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Essentials of Pediatric Nursing
Rimple Sharma
UNIT 1: MODERN CONCEPT OF CHILD CARE
1:
Modern Concepts and Trends in Pediatrics
2:
Child Welfare
NATIONAL POLICY AND LEGISLATION RELATED TO CHILD HEALTH AND WELFARE
Introduction
Legislation Related to Child Welfare
Various Acts related to Children's Welfare are:
1. The Children's Act, 1960
2. Juvenile Justice Act 1986
3. The Child Labor (Prohibition and Regulation) Act, 1986
4. The Child Marriage Restraint Act, 1929
Key features of the Act are:
5. Education for All Handicapped Children Act, 1975
6. The Child Abuse Prevention and Treatment Act
The Act defines the following terms:
Major Provisions of the Act are:
NATIONAL PROGRAMMES RELATED TO CHILD HEALTH AND WELFARE
National programmes related to child health and welfare in India are as follows:
1. National Health Policy, 2001
2. Universal Immunisation Programme
3. Child Survival and Safe Motherhood Program (CSSM)
The objectives of CSSM were:
The strategies for attainment of these objectives are-
Strategies for achieving these objectives:
4. Reproductive and Child Health Programme
RCH Programme Interventions
1. Maternal Health Interventions
2. Child Health Interventions
RCH Phase I interventions at district level are as follows:
RCH Phase II
5. National Diarrheal Disease Control Programme
The goals of this programme were as follows-
The programme includes four strategies for diarrheal control-
6. Nutritional Programmes in India
i. Vitamin A Prophylaxis Programme
ii. Prophylaxis against Nutritional Anemia
iii. Control of Iodine Deficiency Disorders
iv. Special Nutrition Programme
v. Baalwadi Nutrition programme
vi. Integrated Child Development Scheme (ICDS)
vii. Mid-Day Meal Programme
Guidelines for mid-day meal preparation-
An example of model menu is as follows:
AGENCIES RELATED TO CHILD WELFARE
Child Welfare Agencies
A) National Agencies
1. Indian Red Cross Society (IRCS)
2. Central Social Welfare Board
3. Indian Council for Child Welfare (ICCW)
4. All India Women's Conference (AIWC):
5. Child Relief and You (CRY)
B) International Agencies
1. World Health Organization (WHO)
Objective
Organizational Structure
Functions of WHO
Activities of WHO in India
2. United Nations International Children's Emergency Fund (UNICEF)
Working of UNICEF
3. International Red Cross
4. Food and agricultural Organizational (FAO)
Other International Agencies, not directly related with children are:
Review Questions
3:
Difference Between Children and Adults
4:
Care of Sick Child
PRINCIPLES OF PRE AND POSTOPERATIVE CARE
Introduction
Preoperative Care
Principles of Physical Preparation in Preoperative Phase
Preoperative Teaching Principles
Postoperative Care
A. Immediate Postoperative Care
B. Care after 24 hours of Surgery
GRIEF AND BEREAVEMENT
Definition
Mourning
Bereavement
Causes, Incidence and Risk Factors
Stages of Grief
Symptoms of Grief
Factors Influencing Grief Response
Length of Grief Process
Complicated or Dysfunctional Grief
Grief and Children
Grief Management in Children
CHILD MORBIDITY AND MORTALITY RATES
Morbidity Measures
Mortality Measures
Other Mortality Indicators:
Preventive measures to reduce infant mortality
Child Health Goals/Targets
UNIT 2: THE HEALTHY CHILD
5:
Growth and Development
TODDLERS (1—3 YEARS)
15 Months
18 Months
24 Months
30 Months
PRESCHOOL CHILD (3—6 YEARS)
4 years
5 years
6 years
SCHOOL-AGED CHILDREN (6—11 YEARS)
6—8 years
6. Sensory Development
8—10 years
10—12 years
ADOLESCENTS (12—18 YEARS)
12—13 Years (Early Adolescence)
14 —16 Years (Middle Adolescence)
17—21 Years (Late Adolescence)
Girls
8—9 years
9—10 years
10—11 years
11—12 years
12—13 years
13—14 years
14—15 years
Boys
9—10 years
10—11 years
11—12 years
12—13 Years
13—14 years
14—15 year
15—16 years
16 —17 years
6:
The Healthy Child
NEEDS OF NORMAL CHILDREN THROUGH STAGES OF DEVELOPMENT AND PARENTAL GUIDANCE
Needs of Infants
Needs of Toddlers
Needs of a School Child
Needs of Adolescents
NUTRITIONAL NEEDS OF INFANTS BREASTFEEDING
Introduction
Physiology of Lactation
Types of Breast Milk
Initiation of Breastfeeding
Technique of Breastfeeding
Signs of Poor Attachment
Advantages of Breastfeeding
Exclusive Breastfeeding
Factors Inhibiting Breastfeeding
ARTIFICIAL FEEDING
Indications for Artificial Feeding
Artificial Formulas/Feeds
Difference in Constituents of Human and Cow's milk
Methods of Artificial Feeding
Principles of Bottle-feeding
Technique of Bottle-feeding
Technique of Katori and Spoon Feeding
Technique of Cup Feeding
Problems Associated with Artificial Feeding
COMPLEMENTARY FEEDING OR WEANING
Definition
Guiding Principles for Complementary Feeding
Weaning Foods
Problems during Weaning
BABY FRIENDLY HOSPITAL INITIATIVE
Recognition as Baby Friendly Hospital
PLAY
Definition
Types of Play
Types of Active Play
Types of Passive Play
Selection of Toys
PLAY THERAPY
Introduction
Definition
Types of Play Therapy
Play Therapy Team
Suitable Play Material According to Age
ACCIDENTS: CAUSE AND PREVENTION
Introduction
Common Childhood Accidents
Types of Accidents
Factors Affecting Accidents
Causes of Accidents
Effects of Accidents
Common Childhood Accidents
Prevention of household and outdoor accidents in toddlers
Prevention of Accidents
PREVENTIVE IMMUNIZATION AND COLD CHAIN
IMMUNITY
Vaccines and Immunoglobulins
Immunoglobulins
COLD CHAIN
Equipment of Cold Chain System
Expanded Programme on Immunization
Optional Vaccines
PREVENTIVE PEDIATRICS
Introduction
Aims of Preventive Pediatrics
Aspects of Preventive Pediatrics
Levels of Preventive Pediatrics
Preventive Pediatrics
1. Preventive care during fetal life
2. Preventive care of Neonate
3. Preventive care of Infant, Toddler and Preschoolers
i. Feeding of the child
ii. Weaning
iii. Giving nutritional supplements
iv. Monitoring of Growth and Development
v. Immunization
vi. Safety and security of children
vii. Early detection and treatment of minor ailments.
viii. Health education
UNDER-FIVE CLINICS/WELL BABY CLINICS
Aims and Objectives
Care in Illness comprises of diagnosis and treatment of:
2. Preventive Care
3. Growth Monitoring
4. Family Planning
5. Health Education
Review Questions
UNIT 3: NURSING CARE OF A NEONATE
7:
Care of a Normal Newborn
CARE OF NEWBORN
IMMEDIATE PHYSIOLOGICAL CHANGES IN NEW BORN
NEW BORN ASSESSMENT
Immediate new born assessment includes:
Assessment in this period includes:
F. Assessment of Gestational Age
CLINICAL AND NEUROLOGICAL COMPARISON OF PRETERM AND FULL TERM INFANT
IMMEDIATE CARE OF NEWBORN AT BIRTH
LATER AND ROUTINE CARE OF NEW BORN
NEONATAL RESUSCITATION
Introduction
TABC of Resuscitation
Steps of Resuscitation
Review Questions
8:
Care of Low Birth Weight Infants
PHYSIOLOGICAL HANDICAPS OF PREMATURITY OR PROBLEMS ASSOCIATED WITH PREMATURITY
Etiology of Small-for-Date baby/IUGR
Problems of Small-for-Date infants
Principles of Management of Low Birth Weight Infants
Guidelines for Modes of feeding LBW babies
Discharge and Follow -Up
KANGAROO MOTHER CARE
INTRODUCTION
Advantages/Benefits of Kangaroo Mother Care
Eligibility Criteria
Procedure of Kangaroo Mother Care
Time of Initiation
Duration of KMC
Discharge Criteria
9:
Common Neonatal Disorders
A. COMMON NEONATAL DISORDERS
1. BIRTH INJURIES
i. Soft Tissue Injury
iii. Nerve Injury
2. Problems Related To Physiological Factors
Comparison of Major Types of Jaundice
i. Pharmacologic Management
ii. Exchange Blood Transfusion
iii. Phototherapy
Complications of Jaundice
Glucose Metabolism
Clinical Features
Calcium metabolism and function
Etiology
iv. HYPOTHERMIA
Introduction
Thermal Regulation
Thermoneutral environmen t
Definition of Hypothermia
Temperature Recording
Clinical Features
Management
Hyperthermia
3. Problems of Respiratory System
i. RESPIRATORY DISTRESS SYNDROME
Introduction
Pathogenesis
Diagnostic Evaluation
Management
Nursing Management
Prevention of Respiratory Distress Syndrome
ii. MECONIUM ASPIRATION SYNDROME
Introduction
Clinical Features
Management
Prognosis
4. NEONATAL SEPSIS
Etiology
Clinical Features
Diagnostic Evaluation
A. Supportive Care
B. Antibiotic therapy
ANTIBIOTIC THERAPY IN NEONTAL SEPSIS
Prognosis
5. NEONATAL SEIZURES
Classification of Neonatal Seizures
Etiology
Diagnostic Evaluation
Management
B. MINOR DISORDERS IN NEWBORNS
1. OPHTHALMIA NEONATORUM
Diagnosis
Treatment
Prevention
2. ORAL AND PERIANAL THRUSH
Treatment
3. SKIN INFECTIONS
4. OMPHALITIS
Treatment
5. NEONATAL MASTITIS
6. NASOPHARYNGITIS
7. RHINITIS
OTHER SYMPTOMS COMMONLY PRESENT IN NEONATES
8. VOMITING
Causes
Types of vomitus
Management
9. EXCESSIVE CRYING IN INFANTS
Causes of Cry
Assessment
Care of Crying Infants
10. ABDOMINAL DISTENSION
Common Causes
Associated Clinical Features
Assessment
Management
11. CONSTIPATION
Classification
Causes
Management
Preventive Measures
12. PAIN IN CHILDREN
Approach to a Child with Pain
Management
C. COMMON CONGENITAL MALFORMATIONS
Definition
Etiology
1. Genetic Factors
2. Abnormal intrauterine environment
Occurrence Rate
Common Congenital Malformations
Diagnostic evaluation
A. Prenatal Diagnosis
B. Postnatal Diagnosis
Responsibility of the Nurse in Prevention of Congenital Anomalies
GENETIC COUNSELLING
Indications and Purpose of Genetic Counseling
Objectives of Genetic Counseling
Components of Genetic Counseling
Steps in Genetic Counseling
1. Diagnosis
2. Risk Estimation and Detection of Carriers
3. Communication
4. Back up to counseling
Role of Nurse in Genetic Counseling
Review Questions
CHAPTER 10:
Planning and Organization of Neonatal Unit
ORGANIZATION OF NEONATAL AND PEDIATRIC UNIT
A. Physical Facilities
1. Space
2. Location
3. Floor Plan
4. Ventilation
5. Lighting
6. Temperature and Humidity
7. Acoustic Characteristics
8. Electrical Outlets
9. Ambience and Ward Culture
10. Handling and Social Contacts
11. Communication System
B. Ward Personnel
C. Equipment
i. Resuscitation Equipments
ii. Bag and Mask Resuscitator
iii. Oxygen and Suction Facilities
iv. Catheters, Syringes and Needles
v. Feeding Equipment
vi. Weighing Machine
vii. Thermometer
viii. Oxygen Hood
ix. Phototherapy Unit
x. Infusion Pump
D. Laboratory Facilities
E. Procedure Manual
Review Questions
UNIT 4: INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESS (IMNCI)
CHAPTER 11:
Integrated Management of Neonatal and Childhood Illness
IMNCI Case Management Process
Review Questions
UNIT 5: NURSING MANAGEMENT IN COMMON CHILDHOOD DISEASES
12:
Nutritional Deficiency Disorders
NUTRITIONAL DEFICIENCY DISORDERS
PROTEIN ENERGY MALNUTRITION (PEM)
Introduction
Classification of PEM
Etiology
Clinical Features
A. Marasmus
B. Kwashiorkor
Diagnostic Evaluation
Management
I. Treatment in Initial Phase (1-2 weeks)
Treatment of Complications
a. Hypoglycemia
b. Hypothermia
c. Infections
d. Electrolyte disturbances
e. Dehydration
f. Deficiencies
Initiation of Feeding
II. Rehabilitative Phase (2-6 weeks)
Recovery and Discharge
Prevention of Malnutrition
VITAMIN-DEFICIENCY DISORDERS
A. FAT SOLUBLE VITAMINS
Absorption
Functions of Vitamin A
Sources of Vitamin A
Vitamin A Deficiency
Incidence
Causes of vitamin A Deficiency
Clinical Manifestations of Deficiency
Other Symptoms:
Eyes:
Skin
Hair and Nails
Management
Hypervitaminosis A
Sign and symptoms of toxicity
2. VITAMIN-D
Absorption
Functions
Daily Requirement
Vitamin D Deficiency
Risk Factors
Pathophysiology of Vitamin D Deficiency
Clinical Manifestations of Deficiency
Complications
Diagnostic Evaluation
Management
Prevention
Hypervitaminosis D
3 Vitamin E
Absorption and Storage
Functions
Sources
Daily Requirement
Clinical Manifestations of Deficiency
Management
4 Vitamin-K
Functions
Sources
Daily Requirements
Vitamin-K Deficiency
Causes of Deficiency
Clinical Manifestations of Deficiency
Management
Hypervitaminosis K
B. WATER SOLUBLE VITAMINS
1. VITAMIN C (ASCORBIC ACID)
Absorption
Functions
Sources of vitamin C
Vegetables
Vitamin–C Deficiency
Clinical Manifestations of Deficiency
Diagnostic Evaluation
Management
Vitamin C Toxicity
2. VITAMIN –B COMPLEX
1. VITAMIN – B1 (THIAMINE)
Functions
Sources
Clinical Manifestations of Deficiency
Diagnostic Evaluation
Management
2. VITAMIN B2 (RIBOFLAVIN)
Functions
Sources
Daily Requirement
Clinical Manifestations of Deficiency
Management
3. NICOTINIC ACID (NIACIN)
Functions
Sources
Clinical Manifestations of Deficiency
Diagnostic Evaluation
Management
4. VITAMIN B6 (PYRIDOXINE)
Functions
Sources
Clinical Manifestations of Deficiency
Management
5. BIOTIN
Functions
Sources
Clinical Manifestations of Deficiency
6. VITAMIN B12
Functions
Sources
Vitamin B12 Deficiency
Causes of Deficiency
Clinical Manifestations of Deficiency
Diagnostic Evaluation
Management
7. FOLIC ACID
Functions
Sources
Daily Requirement
Clinical Manifestations of Deficiency
Management
Review Questions
Answer Key
13:
Disorders of Respiratory System
DISORDERS OF RESPIRATORY SYSTEM
I. APNEA OF PREMATURITY
Definition
Types
Incidence
Pathophysiology
Management
Prognosis
II. ACUTE RESPIRATORY DISORDERS
A. Upper Respiratory Disorders
1. SINUSITIS
Definition
Etiology
Clinical Features
Diagnostic Evaluation
Management
2. NASOPHARYNGITIS
Definition
Incidence and Etiology
Pathophysiology
Clinical Features
Management
Nursing Management
3. STRIDOR
Definition
Types of Stridor
Etiology
Diagnostic Evaluation
Management
4. PHARYNGITIS AND TONSILLITIS
Incidence and Etiology
Clinical Features
Diagnostic Evaluation
Management
Nursing Management
5. CROUP
Definition
Incidence and Etiology
Pathophysiology
Clinical Features
Diagnostic Evaluation
Management
B. Lower Respiratory Tract Disorders
1. ACUTE BRONCHITIS
Definition
Incidence and Etiology
Clinical Features
Diagnostic Evaluation
Management
2. BRONCHIOLITIS
Definition
Incidence and Etiology
Clinical Features
Diagnostic Evaluation
Management
3. PNEUMONIA
Definition
Incidence
Classification
Clinical Features
Pathogenesis
Diagnostic Evaluation
Management
Nursing Management
Complications
Prevention
4. RESPIRATORY DISTRESS SYNDROME
III. CHRONIC RESPIRATORY DISORDERS
1. TUBERCULOSIS
2. BRONCHIAL ASTHMA
Definition
Incidence and Etiology
Etiology
Clinical Features
Diagnostic Evaluation
Management
a. Fast acting drugs
b. Long term control
Delivery Methods
c. Other drugs
Nursing Management
3. CYSTIC FIBROSIS
Clinical Features
Diagnostic Evaluation
Management
4. LUNG ABSCESS
Etiology and Risk Factors
Types of Lung Abscess
Clinical Features
Diagnostic Evaluation
Management
Complications
Prognosis
Review Questions
Answer Key
14:
Disorder of Gastrointestinal System
DISORDERS OF GASTROINTESTINAL SYSTEM
I. CONGENITAL DISORDERS OF GASTROINTESTINAL SYSTEM
A. DISORDERS OF MOUTH
Cleft Lip and Cleft Palate
Introduction
Definition
Incidence and Etiology
Pathophysiology
Complications
Diagnostic Evaluation
Management
Nursing Management
Care of the Baby at Birth
Care of the Baby before Surgery
B. DISORDER OF ESOPHAGUS
TRACHEOESOPHAGEAL FISTULA (TEF)
Introduction
Definition
Incidence and Etiology
Pathophysiology
Types
Clinical Features
Diagnostic Evaluation
Management
Nursing Management
Preoperative Nursing Care
Postoperative Nursing Care
C. DISORDER OF STOMACH
PYLORIC STENOSIS
Definition
Incidence and Etiology
Pathophysiology
Clinical Features
Diagnostic Evaluation
Management
Surgical Management
Nursing Management
Preoperative Nursing Care
Postoperative Nursing Care
D. DISORDERS OF INTESTINE
HERNIA
Definition
Etiology and Risk Factors
Common Hernia in Infants
1. Gastroschisis and Omphalocele
Definition
Risk Factors
Incidence and Etiology
Pathophysiology
Clinical Features
Omphalocele
Gastroschisis
Diagnostic Evaluation
Management
A. Medical Management
Intact Omphalocele
Gastroschisis
B. Surgical Care
Omphalocele
Gastroschisis
Prognosis
Difference between Gastroschisis and Omphalocele
2. Inguinal Hernia
Pathophysiology
Clinical Features
Diagnostic Evaluation
Management
3. Umbilical Hernia
Pathophysiology
Clinical Features
Diagnostic Evaluation
Management
Nursing Management
Preoperative Nursing Care
Postoperative Care
Summary of Hernias
INTESTINAL OBSTRUCTION
Definition
Incidence and Etiology
Small Bowel Obstruction
Large Bowel Obstruction
Pathophysiology
Clinical Features
Diagnostic Evaluation
Management
Medical Management
Surgical Management
Prognosis
INTUSSUSCEPTION
Definition
Incidence and Etiology
Classification
Pathophysiology
Clinical Features
Diagnostic Evaluation
Management
Nursing Management
A. Preoperative Nursing Care
B. Postoperative Nursing Care
HIRSCHSPRUNG’S DISEASE/MEGACOLON
Definition
Incidence and Etiology
Pathophysiology
Clinical Features
Diagnostic Evaluation
Management
A. Medical Management
B. Surgical Management
Corrective Definitive Surgeries
a. Swenson procedure
b. Duhamel Procedure
c. Soave’s Procedure
Nursing Management
Preoperative Nursing Care
Postoperative Nursing Care
ANORECTAL MALFORMATION
Definition
Incidence and Etiology
Pathophysiology
Classification
Diagnostic Evaluation
Management
Nursing Management
Preoperative Nursing Care
Post-operative Nursing Care
a. Care of Colostomy
b. Care after a Pull -Through and Anoplasty
Discharge Guidance to the Parents
Outcome/Prognosis
III. INFECTION AND INFESTATION OF GASTROINTESTINAL SYSTEM
DIARRHEA
Introduction
Definition
Incidence
Classification
Etiology
Predisposing Factors
Physiological Disturbances in Diarrhea
Clinical Features and Assessment
1. Mild Diarrhea
2. Moderate Diarrhea
3. Severe Diarrhea
Diagnostic Evaluation
Management
1. Fluid replacement
Administration of ORS
i. Treatment plan A
ii. Treatment Plan B
a. Rehydration Therapy
b. Maintenance therapy
iii. Treatment Plan C
2. Administer the prescribed drugs
3. Maintain nutritional status
4. Educate the mother regarding prevention of diarrhea
WORM INFESTATION
Introduction
Common Types of Worms Infesting Children
Disease Picture
1. Round Worms (Ascariasis)
2. Hookworms (Ancylostomiasis)
3. Threadworms (Enterobiasis)
Diagnostic Evaluation
Management
Drug Therapy
Home Remedies for Worm Infestation
Nursing Care in Worm Infestation
Preventive Methods
III. MISCELLANEOUS DISORDERS
INDIAN CHILDHOOD CIRRHOSIS
Definition
Incidence and Etiology
Pathology
Clinical Features
Management
FLUID AND ELECTROLYTE CRISIS
Introduction
Dehydration
Pathophysiology
Classification
1. Isotonic Dehydration
2. Hypotonic Dehydration
3. Hypertonic Dehydration
Clinical Features
Diagnostic Evaluation
Evaluation of the extent of Dehydration
Management
Nursing Management
Review Questions
Answer Key
15:
Disorders of Cardiovascular System
DISORDERS OF CARDIOVASCULAR SYSTEM
CONGENITAL HEART DEFECTS
Incidence and Etiology
Types of Congenital Heart Defects
I. ACYANOTIC HEART DISEASES
(A) Disorders of Increased Pulmonary Blood Flow
1. ATRIAL SEPTAL DEFECT
Definition
Incidence and Types
Pathophysiology
Clinical Features
Diagnostic Evaluation
Therapeutic Management
Postoperative Complications
2. VENTRICULAR SEPTAL DEFECT
Definition
Incidence and Types
Pathophysiology
Clinical Features
Diagnostic Evaluation
Therapeutic Management
Post-operative Complications
3. PATENT DUCTUS ARTERIOSUS (PDA)
Incidence
Pathophysiology
Clinical Features
Diagnostic Evaluation
Therapeutic Management
(B) Disorders with Decreased Pulmonary Blood Flow
1. COARCTATION OF AORTA
Definition
Incidence and Types
Pathophysiology
Clinical Features
Diagnostic Evaluation
Therapeutic Management
2. AORTIC STENOSIS
Definition
Incidence and Types
Pathophysiology
Clinical Features
Diagnostic Evaluation
Therapeutic Management
3. PULMONARY STENOSIS
Definition
Incidence and Types
Pathophysiology
Clinical Features
Diagnostic Evaluation
Therapeutic Management
II. CYANOTIC HEART DEFECTS
(A) Cyanotic Disorder with Decreased Pulmonary Blood Flow
1. TETRALOGY OF FALLOT (TOF)
Definition
Incidence
Pathophysiology
Clinical Features
Diagnostic Evaluation
Therapeutic Management
Medical Management
Surgical Management
a. Palliative surgery
b. Corrective surgery
Postoperative Complications
2. TRICUSPID ATRESIA
Definition
Incidence
Pathophysiology
Clinical Features
Diagnostic Evaluation
Therapeutic Management
Postoperative Complications
(B). Cyanotic Disorder with Mixed Circulation
1. COMPLETE D-TRANSPOSITION OF GREAT ARTERIES (TGA)
Definition
Incidence
Pathophysiology
Clinical Features
Diagnostic Evaluation
Therapeutic Management
NURSING MANAGEMENT OF CHILDREN WITH CARDIAC SURGERY
Postoperative Care
OTHER CARDIAC DISORDERS
1. CONGESTIVE HEART FAILURE (CHF)
Etiopathophysiology
Clinical Features
Diagnostic Evaluation
Therapeutic Management
Nursing Diagnosis
Nursing Interventions:
Nursing Interventions
Nursing Interventions
Nursing Interventions
2. RHEUMATIC FEVER
Definition
Incidence
Pathophysiology
Diagnostic Evaluation
Major Criteria
Minor Criteria
Management
RHEUMATIC HEART DISEASE
Introduction
A. Mitral Regurgitation
Treatment
B. Mitral Stenosis
Treatment
C. Aortic Regurgitation
Treatment
D. Tricuspid Regurgitation
Treatment
Review Questions
Answer Key
16:
Disorders of Genitourinary System
I. CONGENITAL RENAL MALFORMATIONS
Introduction
A. Congenital Defects Related to Kidney/Upper Urinary tract
1. RENAL AGENESIS, HYPOPLASIA
2. HORSE SHOE (FUSED) KIDNEY/RENAL ECTOPIA
3. POLYCYSTIC KIDNEY
4. RENAL DYSPLASIA
5. ENLARGED KIDNEYS
B. Congenital Defects Related to Bladder and Urethra
1. EXSTROPHY OF BLADDER
Pathophysiology
Clinical Features
Management
Nursing Care
i. Preoperative Care
ii. Postoperative Care
Postoperative Nursing Care
2. HYPOSPADIAS
Pathophysiology
Assessment
Management
Nursing Management
Preoperative Preparation
Postoperative care
3. EPISPADIAS
Management
Assessment and Diagnosis
Nursing Care
4. PHIMOSIS
5. OBSTRUCTIVE UROPATHY
Pathophysiology
Assessment
Physical Assessment
Diagnostic Procedures
Management
Nursing Care
Preoperative Care
Postoperative Care
II. INFECTIOUS DISORDERS OF RENAL SYSTEM
1. GLOMERULONEPHRITIS
Definition
Incidence and Etiology
Pathophysiology
Clinical Features
Diagnostic Evaluation
Nursing Management
i. History taking and assessment
ii. Monitor fluid status
iii. Prevent from infection Impaired renal function places the child at risk for infection so:
iv. Prevent skin breakdown
v. Meet the nutritional needs of the child
vi. Emotional support
2. URINARY TRACT INFECTION (UTI)
Definition
Classification
Incidence and Etiology
Risk factors
Pathophysiology
Clinical Features
Diagnostic Evaluation
Treatment
Nursing Management
Prevention
Prognosis
Possible complications
III. MISCELLANEOUS DISORDERS
1. NEPHROTIC SYNDROME
Introduction
Definition
Incidence and Etiology
Pathophysiology
Clinical Manifestations
Diagnostic Evaluation
Medical Management
Nursing Management
Complications
Expectations (Prognosis)
2. RENAL FAILURE
Introduction
A. Acute Renal Failure (ARF)
Incidence and Etiology
Pathophysiology
Clinical Features
Specific Features
Nonspecific Features
Diagnostic Evaluation
Medical Management
i. Treatment of underlying cause
ii. Treating the Complications
iii. Dialysis
Nursing Management
Prognosis and Outcome
B. CHRONIC RENAL FAILURE
Incidence and Etiology
Pathophysiology
Clinical Features
a. Early Signs
b. Late signs
Others features include:
Diagnostic Evaluation
Management
1. Diet
2. Controlling Hypertension
3. Managing Anemia
4. Managing Infections
5. Maintain Growth
6. Dental Care
Prognosis
2. WILM’S TUMOR
Definition
Incidence and Etiology
Pathophysiology
Clinical Features
Diagnostic Evaluation
Other tests include:
Management
Nursing Management
A. Preoperative care
Postoperative Care
Review Questions
Answer Key
17:
Disorders of Neurological System
DISORDERS OF CENTRAL NERVOUS SYSTEM
I. Infection of Central Nervous System
MENINGITIS
Definition
Classification
Etiology
Predisposing Factors
Pathophysiology
Clinical Features
Diagnostic Evaluation
Management
1. Specific treatment
Duration of Antibiotic Therapy
2. Symptomatic treatment
Nursing Management
Complications of Meningitis
Prevention
II. Disorder of Circulation of Cerebrospinal Fluid
HYDROCEPHALUS
Definition
Incidence
Normal Pathway of CSF
Classification
Hydrocephalus
a. Non-communicating or obstructive hydrocephalus
b. Communicating or non-obstructive hydrocephalus
Clinical Features
Clinical Features in Older Children
Diagnostic Evaluation
Management
Nursing Management
Pre-operative Nursing Care
Postoperative Care
Prognosis
III. Disorders of Neural Tube Development
1. NEURAL TUBE DEFECTS
2. SPINA BIFIDA
Definition
Incidence and Etiology
Classification
Pathophysiology
Clinical Features
A. Spina Bifida Occulta
B. Spina Bifida Cystica
Diagnostic Evaluation
Management
Nursing Management
Preoperative Care
Nursing Interventions
Nursing Interventions
Nursing Interventions
Nursing Interventions
Postoperative Care
Nursing Interventions
Nursing Interventions
Nursing Intervention
Nursing Intervention
Nursing Intervention
Nursing Interventions
Prognosis
Complications
Prevention
IV. SEIZURE DISORDER OR EPILEPSY
Introduction
Definition
Incidence and Etiology
Pathophysiology
Classification of Seizures
1. Partial Seizures
2. Generalized Seizure
3. Other types of Seizures are
Diagnostic Evaluation
Management
1. Medical Management
2. Surgical Management
Nursing Management
Emergency care during seizures
Care of the child after seizures
Prevention
Review Questions
Answer Key
18:
Disorders of Hematological System
THALASSEMIA
Introduction
Definition
Types
Pathologic Defect
Clinical Features
Diagnostic Evaluation
Management
Nursing Management
Prognosis
Prevention
HEMOPHILIA
Definition
Types
Transmission of Disease
Pathophysiology
Normal Clotting Mechanism
Clinical Features
Diagnostic Evaluation
Management
Nursing Management
Prognosis
PURPURA
Definition
Types
Pathophysiology
Clinical Features
Diagnostic evaluation
Management
Etiology
Pathophysiology
Clinical Features
Diagnostic Evaluation
Management
Nursing Management
Prognosis
LEUKEMIA
Definition
Incidence and Etiology
Classification
Pathophysiology
Acute lymphoid leukemia (ALL)
Acute Non-lymphoid Leukemia/Acute Myeloid Leukemia (AML)
Diagnostic Evaluation
Management
Nursing Management
Review Questions
Answer Key
19:
Disorders of Endocrine System
I. DISORDERS OF THE PANCREAS
DIABETES MELLITUS
Definition
Classification
Incidence and Etiology
Pathophysiology
Diabetes Diagnostic Criteria
Management
Complications
II. DISORDERS OF THYROID GLAND
CONGENITAL HYPOTHYROIDISM
Introduction
Classification
Pathophysiology
Clinical Features
Diagnostic Evaluation
Medical Management
Nursing Management
Prognosis
HYPERTHYROIDISM
Incidence and Etiology
Clinical Features
Diagnostic Evaluation
Medical Management
1. ACUTE ADRENOCORTICAL INSUFFICIENCY
Clinical Features
Diagnostic Evaluation
Management
Nursing Management
2. CHRONIC ADRENOCORTICAL INSUFFICIENCY (ADDISON'S DISEASE)
Clinical Features
Diagnostic Evaluation
Medical Management
Nursing Management
1. CUSHING'S SYNDROME
Etiology
Clinical Features
Diagnostic Evaluation
Management
Nursing Management
Complications
Prognosis
IV. DISORDERS OF PITUITARY GLAND
1. PITUITARY DWARFISM
Diagnostic Evaluation
Management
Nursing Management
1. PITUITARY GIGANTISM AND ACROMEGALY
Diagnostic Evaluation
Medical management
Nursing Management
1. DIABETES INSIPIDUS
Classification
Clinical Features
Diagnostic Evaluation
Management
Complications
Review Questions
Answer Key
20:
Disorders of Musculoskeletal System
A. DISORDERS OF SPINAL CORD
1. KYPHOSIS
Types
Etiology, Incidence and Risk Factors
Clinical Features
Diagnostic Evaluation
Management
Prognosis
Complications
Definition
Etiology
Clinical Features
Diagnostic Evaluation
Management
Prognosis:
3. SCOLIOSIS
Definition
Incidence and Etiology
B. DISORDERS OF HIP AND LOWER EXTREMITIES
1. DEVELOPMENTAL DYSPLASIA OF HIP (DDH)
Introduction
There are 3 degrees of Developmental Dysplasia of Hip
Incidence and Etiology
Pathophysiology
Clinical Features
Diagnostic Evaluation
Management
Nursing Management
Prognosis
Possible Complication
2. CLUBFOOT
Introduction
Definition
Types
Clinical Features
Diagnostic Evaluation
Management
A. Non-operative management
B. Surgical management
Follow-up
Nursing Management
FRACTURE
Definition
Characteristics of Fracture in Children
I. Classification on the basis of communication with environment
II. Classification on the basis of Pattern
III. Miscellaneous Types
Common Sites of Fracture in Children
Process of Bone Healing
A. Assessment
B. Diagnosis
Management of Fracture
Principles of traction
Methods of attaching traction devices
Commonly used tractions
I. Nursing Management of Children with Cast
II. Nursing Management of children in traction
Review Questions
Answer Key
21:
Disorders of Skin, Eyes and Ears
(A) BACTERIAL SKIN INFECTIONS
(1) IMPETIGO
Clinical Features
Diagnostic Evaluation
Management
(2) CELLULITIS
Etiology
Clinical Features
Diagnostic Evaluation
Management
Complications of Cellulitis
(3) FOLLICULITIS, BOILS, AND CARBUNCLES
Clinical Features
Diagnostic Evaluation
Management
(4) STAPHYLOCOCCAL SCALDED SKIN SYNDROME
Clinical Features
Diagnostic Evaluation
Management
(B) FUNGAL INFECTIONS
(1) CANDIDIASIS (YEAST INFECTION)
Clinical Features
Diagnostic Evaluation
Management
(2) TINEA INFECTIONS (RINGWORM)
Common types of ringworm
Diagnostic Evaluation
Management
(3) TINEA VERSICOLOR
Etiology
Clinical Features
Diagnostic Evaluation
Management
(C) VIRAL SKIN INFECTIONS
(1) WARTS
Management
(2) MOLLUSCUM CONTAGIOSUM
Etiology
Clinical Features
Diagnostic Evaluation
Management
(3) RUBELLA (GERMAN MEASLES)
Etiology
Childhood Rubella
Congenital Rubella Syndrome
Diagnostic Evaluation
Prevention
(4) RUBEOLA (MEASLES)
Etiology
Clinical Features
Diagnostic Evaluation
Management
Prevention
(5) CHICKENPOX
Clinical Features
Diagnostic Evaluation
Management
Immunity from Chickenpox
Complications
Prevention
(D) PARASITIC SKIN INFECTIONS
(1) SCABIES
Clinical Features
Diagnostic Evaluation
Management
(E) OTHER DISORDERS
(1) DIAPER RASH
Management
(2) DISORDERS OF EYES
Anatomy of the Eye
Normal Development of Eye
DISORDER OF EYES
1. CONJUNCTIVITIS
Definition
Etiology
Pathophysiology
Clinical Features
Diagnostic Evaluation
Management
Prevention
Family Teaching
2. OPHTHALMIA NEONATRUM
Definition
Etiology
Mode of Infection
Pathology
Clinical Features
Management
Prevention
Complications
3. RETINITIS
Definition
Etiology
Clinical Features
Diagnostic Evaluation
Management
4. STYE (HORDEOLUM)
Definition
Etiology
Clinical Features
Management
Prevention
1. CATARACT
Definition
Incidence
Types
Etiology
Pathophysiology
Diagnostic Evaluation
Management
Postoperative Care
2. GLAUCOMA
Definition
Types
Incidence and Etiology
Pathophysiology
Clinical Features
Diagnostic Evaluation
Management
Postoperative Care
3. PTOSIS
Definition
Etiology
Diagnostic Evaluation
Management
4. REFRACTORY ERRORS
Incidence and Etiology
Types
A. MYOPIA (NEARSIGHTEDNESS)
Definition
Types
Pathophysiology
Clinical Features
Management
B. HYPEROPIA (FARSIGHTEDNESS)
Definition
Pathophysiology
Clinical Features
Management
C. ASTIGMATISM
Definition
Types
Pathophysiology
Management
C. DISORDERS OF IMPAIRMENT OF EYE MUSCLES
1. STRABISMUS (SQUINT)
Definition
Incidence
Types
Diagnostic Evaluation
i. Hirschberg test
ii. Cover-Uncover/test
Management
Medical Management
Surgical Management
Nursing Interventions
2. AMBLYOPIA
Definition
Incidence and Etiology
Clinical Features
Diagnostic Evaluation
Management
1. RETINOPATHY OF PREMATURITY (ROP)
2. FAMILIAL (CONGENITAL) BLINDNESS
3. RETINITIS PIGMENTOSA
4. LEBER'S CONGENITAL AMAUROSIS
5. CONGENITAL GLAUCOMA
6. DERMOID CYSTS
(3) DISORDERS OF EAR
INTRODUCTION
1. OTITIS EXTERNA (SWIMMER'S EAR)
Definition
Etiology
Clinical Features
Diagnostic Evaluation
Management
Prevention
2. FOREIGN BODIES IN THE EAR
Clinical Features
Management
B) OTITIS MEDIA (MIDDLE EAR INFECTION)
Definition
Incidence and Etiology
Risk Factors
Types of Otitis Media
Clinical Features
Diagnostic Evaluation
Treatment
Complications
C) HEARING LOSS IN BABIES
Types of Hearing Loss
Diagnosis of hearing loss
Management of Hearing Loss
Hearing Aids
Different types of hearing aids:
Parental Education in the Use of Hearing Aid
Review Questions
Answer Key
22:
Common Communicable Diseases
COMMON COMMUNICABLE DISEASES
1. TUBERCULOSIS
Epidemiology
Pathophysiology
Clinical Features
Diagnostic Evaluation
Management
Drugs
Anti-Tuberculosis Regimen
B. Steroids
Prevention
Nursing Management
2. MEASLES
Epidemiology
Risk Factors
Pathophysiology
Clinical Features
Types of Measles
Complications
Diagnostic Evaluation
Management
Nursing Management
Prevention
3. DIPHTHERIA
Epidemiology
Pathogenesis
Clinical Features
Diagnostic Evaluation
Complications
Management
Nursing Management
Prevention
4. PERTUSSIS (WHOOPING COUGH)
Risk Factors
Epidemiology
Clinical Features
Diagnostic Evaluation
Complications
Management
Prevention
TETANUS
Epidemiology
Pathophysiology
Types
Clinical Features
Diagnostic Evaluation
Management
Nursing Management
Prevention
6. POLIOMYELITIS
Epidemiology
Pathogenesis
Clinical Features
Complications
Diagnostic Evaluation
Management
Nursing Management
Prevention
7. TYPHOID (ENTERIC FEVER)
Epidemiology
Pathophysiology
Clinical Features
Typhoid State
Diagnosis
Management
Surgical Care
Nursing Management
Prevention
Complications
Prognosis
Review Questions
Answer Key
23:
Pediatric Emergencies
1. FOREIGN BODY
Introduction
A. Foreign Body Aspiration
Commonly Aspirated Foreign Bodies
Etiology and Incidence
Pathophysiology
Clinical Features
Diagnostic Evaluation
Management
Management of an Obstructed Airway
Transport
Emergency Treatment of Infants and children with Airway Obstruction caused by a foreign body
B. FOREIGN BODY IN EAR
Objects Commonly Put in Ears
Diagnostic Evaluation
Management
C. OREIGN BODY IN NOSE
Clinical Features
Management
II. POISONING
Common Poisonous Household materials
Risk Factors
Clinical Features
Management
Prevention of Poisoning
III. DROWNING
Definition
Clinical Features
Pathophysiology
Management
VI. BURNS
Causes of Burn
Pathophysiology
A. Local skin response
A. Systemic response
i. Cardiac functions
ii. Hemodynamics
iii. Cellular response
iv. Renal functions
v. Gastrointestinal tract functions
vi. Immune response
Assessment of Burn Depth and Severity
Diagnostic Evaluation
Emergency First Aid
Immediate Management
Prevention
Review Questions
Answer Key
24:
HIV/AIDS in Children
UNIT 6: MANAGEMENT OF BEHAVIORAL AND SOCIAL PROBLEMS IN CHILDREN
CHAPTER 25:
Management of Common Behavior Disorders
i. HABIT DISORDER
a. Thumb Sucking
Definition
Age of Occurrence
Causes of Thumb Sucking
Problems caused by Thumb Sucking
Management
Do’s
Don’ts
B. NAIL BITING
Causes of nail biting
Management
C. TIC DISORDER
Definition
Types of Tics
Onset
Causes of Tic Disorder
Management
Prevention
D. ENURESIS
Definition
Types of Enuresis
Causes of Enuresis
Management
E. ECOPRESIS
Definition
Incidence
Causes of Encopresis
Management
II. SPEECH DISORDERS
A. STAMMERING/STUTTERING
Clinical Features
Causes of Stammering/Stuttering
Risk Factors
Management
III. EATING DISORDERS
A. PICA
Definition
Types
Causes of Pica
Management
B. ANOREXIA NERVOSA
Definition
Incidence
Etiology
Clinical Features
Management
C. BULIMIA NERVOSA
Definition
Incidence and Etiology
Clinical Features
Management
IV. SLEEP DISORDERS
Management
V. PERSONALITY DISORDERS
A. TEMPER TANTRUMS
Definition
Causes of Temper Tantrums
Management
B. JUVENILE DELINQUENCY
Introduction
Definition
Presentation of Antisocial Problems in Children
Etiology
i. Genetics
ii. Body build
iii. Sex
iv. Age
v. Intelligence
vi. Family background
vii. EEG Studies
viii. Personality testing
Prevention of Juvenile delinquency
Management
Corrective Therapies
Drug Therapy
C. SHYNESS
Causes of Shyness
Management
Review Questions
CHAPTER 26:
Management of Common Psychiatric Problems
II. PERVASIVE DEVELOPMENTAL DISORDERS (PDD)
Clinical Features
Etiology
Management
III. DISRUPTIVE BEHAVIOR DISORDERS
A. Oppositional defiant disorder (ODD)
B. Conduct Disorders
C. Attention Deficit Hyperactivity Disorder (ADHD)
Etiology and Risk Factors
Diagnostic Evaluation
Management
IV. ANXIETY DISORDERS
Definition
Clinical Features
Type of Anxiety Disorders
A. Generalized Anxiety Disorder
B. Panic Disorder
C. Obsessive-Compulsive Disorder (OCD)
D. Post-traumatic Stress Disorder
E. Phobias
Causes of Anxiety Disorders
Management
Review Questions
CHAPTER 27:
Management of Challenged Children
I. PHYSICAL HANDICAPS
Reaction of Child and Parents to Physical Handicaps
Reaction of Young Children
Reaction of Older Children
Reaction of Adolescents
Reaction of Parents
Management
Prevention of Physical Handicaps
A. BLINDNESS
Definition
Prevalence and Etiology
Problems of a Blind Child
Management
B. DEAFNESS
Definition
Causes of Deafness
Problems of Deaf Children
Management
II. MENTAL HANDICAPS
A. MENTAL RETARDATION
Definition
Measurement of IQ
Classification of Mental Retardation
Problems/Disorders Associated with Mental Retardation
Causes of Mental Retardation
Diagnostic Evaluation
Management
1. Primary Prevention
a. Health Promotion
b. Specific Protection
2. Secondary Prevention
3. Tertiary Prevention
a. Disability limitation
b. Rehabilitation
Care of Hospitalized Mentally Retarded Children
Nursing Care Plan for Mentally Retarded Children
Counseling of Parents
B. CEREBRAL PALSY
Definition
Incidence and Etiology
Classification/Types of cerebral Palsy
1. Spastic cerebral Palsy
Clinical Features
Diagnostic Evaluation
Management
1. Physical therapy
2. Occupational therapy
3. Speech therapy
4. Biofeedback
5. Massage therapy
6. Drug Therapy
7. Surgery and Orthosis
Prognosis
III. SOCIAL HANDICAPS
Definition
A. ORPHANS
Behavioral Problems Associated with Orphans
B. NEGLECTED CHILDREN
Definition
Types of Neglect
1. Physical Neglect
2. Nutritional Neglect
3. Emotional Deprivation
4. Medical Care Neglect
5. Educational Neglect
Management
C. CHILDREN OF DIVORCED OR STEP PARENTS
Handling Children of Divorced Parents
Effect of Step Parent
Review Questions
CHAPTER 28:
Welfare Services for Handicapped Children
SCHEMES FOR WELFARE OF HANDICAPPED
Facilities for Disabled
Organizations Providing Facilities to the Disabled
Educational Facilities for Handicapped
Self-Employment
Other Facilities
District Rehabilitation Centers
Vocational Rehabilitation Centers (VRC)
Voluntary Organizations
CHILD GUIDANCE CLINICS
Concept of Child Guidance Clinics
Definition
Objectives
Services Provided by Child Guidance Clinics
Review Questions
Appendices
Appendix I Sample Question Papers
Appendix II Calculation of Fluid Requirement for Children
Appendix III Formulas for Calculation of Various Tube Sizes
INDEX
TOC
Index
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