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

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eCHAPTER1:NURSE’SROLE INCARE OF THECHILD:HOSPITAL,COMMUNITY,ANDHOMELearning Outcome 1Describethecontinuum of pediatric health care.Concepts for Lecture1.The continuum of care includes a variety of settings and complexities of care forchildren and their families.Suggestions for Classroom ActivitiesHave students describe locations where nurses might encounter children and theirfamilies.Suggestions for Clinical ActivitiesHave students identify the level of care provided by nurses in various clinicalsettings where nurses encounter children and families.Learning Outcome 2Compare the roles of nurses in child health care.Concepts for Lecture1.Pediatric nurses have many roles beyond directpatientcare.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 toplan patient care.Suggestions for Classroom ActivitiesAsk students to describe an example of a nurse's acting as apatientadvocate fora pediatricpatient.Have students do a literature search to find examples of pediatric nursingresearch of a nursing procedure. Discuss how the study could contribute toevidence-based practice.Suggestions for Clinical ActivitiesHave students interview a nurse in a pediatric setting aboutpatienteducation,

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6epatientadvocacy, case management, and research experiences. How does thenurse use evidence-based practice to informpatienteducation and advocacy?Learning Outcome 3Analyze the current societal influences on pediatric health care and nursing practice.Concepts for Lecture1.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 apatientadvocate fora pediatricpatient.Have students do a literature search to find examples of pediatric nursingresearch of a nursing procedure. Discuss how the study could contribute toevidence-based practice.Suggestions for Clinical ActivitiesHave students interview a nurse in a pediatric setting aboutpatienteducation,patientadvocacy, case management, and research experiences.Learning Outcome 4Report the most common causes of child mortalityby age groupand reasons forhospitalization.Concepts for Lecture1.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 children is not consistent across theUnited States.4.Research and technology allow many children with congenital anomalies and lowbirth weights to survive.

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eSuggestions 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 andtheir families.Learning Outcome 5Contrast the policies for obtaining informed consent of minors to policies for adults.Concepts for Lecture1.The parent or legal guardian must give informed consent prior to treatment orresearch 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 finaldecisions regarding treatment or research participation.Suggestions for Classroom ActivitiesConduct a role-playing scenario. Have one student be a nurse and another be aparent 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 apatient’s chart. Discuss whatwas included or is missing from the form.Learning Outcome 6Examine three unique pediatric legal and ethical issues in pediatric nursing practice.Concepts for Lecture1.State laws vary regarding what information about an adolescent’s health care maybe withheld from the parent.

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6e2.Pediatric nurses might face ethical dilemmas when providing care to children andtheir families.3.Pediatric nurses should be aware of the ethical issues and legal responsibilitiessurrounding 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 hospitalunit. A pregnant 15-year-old has been diagnosed with cancer, and must receivechemotherapy that will put her fetus at risk. Ask students to identify the ethicaldilemmas in this situation and to discuss how nurses should respond.Suggestions for Clinical ActivitiesHave students investigate the policies for addressing ethical dilemmas involvingchildren at the clinical site.GENERALCHAPTERCONSIDERATIONS1. Have students study and learn key terms listed atthebeginning ofthechapter.2. Have students completeend-of-chapter Clinical Reasoning in Action questions andcheck their answers against the suggested responses provided atwww.pearsonhighered.com/nursingresources.3. Use the Classroom Response Questions provided in PowerPoint to assessstudents prior to lecture.

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eCHAPTER2:FAMILY-CENTEREDCARE ANDCULTURALCONSIDERATIONSLearning Outcome 1Describe key concepts of family-centered care.Concepts for Lecture1.Family-centered care isa philosophy of health care in which a mutually beneficialpartnership develops between families and the nurse, and also other healthprofessionals.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 carewhen a child is reluctant to take his medicine.Suggestions for Clinical ActivitiesHave students describe how they see family-centered care provided in theirclinical setting.Have students interview a nurse at a clinical setting for examples of how family-centered care is implemented.Learning Outcome 2Identify characteristics of different types of families.Concepts for Lecture1.A family can be a self-identified group of two or more persons joined together byshared resources and emotional closeness, regardless of whether they are relatedor 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 theirchildren.Suggestions for Classroom ActivitiesHavestudents draw a diagram of their family with designations of whom theythink of as their immediate and extended family members. Ask each student toshow his diagram to another student and explain the family’s structure.

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eHave students divide into pairs and diagram the structure of their partner’s familyand then discuss the differences.Suggestions for Clinical ActivitiesHave students identify the types of families seen at the clinical setting. Discusshow they identified the types.Learning Outcome 3Contrast four different parenting styles and analyze their impact on child personalitydevelopment.Concepts for Lecture1.The manner in which children are parented influences their developmentaloutcomes.2.Families generally exhibit one general style of parenting (authoritarian,authoritative, permissive, or indifferent), but might vary their style for certainsituations.Suggestions for Classroom ActivitiesAsk students to label their own parents’ parenting styles. Discuss what evidencethey have for the label they assigned.Discuss which parenting style is likely to have the best influence on childpersonality development. How can nurses encourage parents to use this style ofparenting?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 themall by himself).Suggestions for Clinical ActivitiesHave students conduct a literature review of parenting styles and nursingpractice. What does research indicate about how knowledge of parenting stylescan affect nursing care?Learning Outcome 4Explain the effects of major family changes on children.

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eConcepts for Lecture1.Changes in family dynamics or functioning (e.g., parental divorce, the addition ofa stepparent, foster care placement, or adoption) can impact children in a varietyof ways.2.Nurses can assist families experiencing change by inquiring about thecircumstances and the changes the child is experiencing.Suggestions for Classroom ActivitiesHave students divide into pairs.Have students briefly assess the familyfunctioning influences on their family, then share that assessment with anotherstudent.Suggestions for Clinical ActivitiesDiscuss how the agency addresses the nursing needs of families who are affectedby divorce, foster parenting, and stepparenting. Who makes the healthcaredecisions in these families? How are nurses involved in these situations?Have students review the literature on how family functioning is affected bychanges such as divorce, stepparenting, foster parenting, or adoption. Whatshould the nurse’s role be when working with families experiencing thesechanges?Learning Outcome 5List the categories of family strengths that help families develop and cope with stressors.Concepts for Lecture1.A child’s illness or injury affects every member of the family.2.Pediatric nurses need to be able to assess family strengths and supportmechanisms to identify strategies for coping and to determine when families haveoverextended their resources and need additional support.3.Family strengths arethe positive relationships and processes that support andprotect families and family members during times of adversity and change.4.Four types of strengths help families develop, adapt to change, and overcomechallenges.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 forPrinciples of Pediatric Nursing: Caring for Children6ecategories (resilience, assets, capabilities, and motivations). Discuss howstudents assessed each category.Suggestions for Clinical ActivitiesHave students identify ways in which they can use the nursing history used in theclinical setting to assess a family’s strengths.Assign students to conduct a family strengths assessment on a family in theclinical setting. In class, discuss how information obtained from the assessmentcould be used in planning nursing care with the family.Learning Outcome6Summarizethe advantages of using a family or cultural assessment tool.Concepts for Lecture1.Family and cultural assessment tools help the nurse gather information aboutfamilies, their members, their relationships with each other, and their values andbeliefs.2.Knowing how a family nurtures its members, solves problems, and communicatescan help the nurse identify more effective strategies for managing the child’shealth care.Suggestions for Classroom ActivitiesIn pairs, have students draw a family ecomap of their partners’ families. Discusshow this assessment could be used to help the family identify and plansupportive services in the community.Review the case study for this chapter. Have students identify resources in yourcommunity that would be helpful for a client such as Casey and his family. Ofthese resources, how many of them employ staff who speak English andSpanish? How many of them do not employ bilingual staff but hire contractedinterpreters when needed? Are there services available in your community tomeet 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 theclinical setting. Discuss the advantages and disadvantages of using each tool witha selected family.Have students find a nursing research study that incorporates the use of a familyor cultural assessment tool in the study. Lead a discussion in class about how thetools were used and what strengths and weaknesses were determined by theresearch.

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eLearning Outcome7Develop a family-centered nursing care plan for the child and family.Concepts for Lecture1.The goal of culturally competent family-centered nursing management is to assessand help families recognize their strengths and resources. This information thencan be used in collaboratively planning the nursing care plan with the child andfamily.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’sillness or injury. Discuss how an absence of these strengths might impact afamily 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 identifyfamily strengths and resiliency, and what challenges they face in helping identifyfamilies’ strengths and needs.Learning Outcome8Describe cultural influences on the family’s beliefs about health, illness, and treatments.Concepts for Lecture1.Culture can determine which member of the household is the primary decisionmakerfor the child and family.2.Culture determines family goals, member roles, and childbearing practices andbeliefs.3.Communication and language skills can impact ability to understand and followtreatment recommendations.4.Cultural practices can include diet and family eating patterns which can contributeto 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 forPrinciples of Pediatric Nursing: Caring for Children6eSuggestions for Classroom ActivitiesAsk students to divide into pairs and choose a common childhood illness orinjury (e.g., asthma, influenza, strep throat, eye injury, arm or leg fracture).Partners will identify alternative therapies that might be beneficial or harmful toa child with that condition and then report their findings to the class, explainingtheir reasoning.Suggestions for Clinical ActivitiesHave students interview a nurse in a pediatric setting about the influences ofculture on family beliefs that the nurse sees in that setting.Learning Outcome9Discuss nursing interventions for providing culturally sensitive and competent care to thechild and family.Concepts for Lecture1.Nurses provide culturally sensitive and competent interventions by collaboratingwith the family to design the plan of care and by assisting the family indetermining how they can incorporate prescribed therapies with healthcarepractices.2.Nurses also provide culturally sensitive and competent interventions bycollaborating with the family to identify and select resources that will supportthem in maintaining ongoing appropriate care for the child.Suggestions for Classroom ActivitiesDiscuss techniques for establishing a therapeutic relationship with a family whospeak a different language.Have students identify and discuss resources available in your community forfamilies from different cultures.Have students discuss ways to help families identify and select communityresources.Suggestions for Clinical ActivitiesAssign students to interview a pediatric nurse to determine what strategies sheuses to provide culturally sensitive and competent nursing interventions tofamilies.

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eGENERALCHAPTERCONSIDERATIONS1. Have students study and learn key terms listed atthebeginning ofthechapter.2. Have students completeend-of-chapter Clinical Reasoning in Action questions andcheck their answers against the suggested responses provided atwww.pearsonhighered.com/nursingresources.3. Use the Classroom Response Questions provided in PowerPoint to assessstudents prior to lecture.

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eCHAPTER3:GENETIC ANDGENOMICINFLUENCESLearning Outcome 1Explain the roles of genetic and genomic concepts in health promotion, diseaseprevention, screening, diagnostics, selection of treatment, and monitoring of treatmenteffectiveness.Concepts for Lecture1.Genomics offers the promise of personalized health care based on an individual’sor population’s risk for disease.2.Specific knowledge about an individual’s genetic makeup and associated risk fordisease provides a basis for health screening and could provide motivation tomaintain a healthy lifestyle.3.With knowledge of genetic conditions, the pediatric nurse canprovidehealthteaching andensureearly detection of complications from genetic conditions withemphasis on primary and secondary care interventions.Suggestions for Classroom ActivitiesIn pairs, have students discuss how genetics plays a role in the health screeningprocess. Ask students to discuss whether any members of their own families havereceived health screenings based on genetic considerations and how they mighthave benefited from the information gained from the screening.In small groups, have students research how advances in genomics have led tochanges in health-promotion activities for one of the following specific agegroups: newborns and infants, toddlers, school-age children, and adolescents.Each group should prepare a short presentation on the findings to give to theclass.Suggestions for Clinical ActivitiesObserve the strategies used by a nurse in the clinical setting to explain a screeningor procedure, or to discuss a health-promotion activity based on a child’s genetic(individual or population) profile. What strategies were effective? What strategiescould the nurse have used to improve communication?Learning Outcome 2Elicitafamily health history and construct ageneticpedigree.Concepts for Lecture

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6e1.Pediatric nurses and all other health professionals should know how to collect athree-generation family history, record the history in a pedigree, and “thinkgenetic.”2.A finished pedigree provides a clear, visual representation of a family’s medicaldata and biological relationships at a glance.Suggestions for Classroom ActivitiesIn pairs, have students collect a three-generation family history from theirpartners. Each student should record the partner’s history in a pedigree. Havestudents discuss the completed pedigrees, identifying any possible indicators forscreenings 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 athree-generation family health history. How is the history recorded? Whatinformation do patients find difficult to recall or discuss?Learning Outcome 3Incorporate knowledge of genetic and genomic influences and risk factors intoassessment, planning, and implementation of nursing care.Concepts for Lecture1.The pediatric nurse in any healthcare setting should “think genetic” whenperforming a physical assessment.2.An early finding by the nurse will provide the child and family with anopportunity for a genetic referral and more specialized health care.3.As a routine part of the patient assessment, the pediatric nurse should screen forboth 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 thepresence of a dysmorphic anomaly in that body area. Have groups present theirfindings to the class.Suggestions for Clinical ActivitiesRequire students to conduct a physical assessment of a child they care for duringtheir clinical rotation that includes assessing for dysmorphic anomalies.

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eLearning Outcome4Integrate basic genetic and genomic concepts intochild and family education.Concepts for Lecture1.Pediatric nurses integrate basic genetic and genomic concepts into care planningby providing referrals to genetic specialists and by informing children andfamilies of what to expect from a genetic referral.2.Pediatric nurses integrate basic genetic and genomic concepts into familyeducation by providing information about genetic disorders and by clarifying andreinforcing information obtained from a genetic referral or test.3.Pediatric nurses working with families whose child might have a genetic disordershould assess the family’s coping mechanisms and support systems, and mightneed 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 andconduct a literature review to determine what information about the disorder toprovide during a family teaching session. Have each group develop a familyteaching session and present it to the class.Suggestions for Clinical ActivitiesInterview a social worker or mental health professional who works with childrenand families with genetic disorders to learn more about the psychosocial needs ofthese families and how the professional assists families in meeting those needs.Learning Outcome5Understand implications of genome science on the nursing role, with particular attentionto ethical, legal, and social issues.Concepts for Lecture1.By maintaining a basic knowledge of genetics and genomics concepts, nurses areable to maintain a professional standard of care.2.Nurses who understand the ethical, legal, and social issues associated withgenetics and genomics concepts are able to provide essential information tochildren and families.Suggestions for Classroom Activities

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eDiscuss state laws regarding genetic testing and the protection or disclosure ofgenetic information. Discuss the nurse’s role in the protection of an individual’sgenetic information.Suggestions for Clinical ActivitiesIn the clinical setting, students should ask for a copy of any policies related togenetic information and then interview a nurse in the setting to determine how thepolicies are implemented.Learning Outcome6Discuss the significance of recent advances in human genetics and genomics and theirimpact on healthcare delivery.Concepts for Lecture1.Knowledge gained from human genome research is changing all aspects of healthcare, 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 healthcaresettings to individuals, families, communities, and populations.Suggestions for Classroom ActivitiesDivide students into small groups. Have each group take one aspect of healthcare (health promotion and disease prevention, screenings, treatment, ormonitoring treatment effectiveness) and conduct a review of the literature to findexamples of how genetics and genome research have influenced that area. Eachgroup 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 howthe health department uses genetics and genome research to inform servicesprovided in the community.GENERALCHAPTERCONSIDERATIONS1. Have students study and learn key terms listed atthebeginning ofthechapter.2. Have students completeend-of-chapter Clinical Reasoning in Action questions andcheck their answers against the suggested responses provided atwww.pearsonhighered.com/nursingresources.3. Use the Classroom Response Questions provided in PowerPoint to assessstudents prior to lecture.

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6e

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eCHAPTER4:GROWTH ANDDEVELOPMENTLearning Outcome 1Describe major theories of development as formulated by Freud, Erikson, Piaget,Kohlberg, social learning theorists, and behaviorists.Concepts for Lecture1.Pediatric nurses integrate knowledge of physical growth and psychosocialdevelopment into each healthcare encounter.Suggestions for Classroom ActivitiesAsk students to calculate how much they would weigh and how tall they wouldbe inoneyear if they grew at the same rate as an infant.Divide the class into six groups: Freud, Erikson, Piaget, Kohlberg, Bandura, andWatson. Have each group analyze the theory proposed by their theorist regardingits focus on nature versus nurture.Suggestions for Clinical ActivitiesHave students describe how the work of a particular theorist is implemented inthe clinical setting. Observe how play, procedures, visiting rules, and clientteaching are influenced by the major theories.Have students conduct a literature review on how a selected developmentaltheory has been integrated into nursing practice. Discuss thepolicies andproceduresthatwere implemented in accordance with the theory’s concepts.Learning Outcome 2Recognize risks to developmental progression and factors that protect against those risks.Concepts for Lecture1. Illness can interfere with normal developmental processes.2. Illness adds challenges for the nurse to promote normal growth and development inthe hospitalized and nonhospitalized infant, child, and adolescent.3. Prematurity of an infant greatly interferes with the normal developmentalprogression seen during infancy.4. Children being adopted through international adoption may have profoundalterations in the normal developmental process based on the circumstances of theirlives in their countries of origin.5. Using the frameworks of the theorists discussed in this chapter will aid the studentin recognizing what level compromised children are at in terms of their development.

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6e6. Assessing an infant’s or young child’s communication can give insight to conditionsthat may interfere with normal developmental progression (e.g., the ability to see orhear, autism).7. Watching a child play is an excellent way to assess a child’s development and toevaluate whether or not that child is on target for normal developmental progression.8. Discuss the impact of resiliency when risks to normal developmental progressionare present.Suggestions for Classroom ActivitiesAsk students to list risk factors and protective factors in their own family beforediscussing this content. Use their answers as a framework for discussion.Suggestions for Clinical ActivitiesHave students use Table, “Assessment Questions toDetermine ResilienceCapability” to assess a family for protective and risk factors.Learning Outcome3Plan nursing interventions for children that are appropriate for the child’s developmentalstate, based on theoretical frameworks.Concepts for Lecture1.Major developmental theories guide nursing interventions for children in each agegroup in a variety of situations.Suggestions for Classroom ActivitiesDivide the class into six groups: Freud, Erikson, Piaget, Kohlberg, Bandura, andWatson. Have each group devise nursing activities (teaching, procedures) basedonits theorist'stheories for each stage of development.Suggestions for Clinical ActivitiesHave studentsidentify how the work of the major theorists has affected nursinginteractions with parents. What parental behaviors are encouraged anddiscouraged? How are they encouraged or discouraged?Learning Outcome4

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eExplain contemporary developmental approaches such as temperament theory, ecologictheory, and the resilience framework.Concepts for Lecture1.Contemporary approaches expand on the major theoretical frameworks todescribe child development.2.Temperament theory, ecologic theory, and the resilience framework can guidenursing interventions by identifying needs and utilizing family strengths.Suggestions for Classroom ActivitiesAskstudents to compare the effect of environment on child development in theecologic, temperament, and resiliency theories. Have students discuss thedifferences.Suggestions for Clinical ActivitiesHave students conduct a literature review of how ecologic, temperament, andresiliency theories have been integrated into nursing practice. Compare thefindings in the literature with what is being implemented in the clinical setting.Learning Outcome5Identifymajor developmental milestones for infants, toddlers, preschoolers, school-agechildren, and adolescents.Concepts for Lecture1.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 psychosocialmilestones 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 influencesthat have affected them and their siblings. Have students discuss each area.Suggestions for Clinical ActivitiesDiscusshow the agency incorporates play, knowledge of temperament, andcommunication 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 forPrinciples of Pediatric Nursing: Caring for Children6eLearning Outcome6Synthesize information from several theoretical approaches to plan assessments of thechild’s growth and developmental milestones.Concepts for Lecture1.Nurses use knowledge of development theories when planning and conductingassessments of children in order to analyze children’s development, identify anyslow or abnormal development, and assist parents in planning ways to encourageand support the next emerging developmental abilities.Suggestions for Classroom ActivitiesDivide the classinto six groups: newborn, infant, toddler, preschooler, school-age, and adolescent. Have each group plan how it would proceed to assess thegrowth and development of children in its assigned age group. Students shouldplan how to assess growth, motor skills, language, and sensory abilities.Suggestions for Clinical ActivitiesHave studentsidentify the tools used by the clinical agency to assess growth anddevelopment. Discuss the strengths and weaknesses of these tools.Learning Outcome7Describe the role of play in the growth and development of children.Concepts for Lecture1.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 theclass into six groups: newborn, infant, toddler, preschooler, school-age, and adolescent. Have each group plan how it would encourage play in aclinical setting with a child or adolescent in isolation.Discuss how or if the concept of play changes as the child grows. Whatprecautions do parents and caregivers need to take for toddlers? How are thesesimilar or different from the precautions that parents of adolescents might need

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eto take? What would you categorize as “play” for the adolescent? Are texting orsocial networking forms of play? If so, why?Suggestions for Clinical ActivitiesHave students assess the play areas and toys provided for patients in the clinicalsetting. Are the play areas and toys age-appropriate? How do they promotegrowth and development?Learning Outcome8Use data collected during developmental assessments toimplement activities thatpromotedevelopment of children and adolescents.Concepts for Lecture1.Nurses use knowledge of physical, cognitive, and psychosocial developmentalmilestones to plan care.Suggestions for Classroom ActivitiesDivide the classinto six groups: newborn, infant, toddler, preschooler, school-age, and adolescent. Have each group plan how it would promote growth anddevelopment for a child with an illness that restricted mobility, and for a childwhose parents did not speak English.Suggestions for Clinical ActivitiesHave studentsidentify activities used by the clinical agency to promote growthand development for children at each stage of development. Discuss the strengthsand weaknesses of the activities identified.GENERALCHAPTERCONSIDERATIONS1. Have students study and learn key terms listed atthebeginning ofthechapter.2. Have students completeend-of-chapter Clinical Reasoning in Action questions andcheck their answers against the suggested responses provided atwww.pearsonhighered.com/nursingresources.3. Use the Classroom Response Questions provided in PowerPoint to assessstudents prior to lecture.

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eCHAPTER5:PEDIATRICASSESSMENTLearning Outcome 1Describe the elements of a health history for infantsand childrenat different ages.Concepts for Lecture1.The pediatric health history includes the chief complaint, history of present illnessor injury, past history, current health status, review of systems, patientinformation, 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 agegroups. What equipment, lighting, toys, and educational aides would be best foreach 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 qualityof available equipment.Learning Outcome 2Apply communication strategies to improve the quality of historical data collected.Concepts for Lecture1.Be sure parents know the purpose of the interview, and that the information willbe used appropriately.2.Establish a rapport with the family and use careful listening techniques to collecthigh-quality history data.3.While communicating, be aware of your own nonverbal behavior and languagestyle.Suggestions for Classroom ActivitiesDiscusswhat effective communication is during a pediatric assessment. Howwill you know that you are communicating effectively?Present the casesof a parent of childrenofdifferent ages,parents ofdifferentcultural backgrounds, andparents indifferent family structures. Discuss how thenurse would improve communication with each client.

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eSuggestions for Clinical ActivitiesConduct a pediatric assessmentand analyze your communication strategies. Whatdid you do to facilitate rapport with the child and caregiver? What verbal andnonverbal communication did you use to show interest and to facilitate datacollection?Learning Outcome 3Demonstratestrategies to gain cooperation of a young child for assessment.Concepts for Lecture1.Nurses must consider the developmental level of children to gain theircooperation 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 olderchildren as appropriate.Suggestions for Classroom ActivitiesDiscuss techniques that assess development but are presented as games or asother observations of behavior.Divide the class into small groups. Have each group develop a game or activityto 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 facilitatecooperation with a young child. Analyze the verbal and nonverbalcommunication. What strategies were effective? What strategies might the nursehave used to improve communication?Learning Outcome 4Describethe differences in sequence of the physical assessments for infants, children, andadolescents.Concepts for Lecture1.Use a foot-to-head approach for younger children, and a head-to-foot approach forolder 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 toprivacy and concerns about development of secondary sexual characteristics.

Class Notes for Principles of Pediatric Nursing Caring for Children, 6th Edition - Page 25 preview image

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eSuggestions for Classroom ActivitiesDiscuss how thesequence of a pediatric health exam would vary for an infant,toddler, school-age child, and adolescent. Divide students into groups for eachage. Put a column on a blackboard for each group and have students enter thesequence they would use to examine each age group. Discuss the differences.Suggestions for Clinical ActivitiesObservea nurse conducting a pediatric health exam. How did the nurse alter thesequence of the exam to facilitate the child’s cooperation? What would you dodifferently? What measures were particularly effective?Learning Outcome 5Modify physical assessment techniques according to the age and developmental stage ofthe child.Concepts for Lecture1.Nurses must consider a child’s anxiety level and take measures to reduce fearsduring an examination.2.Equipment used, locations for auscultation, and order of the examination will varyas the child ages.Suggestions for Classroom ActivitiesConducta role-playing exercise with students playing the roles of a nurse andchildren of different ages. What measures can be used to reduce anxiety for eachage group? How will equipment vary for each age group?Suggestions for Clinical ActivitiesAssessan examination room in a clinical setting. What equipment is available indifferent sizes for different sizes of children? How do you choose the correct size?What equipment is missing that would improve assessment of different-agechildren?Learning Outcome 6List five normal variations in pediatric physical findings (such as a hyperpigmented patchin an infant) found during a physical assessment.

Class Notes for Principles of Pediatric Nursing Caring for Children, 6th Edition - Page 26 preview image

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eConcepts for Lecture1.Nurses can identify possible health problems of children while conducting anexamination.2.Health problems of children will vary by age; nurses need to be alert for thesecommon problems while examining children.Suggestions for Classroom ActivitiesDivide students into small groups. Give each group a body system. Ask studentswhat alterations might indicate a health problem. For example, for eyes, studentsshould 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 theclinical area. What data from the assessment were used by the physician todiagnose the problem? What data did nurses collect?Learning Outcome 7Evaluate the growth pattern of an infant or child.Concepts for Lecture1. The weight of a child should be calculated by taking two measurements and averagingthem 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-appropriategrowth curve will assist the nurse in determining whether the child exhibits steadyexpected 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’sbody 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 growthcurve appropriate for age and gender that has prior measurements plotted. Oncecomplete, havestudentsidentify the percentile in which weight, length, or heightand head circumference fall.Suggestions for Clinical ActivitiesDiscuss the appropriate methods to determine an infant or child’s weight, lengthor height, and head circumference, as well as which measurements are appropriatefor which age groups.

Class Notes for Principles of Pediatric Nursing Caring for Children, 6th Edition - Page 27 preview image

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eLearning Outcome 8Distinguish between expected and unexpected physical signs to identify at least five signsthat require urgent nursing intervention.Concepts for Lecture1.The physical assessment usually offers important findings about a child’s healthcondition. Assessment findings may be subtle or obvious. Continuous monitoringand reassessment to identify trends are critical in identifying serious changes in thechild’s status.Suggestions for Classroom ActivitiesDiscuss as a class the general principles that nurses should follow when workingwith 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 studentspractice handling the equipment (examples: connecting an Ambu-bag to oxygensupply, bagging a child, etc.).GENERALCHAPTERCONSIDERATIONS1. Have students study and learn key terms listed atthebeginning ofthechapter.2. Have students completeend-of-chapter Clinical Reasoning in Action questions andcheck their answers against the suggested responses provided atwww.pearsonhighered.com/nursingresources.3. Use the Classroom Response Questions provided in PowerPoint to assessstudents prior to lecture.

Class Notes for Principles of Pediatric Nursing Caring for Children, 6th Edition - Page 28 preview image

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eCHAPTER6:INTRODUCTION TOHEALTHPROMOTIONANDMAINTENANCELearning Outcome 1Define health promotion andhealthmaintenance.Concepts for Lecture1.Health promotion refers to activities that increase well-being and enhancewellness or health.2.Health maintenance refers to activities that preserve one’s present health orprevent the occurrence of disease or injury.Suggestions for Classroom ActivitiesDraw three columns on the blackboard labeled Health Promotion, Overlap, andHealth Maintenance. Ask students to call out nursing activities related to growthdevelopment, disease prevention, injury prevention, nutrition, oral health, andmental health. Then ask students to place each activity in the appropriatecolumn.Suggestions for Clinical ActivitiesHave students discuss how health promotion and health maintenance activities aredemonstrated in the clinical setting.Learning Outcome 2Describe how health promotion and health maintenance are addressed by partnering withfamilies during health supervision visits.Concepts for Lecture1.Health promotion and health maintenance partnerships with families are createdthrough communication, advocacy, and teaching.Suggestions for Classroom ActivitiesConduct a role-playing exercise with one student as a nurse and two students asparents of a child of a selected age. Have the nurse demonstrate how to fostercommunication 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.

Class Notes for Principles of Pediatric Nursing Caring for Children, 6th Edition - Page 29 preview image

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eSuggestions for Clinical ActivitiesHave students observe communication, advocacy, and teaching with parents in theclinical setting. Discuss how the agency fosters or hinders health promotion andhealth maintenance activities by nurses.Learning Outcome 3Describethe components of a health supervision visit.Concepts for Lecture1.Health supervision refers to services to maintain and promote a family’s healthand assess the growth and development of its children.2.The major components of a health supervision visit are identification of teachingtopics; development of relationships with the family; general observations;growth and development surveillance; and assessments of nutrition, physicalactivity, oral health, mental and spiritual health, disease prevention strategies, andinjury prevention strategies.Suggestions for Classroom ActivitiesDiscussthe components of a health supervision visit. Where can supervisionvisits take place? What equipment, resources, and facilities in a clinical agencywould be ideal to conduct a health supervision visit?Suggestions for Clinical ActivitiesObserve the facilities and resources available to nurses for health supervisionvisits. Are these facilities and resources adequate? What would students change?Learning Outcome 4Analyze the nurse’s role in providing health promotion and health maintenance forchildren and families.Concepts for Lecture1.Health supervision visits must have planned assessments, interventions, andteaching topics.Suggestions for Classroom ActivitiesDiscuss thenurse’s role in preparation for a health supervision visit. How should

Class Notes for Principles of Pediatric Nursing Caring for Children, 6th Edition - Page 30 preview image

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6ea nurse prepare for a health supervision visit? What information about the familyshould be reviewed before meeting the family?Suggestions for Clinical ActivitiesObserve a nurse in preparation for a health supervision visit. What informationdoes the nurse collect? What teaching needs are expected to be addressed? Howmuch time is allotted for the visit? Is the allotted time sufficient?Interview a nurse who conducts health supervision visits. What communicationstrategies does she use during visits? How does she work collaboratively withfamilies to plan interventions?Learning Outcome 5Performthe general observations made of children and their families as they come to thepediatric healthcare home for health supervision visits.Concepts for Lecture1.General observations are made by nurses at every encounter with children andfamilies.2.Generalobservations include the physical contact between the child and familymembers, developmental tasks of the child, and the parental level of stress or easein conducting childcare activities.Suggestions for Classroom ActivitiesDiscuss thegeneral observations made during a health supervision visit. Havestudents meet in small groups and list the observations they would make aboutparents’ appearance, behavior, and relationships with the child. Make anotherlist of the general observations of a child during the visit. What should the nursenote 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 aguided questionnaire or a freeform documentation area?Interview a nurse on how she conducts the general observations of a familyduring a health supervision visit.Learning Outcome 6Synthesize the areas of assessment and intervention for health supervision visits—growthand development surveillance, nutrition, physical activity, oral health, mental andspiritual health, family and social relations, disease prevention strategies, and injuryprevention strategies.

Class Notes for Principles of Pediatric Nursing Caring for Children, 6th Edition - Page 31 preview image

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Ball/Bindler/Cowen,Instructor's Resource Manual forPrinciples of Pediatric Nursing: Caring for Children6eConcepts for Lecture1.Nurses must be prepared with assessment tools and documentation guides toassess all components of a health supervision visit.Suggestions for Classroom ActivitiesDemonstrate a Denver II screening assessment with a child and parent. Explainto the students how to conduct and score the assessment. After the child andparent have left, discuss how the assessment went, and any improvements thatwere needed.Discuss how to interpret Denver II scores. Review the nurse’s role when a childfails a task.Discuss the uses of other developmental screening tools. Demonstrate or show avideo 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 healthsupervision visit. Have students create a checklist of assessments they wouldmake. Use the areas of assessment in nutrition, physical activity, oral health, andmental/spiritual health.Suggestions for Clinical ActivitiesHave students perform a Denver II assessment on a child. Have students discusstheir analysis of their assessment technique. Also discuss their interpretation ofthe results. What actions should be taken by the nurse?Investigate the charts for tools used to conduct developmental, nutrition, oralhealth, physical activity, and mental health assessments at the agency. Whattools are used? Are these tools adequate? What tools are missing?Learning Outcome 7Plan health promotion and health maintenance strategies employed during healthsupervision visits.Concepts for Lecture1.Nursescollaborate with the family to share concerns and questions, provideimmunizations, 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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