RNRS 193: Pediatric Nursing

• identify and implement strategies for effectively communicating with children of different age and developmental levels and their families in order to deliver individualized and sensitive care of children at all ages and their families, shown through supervised clinical contact with child clients and their families, as well as on written examinations. consistently utilize verbal and written communications in English with the purpose of assisting clients to promote, maintain, or restore well-being, demonstrated through supervised interaction with clients and appropriate documentation for the agency.
• utilize biopsychosocial concepts and theories, and principles of critical thinking in order to apply the nursing process to the care of children and their families, demonstrated in the clinical settings by observation and verbal report to the clinical instructor. demonstrate a broad base of knowledge and critical thinking in the application of the nursing process by both generating and modifying nursing care and care plans for child clients and their families experiencing complex care situations in various health care settings in order to provide individualized nursing care. employ knowledge of common childhood health care problems using the nursing process to provide quality nursing care, demonstrated through observations in clinical settings, written exams and nursing care plans.
• demonstrate proper use of computing skills through appropriate computer documentation at the clinical sites; using internet research for preparing, revising and adding to nursing care plans as class assignments; and the ability to retrieve information using technological means to apply information in the care of children and their families.
• recognize and practice culturally sensitive care with the integration of developmental theories in health care settings while rendering nursing care to meet the needs of child clients and their families with complex alterations in wellness by means of using college level vocabulary, proper grammar and associated medical terminology for the purpose of providing culturally sensitive and ethical nursing care to clients encountered in clinical settings in our community. Demonstrate responsibility and accountability for nursing activities in the role of the pediatric nurse by utilizing the nursing process, principles of health teaching, health promotion, illness prevention and restorative or end-of-life care to promote adaptation for children and their families. operate as a member of a nursing team by demonstrating collaboration with other members to formulate nursing care plans for those child clients assigned to the student with the intention that this behavior assists the student in professional socialization.
• illustrates correct analysis, interpretation, documentation and delivery of drug doses per physician orders to assigned child clients under direct supervision of a clinical instructor in order to demonstrate proficient pharmacologic knowledge and safe nursing care.

1. Unit 1 – Basic Concepts of Pediatrics
   1. Define and describe pediatric nursing including role and practice standards.
   2. Describe the historical significance of the history of pediatric nursing and its impact on family centered care.
   3. Describe biologic, psychosocial and cognitive development and growth behaviors utilizing Erikson and Piaget’s theories.
   4. Identify methods of communicating with the pediatric client and/or their significant others.
   5. Identify common safety issues for the pediatric client according to age groups.
   6. List the normal parameters for vital signs according to age groups and appropriately assess pain and implement effective pain management techniques.
   7. Perform an age-appropriate physical examination for a pediatric client.
   8. Identify nutritional requirements for the pediatric client according to age groups.
   9. Explain the role of play for the pediatric client and implement age-appropriate play therapy.
   10. Implement a plan of care for a pediatric client that is developmentally appropriate and demonstrates cultural sensitivity.
   11. Implement age-appropriate techniques for the safe, accurate administration of medications, including intravenous therapy.
   12. Communicate appropriately with the child and/or their significant others in the presences of chronic and terminal illnesses.
2. Unit 2 – Caring for Children with Alteration in Oxygenation
   1. Delineate the differences in the anatomy, physiology and functioning of the respiratory system of children and adults.
   2. Describe the pathophysiology, clinical manifestations, treatment and nursing management of common acute and chronic alterations in oxygenation: asthma, bronchiolitis, croup, cystic fibrosis and pneumonia.
   3. Describe the actions of medications that are commonly used in the treatment of alterations in oxygenation.
   4. Describe the role of caregiver, teacher and manager of care using the nursing process with children experiencing chronic oxygenation alterations and interact appropriately with their families.
3. Unit 3 – Caring for Children with Alterations in Nutrition/Elimination
   1. Describe the differences between the anatomy and physiology of the gastrointestinal system of the infant and the adult.
   2. Discuss the pathophysiology, etiology, signs and symptoms of common disorders of nutrition and elimination and the nursing management using the nursing process as an organizing framework.
   3. Discuss the nursing management for children and their families requiring surgery for specific disorders of nutrition and elimination.
   4. Identify the educational needs for children and their families with problems in nutrition and develop a teaching plan that reflects age-appropriate and culturally sensitive content.
   5. Delineate the differences in the anatomy, physiology and functioning of the genitourinary system of children and adults.
   6. Describe the pathophysiology, clinical manifestations, treatment and nursing management in the role of caregiver, teacher and manager of care with common alterations in elimination related to the genitourinary system: Acute glomerulonephritis, nephritic syndrome, urinary tract infection, Wilm’s Tumor and related fluid and electrolyte imbalances using the nursing process as the organizing framework.
   7. Describe the actions of medications that are commonly used in the treatment of alterations in genitourinary functions.
4. Unit 4 – Caring for Children with Alterations in Immunologic Function
   1. List the primary functions and describe the differences between the anatomy and physiology of the immune system of the infant and the adult.
   2. Discuss the pathophysiology, etiology, signs and symptoms of common immunological alterations and the nursing management using the nursing process as an organizing framework.
   3. Discuss the immunization schedule and explain the common side effects and adverse reactions of the various vaccines.
   4. Identify the educational needs for children and their families and develop a teaching plan that reflects age-appropriate and culturally sensitive content.
   5. Identify pharmacological substances and the nursing implications specific to immune function.
5. Unit 5 – Caring for Children with Alterations in Circulation
   1. Delineate the differences in the anatomy, physiology and functioning of the circulatory/cardiovascular system of children and adults.
   2. Describe the pathophysiology, clinical manifestations, treatment and nursing management of common acute and chronic alterations in circulation: congenital heart disease, hemophilia, iron deficiency anemia and sickle cell disease.
   3. Describe the actions of medications that are commonly used in the treatment of alterations in circulation.
   4. Describe the role of caregiver, teacher and manager of care using the nursing process with children experiencing chronic circulatory alterations and interact appropriately with their families.
6. Unit 6 – Caring for Children with Alterations in Neurosensory Functions
   1. Delineate the differences in the anatomy, physiology and functioning of the neurosensory system of children and adults.
   2. Describe the common causes of hearing and visual impairment in children and how hearing or visual impairments affect the child’s development of speech and language.
   3. Describe the pathophysiology, clinical manifestations, treatment and nursing management in the role of caregiver, teacher and manager of care with common alterations in neurosensory functioning: Bacterial meningitis, cerebral palsy, minor head injury, hydrocephalus, Reye’s Syndrome, seizures, spina bifida. Utilize the nursing process as the organizing framework.
   4. Describe the actions of medications that are commonly used in the treatment of alterations in neurosensory.
7. Unit 7 – Caring for Children with Alterations in Metabolism – Endocrine
   1. Delineate the differences in the anatomy, physiology and functioning of the endocrine system of children and adults.
   2. Describe the pathophysiology, clinical manifestations, treatment and nursing management in the role of caregiver, teacher and manager of care with common alterations in metabolism related to the endocrine system: Growth Hormone Deficiency, Precocious Puberty and Type I Diabetes using the nursing process as the organizing framework. Identify the educational needs for children and their families and develop a teaching plan that reflects age-appropriate and culturally sensitive content.
   3. Describe the actions of medications that are commonly used in the treatment of alterations in metabolism – endocrine
8. Unit 8 – Caring for Children with Alterations in Mobility
   1. Delineate the differences in the anatomy, physiology and functioning of the musculoskeletal system of children and adults.
   2. Describe the pathophysiology, clinical manifestations, treatment and nursing management in the role of caregiver, teacher and manager of care with common alterations in mobility: Developmental Dysplasia of the hip, Fractures and Scoliosis using the nursing process as the organizing framework and identify the educational needs for children and their families and develop a teaching plan that reflects age-appropriate and culturally sensitive content.
   3. Describe the actions of medications that are commonly used in the treatment of alterations in mobility.
9. Unit 9 – Caring for Children with Pediatric Emergencies
   1. Identify environmental issues which may contribute to abuse and neglect, drowning, poisonings, suicide, substance abuse and unexpected death of an infant.
   2. Describe the pathophysiology, clinical manifestations, treatment and nursing management in the role of caregiver, teacher and manager of care during pediatric emergencies: Abuse, Near drowning, suicide, substance abuse and unexpected death of an infant using the nursing process as the organizing framework, identify the educational needs for children and their families and develop a teaching plan that reflects age-appropriate and culturally sensitive content.

Under supervision by clinical instructors, the student nurse will perform the following skills in a clinical setting (or simulated lab situation using computerized simulation manikins) on patients who are children experiencing alterations in wellness, utilizing the steps of the nursing process during all phases of care:

1. Complete and critically analyze a comprehensive assessment of a child client and family within the physiologic, psychologic, social, cultural, and spiritual realms.
2. Cluster assessment cues into relevant groups of identifying criteria and formulate individualized nursing diagnoses.
3. Prioritize nursing diagnoses and individual interventions to be carried out by the health care team.
4. Direct and carry out nursing interventions, participation in the implementation of collaborative interventions, and to follow up on those interventions appropriately delegated to other members of the health care team.
5. Identify behavioral cues in a child client with an alteration in wellness and apply these cues to a communication plan to be used by the nursing team in caring for the client and family.
6. Administer medications demonstrating correct critical thinking and the use of developmental theories regarding pharmacologic interventions.
7. Plan for and consistently provide appropriate infection control and other safety measures as indicated by child client’s health and developmental status.