Paediatric Health Nursing (Peads/PHN)

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Peads/PHN Overview:

This course if of 7 credit hours. The focus of this course is to develop knowledge, skills and attitudes in the care of children in primary, secondary and tertiary settings. You will apply a concepts related to Growth and Development and its deviation in all aspects of children’s health. Emphasis is placed on common health problems occurring in Pakistan and in South Asian Countries.

Course Objectives:

At the end of the course, you will be able to learn the followings.

Develop awareness on common health issues of the children in Pakistan
Discuss principles of growth and development and its deviation in all aspects of nursing care.
Discuss the impact of hospitalization on the child and family.
Discuss the role of a family in the care of sick children in Pakistani Context.
Integrate pharmacological knowledge into care of sick children.
Integrate research based information in the care of child and family.

Teaching/Learning strategies:

Lecture, discussion, demonstration, guest lecture, field trip, role play, sharing of clinical experience, group presentation, literature review, group work, case study, self-learning modules ,toy making workshop and tutorials.

Course Expectations:

Attend all classes and clinical.
Do pre and post reading and participate in all classes and clinical conferences.
Achieve a satisfactory level in clinical performance and a passing grade for the course.
Submit assignments and take unit tests and examinations as scheduled.

Evaluation Criteria:

Midterm 25%
Case based tutorials (2) 20%
Clinical assignment 20%
Final 35%
Total: 100%

Clinical: Pass/Fail

Paediatric Health Nursing Outline

Following units will be discussed in this course of paediatric health nursing.

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Perspective of Paediatric nursing.

Evolution in Pediatric Nursing
Role of paediatric nurse
Paediatric Nursing in Pakistani culture
Convention on the rights of the child.
Commonly occurring ethical issues in pediatric setting of Pakistan

Growth and development in children and Nursing Aspects for dealing with deviations:

Assessing Growth & Development in children of different age group
Growth & Development pattern in South Asian Countries, and influence of Pakistani culture on Growth and Development of child.
Factors influencing physical and emotional development of children
Assessing Milestones
Nursing Care aspects for dealing with deviations in Growth & Development pattern.

Pharmacological Care aspects while dealing with Pediatric Patients

Drug dosage calculation for the Pediatric drugs
Common Paediatric drug dilutions
Common Paediatric concerns/complications during drug therapy
Caring for children receiving Chemotherapy, antimicrobial therapy and long-term Insulin therapy
Managing pain in children by using pharmacological and non- pharmacological approaches.

Communication/Therapeutic Play while caring for children with various disease process

Guidelines for communication with children and families.
Role of play in growth and development of children.
Functions of play for hospitalized children.
Therapeutic play versus play therapy.
Play as a tool for nursing management
Importance of therapeutic play from Pakistani Perspectives

Health promotion of the new born and family from Global and Pakistani Perspectives

Nursing care approaches for dealing with Small for Gestation Age and Low Birth Weight infants: A commonly occurring problem in Pakistan
Concept of Small for Gestation Age, Low for Gestation Age, Appropriate for Gestation Age and low birth weight infants
Assessment of new born
Gestational age assessment
Head to toe assessment
Developmental Care Approach for premature and newborns in Pakistani families
Nursing care of the full term and premature babies and their families

Nursing Care Aspects for High Risk newborn:

Common newborn related problems in Pakistan and its Management:

Birth injuries and other related injuries in newborns
Respiratory Distress Syndrome and surfactant therapy
Transient Tachypnea of Newborn
PPHN
Intra Ventricular Hemorrhage
Hyperbilirubinemia.
Child with G6PD
Birth Asphyxia and nursing management
Septicemia and care aspects
Hypoglycemia/ Infant of diabetic mothers
Hypocalcaemia
Inborn error of metabolism

Nursing care, pharmacological and non-pharmacological measures for dealing with the above health issues of newborns

Care of child & family during hospitalization

Impact of hospitalization on the child and family and related Nursing Care Approaches:

Stressor and reaction related to developmental stage.
Stressor and reactions of the family of the child who is hospitalized.
Nursing care of a child who is hospitalized.
Nursing care process of child and family with hospitalization
Medication administration to children (clinical).
Pharmacological and non-pharmacological pain management.

Preparation for hospitalization (clinical).

Common Health problems in Pakistani children and their nursing management:

Infants

Nutrition disturbance

Protein energy malnutrition
Feeding difficulties
Failure to thrive
Sudden infant death syndrome
Teething problems

Early /later child hood

Nursing Care approaches for dealing with above health problems according to the age group
Dealing with common complications of Nutritional problems and communicable diseases found commonly in Pakistan
Post-Polio Syndrome
Chronic inflammatory demyelinated polyneuropathy

Congenital defects of heart and Cardio-vascular dysfunction.

Understanding Fetal circulation
Congenital malformations of heart.
Pharmacology related treatment modalities for the above (Indomethacin and prostaglandin therapy)
Rheumatic heart disease.
Nursing Care approaches while dealing with clients with above disorders

G.I dysfunctions in Children

Commonly occurring GI dysfunctions reported in early days of life that needs urgent management:

Ingestion problems and structural defects of GI (Cleft palate, cleft lip tongue tie and Tracheo esophageal fistula
Pyloric stenosis.
Biliary Atresia
Liver Abscess
Intestinal obstruction
Hernia
Hirschprung’s disease
Intussusceptions
volvulus
Amibiasis
NEC (Necrotizing Enterocolitis)
Nursing care, pharmacological, medical and surgical modalities for dealing with the above disorders
Commonly used medications in Pakistan for the above disorders

Genito-urinary dysfunctions in Children

Commonly occurring GU dysfunctions in pediatrics

Upper and Lower Urinary tract infection
Nephrotic syndrome
Congenital Renal atrophy
Bartter syndrome
Nursing management and treatment modalities for the children with the above disorders

Fluid and Electrolyte imbalance in Children with various dysfunctions:

Nursing Care aspects for maintaining fluid and electrolyte balance in the children with following conditions
Burns,
GI
GU

Respiratory dysfunction in Children:

Commonly occurring Respiratory problems in Pediatrics

Upper and Lower Respiratory Tract Infections:

Pharyngitis
Tonsillitis
Otitis media
Bronchlis
Pnemonia
Asthma
Croup Syndrome
Cystic fibrosis
Reactive Airway Diseases (RAD)

Caring for pediatric client on Mechanical ventilator and Nursing care aspects, pharmacological and other medical management for the paediatric patients with the above disorders.

Musculo-skeletal dysfunctions in Children

Kyphosis
Lordosis
Scoliosis
Types of common Fractures in children
Rheumatoid arthritis
Congenital hip dislocation
Nursing care, child with cast and traction, rehabilitative care and other medical and surgical management for the children with the above disorders.

Neuro-muscular dysfunctions in Children

Commonly occurring neuron-muscular dysfunctions in Pediatric patients:

Cerebral palsy
Muscular dystrophy
Gillian–Barre Syndrome
Spina bifida
Meningomyelocele
Nursing care, rehabilitative care and other medical and surgical management for the children with the above disorders
Overview of institutes i-e, NGO’s and Gioverntment law organization working in Pakistan for the rehabilitation of children with the above dysfunctions.

Cognitive/Sensory dysfunctions and Rehabilitation

Hearing and visual impairment.
Mental retardation
Downs’ syndrome
Nursing care, rehabilitative care and other medical management for the children with the above disorders.

Cerebral dysfunction in children

Meningitis, Hydrocephalus
Encephalitis
Seizures disorders ( Febrile and Epilepsy)
Head injury due to various causes in children with different age group
Nursing care aspects; pharmacological, medical and surgical modalities for the above disorders.

Paediatric Oncology

Leukemia in children and its prognosis in Pakistan from current treatment modalities
Hodgkin disease and non Hodgkin lymphoma*.
Porta cath care in Paediatric patients
Nursing Care for pediatric patients receiving chemotherapy from different routes
Palliative Care approaches in Pakistani Culture
Nursing care approach for dealing with death and dying situations.

Hematological dysfunctions in Children

RBC disorders:

Anaemia
Thalassemia,
Sickle cell anaemia,
Aplastic anaemia

Platelet disorders

Hemophilia
Disseminated intravascular coagulation,
Thrombocytopenia
Care of pediatric patients receiving blood transfusion and blood products (Pharmacological and non pharmacological management).

Endocrine dysfunctions in Pediatric Clients

Insulin Dependent diabetes mellitus (IDDM) and Diabetic insipidus
Cushing syndrome.
Hyperthyroidism
Hypothyroidism
Hypopituitarism
Hyperpituitarism
Nursing Care approaches for dealing with above health problems
Pharmacological, medical and surgical management for the above.

Clinical Objectives

Apply principles of growth and development in all aspects of nursing care.
Identify the impact of hospitalization on the child and family and utilize the strategies to decrease the stress of hospitalization.
Utilize Gordon’s Functional Health Pattern effectively when providing care to a child and family with acute or chronic illness.
Utilize communication skills that facilitate therapeutic relationship with children, their families and health care team members.
Integrate therapeutic play to minimize stress of a child during hospitalization.
Identify needs and give health education to child / family at their level of understanding to promote health and prevent disease.

References:

1Adams, L. M, Tentis, E. (2003). The art and science of disciplining children. Pediatric Clinics North America, 50 (4), 817-840.
Bruce, B. S, Lake, J. P, Eden, V. A, Denney, J. C. (2004). Children at risk of injury. Journal of Pediatric Nursing: Nursing care of Children and Families, 19(2), 121-127.
Butler, R. (2001). Cough and colds: Nurse management of upper respiratory tract infections. Nursing Standard, 15 (39), 33-35.
Carpenter, D. R., Narsavage, G. L. (2004). One breath at a time: Living with cystic fibrosis. Journal of Pediatric Nursing: Nursing care of Children and Families, 19 (1), 25-32.
D, Ige Fshelton. (Aug 2004). Reducing the risk of sudden infant death syndrome (sids) in african-american communities. Pediatric-Nursing, 19(4), 290-292.
Edwards, H. E. Courtney, M. D Wilson, J. E, Monaghan, S. J, Walsh, A. M. (2003). Fever management audit: Australian nurses' antipyretic usage. Pediatric Nursing, 29(1), 31-37.
Haig, M. (Sep 23 - Oct 13, 2004). Toilet training. British Journal of Nursing, 13(17), 1025.
Harris, A. (2004). Toilet training children with learning difficulties: What the literature tells us. British Journal of Nursing, 13 (13), 773-777.
Koschel, M. J. (2003). Emergency. Is it child abuse? Even when the adult's account seems to be true, reassess. American Journal of Nursing, 103(4), 45-46 (11 ref).
Morin, K. (2004). Infant nutrition. Solids when and why. The American Journal of Maternal Child Nursing, 29(4), 259(253 ref).
Priya-J J. (2004). Kangaroo care for low birth weight babies. Journal of India, 95 (9), 209-202 (210 ref).
Pullen, R. L. (2004a). Assessing for signs of meningitis. Nursing, 34(5), 18.
Shaikh, N. (2004). Time to get on the potty: Are constipation and stool toileting refusal causing delayed toilet training? Journal of Pediatric, 145 (1), 12-13.

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