
- Older Child
- Physical Assessment Signs
- Younger Child
- Older Child
- Prevention.
- Nursing Care Management
- BOX 23-4 Early Evidence of Respiratory Complications
- Family Support.
- PHARYNGITIS
- FIG. 23-1 Tonsillitis and pharyngitis.
- Clinical Manifestations
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- TONSILLITIS
- Pathophysiology
- FIG. 23-2 Location of various tonsillar masses.
- Etiology
- Clinical Manifestations
- Therapeutic Management
- Nursing Care Management
- NURSINGALERT
- Family Support and Home Care.
- INFLUENZA
- Clinical Manifestations
- Therapeutic Management
- Prevention.
- Nursing Care Management
- OTITIS MEDIA
- Etiology
- BOX 23-5 Standard Terminology for Otitis Media
- Pathophysiology
- Diagnostic Evaluation
- BOX 23-6 Clinical Manifestations of Otitis Media
- ACUTE OTITIS MEDIA
- Infant or Very Young Child
- Older Child
- CHRONIC OTITIS MEDIA
- Therapeutic Management
- Prevention.
- Nursing Care Management
- INFECTIOUS MONONUCLEOSIS
- Etiology and Pathophysiology
- Diagnostic Tests
- Therapeutic Management
- BOX 23-7 Clinical Manifestations of Infectious Mononucleosis
- EARLY SIGNS
- ACUTE DISEASE
- Cardinal Features
- Common Features
- Prognosis.
- Nursing Care Management
- NURSINGALERT
- TABLE 23-1 Comparison of Croup Syndromes
- CROUP SYNDROMES
- ACUTE EPIGLOTTITIS
- Clinical Manifestations
- NURSINGALERT
- NURSINGALERT
- Therapeutic Management
- Nursing Care Management
- NURSINGALERT
- CRITICAL THINKING EXERCISE
- Croup Syndrome
- QUESTIONS
- ACUTE LARYNGITIS
- Therapeutic Management and Nursing Care Management
- ACUTE LARYNGOTRACHEOBRONCHITIS
- BOX 23-8 Progression of Symptoms in Laryngotracheobronchitis
- STAGE I
- STAGE II
- STAGE III
- STAGE IV
- Therapeutic Management
- Nursing Care Management
- NURSINGALERT
- ACUTE SPASMODIC LARYNGITIS
- Therapeutic Management and Nursing Care Management
- BACTERIAL TRACHEITIS
- Therapeutic Management and Nursing Care Management
- INFECTIONS OF THE LOWER AIRWAYS
- TABLE 23-2 Comparison of Conditions Affecting the Bronchi
- BRONCHITIS
- RESPIRATORY SYNCYTIAL VIRUS AND BRONCHIOLITIS
- Pathophysiology
- Clinical Manifestations
- Diagnostic Evaluation
- Therapeutic Management
- BOX 23-9 Signs and Symptoms of Respiratory Syncytial Virus
- INITIAL
- WITH PROGRESSION OF ILLNESS
- SEVERE ILLNESS
- Prevention of RSV Infection
- NURSINGALERT
- Nursing Care Management
- PNEUMONIAS
- BOX 23-10 General Signs of Pneumonia
- Viral Pneumonia
- Primary Atypical Pneumonia
- Severe Acute Respiratory Syndrome
- Nursing Care Management.
- Avian Influenza Virus
- Bacterial Pneumonia
- Complications.
- Prognosis.
- Prevention.
- Nursing Care Management
- FIG. 23-3 Child placed in semierect position is often more comfortable, and this position enhances diaphragmatic expansion.
- OTHER INFECTIONS OF THE RESPIRATORY TRACT
- PERTUSSIS (WHOOPING COUGH)
- TUBERCULOSIS
- BOX 23-11 Clinical Manifestations of Tuberculosis
- Diagnostic Evaluation
- BOX 23-12 Tuberculin Skin Test (TST) Recommendations for Infants, Children, and Adolescents*
- CHILDREN FOR WHOM IMMEDIATE TST IS INDICATED
- CHILDREN WHO SHOULD HAVE ANNUAL TST‡
- CHILDREN WHO SOME EXPERTS RECOMMEND SHOULD BE TESTED EVERY 2 TO 3 YEARS
- CHILDREN WHO SOME EXPERTS RECOMMEND SHOULD BE CONSIDERED FOR TST AT 4 TO 6 AND 11 TO 16 YEARS
- CHILDREN AT INCREASED RISK FOR PROGRESSION OF INFECTION TO DISEASE
- BOX 23-13 Definition of Positive Tuberculin Skin Test (TST) Results in Infants, Children, and Adolescents*
- INDURATION ≥5 mm
- INDURATION ≥10 mm
- INDURATION ≥15 mm
- Therapeutic Management
- Prognosis.
- Prevention.
- Nursing Care Management
- PULMONARY DYSFUNCTION CAUSED BY NONINFECTIOUS IRRITANTS
- FOREIGN BODY ASPIRATION
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- NURSINGALERT
- Prevention.
- ASPIRATION PNEUMONIA
- Nursing Care Management
- ACUTE RESPIRATORY DISTRESS SYNDROME/ACUTE LUNG INJURY
- Prognosis.
- Nursing Care Management
- SMOKE INHALATION INJURY
- NURSINGALERT
- Therapeutic Management
- Nursing Care Management
- ENVIRONMENTAL TOBACCO SMOKE EXPOSURE
- Nursing Care Management
- LONG-TERM RESPIRATORY DYSFUNCTION
- ASTHMA
- FAMILY-CENTERED CARE
- Decreasing Childhood Exposure to Environmental Tobacco Smoke
- BOX 23-14 Asthma Severity Classification in Children: Ages 0 to 11*
- STEP 5 OR 6: SEVERE PERSISTENT ASTHMA
- STEP 3 OR 4: MODERATE PERSISTENT ASTHMA
- STEP 2: MILD PERSISTENT ASTHMA
- STEP 1: INTERMITTENT ASTHMA
- Etiology
- BOX 23-15 Triggers Tending to Precipitate or Aggravate Asthmatic Exacerbations
- Pathophysiology
- FIG. 23-4 Mechanisms of obstruction in asthma.
- Diagnostic Evaluation
- NURSINGALERT
- BOX 23-16 Clinical Manifestations of Asthma
- COUGH
- RESPIRATORY-RELATED SIGNS
- CHEST
- WITH REPEATED EPISODES
- nursingcareguidelines
- Interpreting Peak Expiratory Flow Rates*
- Therapeutic Management
- FAMILY-CENTERED CARE
- “Allergy-Proofing” the Home and Community
- Allergen Control.
- Drug Therapy.
- Exercise.
- Chest Physical Therapy.
- Hyposensitization.
- Prognosis.
- Status Asthmaticus.
- NURSINGALERT
- Nursing Care Management
- Avoid Allergens.
- NURSINGALERT
- Relieve Bronchospasm.
- nursingcareplan: The Child with Asthma
- FIG. 23-5 Child using metered-dose inhaler with spacer and face mask.
- FAMILY-CENTERED CARE
- Use of a Peak Expiratory Flow Meter
- FAMILY-CENTERED CARE
- Use of a Metered-Dose Inhaler*
- STEPS FOR CHECKING HOW MUCH MEDICINE IS IN THE CANISTER
- STEPS FOR USING THE INHALER
- NURSINGALERT
- Provide Acute Asthma Care.
- FIG. 23-6 Child with asthma is allowed play activity as tolerated.
- Support Child or Adolescent and Family.
- FIG. 23-7 Children with asthma may take a nebulized aerosol treatment with (A) a mask or (B) mouthpiece.
- CYSTIC FIBROSIS
- Pathophysiology
- FIG. 23-8 Various effects of exocrine gland dysfunction in cystic fibrosis.
- BOX 23-17 Clinical Manifestations of Cystic Fibrosis
- MECONIUM ILEUS*
- GASTROINTESTINAL MANIFESTATIONS
- PULMONARY MANIFESTATIONS
- Diagnostic Evaluation
- Therapeutic Management
- Management of Pulmonary Problems.
- FIG. 23-9 Child using Flutter mucus clearance device.
- NURSINGALERT
- Management of Gastrointestinal Problems.
- Management of Endocrine Problems.
- Prognosis.
- Nursing Care Management
- Hospital Care.
- Home Care.
- Family Support.
- ETHICAL CASE STUDY: Cystic Fibrosis and End-of-Life Care
- ETHICAL DECISION MAKING MODEL
- Evaluate the Issue
- Treat All Involved with Respect
- Hear All Sides
- Initiate Action
- Consider the Outcome
- Transition to Adulthood.
- OBSTRUCTIVE SLEEP-DISORDERED BREATHING
- RESPIRATORY EMERGENCY
- RESPIRATORY FAILURE
- Diagnostic Evaluation
- Therapeutic Management
- BOX 23-18 Clinical Manifestations of Respiratory Failure
- CARDINAL SIGNS
- EARLY BUT LESS OBVIOUS SIGNS
- SIGNS OF MORE SEVERE HYPOXIA
- Nursing Care Management
- CARDIOPULMONARY RESUSCITATION
- Resuscitation Procedure
- Open the Airway.
- Give Breaths.
- Pulse Check.
- 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.
- FIG. 23-11 Open airway using the head tilt—chin lift maneuver and check breathing.
- FIG. 23-12 Mouth-to—mouth and nose breathing for infant.
- FIG. 23-13 Locating brachial pulse in infant.
- FIG. 23-14 Combining chest compressions with breathing in infant.
- Chest Compression.
- FIG. 23-15 Chest compressions in child: one hand for smaller child (A) and two hands for larger child (B).
- Medications.
- FIG. 23-16 Relief of foreign body obstruction in infant. A, Back blows. B, Chest thrusts.
- TABLE 23-3 Drugs for Pediatric Cardiopulmonary Resuscitation
- AIRWAY OBSTRUCTION
- NURSINGALERT
- Infants
- FIG. 23-17 Abdominal thrusts in standing child for relief of foreign body obstruction.
- Children
- FIG. 23-18 Recovery position for child after respiratory emergency.
- KEY POINTS
- answers to CRITIAL THINKING EXERCISE
- CROUP SYNDROME
- References
- Chapter 24 The Child with Gastrointestinal Dysfunction
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- GASTROINTESTINAL DYSFUNCTION
- DEHYDRATION
- Water Balance in Infants
- Body Surface Area.
- BOX 24-1 Clinical Manifestations of Gastrointestinal Dysfunction in Children
- Basal Metabolic Rate.
- Kidney Function.
- Fluid Requirements.
- BOX 24-2 Daily Maintenance Fluid Requirements
- Types of Dehydration
- Diagnostic Evaluation
- TABLE 24-1 Evaluating Extent of Dehydration
- Therapeutic Management
- Nursing Care Management
- Intake and Output.
- DISORDERS OF MOTILITY
- DIARRHEA
- Etiology
- TABLE 24-2 Infectious Causes of Acute Diarrhea
- Pathophysiology
- Diagnostic Evaluation
- Therapeutic Management
- BOX 24-3 Model for Rehydration
- Prevention
- NURSINGALERT
- Nursing Care Management
- CRITICAL THINKING EXERCISE
- Diarrhea
- QUESTIONS
- nursingprocess: The Child with Diarrhea
- ASSESSMENT
- DIAGNOSIS (PROBLEM IDENTIFICATION)
- PLANNING
- IMPLEMENTATION
- EVALUATION
- Prevention.
- NURSINGALERT
- CONSTIPATION
- Newborn Period
- Infancy
- Childhood
- CRITICAL THINKING EXERCISE
- Constipation
- QUESTIONS
- Nursing Care Management
- BOX 24-4 High-Fiber Foods
- BREAD, GRAINS
- VEGETABLES
- FRUITS
- MISCELLANEOUS
- HIRSCHSPRUNG DISEASE
- Pathophysiology
- FIG. 24-1 Hirschsprung disease.
- BOX 24-5 Clinical Manifestations of Hirschsprung Disease
- NEWBORN PERIOD
- INFANCY
- CHILDHOOD
- Diagnostic Evaluation
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- Preoperative Care.
- Postoperative Care.
- Discharge Care.
- VOMITING
- Therapeutic Management
- Nursing Care Management
- GASTROESOPHAGEAL REFLUX
- BOX 24-6 Clinical Manifestations and Complications of Gastroesophageal Reflux
- SYMPTOMS IN INFANTS
- SYMPTOMS IN CHILDREN
- COMPLICATIONS
- Pathophysiology
- Diagnostic Evaluation
- Therapeutic Management
- FIG. 24-2 Nissen fundoplication sutures passing through esophageal musculature.
- Nursing Care Management
- FUNCTIONAL ABDOMINAL PAIN DISORDERS
- Etiology
- Pathophysiology
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- INFLAMMATORY DISORDERS
- ACUTE APPENDICITIS
- Etiology
- Pathophysiology
- Diagnostic Evaluation
- BOX 24-7 Clinical Manifestations of Appendicitis
- NURSINGALERT
- Therapeutic Management
- Ruptured Appendix.
- Prognosis.
- Nursing Care Management
- NURSINGALERT
- Postoperative Care.
- MECKEL DIVERTICULUM
- nursingcareplan The Child with Appendicitis
- Pathophysiology
- Diagnostic Evaluation
- Therapeutic Management
- Prognosis.
- BOX 24-8 Clinical Manifestations of Meckel Diverticulum
- ABDOMINAL PAIN
- BLOODY STOOLS*
- SOMETIMES
- Nursing Care Management
- INFLAMMATORY BOWEL DISEASE
- Etiology
- TABLE 24-3 Clinical Manifestations of Inflammatory Bowel Diseases
- Pathophysiology of Ulcerative Colitis
- Pathophysiology of Crohn Disease
- Diagnostic Evaluation
- Therapeutic Management
- Medical Treatment.
- Nutritional Support.
- Surgical Treatment.
- Prognosis.
- Nursing Care Management
- CRITICAL THINKING EXERCISE
- Inflammatory Bowel Disease
- QUESTIONS
- Family Support.
- PEPTIC ULCER DISEASE
- Etiology
- Pathophysiology
- Diagnostic Evaluation
- BOX 24-9 Characteristics of Peptic Ulcers
- NEONATES
- INFANTS TO 3-YEAR-OLD CHILDREN
- 2- TO 6-YEAR-OLD CHILDREN
- CHILDREN 6 YEARS AND OLDER
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- HEPATIC DISORDERS
- ACUTE HEPATITIS
- Etiology
- Hepatitis A.
- Hepatitis B.
- TABLE 24-4 Comparison of Types A, B, and C Hepatitis
- Hepatitis C.
- Hepatitis D.
- Hepatitis E.
- Hepatitis G.
- Diagnostic Evaluation
- Pathophysiology
- Therapeutic Management
- Prevention.
- Prognosis.
- Nursing Care Management
- CIRRHOSIS
- Therapeutic Management
- Prognosis.
- FAMILY FOCUS
- End-Stage Liver Disease
- Nursing Care Management
- BILIARY ATRESIA
- Etiology and Pathophysiology
- Diagnostic Evaluation
- BOX 24-10 Clinical Manifestations of Extrahepatic Biliary Atresia
- Therapeutic Management
- Prognosis.
- ETHICAL CASE STUDY: Liver Transplant
- ETHICAL DECISION MAKING MODEL
- Treat All Involved with Respect
- Hear All Sides
- Initiate Action
- Consider the Outcome
- Nursing Care Management
- STRUCTURAL DEFECTS
- CLEFT LIP OR CLEFT PALATE
- Etiology
- 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.
- Pathophysiology
- Diagnostic Evaluation
- Therapeutic Management
- Surgical Correction of Cleft Lip.
- Surgical Correction of Cleft Palate.
- Prognosis.
- Nursing Care Management
- Feeding.
- Preoperative Care.
- Postoperative Care for Cleft Lip.
- Postoperative Care of Cleft Palate.
- NURSINGALERT
- Long-Term Care.
- ESOPHAGEAL ATRESIA WITH TRACHEOESOPHAGEAL FISTULA
- Etiology
- Pathophysiology
- FIG. 24-4 A-E, Five most common types of esophageal atresia and tracheoesophageal fistula.
- nursingprocess: The Child with a Cleft Lip or Cleft Palate
- ASSESSMENT
- DIAGNOSIS (PROBLEM IDENTIFICATION)
- PLANNING
- IMPLEMENTATION
- EVALUATION
- Diagnostic Evaluation
- BOX 24-11 Clinical Manifestations of Tracheoesophageal Fistula
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- NURSINGALERT
- Postoperative Care.
- Special Problems.
- HERNIAS
- OBSTRUCTIVE DISORDERS
- HYPERTROPHIC PYLORIC STENOSIS
- Pathophysiology
- Diagnostic Evaluation
- TABLE 24-5 Summary Outline of Hernias
- BOX 24-12 Clinical Manifestations of Mechanical/Paralytic Intestinal Obstruction
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- Preoperative Care.
- 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.
- BOX 24-13 Clinical Manifestations of Hypertrophic Pyloric Stenosis
- Postoperative Care.
- INTUSSUSCEPTION
- FIG. 24-6 Ileocolic intussusception.
- Pathophysiology
- NURSINGALERT
- Diagnostic Evaluation
- BOX 24-14 Clinical Manifestations of Intussusception
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- NURSINGALERT
- MALROTATION AND VOLVULUS
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- ANORECTAL MALFORMATIONS
- Diagnostic Evaluation
- TABLE 24-6 Classification of Anorectal Malformations
- Therapeutic Management
- Nursing Care Management
- Family Support, Discharge Planning, and Home Care.
- MALABSORPTION SYNDROMES
- CELIAC DISEASE
- Pathophysiology
- Diagnostic Evaluation
- BOX 24-15 Clinical Manifestations of Celiac Disease
- IMPAIRED FAT ABSORPTION
- IMPAIRED NUTRIENT ABSORPTION
- BEHAVIORAL CHANGES
- CELIAC CRISIS*
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- SHORT-BOWEL SYNDROME
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- KEY POINTS
- answers to CRITIAL THINKING EXERCISE
- DIARRHEA
- CONSTIPATION
- INFLAMMATORY BOWEL DISEASE
- References
- UNIT TEN THE CHILD WITH PROBLEMS RELATED TO THE PRODUCTION AND CIRCULATION OF BLOOD
- Interactive Review — Unit Ten
- Chapter 25 The Child with Cardiovascular Dysfunction
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- CARDIOVASCULAR DYSFUNCTION
- History and Physical Examination
- Inspection
- Palpation and Percussion
- Auscultation
- Diagnostic Evaluation
- TABLE 25-1 Procedures for Cardiac Diagnosis
- Electrocardiogram.
- NURSINGTIP
- Echocardiography.
- Cardiac Catheterization.
- TABLE 25-2 Current Interventional Cardiac Catheterization Procedures in Children
- Nursing Care Management
- Preprocedural Care.
- Postprocedural Care.
- NURSINGALERT
- CONGENITAL HEART DISEASE
- FAMILY-CENTERED CARE
- After Cardiac Catheterization
- CRITICAL THINKING EXERCISE
- Cardiac Catheterization
- QUESTIONS
- 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.
- CIRCULATORY CHANGES AT BIRTH
- ALTERED HEMODYNAMICS
- CLASSIFICATION OF DEFECTS
- FIG. 25-2 Comparison of acyanotic-cyanotic and hemodynamic classification systems of congenital heart disease.
- Defects with Increased Pulmonary Blood Flow
- Obstructive Defects
- Defects with Decreased Pulmonary Blood Flow
- BOX 25-1 Defects with Increased Pulmonary Blood Flow
- ATRIAL SEPTAL DEFECT
- VENTRICULAR SEPTAL DEFECT
- ATRIOVENTRICULAR CANAL DEFECT
- PATENT DUCTUS ARTERIOSUS
- FIG. 25-3 Hemodynamics in defects with increased pulmonary blood flow. See Fig. 25-1 for abbreviations.
- 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.
- FIG. 25-5 Hemodynamic defects with decreased pulmonary blood flow. See Fig. 25-1 for abbreviations.
- Mixed Defects
- BOX 25-2 Obstructive Defects
- COARCTATION OF THE AORTA
- AORTIC STENOSIS
- Valvular Aortic Stenosis
- Subvalvular Aortic Stenosis
- PULMONIC STENOSIS
- BOX 25-3 Defects with Decreased Pulmonary Blood Flow
- TETRALOGY OF FALLOT
- TRICUSPID ATRESIA
- BOX 25-4 Mixed Defects
- TRANSPOSITION OF THE GREAT ARTERIES, OR TRANSPOSITION OF THE GREAT VESSELS
- TOTAL ANOMALOUS PULMONARY VENOUS CONNECTION
- TRUNCUS ARTERIOSUS
- HYPOPLASTIC LEFT HEART SYNDROME
- CLINICAL CONSEQUENCES OF CONGENITAL HEART DISEASE
- CONGESTIVE HEART FAILURE
- FIG. 25-6 Pathophysiology of congestive heart failure. ADH, Antidiuretic hormone.
- Pathophysiology
- BOX 25-5 Clinical Manifestations of Congestive Heart Failure
- IMPAIRED MYOCARDIAL FUNCTION
- PULMONARY CONGESTION
- SYSTEMIC VENOUS CONGESTION
- Diagnostic Evaluation
- Therapeutic Management
- Improve Cardiac Function.
- NURSINGALERT
- Remove Accumulated Fluid and Sodium.
- NURSINGALERT
- Decrease Cardiac Demands.
- Improve Tissue Oxygenation.
- TABLE 25-3 Diuretics Used in Congestive Heart Failure
- NURSINGALERT
- Nursing Care Management
- Assist in Measures to Improve Cardiac Function.
- BOX 25-6 Common Signs of Digoxin Toxicity in Children
- GASTROINTESTINAL
- CARDIAC
- nursingprocess
- The Child with Congestive Heart Failure
- ASSESSMENT
- DIAGNOSIS (PROBLEM IDENTIFICATION)
- PLANNING
- IMPLEMENTATION
- EVALUATION
- nursingcareplan
- The Child with Congestive Heart Failure (CHF)
- NURSINGALERT
- FAMILY-CENTERED CARE
- Administering Digoxin
- Monitor Afterload Reduction.
- CRITICAL THINKING EXERCISE
- Digoxin Toxicity
- QUESTIONS
- Decrease Cardiac Demands.
- Reduce Respiratory Distress.
- Maintain Nutritional Status.
- Assist in Measures to Promote Fluid Loss.
- NURSINGTIP
- Support Child and Family.
- HYPOXEMIA
- Clinical Manifestations
- FIG. 25-7 Clubbing of the fingers.
- Therapeutic Management
- CRITICAL THINKING EXERCISE
- Hypercyanotic Spell
- QUESTIONS
- Nursing Care Management
- FIG. 25-8 Infant held in knee-chest position.
- nursingcareguidelines
- Treating Hypercyanotic Spells
- TABLE 25-4 Selected Shunt Procedures for Children with Cardiac Defects
- FIG. 25-9 Schematic diagram of cardiac shunts.
- NURSINGALERT
- NURSING CARE OF THE FAMILY AND CHILD WITH CONGENITAL HEART DISEASE
- HELP FAMILY ADJUST TO THE DISORDER
- FAMILY FOCUS
- Diagnosis of Heart Disease
- EDUCATE FAMILY ABOUT THE DISORDER
- HELP FAMILIES MANAGE THE ILLNESS AT HOME
- PREPARE CHILD AND FAMILY FOR INVASIVE PROCEDURES
- PROVIDE POSTOPERATIVE CARE
- Observe Vital Signs
- BOX 25-7 Selected Complications After Cardiac Surgery and Treatment Approaches
- CARDIAC
- RESPIRATORY
- NEUROLOGIC
- INFECTIOUS DISEASE
- HEMATOLOGIC
- OTHER
- Maintain Respiratory Status
- NURSINGALERT
- NURSINGALERT
- Monitor Fluids
- NURSINGALERT
- Provide Rest and Progressive Activity
- Provide Comfort and Emotional Support
- FAMILY-CENTERED CARE
- Topics to Include in Discharge Teaching After Cardiac Surgery
- PLAN FOR DISCHARGE AND HOME CARE
- ACQUIRED CARDIOVASCULAR DISORDERS
- BACTERIAL (INFECTIVE) ENDOCARDITIS
- Pathophysiology
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- BOX 25-8 Clinical Manifestations of Infective Endocarditis
- BOX 25-9 Cardiac Conditions Associated with the Highest Risk of Adverse Outcome from Endocarditis
- nursingcareguidelines
- Diagnosis of Initial Attack of Rheumatic Fever (Jones Criteria, 1992 Update)*
- MAJOR MANIFESTATIONS
- Carditis
- Polyarthritis
- Erythema Marginatum
- Chorea (St. Vitus Dance, Sydenham Chorea)
- Subcutaneous Nodes
- MINOR MANIFESTATIONS
- Clinical Findings
- Laboratory Findings
- SUPPORTING EVIDENCE OF ANTECEDENT GROUP A STREPTOCOCCAL INFECTION
- RHEUMATIC FEVER
- Etiology
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- HYPERLIPIDEMIA (HYPERCHOLESTEROLEMIA)
- TABLE 25-5 Classification of Cholesterol Levels in Children from Families with a History of Heart Disease
- Diagnostic Evaluation
- Therapeutic Management
- EVIDENCE-BASED PRACTICE
- Cholesterol Screening for Children
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- Nursing Care Management
- CARDIAC DYSRHYTHMIAS
- Diagnostic Evaluation
- Bradydysrhythmias.
- Tachydysrhythmias.
- PULMONARY ARTERY HYPERTENSION
- Clinical Manifestations
- Therapeutic Management
- CARDIOMYOPATHY
- Therapeutic Management
- Nursing Care Management
- HEART TRANSPLANTATION
- Nursing Care Management
- VASCULAR DYSFUNCTION
- SYSTEMIC HYPERTENSION
- Etiology
- Diagnostic Evaluation
- BOX 25-10 Clinical Manifestations of Hypertension
- ADOLESCENTS AND OLDER CHILDREN
- INFANTS OR YOUNG CHILDREN
- Therapeutic Management
- Nursing Care Management
- KAWASAKI DISEASE (MUCOCUTANEOUS LYMPH NODE SYNDROME)
- BOX 25-11 Diagnostic Criteria for Kawasaki Disease
- Pathophysiology
- Clinical Manifestations
- Cardiac Involvement.
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- Discharge Teaching.
- SHOCK
- Pathophysiology
- BOX 25-12 Types of Shock
- HYPOVOLEMIC
- Characteristics
- Most Frequent Causes
- DISTRIBUTIVE
- Characteristics
- Most Frequent Causes
- CARDIOGENIC
- Characteristic
- Most Frequent Causes
- BOX 25-13 Clinical Manifestations of Shock
- COMPENSATED
- DECOMPENSATED
- IRREVERSIBLE
- Diagnostic Evaluation
- Therapeutic Management
- Ventilatory Support.
- Cardiovascular Support.
- Nursing Care Management
- NURSINGALERT
- ANAPHYLAXIS
- emergencytreatment
- Shock
- VENTILATION
- FLUID ADMINISTRATION
- CARDIOVASCULAR SUPPORT
- GENERAL SUPPORT
- IN ADDITION:
- Septic Shock
- Anaphylaxis
- NURSINGALERT
- Clinical Manifestations
- Therapeutic Management
- Nursing Care Management
- SEPTIC SHOCK
- BOX 25-14 Definitions of Systemic Inflammatory Response Syndrome, Infection, Sepsis, and Severe Sepsis
- TABLE 25-6 Age-Specific Vital Signs and Laboratory Variables in Septic Shock*
- TOXIC SHOCK SYNDROME
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- BOX 25-15 Criteria for Definition of Toxic Shock Syndrome
- KEY POINTS
- answers to CRITIAL THINKING EXERCISE
- CARDIAC CATHETERIZATION
- DIGOXIN TOXICITY
- HYPERCYANOTIC SPELL
- References
- Chapter 26 The Child with Hematologic or Immunologic Dysfunction
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- HEMATOLOGIC AND IMMUNOLOGIC DYSFUNCTION
- FYI
- RED BLOOD CELL DISORDERS
- ANEMIA
- Classification
- Consequences of Anemia
- TABLE 26-1 Tests Performed as Part of the Complete Blood Cell Count
- 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.
- BOX 26-1 Red Blood Cell Morphology
- SIZE (CELL SIZE)
- SHAPE (CELL SHAPE)
- COLOR (CELL STAINING CHARACTERISTICS)
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- Prepare Child and Family for Laboratory Tests.
- NURSINGTIP
- Red blood cells
- White blood cells
- Platelets
- Plasma
- Decrease Tissue Oxygen Needs.
- NURSINGALERT
- Prevent Complications.
- IRON DEFICIENCY ANEMIA
- Pathophysiology
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- NURSINGTIP
- Diet.
- SICKLE CELL ANEMIA
- Pathophysiology
- FIG. 26-2 Differences between effects of normal (A) and sickled (B) red blood cells on circulation with related complications. CVA, Cerebrovascular accident.
- BOX 26-2 Clinical Manifestations of Sickle Cell Anemia
- GENERAL
- VASOOCCLUSIVE CRISIS
- SEQUESTRATION CRISIS
- EFFECTS OF CHRONIC VASOOCCLUSIVE PHENOMENA
- Heart
- Lungs
- Kidneys
- Liver
- Spleen
- Eyes
- Extremities
- Central nervous system
- Clinical Manifestations
- Diagnostic Evaluation
- Therapeutic Management
- ETHICAL CASE STUDY Sickle Cell Disease
- ETHICAL DECISION MAKING MODEL
- Evaluate the Issue
- Treat All Involved with Respect
- Hear All Sides
- Initiate Action
- Consider the Outcome
- EVIDENCE-BASED PRACTICE
- Sickle Cell Anemia and Penicillin Prophylaxis
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- NURSINGALERT
- Prognosis.
- Nursing Care Management
- Educate Family and Child.
- NURSINGTIP
- FAMILY FOCUS
- Fear of Addiction
- Promote Supportive Therapies During Crises.
- NURSINGALERT
- Recognize Other Complications.
- NURSINGALERT
- Support Family.
- β-THALASSEMIA (COOLEY ANEMIA)
- Pathophysiology
- BOX 26-3 Clinical Manifestations of b-Thalassemia
- ANEMIA (BEFORE DIAGNOSIS)
- PROGRESSIVE ANEMIA
- OTHER FEATURES
- BONE CHANGES (OLDER CHILDREN IF UNTREATED)
- Diagnostic Evaluation
- Therapeutic Management
- NURSINGALERT
- Prognosis.
- Nursing Care Management
- APLASTIC ANEMIA
- Etiology
- Diagnostic Evaluation
- Therapeutic Management
- BOX 26-4 Common Causes of Acquired Aplastic Anemia
- Nursing Care Management
- DEFECTS IN HEMOSTASIS
- HEMOPHILIA
- Pathophysiology
- BOX 26-5 Clinical Manifestations of Hemophilia
- Diagnostic Evaluation
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- Prevent Bleeding.
- Recognize and Control Bleeding.
- Prevent Crippling Effects of Bleeding.
- Support Family and Prepare for Home Care.
- IDIOPATHIC THROMBOCYTOPENIC PURPURA
- BOX 26-6 Clinical Manifestations of Idiopathic Thrombocytopenic Purpura
- Diagnostic Evaluation
- Therapeutic Management
- BOX 26-7 Criteria for Anti-D Antibody Therapy
- NURSINGALERT
- Prognosis.
- Nursing Care Management
- FIG. 26-3 Effects of disseminated intravascular coagulation. RBC, Red blood cell.
- DISSEMINATED INTRAVASCULAR COAGULATION
- Pathophysiology
- Diagnostic Evaluation
- BOX 26-8 Clinical Manifestations of Disseminated Intravascular Coagulation
- Therapeutic Management
- Nursing Care Management
- EPISTAXIS (NOSEBLEEDING)
- Nursing Care Management
- emergencytreatment
- Epistaxis
- NEOPLASTIC DISORDERS
- Leukemias
- Classification
- Morphology.
- Pathophysiology
- TABLE 26-2 Pathology and Related Clinical Manifestations of Leukemia
- Diagnostic Evaluation
- Therapeutic Management
- Hematopoietic Stem Cell Transplantation.
- Prognosis
- Late Effects of Treatment
- Nursing Care Management
- Prepare Child and Family for Diagnostic and Therapeutic Procedures.
- Relieve Pain.
- nursingcareplan
- The Child with Cancer
- Prevent Complications of Myelosuppression.
- Infection
- NURSINGALERT
- nursingcareguidelines
- Calculating the Absolute Neutrophil Count
- EXAMPLE:
- Hemorrhage
- Anemia
- Use Precautions in Administering and Handling Chemotherapeutic Agents.
- NURSINGALERT
- NURSINGALERT
- Manage Problems of Drug Toxicity.
- Nausea and Vomiting
- Anorexia
- Mucosal Ulceration
- NURSINGALERT
- Neuropathy
- Hemorrhagic Cystitis
- NURSINGALERT
- Alopecia
- NURSINGTIP
- Moon Face
- Mood Changes
- Provide Emotional Support.
- Lymphomas
- HODGKIN DISEASE
- FIG. 26-4 Main areas of lymphadenopathy and organ involvement in Hodgkin disease.
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- NON-HODGKIN LYMPHOMA
- Diagnostic Evaluation
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- IMMUNOLOGIC DEFICIENCY DISORDERS
- HUMAN IMMUNODEFICIENCY VIRUS INFECTION AND ACQUIRED IMMUNODEFICIENCY SYNDROME
- Epidemiology
- Etiology
- Pathophysiology
- Clinical Manifestations
- Diagnostic Evaluation
- BOX 26-9 Common Clinical Manifestations of Human Immunodeficiency Virus Infection in Children
- BOX 26-10 Common Defining Conditions for Acquired Immunodeficiency Syndrome in Children
- Therapeutic Management
- TABLE 26-3 Pediatric HIV Infection Classification*
- TABLE 26-4 Immunologic Categories Based on Age-Specific CD4 T-Lymphocyte Counts and Percent of Total Lymphocytes
- Prognosis.
- Nursing Care Management
- FAMILY FOCUS
- Caregivers and the Infant with Human Immunodeficiency Virus Infection
- nursingprocess
- The Child with Human Immunodeficiency Virus Infection
- ASSESSMENT
- DIAGNOSIS (PROBLEM IDENTIFICATION)
- PLANNING
- IMPLEMENTATION
- EVALUATION
- SEVERE COMBINED IMMUNODEFICIENCY DISEASE
- Therapeutic Management
- Nursing Care Management
- WISKOTT-ALDRICH SYNDROME
- Nursing Care Management
- TECHNOLOGIC MANAGEMENT OF HEMATOLOGIC AND IMMUNOLOGIC DISORDERS
- BLOOD TRANSFUSION THERAPY
- TABLE 26-5 Nursing Care of the Child Receiving Blood Transfusions
- HEMATOPOIETIC STEM CELL TRANSPLANTATION
- Nursing Care Management
- APHERESIS
- FAMILY FOCUS
- The Decision for a Hematopoietic Stem Cell Transplant
- Nursing Care Management
- KEY POINTS
- References
- UNIT ELEVEN THE CHILD WITH A DISTURBANCE OF REGULATORY MECHANISMS
- Interactive Review — Unit Eleven
- Chapter 27 The Child with Genitourinary Dysfunction
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- GENITOURINARY DYSFUNCTION
- Clinical Manifestations
- Laboratory Tests
- Nursing Care Management
- GENITOURINARY TRACT DISORDERS AND DEFECTS
- Urinary Tract Infection
- Classification
- Etiology
- Anatomic and Physical Factors.
- TABLE 27-1 Radiologic and Other Tests of Urinary System Function
- TABLE 27-2 Urine Tests of Renal Function
- TABLE 27-3 Blood Tests of Renal Function
- FYI
- Altered Urine and Bladder Chemistry.
- Diagnostic Evaluation
- NURSINGALERT
- BOX 27-1 Clinical Manifestations of Urinary Tract Disorders or Disease
- NEONATAL PERIOD (BIRTH TO 1 MONTH)
- INFANCY (1 TO 24 MONTHS)
- CHILDHOOD (2 TO 14 YEARS)
- Therapeutic Management
- Vesicoureteral Reflux.
- Prognosis.
- Nursing Care Management
- NURSINGTIP
- Prevention.
- nursingcareguidelines
- Prevention of Urinary Tract Infection
- FACTORS PREDISPOSING TO DEVELOPMENT
- MEASURES OF PREVENTION
- CRITICAL THINKING EXERCISE
- Urinary Tract Infection and Constipation
- QUESTIONS
- OBSTRUCTIVE UROPATHY
- FIG. 27-1 Major sites of urinary tract obstruction.
- Nursing Care Management
- EXTERNAL DEFECTS
- Psychologic Problems Related to Genital Surgery
- TABLE 27-4 Defects of the Genitourinary Tract
- Nursing Care Management
- GLOMERULAR DISEASE
- NEPHROTIC SYNDROME
- FIG. 27-2 Sequence of events in nephrotic syndrome. ADH, Antidiuretic hormone.
- Pathophysiology
- Diagnostic Evaluation
- BOX 27-2 Clinical Manifestations of Nephrotic Syndrome
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- NURSINGTIP
- Family Support and Home Care.
- ACUTE GLOMERULONEPHRITIS
- Etiology
- BOX 27-3 Clinical Manifestations of Acute Poststreptococcal Glomerulonephritis
- Pathophysiology
- Diagnostic Evaluation
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- MISCELLANEOUS RENAL DISORDERS
- HEMOLYTIC UREMIC SYNDROME
- BOX 27-4 Clinical Manifestations of Hemolytic Uremic Syndrome
- BOX 27-5 Clinical Manifestations of Wilms Tumor
- Pathophysiology
- Diagnostic Evaluation
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- WILMS TUMOR
- Etiology
- Diagnostic Evaluation
- NURSINGALERT
- BOX 27-6 Staging of Wilms Tumor
- Stage I
- Stage II
- Stage III
- Stage IV
- Stage V
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- Preoperative Care.
- Postoperative Care.
- Family Support.
- NURSINGALERT
- RENAL FAILURE
- ACUTE RENAL FAILURE
- Pathophysiology
- Diagnostic Evaluation
- BOX 27-7 Clinical Manifestations of Acute Renal Failure
- NURSINGALERT
- NURSINGALERT
- Therapeutic Management
- Complications.
- Prognosis.
- Nursing Care Management
- Family Support.
- nursingcareplan: The Child with Acute Renal Dysfunction
- CHRONIC RENAL FAILURE
- Pathophysiology
- Diagnostic Evaluation
- Therapeutic Management
- BOX 27-8 Clinical Manifestations of Chronic Renal Failure
- Prognosis.
- Nursing Care Management
- FAMILY FOCUS
- Family Priorities
- TECHNOLOGIC MANAGEMENT OF RENAL FAILURE
- DIALYSIS
- NURSINGALERT
- TRANSPLANTATION
- FIG. 27-3 Diversional activities help lessen the boredom children can experience during hemodialysis.
- NURSINGALERT
- KEY POINTS
- answers to CRITIAL THINKING EXERCISE
- URINARY TRACT INFECTION AND CONSTIPATION
- References
- Chapter 28 The Child with Cerebral Dysfunction
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- CEREBRAL DYSFUNCTION
- GENERAL ASPECTS
- INCREASED INTRACRANIAL PRESSURE
- BOX 28-1 Clinical Manifestations of Increased Intracranial Pressure in Infants and Children
- INFANTS
- CHILDREN
- PERSONALITY AND BEHAVIORAL SIGNS
- LATE SIGNS
- BOX 28-2 Levels of Consciousness
- ALTERED STATES OF CONSCIOUSNESS
- Levels of Consciousness
- Coma Assessment
- FIG. 28-1 Pediatric coma scale.
- NURSINGALERT
- NEUROLOGIC EXAMINATION
- Vital Signs
- Skin
- Eyes
- 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.
- NURSINGALERT
- NURSINGALERT
- NURSINGALERT
- Motor Function
- FIG. 28-3 A, Flexion posturing. B, Extension posturing.
- Posturing
- Reflexes
- NURSINGALERT
- SPECIAL DIAGNOSTIC PROCEDURES
- TABLE 28-1 Neurologic Diagnostic Procedures
- NURSING CARE OF THE UNCONSCIOUS CHILD
- NURSINGALERT
- RESPIRATORY MANAGEMENT
- NURSINGALERT
- INTRACRANIAL PRESSURE MONITORING
- NURSINGALERT
- NURSINGALERT
- CRITICAL THINKING EXERCISE
- Hydrocephalus
- QUESTIONS
- Nursing Activities
- NURSINGALERT
- Suctioning
- NUTRITION AND HYDRATION
- Altered Pituitary Secretion
- MEDICATIONS
- THERMOREGULATION
- ELIMINATION
- HYGIENIC CARE
- NURSINGALERT
- POSITIONING AND EXERCISE
- STIMULATION
- Regaining Consciousness
- FAMILY SUPPORT
- CEREBRAL TRAUMA
- HEAD INJURY
- Etiology
- Pathophysiology
- 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.
- Concussion.
- FIG. 28-5 A, Epidural (extradural) hematoma and compression of temporal lobe through tentorial hiatus. B, Subdural hematoma.
- Contusion and Laceration.
- Fractures.
- Complications
- NURSINGALERT
- Epidural Hemorrhage.
- Subdural Hemorrhage.
- BOX 28-3 Clinical Manifestations of Acute Head Injury
- MINOR INJURY
- SIGNS OF PROGRESSION
- SEVERE INJURY
- ASSOCIATED SIGNS
- NURSINGALERT
- Cerebral Edema.
- NURSINGALERT
- Diagnostic Evaluation
- NURSINGALERT
- Initial Assessment.
- NURSINGALERT
- NURSINGALERT
- NURSINGALERT
- emergencytreatment
- Head Injury
- Special Tests.
- Posttraumatic Syndromes.
- Therapeutic Management
- FAMILY FOCUS
- Maintaining Contact
- Surgical Therapy.
- Prognosis.
- Nursing Care Management
- NURSINGALERT
- Family Support.
- Rehabilitation.
- Prevention.
- NEAR-DROWNING
- Pathophysiology
- Therapeutic Management
- BOX 28-4 Clinical Manifestations of Near-Drowning
- CATEGORY A
- CATEGORY B
- CATEGORY C
- NURSINGALERT
- Prognosis.
- Nursing Care Management
- nursingcareguidelines
- Establishing Brain Death in Children
- Prevention.
- NERVOUS SYSTEM TUMORS
- BRAIN TUMORS
- Diagnostic Evaluation
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- Prevent Postoperative Complications.
- NURSINGALERT
- NURSINGALERT
- NURSINGALERT
- NURSINGALERT
- Support Child and Family.
- NEUROBLASTOMA
- Diagnostic Evaluation
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- INTRACRANIAL INFECTIONS
- BACTERIAL MENINGITIS
- Pathophysiology
- Clinical Manifestations
- EVIDENCE-BASED PRACTICE
- Children with Bacterial Meningitis and Preventive Vaccines
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- NURSINGALERT
- Diagnostic Evaluation
- BOX 28-5 Clinical Manifestations of Bacterial Meningitis
- CHILDREN AND ADOLESCENTS
- INFANTS AND YOUNG CHILDREN
- NEONATES: SPECIFIC SIGNS
- NEONATES: NONSPECIFIC SIGNS THAT MAY BE PRESENT
- Therapeutic Management
- Drugs.
- Nonspecific Measures.
- Prognosis.
- Prevention.
- NURSINGALERT
- NURSINGALERT
- Nursing Care Management
- Family Support.
- NONBACTERIAL (ASEPTIC) MENINGITIS
- ENCEPHALITIS
- Etiology
- TABLE 28-2 Variation of Cerebrospinal Fluid Analysis in Bacterial and Viral Meningitis
- Diagnostic Evaluation
- BOX 28-6 Clinical Manifestations of Encephalitis
- ONSET: SUDDEN OR GRADUAL
- SEVERE CASES
- Therapeutic Management
- Nursing Care Management
- RABIES
- BOX 28-7 Clinical Manifestations of Rabies
- INITIAL SIGNS
- EXCITEMENT PHASE
- SEVERE SPASM OF RESPIRATORY MUSCLES*
- NURSINGALERT
- Therapeutic Management
- Nursing Care Management
- REYE SYNDROME
- BOX 28-8 Staging Criteria for Reye Syndrome
- Therapeutic Management
- Prognosis.
- Nursing Care Management
- SEIZURE DISORDERS†
- EPILEPSY
- Etiology
- Pathophysiology
- BOX 28-9 Etiology of Seizures in Children
- NONRECURRENT (ACUTE)
- RECURRENT (CHRONIC)
- Seizure Classification and Clinical Manifestations
- Diagnostic Evaluation
- BOX 28-10 Classification and Clinical Manifestations of Seizures
- PARTIAL SEIZURES
- Simple Partial Seizures with Motor Signs
- Simple Partial Seizures with Sensory Signs
- Complex Partial Seizures (Psychomotor Seizures)
- GENERALIZED SEIZURES
- Tonic-Clonic Seizures (Formerly Known as Grand Mal)
- Tonic Phase
- Clonic Phase
- Status Epilepticus
- Postictal State
- Absence Seizures (Formerly Called Petit Mal or Lapses)
- Atonic and Akinetic Seizures (Also Known as Drop Attacks)
- Myoclonic Seizures
- Infantile Spasms
- TABLE 28-3 Comparison of Simple Partial, Complex Partial, and Absence Seizures
- Therapeutic Management
- Drug Therapy.
- NURSINGALERT
- Ketogenic Diet.
- Vagus Nerve Stimulation.
- Surgical Therapy.
- Status Epilepticus.
- NURSINGALERT
- Prognosis
- Nursing Care Management
- BOX 28-11 General Observations: The Child During a Seizure
- OBSERVATIONS DURING SEIZURE
- General Description
- Onset
- Behavior
- Movement
- Face
- Eyes
- Respiratory Effort
- Other
- POSTICTAL OBSERVATIONS
- nursingprocess
- The Child with Seizures
- ASSESSMENT
- DIAGNOSIS (PROBLEM IDENTIFICATION)
- PLANNING
- INTERVENTIONS
- EVALUATION
- nursingcareplan: The Child with Seizure Disorder
- emergencytreatment
- Seizures
- TONIC-CLONIC SEIZURE
- During the Seizure
- After the Seizure
- COMPLEX PARTIAL SEIZURE
- During the Seizure
- After the Seizure
- CALL EMERGENCY MEDICAL SERVICES IF
- NURSINGALERT
- Long-Term Care
- BOX 28-12 Seizure Precautions
- NURSINGALERT
- Triggering Factors.
- FEBRILE SEIZURES
- NURSINGALERT
- CEREBRAL MALFORMATIONS
- CRANIAL DEFORMITIES
- Prognosis.
- Nursing Care Management
- FAMILY FOCUS
- Blood Donation
- HYDROCEPHALUS
- Pathophysiology
- 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.
- Diagnostic Evaluation
- Therapeutic Management
- BOX 28-13 Clinical Manifestations of Hydrocephalus
- INFANCY (EARLY)
- INFANCY (LATER)
- INFANCY (GENERAL)
- CHILDHOOD
- FIG. 28-7 Ventriculoperitoneal shunt. Catheter is threaded beneath the skin.
- Prognosis.
- Nursing Care Management
- NURSINGALERT
- Postoperative Care.
- NURSINGALERT
- Family Support.
- KEY POINTS
- answers to CRITIAL THINKING EXERCISE
- HYDROCEPHALUS
- References
- Chapter 29 The Child with Endocrine Dysfunction
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- DISORDERS OF PITUITARY FUNCTION
- NURSINGALERT
- HYPOPITUITARISM
- BOX 29-1 Clinical Manifestations of Hypopituitarism
- TABLE 29-1 Hormones and Their Function
- Diagnostic Evaluation
- BOX 29-2 Evaluating the Growth Curve
- BOX 29-3 Bone Age for Evaluating Growth Disorders
- Therapeutic Management
- Nursing Care Management
- Child and Family Support.
- NURSINGTIP
- PITUITARY HYPERFUNCTION
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- PRECOCIOUS PUBERTY
- BOX 29-4 Causes of Precocious Puberty
- CENTRAL PRECOCIOUS PUBERTY
- PERIPHERAL PRECOCIOUS PUBERTY
- INCOMPLETE PRECOCIOUS PUBERTY
- Therapeutic Management
- Nursing Care Management
- DIABETES INSIPIDUS
- NURSINGALERT
- Diagnostic Evaluation
- NURSINGALERT
- Therapeutic Management
- NURSINGTIP
- Nursing Care Management
- SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE
- Nursing Care Management
- NURSINGALERT
- DISORDERS OF THYROID FUNCTION
- JUVENILE HYPOTHYROIDISM
- BOX 29-5 Clinical Manifestations of Juvenile Hypothyroidism
- Nursing Care Management
- GOITER
- Nursing Care Management
- NURSINGALERT
- LYMPHOCYTIC THYROIDITIS
- BOX 29-6 Clinical Manifestations of Lymphocytic Thyroiditis
- ENLARGED THYROID GLAND
- TRACHEAL COMPRESSION
- HYPERTHYROIDISM (POSSIBLE)
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- HYPERTHYROIDISM
- Diagnostic Evaluation
- Therapeutic Management
- BOX 29-7 Clinical Manifestations of Hyperthyroidism (Graves Disease)
- CARDINAL SIGNS
- PHYSICAL SIGNS
- THYROID STORM
- Nursing Care Management
- NURSINGALERT
- NURSINGALERT
- DISORDERS OF PARATHYROID FUNCTION
- HYPOPARATHYROIDISM
- BOX 29-8 Clinical Manifestations of Hypoparathyroidism
- PSEUDOHYPOPARATHYROIDISM
- IDIOPATHIC HYPOPARATHYROIDISM
- BOTH TYPES
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- HYPERPARATHYROIDISM
- BOX 29-9 Clinical Manifestations of Hyperparathyroidism
- GASTROINTESTINAL
- CENTRAL NERVOUS SYSTEM
- NEUROMUSCULAR
- SKELETAL
- RENAL
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- DISORDERS OF ADRENAL FUNCTION
- ACUTE ADRENOCORTICAL INSUFFICIENCY
- Diagnostic Evaluation
- BOX 29-10 Clinical Manifestations of Acute Adrenocortical Insufficiency
- EARLY SYMPTOMS
- GENERALIZED HEMORRHAGIC MANIFESTATIONS (WATERHOUSE-FRIDERICHSEN SYNDROME)
- SHOCKLIKE STATE
- NEWBORN
- Therapeutic Management
- Nursing Care Management
- NURSINGALERT
- NURSINGTIP
- CHRONIC ADRENOCORTICAL INSUFFICIENCY (ADDISON DISEASE)
- Therapeutic Management
- BOX 29-11 Clinical Manifestations of Chronic Adrenocortical Insufficiency
- NEUROLOGIC SYMPTOMS
- PIGMENTARY CHANGES
- GASTROINTESTINAL SYMPTOMS
- CIRCULATORY SYMPTOMS
- HYPOGLYCEMIA
- OTHER SIGNS (SEEN IN SOME CHILDREN)
- Nursing Care Management
- BOX 29-12 Etiology of Cushing Syndrome
- Pituitary
- Adrenal
- Ectopic
- Iatrogenic
- Food dependent
- CUSHING SYNDROME
- FIG. 29-1 Characteristics of Cushing syndrome.
- Clinical Manifestations
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- NURSINGALERT
- CONGENITAL ADRENAL HYPERPLASIA
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- NURSINGALERT
- PHEOCHROMOCYTOMA
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- NURSINGALERT
- DISORDERS OF PANCREATIC HORMONE SECRETION: DIABETES MELLITUS
- TABLE 29-2 Characteristics of Type 1 and Type 2 Diabetes Mellitus
- Pathophysiology
- BOX 29-13 Clinical Manifestations of Type 1 Diabetes Mellitus
- Ketoacidosis.
- Long-Term Complications
- NURSINGALERT
- Diagnostic Evaluation
- Therapeutic Management
- Insulin Therapy.
- Insulin Preparations
- NURSINGALERT
- Dosage
- BOX 29-14 Types of Insulin
- Methods of Administration
- Monitoring.
- Blood Glucose
- Glycosylated Hemoglobin
- Urine
- NURSINGALERT
- Nutrition.
- TABLE 29-3 Plasma Blood Glucose and Hemoglobin A1c Goals for Type 1 Diabetes Mellitus by Age-Group
- Exercise.
- Hypoglycemia.
- NURSINGALERT
- TABLE 29-4 Comparison of Manifestations of Hypoglycemia and Hyperglycemia
- NURSINGALERT
- Morning Hyperglycemia.
- Illness Management.
- Therapeutic Management of Diabetic Ketoacidosis
- Fluid and Electrolyte Therapy.
- NURSINGALERT
- NURSINGALERT
- Nursing Care Management
- EVIDENCE-BASED PRACTICE
- Hospital Admission or Outpatient Care for Children Newly Diagnosed with Type 1 Diabetes Mellitus
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- Hospital Management.
- Child and Family Education.
- nursingprocess
- The Child with Diabetes Mellitus
- ASSESSMENT
- DIAGNOSIS (PROBLEM IDENTIFICATION)
- PLANNING
- IMPLEMENTATION
- EVALUATION
- Medical Identification.
- Nature of Diabetes.
- Meal Planning.
- nursingcareplan
- The Child with Diabetes Mellitus
- Traveling.
- Insulin.
- Injection Procedure.
- FIG. 29-2 School-age children are able to administer their own insulin.
- TABLE 29-5 Onset and Duration of Action Related to Injection Site
- Continuous Subcutaneous Insulin Infusion
- Monitoring.
- FIG. 29-3 Child using finger-stick device to obtain blood sample.
- ATRAUMATIC CARE
- Minimizing Pain of Blood Glucose Monitoring
- NURSINGALERT
- FIG. 29-4 Child using blood glucose monitor and reagent strips to test blood for glucose.
- Urine Testing
- Signs of Hyperglycemia.
- Signs of Hypoglycemia.
- emergencytreatment
- Hypoglycemia
- MILD REACTION—ADRENERGIC SYMPTOMS
- MODERATE REACTION—NEUROGLYCOPENIC SYMPTOMS
- SEVERE REACTION—UNRESPONSIVE, UNCONSCIOUS, OR SEIZURES
- NOCTURNAL REACTION
- Hygiene.
- Exercise.
- NURSINGALERT
- Record Keeping.
- Self-Management
- Child or Adolescent and Family Support.
- NURSINGTIP
- CRITICAL THINKING EXERCISE
- Type 1 Diabetes Mellitus
- QUESTIONS
- KEY POINTS
- answers to CRITIAL THINKING EXERCISE
- TYPE 1 DIABETES MELLITUS
- References
- Chapter 30 The Child with Integumentary Dysfunction
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- INTEGUMENTARY DYSFUNCTION
- SKIN LESIONS
- Skin of Younger Children
- Pathophysiology of Dermatitis
- Diagnostic Evaluation
- History and Subjective Symptoms.
- Objective Findings.
- Types of Lesions.
- Laboratory Studies.
- WOUNDS
- Epidermal Injuries
- Injury to Deeper Tissues
- Process of Wound Healing
- FIG. 30-1 Primary skin lesions.
- FIG. 30-2 Secondary skin lesions.
- TABLE 30-1 Factors That Delay Wound Healing
- Factors That Influence Healing
- GENERAL THERAPEUTIC MANAGEMENT
- TABLE 30-2 Common Wound Care Products
- Dressings
- Topical Therapy
- NURSINGALERT
- Topical Corticosteroid Therapy.
- Other Topical Therapies.
- Systemic Therapy
- NURSING CARE MANAGEMENT
- NURSINGALERT
- Wound Care
- NURSINGALERT
- NURSINGALERT
- Relief of Symptoms
- Topical Therapy
- NURSINGALERT
- HOME CARE AND FAMILY SUPPORT
- INFECTIONS OF THE SKIN
- BACTERIAL INFECTIONS
- TABLE 30-3 Bacterial Infections
- Nursing Care Management
- FIG. 30-3 Impetigo contagiosa.
- FIG. 30-4 Cellulitis of cheek from puncture wound.
- VIRAL INFECTIONS
- TABLE 30-4 Viral Infections
- DERMATOPHYTOSES (FUNGAL INFECTIONS)
- Nursing Care Management
- TABLE 30-5 Dermatophytoses (Fungal Infections)
- SYSTEMIC MYCOTIC (FUNGAL) INFECTIONS
- FIG. 30-5 A, Tinea capitis. B, Tinea corporis. Both infections are caused by Microsporum canis, the “kitten” or “puppy” fungus.
- TABLE 30-6 Systemic Mycoses
- SKIN DISORDERS RELATED TO CHEMICAL OR PHYSICAL CONTACTS
- CONTACT DERMATITIS
- Nursing Care Management
- POISON IVY, OAK, AND SUMAC
- Therapeutic Management
- Nursing Care Management
- FIG. 30-6 Poison ivy.
- FIG. 30-7 Poison ivy lesions. Note “streaked” blisters surrounding one large blister.
- Prevention.
- CRITICAL THINKING EXERCISE
- Poison Ivy
- QUESTIONS
- DRUG REACTIONS
- NURSINGALERT
- Nursing Care Management
- FOREIGN BODIES
- SKIN DISORDERS RELATED TO ANIMAL CONTACTS
- Arthropod Bites and Stings
- TABLE 30-7 Skin Lesions Caused by Arthropods
- FIG. 30-8 Brown recluse spider bite. Note central necrosis surrounded by purplish area and blisters.
- SCABIES
- Nursing Care Management
- BOX 29-1 Clinical Manifestations of Scabies
- LESION
- DISTRIBUTION
- PEDICULOSIS CAPITIS
- Diagnostic Evaluation
- BOX 30-2 Clinical Manifestations of Pediculosis
- DISTRIBUTION
- FIG. 30-9 A, Empty nit case. B, Viable nits.
- Therapeutic Management
- Nursing Care Management
- Prevention.
- TABLE 30-8 Eruptions Caused by Rickettsiae
- COMMUNITY FOCUS
- Preventing the Spread and Recurrence of Pediculosis
- EVIDENCE-BASED PRACTICE
- No-Nit School Policies
- ASK THE QUESTION
- SEARCH FOR EVIDENCE
- Search Strategies
- Databases Used
- CRITICALLY ANALYZE THE EVIDENCE
- APPLY THE EVIDENCE: NURSING IMPLICATIONS
- References
- RICKETTSIAL DISEASES
- LYME DISEASE
- Diagnostic Evaluation
- Therapeutic Management
- FIG. 30-10 Lyme disease. Note annular red rings in erythema chronicum migrans.
- Nursing Care Management
- Mammal Bites and Scratches
- PET AND WILD ANIMAL BITES
- Therapeutic Management
- Nursing Care Management
- HUMAN BITES
- CAT SCRATCH DISEASE
- COMMUNITY FOCUS
- Animal Safety
- MISCELLANEOUS SKIN DISORDERS
- SKIN DISORDERS ASSOCIATED WITH SPECIFIC AGE-GROUPS
- DIAPER DERMATITIS
- Pathophysiology and Clinical Manifestations
- Nursing Care Management
- TABLE 30-9 Miscellaneous Skin Disorders
- FIG. 30-11 Irritant diaper dermatitis. Note sharply demarcated edges.
- FIG. 30-12 Candidiasis of diaper area. Note beefy red central erythema with satellite pustules.
- FAMILY-CENTERED CARE
- Controlling Diaper Rash
- ATOPIC DERMATITIS (ECZEMA)
- BOX 30-3 Clinical Manifestations of Atopic Dermatitis
- DISTRIBUTION OF LESIONS
- APPEARANCE OF LESIONS
- Infantile Form
- Childhood Form
- Adolescent or Adult Form
- OTHER PHYSICAL MANIFESTATIONS
- FIG. 30-13 Infantile atopic dermatitis with oozing and crusting of lesions.
- Therapeutic Management
- Nursing Care Management
- NURSINGALERT
- Family Support.
- nursingcareguidelines
- Preventing Atopy in Children
- IDENTIFY CHILDREN AT RISK
- PRENATAL PRECAUTIONS (LAST TRIMESTER)
- POSTNATAL PRECAUTIONS
- ENVIRONMENTAL CONTROL
- SEBORRHEIC DERMATITIS
- Nursing Care Management
- ACNE
- Pathophysiology
- FIG. 30-14 Acne vulgaris. A, Comedones with a few inflammatory pustules. B, Papulopustular acne.
- Therapeutic Management
- General Measures.
- Cleansing.
- Medications.
- Nursing Care Management
- THERMAL INJURY
- BURNS
- Characteristics of Burn Injury
- Type of Injury.
- Extent of Injury.
- Depth of Injury.
- FIG. 30-15 Estimation of distribution of burns in children. A, Children from birth to age 5 years. B, Older children.
- FIG. 30-16 Classification of burn depth.
- FIG. 30-17 Superficial partial-thickness burns on an African-American child. A, Blisters intact. B, Blisters removed.
- Severity of Injury.
- Inhalation Injury.
- FIG. 30-18 Bottom to top: Deep partial-thickness burn (red area); full-thickness burn (white area); full-thickness burn with eschar (brown area).
- FIG. 30-19 Full-thickness burn with muscle and fascia involved.
- TABLE 30-10 Severity Grading System Adopted by the American Burn Association
- Pathophysiology
- Complications.
- Wound Sepsis.
- Therapeutic Management
- Emergency Care.
- Stop the Burning Process.
- emergencytreatment
- Burns
- MINOR BURNS
- MAJOR BURNS
- Assess the Victim’s Condition.
- Cover the Burn.
- Transport the Child to Medical Aid.
- Provide Reassurance.
- Minor Burns.
- Major Burns.
- Fluid Replacement Therapy.
- Nutrition.
- Medication.
- Management of the Burn Wound.
- Primary Excision.
- Débridement.
- Topical Antimicrobial Agents.
- Biologic Skin Coverings.
- TABLE 30-11 Comparison of Common Topical Preparations
- Permanent Skin Coverings.
- Sheet Graft.
- Mesh Graft.
- FIG. 30-20 Removal of split-thickness skin graft with a dermatome.
- FIG. 30-21 Sheet graft.
- Cultured Epithelium.
- Prognosis.
- Nursing Care Management
- Acute Phase.
- FIG. 30-22 Mesh graft.
- NURSINGALERT
- Management and Rehabilitative Phases.
- NURSINGALERT
- Comfort Management.
- Care of the Burn Wound.
- ATRAUMATIC CARE
- Reducing the Stress of Burn Care Procedures
- Nutrition.
- Prevention of Complications
- Acute Care.
- Long-Term Care.
- FIG. 30-23 Extensive scars from flame burn.
- FIG. 30-24 Child in elasticized (Jobst) garment and “airplane” splints.
- Psychosocial Support of the Child.
- Psychosocial Support of the Family.
- Prevention of Burn Injury.
- SUNBURN
- Nursing Care Management
- NURSINGALERT
- COLD INJURY
- KEY POINTS
- answers to CRITIAL THINKING EXERCISE
- POISON IVY
- References
- UNIT TWELVE THE CHILD WITH A PROBLEM THAT INTERFERES WITH PHYSICAL MOBILITY
- Interactive Review — Unit Twelve
- Chapter 31 The Child with Musculoskeletal or Articular Dysfunction
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- THE IMMOBILIZED CHILD
- IMMOBILIZATION
- Physiologic Effects of Immobilization
- TABLE 31-1 Summary of Physical Effects of Immobilization*
- Psychologic Effects of Immobilization
- FAMILY FOCUS
- Immobilization and Self-Esteem
- Effect on Families
- Nursing Care Management
- Family Support and Home Care.
- TRAUMATIC INJURY
- SOFT-TISSUE INJURY
- Contusions
- FIG. 31-1 Sites of injuries to bones, joints, and soft tissues.
- Dislocations
- Sprains
- Strains
- Therapeutic Management
- NURSINGTIP
- FRACTURES
- Epiphyseal (or Physeal) Injuries
- Types of Fractures
- BOX 31-1 Types of Fractures in Children
- NURSINGALERT
- Bone Healing and Remodeling
- FIG. 31-2 Types of fractures in children.
- Diagnostic Evaluation
- NURSINGALERT
- BOX 31-2 Clinical Manifestations of a Fracture
- Therapeutic Management
- emergencytreatment
- Fracture
- Nursing Care Management
- NURSINGALERT
- THE CHILD IN A CAST
- The Cast
- Cast Application.
- Nursing Care Management
- NURSINGALERT
- NURSINGALERT
- FAMILY-CENTERED CARE
- Cast Care
- FIG. 31-3 Spica cast with hip abductor. Note casts on doll as well.
- Cast Removal.
- FIG. 31-4 Young children usually adapt well to a cast but often fear the removal.
- THE CHILD IN TRACTION
- Purposes of Traction
- FIG. 31-5 Application of traction to maintain bone alignment.
- Types of Traction (General)
- BOX 31-3 Types of Traction
- Upper Extremity Traction
- Lower Extremity Traction
- FIG. 31-6 Buck extension traction.
- FIG. 31-7 Ninety-ninety traction.
- Cervical Traction
- FIG. 31-8 A, Halo vest. B, Crutchfield tong traction.
- Nursing Care Management
- NURSINGALERT
- nursingcareguidelines: Traction Care
- UNDERSTAND THERAPY
- MAINTAIN TRACTION
- MAINTAIN ALIGNMENT
- SKIN TRACTION
- SKELETAL TRACTION
- PREVENT SKIN BREAKDOWN
- PREVENT COMPLICATIONS
- NURSINGTIP
- NURSINGALERT
- DISTRACTION
- External Fixation
- Nursing Care Management
- FIG. 31-9 Child with Ilizarov external fixator during physical therapy on parallel bars.
- AMPUTATION
- NURSINGALERT
- Nursing Care Management
- CONGENITAL DEFECTS
- DEVELOPMENTAL DYSPLASIA OF THE HIP
- Pathophysiology
- Diagnostic Evaluation
- CULTURAL AWARENESS
- Developmental Dysplasia of the Hip
- FIG. 31-10 Configuration and relationship of structures in developmental dysplasia of the hip.
- 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).
- BOX 31-4 Clinical Manifestations of Developmental Dysplasia of the Hip
- INFANT
- OLDER INFANT AND CHILD
- NURSINGALERT
- Therapeutic Management
- FIG. 31-12 Child in Pavlik harness.
- Newborn to Age 6 Months.
- Ages 6 to 18 Months.
- Older Child.
- Nursing Care Management
- NURSINGALERT
- CONGENITAL CLUBFOOT
- FIG. 31-13 Bilateral congenital talipes equinovarus (congenital clubfoot) in 2-month-old infant.
- Classification
- Diagnostic Evaluation
- Therapeutic Management
- FIG. 31-14 Feet casted for correction of bilateral talipes equinovarus.
- Nursing Care Management
- METATARSUS ADDUCTUS (VARUS)
- Nursing Care Management
- SKELETAL LIMB DEFICIENCY
- Pathophysiology
- Therapeutic Management
- Nursing Care Management
- OSTEOGENESIS IMPERFECTA
- BOX 31-5 Classification of Osteogenesis Imperfecta
- Therapeutic Management
- Nursing Care Management
- NURSINGALERT
- ACQUIRED DEFECTS
- LEGG-CALVÉ-PERTHES DISEASE
- Pathophysiology
- BOX 31-6 Radiographic Stages of Legg-Calvé-Perthes Disease
- Clinical Manifestations and Diagnostic Evaluation
- Therapeutic Management
- FAMILY FOCUS
- Legg-Calvé-Perthes Disease
- Nursing Care Management
- SLIPPED CAPITAL FEMORAL EPIPHYSIS
- Pathophysiology
- Diagnostic Evaluation
- Therapeutic Management
- BOX 31-7 Clinical Manifestations of Slipped Capital Femoral Epiphysis
- Nursing Care Management
- KYPHOSIS AND LORDOSIS
- 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.
- IDIOPATHIC SCOLIOSIS
- Diagnostic Evaluation
- NURSINGALERT
- Therapeutic Management
- Bracing and Exercise.
- 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.
- Surgical Management.
- Nursing Care Management
- Preoperative Care.
- Postoperative Care.
- INFECTIONS OF BONES AND JOINTS
- OSTEOMYELITIS
- Pathophysiology
- Diagnostic Evaluation
- BOX 31-8 Clinical Manifestations of Acute Osteomyelitis
- GENERAL MANIFESTATIONS
- LOCAL MANIFESTATIONS
- Therapeutic Management
- Nursing Care Management
- SEPTIC ARTHRITIS
- Therapeutic Management and Nursing Care Management
- SKELETAL TUBERCULOSIS
- Nursing Care Management
- BONE AND SOFT-TISSUE TUMORS
- GENERAL CONCEPTS: BONE TUMORS
- Diagnostic Evaluation
- BOX 31-9 Clinical Manifestations of Bone Tumors
- OSTEOSARCOMA
- Therapeutic Management
- Nursing Care Management
- EWING SARCOMA (PRIMITIVE NEUROECTODERMAL TUMOR)
- Therapeutic Management
- Nursing Care Management
- RHABDOMYOSARCOMA
- Diagnostic Evaluation
- BOX 31-10 Clinical Manifestations of Rhabdomyosarcoma According to Tumor Site
- CENTRAL NERVOUS SYSTEM
- ORBIT
- NASOPHARYNX
- PARANASAL SINUSES
- MIDDLE EAR
- RETROPERITONEAL AREA (USUALLY A “SILENT” TUMOR)
- PERINEUM
- EXTREMITY
- Therapeutic Management
- Nursing Care Management
- DISORDERS OF JOINTS
- JUVENILE IDIOPATHIC ARTHRITIS (JUVENILE RHEUMATOID ARTHRITIS)
- Pathophysiology
- Clinical Manifestations
- Classification of Juvenile Idiopathic Arthritis
- Diagnostic Evaluation
- Therapeutic Management
- Medications.
- Tumor Necrosis Factor Inhibition.
- Physical and Occupational Therapy.
- Nursing Care Management
- Relieve Pain.
- Promote General Health.
- Facilitate Compliance.
- Encourage Heat and Exercise.
- NURSINGTIP
- Support Child and Family.
- SYSTEMIC LUPUS ERYTHEMATOSUS
- BOX 31-11 Clinical Manifestations of Systemic Lupus Erythematosus Related to Tissues Involved
- BOX 31-12 Diagnostic Criteria for Systemic Lupus Erythematosus
- Clinical Manifestations and Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- KEY POINTS
- References
- Chapter 32 The Child with Neuromuscular or Muscular Dysfunction
- LEARNING OBJECTIVES
- RELATED TOPICS and ADDITIONAL RESOURCES
- IN TEXT
- CONGENITAL NEUROMUSCULAR OR MUSCULAR DISORDERS
- CEREBRAL PALSY
- Pathophysiology
- BOX 32-1 Clinical Classification of Cerebral Palsy
- SPASTIC (PYRAMIDAL)
- DYSKINETIC (NONSPASTIC, EXTRAPYRAMIDAL)
- ATAXIC (NONSPASTIC, EXTRAPYRAMIDAL)
- MIXED TYPE
- BOX 32-2 Clinical Signs and Symptoms of Cerebral Palsy
- SPASTIC TYPE
- DYSKINETIC TYPE
- ATAXIC TYPE
- OTHER MANIFESTATIONS
- Diagnostic Evaluation
- BOX 32-3 Early Signs of Cerebral Palsy
- Therapeutic Management
- FIG. 32-1 Mobilization device for child.
- FIG. 32-2 Bike walker used to provide mobility and to enhance leg muscle strength.
- Prognosis.
- NURSINGALERT
- Nursing Care Management
- nursingprocess
- The Child with Cerebral Palsy
- ASSESSMENT
- DIAGNOSIS (PROBLEM IDENTIFICATION)
- PLANNING
- IMPLEMENTATION
- EVALUATION
- FIG. 32-3 Manual jaw control provided anteriorly.
- FIG. 32-4 Manual jaw control provided from the side.
- Support Family.
- FAMILY FOCUS
- The Reality of Acceptance of Cerebral Palsy
- Support Hospitalized Child.
- SPINA BIFIDA (MYELOMENINGOCELE)
- Pathophysiology
- FIG. 32-5 Midline defects of osseous spine with varying degrees of neural herniations.
- Diagnostic Evaluation
- FIG. 32-6 A, Myelomeningocele with intact sac. B, Myelomeningocele with ruptured sac.
- BOX 32-4 Significant Neural Tube Defects
- Prenatal Detection.
- BOX 32-5 Clinical Manifestations of Spina Bifida
- SPINA BIFIDA CYSTICA
- SPINA BIFIDA OCCULTA
- Therapeutic Management
- Infancy.
- Orthopedic Considerations.
- Management of Genitourinary Function.
- Bowel Control.
- Prognosis.
- Prevention.
- NURSINGALERT
- Nursing Care Management
- Care of the Myelomeningocele Sac.
- NURSINGTIP
- NURSINGALERT
- NURSINGALERT
- Prevent Complications.
- Provide Postoperative Care.
- Support Family and Educate About Home Care.
- Latex Allergy
- BOX 32-6 Medical Conditions Associated with Risk of Latex Allergy
- nursingcareguidelines
- Identifying Latex Allergy
- NURSINGALERT
- 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.*
- MEDICAL ITEMS
- HOME AND COMMUNITY ITEMS
- SPINAL MUSCULAR ATROPHY, TYPE 1 (WERDNIG-HOFFMANN DISEASE)
- Diagnostic Evaluation and Therapeutic Management
- Prognosis.
- BOX 32-8 Clinical Manifestations of Spinal Muscular Atrophy (SMA)
- TYPE 1 (WERDNIG-HOFFMANN DISEASE)
- TYPE 2 (INTERMEDIATE SMA)
- TYPE 3 (KUGELBERG-WELANDER SYNDROME; MILD SMA)
- Nursing Care Management
- SPINAL MUSCULAR ATROPHY, TYPE 3 (KUGELBERG-WELANDER DISEASE)
- Therapeutic Management and Nursing Care Management
- MUSCULAR DYSTROPHIES
- DUCHENNE (PSEUDOHYPERTROPHIC) MUSCULAR DYSTROPHY
- FIG. 32-7 Initial muscle groups involved in muscular dystrophies. A, Pseudohypertrophic. B, Fascioscapulohumeral. C, Limb girdle.
- 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.
- BOX 32-9 Characteristics of Duchenne Muscular Dystrophy
- BOX 32-10 Clinical Manifestations of Duchenne Muscular Dystrophy
- Diagnostic Evaluation
- Therapeutic Management
- Nursing Care Management
- ACQUIRED NEUROMUSCULAR DISORDERS
- GUILLAIN-BARRÉ SYNDROME (INFECTIOUS POLYNEURITIS)
- Pathophysiology
- Diagnostic Evaluation
- Therapeutic Management
- BOX 32-11 Clinical Manifestations of Guillain-Barré Syndrome
- INITIAL SYMPTOMS
- OTHER MANIFESTATIONS
- Course and Prognosis.
- Nursing Care Management
- TETANUS
- Pathophysiology
- Therapeutic Management
- BOX 32-12 Clinical Manifestations of Tetanus
- INITIAL SYMPTOMS
- PROGRESSIVE INVOLVEMENT
- OTHER ASPECTS
- Nursing Care Management
- BOTULISM
- BOX 32-13 Clinical Manifestations of Botulism
- GENERAL SIGNS
- INFANT BOTULISM*
- Infant Botulism
- NURSINGALERT
- Nursing Care Management
- SPINAL CORD INJURIES
- Mechanisms of Injury
- Therapeutic Management
- Nursing Care Management
- NURSINGALERT
- FIG. 32-9 Wheelchair allows adolescent mobility and independence.
- KEY POINTS
- References
- APPENDIX A Developmental/Sensory Assessment
- Developmental/Sensory Assessment
- FIG. A-1 A, Denver II. B, Directions for administration of numbered items on Denver II.
- FIG. A-2 A, Denver Articulation Screening Examination (DASE) for children 2½ to 6 years of age. B, Percentile rank.
- FIG. A-3 Denver Eye Screening Test.
- SNELLEN SCREENING*
- Preparation
- FIG. A-4 Snellen chart. A, Letter (alphabet) chart. B, Symbol E chart.
- PROCEDURE
- RECORDING AND REFERRAL
- APPENDIX B Growth Measurements
- Growth Measurements
- Height and Weight Measurements for Boys
- FIG. B-1 ▪ Weight-for-age percentiles, boys, birth to 36 months, CDC growth charts: United States.
- FIG. B-2 ▪ Length-for-age percentiles, boys, birth to 36 months, CDC growth charts: United States.
- FIG. B-3 ▪ Weight-for-length percentiles, boys, birth to 36 months, CDC growth charts: United States.
- FIG. B-4 ▪ Head circumference—for-age percentiles, boys, birth to 36 months, CDC growth charts: United States.
- FIG. B-5 ▪ Weight-for-age percentiles, boys, 2 to 20 years, CDC growth charts: United States.
- FIG. B-6 ▪ Stature-for-age percentiles, boys, 2 to 20 years, CDC growth charts: United States.
- FIG. B-7 ▪ Weight-for-stature percentiles, boys, CDC growth charts: United States.
- FIG. B-8 ▪ Body mass index—for-age percentiles, boys, 2 to 20 years, CDC growth charts: United States.
- Height and Weight Measurements for Girls
- FIG. B-9 ▪ Weight-for-age percentiles, girls, birth to 36 months, CDC growth charts: United States.
- FIG. B-10 ▪ Length-for-age percentiles, girls, birth to 36 months, CDC growth charts: United States.
- FIG. B-11 ▪ Weight-for-length percentiles, girls, birth to 36 months, CDC growth charts: United States.
- FIG. B-12 ▪ Head circumference—for-age percentiles, girls, birth to 36 months, CDC growth charts: United States.
- FIG. B-13 ▪ Weight-for-age percentiles, girls, 2 to 20 years, CDC growth charts: United States.
- FIG. B-14 ▪ Stature-for-age percentiles, girls, 2 to 20 years, CDC growth charts: United States.
- FIG. B-15 ▪ Weight-for-stature percentiles, girls, CDC growth charts: United States.
- FIG. B-16 ▪ Body mass index—for-age percentiles, girls, 2 to 20 years, CDC growth charts: United States.
- Growth Standards of Healthy Chinese Children
- Percentiles for Triceps Skinfold
- Percentiles of Upper Arm Circumference
- APPENDIX C Common Laboratory Tests
- Common Laboratory Tests
- Common Laboratory Tests and Tests Results*
- Common Laboratory Tests and Tests Results*
- Abbreviations Used in Laboratory Tests
- Prefixes Denoting Decimal Factors
- Appendix D NANDA International-Approved Nursing Diagnoses 2007-2008
- NANDA International-Approved Nursing Diagnoses 2007-2008
- APPENDIX E Translations of Wong-Baker FACES Pain Rating Scale*
- Translations of Wong-Baker FACES Pain Rating Scale*
- Brief Word Instructions (Above)
- Original Instructions
- English.
- Spanish.
- French.
- Italian.
- Portuguese.
- Romanian.
- Bosnian.
- German.
- Vietnamese
- Japanese
- Chinese
- APPENDIX F Spanish-English Translations
- Spanish-English Translations
- APPENDIX G Dietary Reference Intakes
- Dietary Reference Intakes
- Recommended Dietary Allowances (RDA) and Adequate Intake (AI)a of Major Nutrients
- Recommended Dietary Allowances (RDA) and Adequate Intake (AI)a of Major Nutrients
- Estimated Safe and Adequate Daily Dietary Intakes of Selected Vitamins and Minerals*
- Estimated Safe and Adequate Daily Dietary Intakes of Selected Vitamins and Minerals*
- Estimated Sodium, Chloride, and Potassium Minimum Requirements of Healthy Persons*
- Estimated Sodium, Chloride, and Potassium Minimum Requirements of Healthy Persons*
- Median Heights and Weights and Estimated Energy Requirements (EERs*)
- Median Heights and Weights and Estimated Energy Requirements (EERs*)
- Contents in Brief
- Contents in Brief
- Companion CD
- ANATOMY REVIEWS
- ANIMATIONS
- CASE STUDIES
- CRITICAL THINKING EXERCISES
- NCLEX REVIEW QUESTIONS
- PEDIATRIC ASSESSMENT VIDEO CLIPS
- Blood Pressure (BP) Levels for Boys by Age and Height Percentile
- Blood Pressure (BP) Levels for Girls by Age and Height Percentile
- Centigrade to Fahrenheit Temperature Conversions
- Normal Temperatures in Children
- Normal Heart Rates for Infants and Children
- Normal Respiratory Rates for Children
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