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Class Notes for Principles of Pediatric Nursing Caring for Children, 6th Edition

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e C HAPTER 1: N URSE ’ S R OLE IN C ARE OF THE C HILD : H OSPITAL , C OMMUNITY , AND H OME Learning Outcome 1 Describe the continuum of pediatric health care. Concepts for Lecture 1. The continuum of care includes a variety of settings and complexities of care for children and their families. Suggestions for Classroom Activities  Have students describe locations where nurses might encounter children and their families. Suggestions for Clinical Activities  Have students identify the level of care provided by nurses in various clinical settings where nurses encounter children and families. Learning Outcome 2 Compare the roles of nurses in child health care. Concepts for Lecture 1. Pediatric nurses have many roles beyond direct patient care . 2. Pediatric nurses apply special knowledge and skills to care for children. 3. Pediatric nurses use the nursing process to identify and solve problems and to plan patient care. Suggestions for Classroom Activities  Ask students to describe an example of a nurse's acting as a patient advocate for a pediatric patient .  Have students do a literature search to find examples of pediatric nursing research of a nur s ing procedure. Discuss how the study could contribute to evidence - based practice. Suggestions for Clinical Activities  Have students interview a nurse in a pediatric setting about patient education,

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e patient advocacy, case management, and research experiences. How does the nurse use evidence - based practice to inform patient education and advocacy? Learning Outcome 3 Analyze the current societal influences on pediatric health care and nursing practice. Concepts for Lecture 1. Current pediatric nursing is culturally sensitive. 2. Current pediatric nursing is family - centered. Suggestions for Classroom Activities  Ask students to describe an example of a nurse's acting as a patient advocate for a pediatric patient .  Have students do a literature search to find examples of pediatric nursing research of a nur s ing procedure. Discuss how the study could contribute to evidence - based practice. Suggestions for Clinical Activities Have students interview a nurse in a pediatric setting about patient education, patient advocacy, case management, and research experiences. Learning Outcome 4 Report the most common causes of child mortality by age group and reasons for hospitalization . Concepts for Lecture 1. Unintentional injury is the leading cause of death throughout childhood. 2. Intentional injury is a major cause of death of children in the United States. 3. Access and financing of health care for chi l dren is not consistent across the United States. 4. Research and technology allow many children with congenital anomalies and low birth weights to survive .

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e Suggestions for Classroom Activities  Discuss the role of nurses in preventing the leading causes of death in infants, children, and pre - teenagers. Suggestions for Clinical Activities  Discuss how access and financing of health care affect the clinical setting.  Discuss how technology in the clinical setting changes the lives of children and their fam i lies . Learning Outcome 5 Contrast the policies for obtaining informed consent of minors to policies for adults. Concepts for Lecture 1. The parent or legal guardian must give informed consent prior to treatment or research participation. 2. In some cases, a parent might not have legal authority to give consent. 3. Adolescents can legally give informed consent in certain circumstances. 4. Children may be involved in decision making, but the parents make final decisions regarding treatment or research participation. Suggestions for Classroom Activities  Conduct a role - playing scenario. Have one student be a nurse and another be a parent of a child who is reluctant to agree to surgery for her child. Suggestions for Clinical Activities  Have students find an informed consent form from a patient ’s chart. Discuss what was included or is missing from the form. Learning Outcome 6 Examine three unique pediatric legal and ethical issues in pediatric nursing practice. Concepts for Lecture 1. State laws vary regarding what information about an adolescent’s health care may be withheld from the parent.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e 2. Pediatric nurses might face ethical dilemmas when providing care to children and their families. 3. Pediatric nurses should be aware of the ethical issues and legal responsibilities surrounding the withholding or withdrawing of medical treatment, genetic testing, and organ transplantation for children. Suggestions for Classroom Activities  Conduct a role - playing scenario. The students are nurses on a pediatric hospital unit. A pre g nant 15 - year - old has been diagnosed with cancer, and must receive chemotherapy that will put her fetus at risk. Ask students to identify the ethical dilemmas in this situation and to di s cuss how nurses should respond. Suggestions for Clinical Activities  Have students investigate the policies for addressing ethical dilemmas involving children at the clinical site. G ENERAL C HAPTER C ONSIDERATIONS 1. Have students study and learn key terms listed at the beginning of the chapter. 2. Have students complete end - of - chapter Clinical Reasoning in Action questions and check their answers against the suggested responses provided at www.pearsonhighered.com/nursingresources . 3. Use the Classroom Response Questions provided in PowerPoint to assess students prior to lecture.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e C HAPTER 2: F AMILY - C ENTERED C ARE AND C ULTURAL C ONSIDERATIONS Learning Outcome 1 Describe key concepts of family - centered care. Concepts for Lecture 1. Family - centered care is a philosophy of health care in which a mutually beneficial partnership develops between families and the nurse, and also other health professionals. 2. Collaborating with families helps promote the best outcomes for children. Suggestions for Classroom Activities  Ask students for examples of the differences between family - centered and family - focused care for a specific situation. For example, differentiate the types of care when a child is reluctant to take his medicine. Suggestions for Clinical Activities  Have students describe how they see family - centered care provided in their clinical setting.  Have students interview a nurse at a clinical setting for examples of how family - centered care is implemented. Learning Outcome 2 Identify characteristics of different types of families. Concepts for Lecture 1. A family can be a self - identified group of two or more persons joined together by shared resources and emotional closeness, regardless of whether they are related or living in the same household. 2. Pediatric nurses work with children from many different types of families. 3. Families play a vital role in the health promotion and health maintenance of their children. Suggestions for Classroom Activities  Have students draw a diagram of their family with designations of whom they think of as their immediate and extended family members. Ask each student to show his diagram to another student and explain the family’s structure.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e  Have students divide into pairs and diagram the structure of their partner’s family and then discuss the differences. Suggestions for Clinical Activities  Have students identify the types of families seen at the clinical setting. Discuss how they identified the types. Learning Outcome 3 Contrast four different parenting styles and analyze their impact on child personality development. Concepts for Lecture 1. The manner in which children are parented influences their developmental outcomes. 2. Families generally exhibit one general style of parenting (authoritarian, authoritative, permissive, or indifferent), but might vary their style for certain situations. Suggestions for Classroom Activities  Ask students to label their own parents’ parenting styles. Discuss what evidence they have for the label they assigned.  Discuss which parenting style is likely to have the best influence on child personality development. How can nurses encourage parents to use this style of parenting?  Have students role - play each style of parenting in different parenting situations (e.g., a teenager misses curfew; a 10 - year - old wants to bike five miles to the mall by himself). Suggestions for Clinical Activities  Have students conduct a literature review of parenting styles and nursing practice. What does research indicate about how knowledge of parenting styles can affect nursing care? Learning Outcome 4 Explain the effects of major family changes on children.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e Concepts for Lecture 1. Changes in family dynamics or functioning (e.g., parental divorce, the addition of a stepparent, foster care placement, or adoption) can impact children in a variety of ways. 2. Nurses can assist families experiencing change by inquiring about the circumstances and the changes the child is experiencing. Suggestions for Classroom Activities  Have students divide into pairs. Have students briefly assess the family functioning infl u ences on their family, then share that assessment with another student. Suggestions for Clinical Activities  Discuss how the agency addresses the nursing needs of families who are affected by divorce, foster parenting, and stepparenting. Who makes the healthcare decisions in these families? How are nurses involved in these situations?  Have students review the literature on how family functioning is affected by changes such as divorce, stepparenting, foster parenting, or adoption. What should the nurse’s role be when working with families experiencing these changes? Learning Outcome 5 List the categories of family strengths that help families develop and cope with stressors. Concepts for Lecture 1. A child’s illness or injury affects every member of the family. 2. Pediatric nurses need to be able to assess family strengths and support mechanisms to identify strategies for coping and to determine when families have overextended their resources and need additional support. 3. Family strengths are the positive relationships and processes that support and protect families and family members during times of adversity and change . 4. Four types of strengths help families develop, adapt to change, and overcome challenges. Suggestions for Classroom Activities  In pairs, have students interview their partners for family strengths in the four

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e categories (resilience, assets, capabilities, and motivations). Discuss how students assessed each category. Suggestions for Clinical Activities  Have students identify ways in which they can use the nursing history used in the clinical setting to assess a family’s strengths.  Assign students to conduct a family strengths assessment on a family in the clinical setting. In class, discuss how information obtained from the assessment could be used in planning nursing care with the family. Learning Outcome 6 Summar ize the advantages of using a family or cultural assessment tool. Concepts for Lecture 1. Family and cultural assessment tools help the nurse gather information about families, their members, their relationships with each other, and their values and beliefs. 2. Knowing how a family nurtures its members, solves problems, and communicates can help the nurse identify more effective strategies for managing the child’s health care. Suggestions for Classroom Activities  In pairs, have students draw a family ecomap of their partners’ families. Discuss how this assessment could be used to help the family identify and plan supportive services in the community.  Review the case study for this chapter. Have students identify resources in your community that would be helpful for a client such as Casey and his family. Of these resources, how many of them employ staff who speak English and Spanish? How many of them do not employ bilingual staff but hire contracted interpreters when needed? Are there services available in your community to meet the needs of Casey and his family? Where are the gaps? Suggestions for Clinical Activities  Discuss how to determine which assessment tools to use with clients in the clinical setting. Discuss the advantages and disadvantages of using each tool with a selected family.  Have students find a nursing research study that incorporates the use of a family or cultural assessment tool in the study. Lead a discussion in class about how the tools were used and what strengths and weaknesses were determined by the research.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e Learning Outcome 7 Develop a family - centered nursing care plan for the child and family. Concepts for Lecture 1. The goal of culturally competent family - centered nursing management is to assess and help families recognize their strengths and resources. This information then can be used in collaboratively planning the nursing care plan with the child and family. 2. Determine the affect the child’s condition has on family functioning. 3. Establishing a therapeutic relationship with the family is an essential intervention. Suggestions for Classroom Activities  In pairs, discuss different strengths that might help a family cope with a child’s illness or injury. Discuss how an absence of these strengths might impact a family and how the nurse could best help the family make gains in these areas. Suggestions for Clinical Activities  Have students discuss with nurses at the clinical facility how the nurses identify family strengths and resiliency, and what challenges they face in helping identify families’ strengths and needs. Learning Outcome 8 Describe cultural influences on the family’s beliefs about health, illness, and treatments. Concepts for Lecture 1. Culture can determine which member of the household is the primary decision maker for the child and family. 2. Culture determines family goals, member roles, and childbearing practices and beliefs. 3. Communication and language skills can impact ability to understand and follow treatment recommendations. 4. Cultural practices can include diet and family eating patterns which can contribute to a health problem or impede recommended treatment. 5. Many cultures practice alternative therapies that can impact the plan of care.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e Suggestions for Classroom Activities  Ask students to divide into pairs and choose a common childhood illness or injury (e.g., asthma, influenza, strep throat, eye injury, arm or leg fracture). Partners will identify alternative therapies that might be beneficial or harmful to a child with that condition and then report their findings to the class, explaining their reasoning. Suggestions for Clinical Activities  Have students interview a nurse in a pediatric setting about the influences of culture on family beliefs that the nurse sees in that setting. Learning Outcome 9 Discuss nursing interventions for providing culturally sensitive and competent care to the child and family. Concepts for Lecture 1. Nurses provide culturally sensitive and competent interventions by collaborating with the family to design the plan of care and by assisting the family in determining how they can incorporate prescribed therapies with healthcare practices. 2. Nurses also provide culturally sensitive and competent interventions by collaborating with the family to identify and select resources that will support them in maintaining ongoing appropriate care for the child. Suggestions for Classroom Activities  Discuss techniques for establishing a therapeutic relationship with a family who speak a different language.  Have students identify and discuss resources available in your community for families from different cultures.  Have students discuss ways to help families identify and select community resources. Suggestions for Clinical Activities  Assign students to interview a pediatric nurse to determine what strategies she uses to provide culturally sensitive and competent nursing interventions to families.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e G ENERAL C HAPTER C ONSIDERATIONS 1. Have students study and learn key terms listed at the beginning of the chapter. 2. Have students complete end - of - chapter Clinical Reasoning in Action questions and check their answers against the suggested responses provided at www.pearsonhighered.com/nursingresources . 3. Use the Classroom Response Questions provided in PowerPoint to assess students prior to lecture.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e C HAPTER 3: G ENETIC AND G ENOMIC I NFLUENCES Learning Outcome 1 Explain the roles of genetic and genomic concepts in health promotion, disease prevention, screening, diagnostics, selection of treatment, and monitoring of treatment effectiveness. Concepts for Lecture 1. Genomics offers the promise of personalized health care based on an individual’s or population’s risk for disease. 2. Specific knowledge about an individual’s genetic makeup and associated risk for disease provides a basis for health screening and could provide motivation to maintain a healthy lifestyle. 3. With knowledge of genetic conditions, the pediatric nurse can provide health teaching and ensure early detection of complications from genetic conditions with emphasis on primary and secondary care interventions. Suggestions for Classroom Activities  In pairs, have students discuss how genetics plays a role in the health screening process. Ask students to discuss whether any members of their own families have received health screenings based on genetic considerations and how they might have benefited from the information gained from the screening.  In small groups, have students research how advances in genomics have led to changes in health - promotion activities for one of the following specific age groups: newborns and infants, toddlers, school - age children, and adolescents. Each group should prepare a short presentation on the findings to give to the class. Suggestions for Clinical Activities  Observe the strategies used by a nurse in the clinical setting to explain a screening or procedure, or to discuss a health - promotion activity based on a child’s genetic (individual or population) profile. What strategies were effective? What strategies could the nurse have used to improve communication? Learning Outcome 2 Elicit a family health history and construct a genetic pedigree . Concepts for Lecture

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e 1. Pediatric nurses and all other health professionals should know how to collect a three - generation family history, record the history in a pedigree, and “think genetic.” 2. A finished pedigree provides a clear, visual representation of a family’s medical data and biological relationships at a glance. Suggestions for Classroom Activities  In pairs, have students collect a three - generation family history from their partners. Each student should record the partner’s history in a pedigree. Have students discuss the completed pedigrees, identifying any possible indicators for screenings or testing based on the information contained in the pedigree. Suggestions for Clinical Activities  Interview a nurse at a clinical setting for strategies to use when conducting a three - generation family health history. How is the history recorded? What information do patients find difficult to recall or discuss? Learning Outcome 3 Incorporate knowledge of genetic and genomic influences and risk factors into assessment, planning, and implementation of nursing care. Concepts for Lecture 1. The pediatric nurse in any healthcare setting should “think genetic” when performing a physical assessment. 2. An early finding by the nurse will provide the child and family with an opportunity for a genetic referral and more specialized health care. 3. As a routine part of the patient assessment, the pediatric nurse should screen for both minor and major dysmorphic anomalies. Suggestions for Classroom Activities  Review Table 3 – 4 Selected Dysmorphic Physical Assessment Findings.  Divide the class into small groups. Ask each group to take one or two areas (e.g., skull, extremities, ears) and list assessment activities necessary to identify the presence of a dysmorphic anomaly in that body area. Have groups present their findings to the class. Suggestions for Clinical Activities  Require students to conduct a physical assessment of a child they care for during their clinical rotation that includes assessing for dysmorphic anomalies.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e Learning Outcome 4 Integrate basic genetic and genomic concepts into child and family education. Concepts for Lecture 1. Pediatric nurses integrate basic genetic and genomic concepts into care planning by providing referrals to genetic specialists and by informing children and families of what to expect from a genetic referral. 2. Pediatric nurses integrate basic genetic and genomic concepts into family education by providing information about genetic disorders and by clarifying and reinforcing information obtained from a genetic referral or test. 3. Pediatric nurses working with families whose child might have a genetic disorder should assess the family’s coping mechanisms and support systems, and might need to assist the family in finding and obtaining support services. Suggestions for Classroom Activities  Divide students into small groups. Have each group pick a genetic disorder and conduct a literature review to determine what information about the disorder to provide during a family teaching session. Have each group develop a family teaching session and present it to the class. Suggestions for Clinical Activities  Interview a social worker or mental health professional who works with children and families with genetic disorders to learn more about the psychosocial needs of these families and how the professional assists families in meeting those needs. Learning Outcome 5 Understand implications of genome science on the nursing role, with particular attention to ethical, legal, and social issues. Concepts for Lecture 1. By maintaining a basic knowledge of genetics and genomics concepts, nurses are able to maintain a professional standard of care. 2. Nurses who understand the ethical, legal, and social issues associated with genetics and genomics concepts are able to provide essential information to children and families. Suggestions for Classroom Activities

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e  Discuss state laws regarding genetic testing and the protection or disclosure of genetic information. Discuss the nurse’s role in the protection of an individual’s genetic information. Suggestions for Clinical Activities  In the clinical setting, students should ask for a copy of any policies related to genetic information and then interview a nurse in the setting to determine how the policies are implemented. Learning Outcome 6 Discuss the significance of recent advances in human genetics and geno mics and their impact on health care delivery. Concepts for Lecture 1. Knowledge gained from human genome research is changing all aspects of health care, including health promotion and disease prevention, screenings, treatment, and monitoring of treatment effectiveness. 2. Nurses must be prepared to deliver genetically competent care in many healthcare settings to individuals, families, communities, and populations. Suggestions for Classroom Activities  Divide students into small groups. Have each group take one aspect of health care (health promotion and disease prevention, screenings, treatment, or monitoring treatment effectiveness) and conduct a review of the literature to find examples of how genetics and genome research have influenced that area. Each group should prepare a short presentation to give to the class. Suggestions for Clinical Activities  Invite a pediatric nurse from the local health department to come and discuss how the health department uses genetics and genome research to inform services provided in the community. G ENERAL C HAPTER C ONSIDERATIONS 1. Have students study and learn key terms listed at the beginning of the chapter. 2. Have students complete end - of - chapter Clinical Reasoning in Action questions and check their answers against the suggested responses provided at www.pearsonhighered.com/nursingresources . 3. Use the Classroom Response Questions provided in PowerPoint to assess students prior to lecture.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e C HAPTER 4: G ROWTH AND D EVELOPMENT Learning Outcome 1 Describe major theories of development as formulated by Freud, Erikson, Piaget, Kohlberg, social learning theorists, and behaviorists. Concepts for Lecture 1. Pediatric nurses integrate knowledge of physical growth and psychosocial development into each healthcare encounter. Suggestions for Classroom Activities  Ask students to calculate how much they would weigh and how tall they would be in one year if they grew at the same rate as an infant .  Divide the class into six groups: Freud, Erikson, Piaget, Kohlberg, Bandura, and Watson. Have each group analyze the theory proposed by their theorist regarding its focus on nature versus nurture. Suggestions for Clinical Activities  Have students describe how the work of a particular theorist is implemented in the clinical setting. Observe how play, procedures, visiting rules, and client teaching are influenced by the major theories.  Have students c onduct a literature review on how a selected develo p mental theory has been integrated into nursing practice . Discuss the policies and procedures that were implemented in accordance with the theory’ s concepts. Learning Outcome 2 Recognize risks to developmental progression and factors that protect against those risks. Concepts for Lecture 1. Illness can interfere with normal developmental processes. 2. Illness adds challenges for the nurse to promote normal growth and development in the hospitalized and nonhospitalized infant, child, and adolescent. 3. Prematurity of an infant greatly interferes with the normal developmental progression seen during infancy. 4. Children being adopted through international adoption may have profound alterations in the normal developmental process based on the circumstances of their lives in their countries of origin. 5. Using the frameworks of the theorists discussed in this chapter will aid the student in recognizing what level compromised children are at in terms of their development.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e 6. Assessing an infant’s or young child’s communication can give insight to conditions that may interfere with normal developmental progression (e.g., the ability to see or hear, autism). 7. Watching a child play is an excellent way to assess a child’s development and to evaluate whether or not that child is on target for normal developmental progression. 8. Discuss the impact of resiliency when risks to normal developmental progression are present. Suggestions for Classroom Activities  Ask students to list risk factors and protective factors in their own family before discussing this content. Use their answers as a framework for discussion. Suggestions for Clinical Activities  Have students use Table , “Assessment Questions to Determine Resilience Capability ” to assess a family for protective and risk factors. Learning Outcome 3 Plan nursing interventions for children that are appropriate for the child’s developmental state, based on theoretical frameworks. Concepts for Lecture 1. Major developmental theories guide nursing interventions for children in each age group in a variety of situations. Suggestions for Classroom Activities  Divide the class into six groups: Freud, Erikson, Piaget, Kohlberg, Bandura, and Watson. Have each group devise nursing activities (teaching, procedures) based on its theorist's theories for each stage of development. Suggestions for Clinical Activities  Have students identify how the work of the major theorists has affected nursing interactions with parents. What parental behaviors are encouraged and discouraged? How are they encouraged or discouraged? Learning Outcome 4

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e Explain contemporary developmental approaches such as temperament theory, ecologic theory, and the resilience framework. Concepts for Lecture 1. Contemporary approaches expand on the major theoretical frameworks to describe child development. 2. Temperament theory, ecologic theory, and the resilience framework can guide nursing interventions by identifying needs and utilizing family strengths. Suggestions for Classroom Activities  Ask students to compare the effect of environment on child development in the ecologic, temperament, and resiliency theories. Have students discuss the differences. Suggestions for Clinical Activities  Have students conduct a literature review of how ecologic, temperament, and resiliency theories have been integrated into nursing practice. Compare the findings in the literature with what is being implemented in the clinical setting. Learning Outcome 5 Identify major developmental milestones for infants, toddlers, preschoolers, school - age children, and adolescents. Concepts for Lecture 1. A child’s growth and development are influenced before birth by genetic, prenatal, and cultural factors. 2. Pediatric nurses must be familiar with the physical, cognitive, and psychosocial milestones for each stage of a child’s life (infancy, toddlerhood, preschool years, school - age years, and adolescence). Suggestions for Classroom Activities  Have students describe the genetic, cultural, family, and prenatal care influences that have affected them and their siblings. Have students discuss each area. Suggestions for Clinical Activities  Discuss how the agency incorporates play, knowledge of temperament, and communication development in the agency’s physical design. How are play, communication, and interaction facilitated or encouraged?

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e Learning Outcome 6 Synthesize information from several theoretical approaches to plan assessments of the child’s growth and developmental milestones. Concepts for Lecture 1. Nurses use knowledge of development theories when planning and conducting assessments of children in order to analyze children’s development, identify any slow or abnormal development, and assist parents in planning ways to encourage and support the next emerging developmental abilities. Suggestions for Classroom Activities  Divide the class into six groups: newborn, infant, toddler, preschooler, school - age, and ad o lescent. Have each group plan how it would proceed to assess the growth and development of children in its assigned age group. Students should plan how to assess growth, motor skills, language, and sensory abilities. Suggestions for Clinical Activities  Have students identify the tools used by the clinical agency to assess growth and development. Discuss the strengths and weaknesses of these tools. Learning Outcome 7 Describe the role of play in the growth and development of children. Concepts for Lecture 1. Play occurs at all stages of a child’s development, and contributes to physical, cognitive, and psychosocial development. 2. Pediatric nurses must consider incorporating play as part of nursing care. Suggestions for Classroom Activities  Divide the class into six groups: newborn, infant, toddler, preschooler, school - age, and ad o lescent. Have each group plan how it would encourage play in a clinical setting with a child or adolescent in isolation.  Discuss how or if the concept of play changes as the child grows. What precautions do parents and caregivers need to take for toddlers? How are these similar or different from the precautions that parents of adolescents might need

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e to take? What would you categorize as “play” for the adolescent? Are texting or social networking forms of play? If so, why? Suggestions for Clinical Activities  Have students assess the play areas and toys provided for patients in the clinical setting. Are the play areas and toys age - appropriate? How do they promote growth and development? Learning Outcome 8 Use data collected during developmental assessments to implement activities that promote development of children and adolescents. Concepts for Lecture 1. Nurses use knowledge of physical, cognitive, and psychosocial developmental milestones to plan care. Suggestions for Classroom Activities  Divide the class into six groups: newborn, infant, toddler, preschooler, school - age, and ad o lescent. Have each group plan how it would promote growth and development for a child with an illness that restricted mobility, and for a child whose parents did not speak English. Suggestions for Clinical Activities  Have students identify activities used by the clinical agency to promote growth and development for children at each stage of development. Discuss the strengths and weaknesses of the activities identified. G ENERAL C HAPTER C ONSIDERATIONS 1. Have students study and learn key terms listed at the beginning of the chapter. 2. Have students complete end - of - chapter Clinical Reasoning in Action questions and check their answers against the suggested responses provided at www.pearsonhighered.com/nursingresources . 3. Use the Classroom Response Questions provided in PowerPoint to assess students prior to lecture.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e C HAPTER 5: P EDIATRIC A SSESSMENT Learning Outcome 1 Describe the elements of a health history for infant s and child ren at different ages. Concepts for Lecture 1. The pediatric health history includes the chief complaint, history of present illness or injury, past history, current health status, review of systems, patient information, and family history. 2. As the child ages, more health history data are collected from the child. Suggestions for Classroom Activities  Have students develop an ideal examination room for children of different age groups. What equipment, lighting, toys, and educational aides would be best for each age group? Suggestions for Clinical Activities  Analyze an examination room or area at the clinical site for safety, appropriateness for age, availability of privacy, educational materials, and quality of available equipment. Learning Outcome 2 Apply communication strategies to improve the quality of historical data collected. Concepts for Lecture 1. Be sure parents know the purpose of the interview, and that the information will be used appropriately. 2. Establish a rapport with the family and use careful listening techniques to collect high - quality history data. 3. While communicating, be aware of your own nonverbal behavior and language style. Suggestions for Classroom Activities  Discuss what effective communication is during a pediatric assessment. How will you know that you are communicating effectively?  Present the case s of a parent of children of different age s , parents of different cultural backgrounds, and parents in di f ferent family structures. Discuss how the nurse would improve communication with each cl i ent.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e Suggestions for Clinical Activities  Conduct a pediatric assessment and analyze your communication strategies. What did you do to facilitate rapport with the child and caregiver? What verbal and nonverbal communication did you use to show interest and to facilitate data collection? Learning Outcome 3 Demonstrate strategies to gain cooperation of a young child for assessment. Concepts for Lecture 1. Nurses must consider the developmental level of children to gain their cooperation for assessment. 2. Involve parents during the assessment; collect the least invasive data first. 3. Use pleasant distractions for younger children; offer some control to older children as appropriate. Suggestions for Classroom Activities  Discuss techniques that assess development but are presented as games or as other observations of behavior.  Divide the class into small groups. Have each group develop a game or activity to assess the development of an infant, a toddler, and a school - age child. Suggestions for Clinical Activities  Observe the strategies used by a nurse in the clinical setting to facilitate cooperation with a young child. Analyze the verbal and nonverbal communication. What strategies were effective? What strategies might the nurse have used to improve communication? Learning Outcome 4 Describe the differences in sequence of the physical assessments for infants, children, and adolescents. Concepts for Lecture 1. Use a foot - to - head approach for younger children, and a head - to - foot approach for older children. 2. For younger children, use least invasive techniques first: inspection, auscultation, percussion, and then palpation. 3. Examine adolescents in the manner of an adult, but pay particular attention to privacy and concerns about development of secondary sexual characteristics.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e Suggestions for Classroom Activities  Discuss how the sequence of a pediatric health exam would vary for an infant, toddler, school - age child, and adolescent. Divide students into groups for each age. Put a column on a blackboard for each group and have students enter the sequence they would use to examine each age group. Discuss the differences. Suggestions for Clinical Activities  Observe a nurse conducting a pediatric health exam. How did the nurse alter the sequence of the exam to facilitate the child’s cooperation? What would you do differently? What measures were particularly effective? Learning Outcome 5 Modify physical assessment techniques according to the age and developmental stage of the child. Concepts for Lecture 1. Nurses must consider a child’s anxiety level and take measures to reduce fears during an examination. 2. Equipment used, locations for auscultation, and order of the examination will vary as the child ages. Suggestions for Classroom Activities  Conduct a role - playing exercise with students playing the roles of a nurse and children of di f ferent ages. What measures can be used to reduce anxiety for each age group? How will equipment vary for each age group? Suggestions for Clinical Activities  Assess an examination room in a clinical setting. What equipment is available in different sizes for different sizes of children? How do you choose the correct size? What equipment is missing that would improve assessment of different - age children? Learning Outcome 6 List five normal variations in pediatric physical findings (such as a hyperpigmented patch in an infant) found during a physical assessment.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e Concepts for Lecture 1. Nurses can identify possible health problems of children while conducting an examination. 2. Health problems of children will vary by age; nurses need to be alert for these common problems while examining children. Suggestions for Classroom Activities  Divide students into small groups. Give each group a body system. Ask students what alter a tions might indicate a health problem. For example, for eyes, students should be observant for discharge, redness, crossed eyes, rubbing, and so on. Suggestions for Clinical Activities  Analyze the health assessment of a client with a diagnosed health problem in the clinical area. What data from the assessment were used by the physician to diagnose the problem? What data did nurses collect? Learning Outcome 7 Evaluate the growth pattern of an infant or child. Concepts for Lecture 1. The weight of a child should be calculated by taking two measurements and averaging them for the final weight. 2. The nurse should measure the infant’s head circumference up to age 2 to 3 years. 3. The place in which a child’s measurements fall on an age - and gender - appropriate growth curve will assist the nurse in determining whether the child exhibits steady expected growth, poor growth, or faster growth than expected for age. 4. The nurse should plot the infant’s weight for length or calculate and plot the child’s body mass index to determine if the child’s weight is appropriate for height. Suggestions for Classroom Activities  Allow students to practice plotting a fictional child’s measurement on a growth curve appropriate for age and gender that has prior measurements plotted. Once complete, have students identify the percentile in which weight, length, or height and head circumference fall. Suggestions for Clinical Activities  Discuss the appropriate methods to determine an infant or child’s weight, length or height, and head circumference, as well as which measurements are appropriate for which age groups.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e Learning Outcome 8 Distinguish between expected and unexpected physical signs to identify at least five signs that require urgent nursing intervention. Concepts for Lecture 1. The physical assessment usually offers important findings about a child’s health condition. Assessment findings may be subtle or obvious. Continuous monitoring and reassessment to identify trends are critical in identifying serious changes in the child’s status. Suggestions for Classroom Activities  Discuss as a class the general principles that nurses should follow when working with a child who has a sudden change in his or her health status. Suggestions for Clinical Activities  Locate emergency equipment in the clinical setting. If possible, have students practice handling the equipment (examples: connecting an Ambu - bag to oxygen supply, bagging a child, etc.). G ENERAL C HAPTER C ONSIDERATIONS 1. Have students study and learn key terms listed at the beginning of the chapter. 2. Have students complete end - of - chapter Clinical Reasoning in Action questions and check their answers against the suggested responses provided at www.pearsonhighered.com/nursingresources . 3. Use the Classroom Response Questions provided in PowerPoint to assess students prior to lecture.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e C HAPTER 6: I NTRODUCTION TO H EALTH P ROMOTION AND M AINTENANCE Learning Outcome 1 Define health promotion and health maintenance. Concepts for Lecture 1. Health promotion refers to activities that increase well - being and enhance wellness or health. 2. Health maintenance refers to activities that preserve one’s present health or prevent the occurrence of disease or injury. Suggestions for Classroom Activities  Draw three columns on the blackboard labeled Health Promotion, Overlap, and Health Maintenance. Ask students to call out nursing activities related to growth development, disease prevention, injury prevention, nutrition, oral health, and mental health. Then ask students to place each activity in the appropriate column . Suggestions for Clinical Activities  Have students discuss how health promotion and health maintenance activities are demonstrated in the clinical setting. Learning Outcome 2 Describe how health promotion and health maintenance are addressed by partnering with families during health supervision visits. Concepts for Lecture 1. Health promotion and health maintenance partnerships with families are created through communication, advocacy, and teaching. Suggestions for Classroom Activities  Conduct a role - playing exercise with one student as a nurse and two students as parents of a child of a selected age. Have the nurse demonstrate how to foster communication and anticipate the parents’ teaching needs. Have the “parents” ask questions that would be expected of the parents of a child of the selected age.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e Suggestions for Clinical Activities  Have students observe communication, advocacy, and teaching with parents in the clinical setting. Discuss how the agency fosters or hinders health promotion and health maintenance activities by nurses. Learning Outcome 3 Describe the components of a health supervision visit. Concepts for Lecture 1. Health supervision refers to services to maintain and promote a family’s health and assess the growth and development of its children. 2. The major c omponents of a health supervision visit are identification of teaching topics; development of relationships with the family; general observations; growth and development surveillance; and assessments of nutrition, physical activity, oral health, mental and spiritual health, disease prevention strategies, and injury prevention strategies. Suggestions for Classroom Activities  Discuss the components of a health supervision visit. Where can supervision visits take place? What equipment, resources, and facilities in a clinical agency would be ideal to conduct a health supervision visit? Suggestions for Clinical Activities  Observe the facilities and resources available to nurses for health supervision visits. Are these facilities and resources adequate? What would students change? Learning Outcome 4 Analyze the nurse’s role in providing health promotion and health maintenance for children and families. Concepts for Lecture 1. Health supervision visits must have planned assessments, interventions, and teaching topics. Suggestions for Classroom Activities  Discuss the nurse’s role in preparation for a health supervision visit. How should

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e a nurse prepare for a health supervision visit? What information about the family should be reviewed before meeting the family? Suggestions for Clinical Activities  Observe a nurse in preparation for a health supervision visit. What information does the nurse collect? What teaching needs are expected to be addressed? How much time is allotted for the visit? Is the allotted time sufficient?  Interview a nurse who conducts health supervision visits. What communication strategies does she use during visits? How does she work collaboratively with families to plan interventions? Learning Outcome 5 Perform the general observations made of children and their families as they come to the pediatric healthcare home for health supervision visits. Concepts for Lecture 1. General observations are made by nurses at every encounter with children and families. 2. General observations include the physical contact between the child and family members, developmental tasks of the child, and the parental level of stress or ease in conducting childcare activities. Suggestions for Classroom Activities  Discuss the general observations made during a health supervision visit. Have students meet in small groups and list the observations they would make about parents’ appearance, behavior, and relationships with the child. Make another list of the general observations of a child during the visit. What should the nurse note about the child’s appearance, behavior, and relationships with the parents? Suggestions for Clinical Activities  Investigate how general observations are recorded at the agency. Is there a guided questionnaire or a freeform documentation area?  I nterview a nurse on how she conducts the general observations of a family during a health supervision visit. Learning Outcome 6 Synthesize the areas of assessment and intervention for health supervision visits — growth and development surveillance, nutrition, physical activity, oral health, mental and spiritual health, family and social relations, disease prevention strategies, and injury prevention strategies.

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    Ball/Bindler/Cowen, Instructor's Resource Manual for Principles of Pediatric Nursing: Caring for Children 6e Concepts for Lecture 1. Nurses must be prepared with assessment tools and documentation guides to assess all components of a health supervision visit. Suggestions for Classroom Activities  Demonstrate a Denver II screening assessment with a child and parent. Explain to the students how to conduct and score the assessment. After the child and parent have left, discuss how the assessment went, and any improvements that were needed.  Discuss how to interpret Denver II scores. Review the nurse’s role when a child fails a task.  Discuss the uses of other developmental screening tools. Demonstrate or show a video of these tools in use.  Divide students into small groups. Assign each group to an assessment area. Each area includes a family with a child of a selected age during a health supervision visit. Have students create a checklist of assessments they would make. Use the areas of assessment in nutrition, physical activity, oral health, and mental/spiritual health. Suggestions for Clinical Activities  Have students perform a Denver II assessment on a child. Have students discuss their analysis of their assessment technique. Also discuss their interpretation of the results. What actions should be taken by the nurse?  Investigate the charts for tools used to conduct developmental, nutrition, oral health, physical activity, and mental health assessments at the agency. What tools are used? Are these tools adequate? What tools are missing? Learning Outcome 7 Plan health promotion and health maintenance strategies employed during health supervision visits. Concepts for Lecture 1. Nurses collaborate with the family to share concerns and questions, provide immunizations, provide anticipatory guidance, offer healthy behavior education, and provide referrals for follow - up care. Suggestions for Classroom Activities  Discuss the role of providing anticipatory guidance during a health supervision

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