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Copyright, ii
About the Authors, iv
Thank You, vi
Preface, vii
Unit I. Nurses, Children, and Families, 1
Chapter 1. Nurse’s Role in Care of the Child: Hospital, Community Settings, and Home, 2
Overview of Pediatric Health Care, 3
Role of the Nurse in the Care of Children, 4
Direct Care Provider, 4
Educator, 5
Advocate, 6
Case Manager, 6
Research, 7
History of Child Health Care, 7
The Beginnings of Child Health Nursing, 7
Historic Legislation, 8
Other Advances Contributing to Improved Child Health Care, 8
Nursing Process in Pediatric Care, 9
Critical Thinking, 10
Evidence-Based Practice, 10
Guidelines for Assessing Quality of Health Care, 11
Contemporary Climate for Pediatric Nursing Care, 11
Partnering with Families: Family-Centered Care, 11
Culturally Competent Care, 12
Pediatric Health Statistics, 13
Infant Mortality, 13
Child Mortality, 13
Healthy People 2010, 14
Morbidity and Hospitalization, 15
Healthcare Financing, 16
Health Benefits, 17
Healthcare Technology, 18
Legal and Ethical Concepts and Responsibilities, 18
Regulation of Nursing Practice, 18
Accountability and Risk Management, 19
Accountability, 19
Patient Safety, 19
Risk Management, 20
Legal and Ethical Issues in Pediatric Care, 21
Informed Consent, 21
Child Participation in Healthcare Decisions, 22
Child’s Rights Versus Parents’ Rights, 23
Confidentiality, 23
Patient Self- Determination Act, 24
Ethical Concepts and Issues, 24
Withholding or Withdrawing Medical Treatment, 25
Genetic Testing of Children, 26
Organ Transplantation Issues, 26
Research Issues, 27
Partnering with Children and Their Families, 27
Chapter 2. Family-Centered Care: Theory and Application, 31
Family Roles, 32
Family-Centered Care, 32
History of Family-Centered Care, 32
Promoting Family-Centered Care, 33
Family Composition, 36
Nuclear Family, 36
Blended or Reconstituted Family, 36
Extended Family, 37
Single-Parent Family, 37
Binuclear Family, 38
Heterosexual Cohabitating Family, 38
Gay and Lesbian Family, 38
Family Functioning, 39
Transition to Parenthood, 39
Parental Influences on the Child, 39
Family Size, 39
Sibling Relationships, 40
Parenting, 40
Authoritarian Parents, 41
Authoritative Parents, 41
Permissive Parents, 42
Indifferent Parents, 42
Parent Adaptability, 42
Assessing Parenting Styles, 42
Discipline and Limit Setting, 42
Special Family Considerations, 43
Divorce and Its Effects on Children, 43
Stepparenting, 44
Foster Care, 45
Foster Parenting, 46
Health Status of Foster Children, 46
Transition to Permanent Placement, 46
Adoption, 47
Legal Aspects of Adoption, 47
Preparation for Adoption, 47
International Adoptions, 48
Family Theories, 48
Family Development Theory, 49
Family Systems Theory, 50
Family Stress Theory, 50
Family Assessment, 50
Family Stressors, 50
Family Strengths, 50
Collecting Data for Family Assessment, 52
Family Assessment Tools, 52
Genogram, 52
Family Ecomap, 52
Family APGAR, 52
Home Observation for Measurement of the Environment, 52
Friedman Family Assessment Model, 53
Calgary Family Assessment Model, 53
Family Support Services, 53
Nursing Management, 56
Chapter 3. Cultural Influences, 61
Culture–Definitions and Basic Concepts, 62
Culture and Nurse Theorists, 62
Application of Cultural Theories, 64
Definitions Related to Culture, 65
Demographics and Cultural Diversity in the United States and Canada, 65
Cultural Competence in Nursing, 66
Health Care and Culture, 69
Disparities in Health and Barriers to Health Care, 69
Access and Barriers, 69
Biological Differences, 71
Environmental Differences, 71
Cultural Practices that Influence Health Care, 72
Family Roles and Organization, 72
Communication, 72
Time Orientation, 74
Nutrition, 74
Health Beliefs, Approaches, and Practices, 75
Health Beliefs, 75
Health Approaches and Practices, 76
Nursing Management, 80
Chapter 4. Genetic and Genomic Influences, 87
Partnering with Families: Meeting the Standard of Genetic Nursing Care Delivery, 88
Impact of Genetic Advances on Health Promotion and Health Maintenance, 91
Genetic Basics, 91
Cell Division, 92
Chromosomal Alterations, 92
Alterations in Chromosome Number, 93
Structural Chromosomal Alterations, 94
Genes, 96
Function and Distribution of Genes, 97
Mitochondrial Genes, 97
Gene Alterations and Disease, 97
Gene Alterations that Decrease Risk of Disease, 99
Single Nucleotide Polymorphisms, 99
Principles of Inheritance, 99
Mendelian Pattern of Inheritance, 99
Recessive Versus Dominant Disorders, 103
Autosomal Dominant, 103
Autosomal Recessive, 104
X-Linked Recessive, 105
X Inactivation, 107
X-Linked Dominant, 107
Y-Linked Disorders, 107
Variability in Classic Mendelian Patterns of Inheritance, 108
Penetrance, 108
New Mutation, 108
Anticipation, 108
Variable Expressivity, 108
Sex-Limited Traits, 108
Sex-Influenced Traits, 108
Other Means of Monogenic Inheritance, 108
Imprinting, 108
Uniparental Disomy, 109
Multifactorial (Polygenic) Disorders, 109
Collaborative Care, 109
Diagnostic Procedures, 109
Genetic Testing, 109
Recommendations for Genetic Testing, 109
Categories of Genetic Tests, 110
Quality and Accuracy of Genetic Tests, 112
Nursing Management, 112
Visions for the Future, 123
Unit II. Child Concepts and Application, 127
Chapter 5. Concepts of Growth and Development, 128
Principles of Growth and Development, 129
Major Theories of Development, 130
Freud’s Theory of Psychosexual Development, 130
Theoretical Framework, 130
Stages, 130
Nursing Application, 131
Erikson’s Theory of Psychosocial Development, 133
Theoretical Framework, 133
Stages, 133
Nursing Application, 134
Piaget’s Theory of Cognitive Development, 135
Theoretical Framework, 135
Stages, 135
Nursing Application, 136
Kohlberg’s Theory of Moral Development, 137
Theoretical Framework, 137
Stages, 137
Nursing Application, 137
Social Learning Theory, 137
Theoretical Framework, 137
Nursing Application, 138
Behaviorism, 138
Theoretical Framework, 138
Nursing Application, 138
Ecologic Theory, 138
Theoretical Framework, 138
Levels or Systems, 139
Nursing Application, 140
Temperament Theory, 140
Theoretical Framework, 140
Nursing Application, 141
Resiliency Theory, 142
Theoretical Framework, 142
Nursing Application, 143
Influences on Development, 143
Prematurity, 143
Family and Parenting, 144
International Adoption, 144
Parent Preparation, 144
Monitoring of the Adopted Child, 144
Nursing Role with Adoptive Families, 144
Cultural Influences, 145
Growth and Development by Age Group, 145
Newborn (Up to 1 Month), 145
Physical Growth and Development and Prenatal Influences, 145
Cognitive Development, 147
Psychosocial Development, 147
Infant (1 Month to 1 Year), 149
Physical Growth and Development, 149
Cognitive Development, 149
Psychosocial Development, 150
Play, 150
Personality and Temperament, 153
Communication, 154
Toddler (1 to 3 Years), 155
Physical Growth and Development, 155
Cognitive Development, 155
Psychosocial Development, 155
Play, 155
Personality and Temperament, 156
Communication, 157
Preschool Child (3 to 6 Years), 158
Physical Growth and Development, 158
Cognitive Development, 158
Psychosocial Development, 159
Play, 159
Personality and Temperament, 160
Communication, 160
School-Age Child (6 to 12 Years), 161
Physical Growth and Development, 162
Cognitive Development, 163
Psychosocial Development, 163
Play, 163
Personality and Temperament, 164
Communication, 164
Sexuality, 164
Adolescent (12 to 18 Years), 164
Physical Growth and Development, 164
Cognitive Development, 165
Psychosocial Development, 165
Activities, 165
Personality and Temperament, 165
Communication, 166
Sexuality, 166
Chapter 6. Child and Family Communication, 170
Communication and the Nurse–Child–Family Relationship, 171
Forms of Communication, 171
Verbal Communication, 171
Nonverbal Communication, 172
Facial Expressions, 173
Body Language, 173
Eye Contact, 174
Touch, 174
Physical Appearance, 174
Factors Influencing Communication with Children and Their Families, 175
Medical Jargon, 175
Gender, 175
Child’s Health Status, 175
Nursing Attitudes, 175
Developmental and Cognitive Considerations for Communication with Children, 176
Newborn, 176
Infant, 177
Toddler and Preschooler, 177
School-Age Child, 178
Adolescent, 178
The Child with Special Needs, 179
Communicating with the Child with an Alteration in Visual Perception, 179
Communicating with the Child with an Alteration in Hearing Perception, 179
Communicating with the Child Who Does Not Speak English, 179
Nursing Management, 180
Chapter 7. Pediatric and Newborn Assessment, 189
Obtaining the Child’s History, 190
Communication Strategies, 190
Strategies to Build a Rapport with the Family and Child, 190
Data to Be Collected, 191
Patient Information, 191
Physiologic Data, 191
Psychosocial Data, 193
Developmental Data, 195
Anatomic and Physiologic Characteristics of Infants and Children, 195
Physical Examination Techniques, 195
Developmental Approach to the Examination, 196
Newborns and Infants Under 6 Months of Age, 196
Infants Over 6 Months of Age, 197
Toddlers, 197
Preschoolers, 197
School-Age Children, 197
Adolescents, 197
General Appraisal, 197
Anthropometric Measurements, 198
Infants and Toddlers, 198
Preschoolers and School-Age Children, 199
Older Children and Adolescents, 199
Body Mass Index, 200
Skinfold Thickness, 200
Assessing Skin and Hair Characteristics and Integrity, 200
Inspection of the Skin, 200
Skin Color, 200
Palpation of the Skin, 201
Temperature, 201
Texture, 201
Moistness, 201
Resilience (Turgor), 201
Capillary Refill Time, 201
Skin Lesions, 201
Inspection of the Hair, 202
Palpation of the Hair, 202
Assessing the Head for Skull Characteristics and Facial Features, 202
Inspection of the Head and Face, 202
Head, 202
Face, 203
Palpation of the Skull, 204
Sutures, 205
Fontanels, 205
Assessing Eye Structures, Function, and Vision, 205
Inspection of the External Eye Structures, 205
Eye Size and Spacing, 206
Eyelids and Eyelashes, 206
Eye Color, 206
Pupils, 207
Inspection of the Eye Muscles, 207
Extraocular Movements, 207
Corneal Light Reflex, 207
Cover–Uncover Test, 207
Vision Assessment, 207
Infants and Toddlers, 207
Visual Fields, 208
Standardized Vision Charts, 208
Inspection of the Internal Eye Structures, 208
Using the Ophthalmoscope, 209
Assessing the Ear Structures and Hearing, 210
Inspection of the External Ear Structures, 210
Inspection of the Tympanic Membrane, 210
Using the Otoscope, 211
Hearing Assessment, 212
Infants and Toddlers, 212
Preschool and Older Children, 212
Bone and Air Conduction of Sound, 213
Assessing the Nose and Sinuses for Airway Patency and Discharge, 213
Inspection of the External Nose, 213
Palpation of the External Nose, 214
Nasal Patency, 214
Assessment of Smell, 214
Inspection of the Internal Nose, 214
Mucous Membranes, 214
Nasal Septum, 214
Discharge, 214
Inspection of the Sinuses, 214
Assessing the Mouth and Throat for Color, Function, and Signs of Abnormal Conditions, 215
Inspection of the Mouth, 215
Lips, 215
Teeth, 215
Mouth Odors, 215
Gums, 215
Buccal Mucosa, 215
Tongue, 216
Palate, 216
Palpation of the Mouth Structures, 216
Tongue, 217
Palate, 217
Inspection of the Throat, 217
Tonsils, 217
Gag Reflex, 217
Assessing the Neck for Characteristics, Range of Motion, and Lymph Nodes, 217
Inspection of the Neck, 217
Palpation of the Neck, 217
Lymph Nodes, 217
Trachea, 218
Thyroid, 218
Range of Motion Assessment, 218
Assessing the Chest for Shape, Movement, Respiratory Effort, and Lung Function, 218
Topographic Landmarks of the Chest, 218
Inspection of the Chest, 220
Chest Circumference, 220
Shape of the Chest, 221
Chest Movement and Respiratory Effort, 221
Palpation of the Chest, 221
Chest Wall, 221
Tactile Fremitus, 222
Auscultation of the Chest, 222
Breath Sounds, 222
Vocal Resonance, 223
Abnormal Breath Sounds, 223
Abnormal Voice Sounds, 223
Percussion of the Chest, 223
Breasts, 224
Inspection, 224
Palpation, 225
Assessing the Heart for Heart Sounds and Function, 225
Inspection of the Precordium, 225
Palpation of the Precordium, 225
Apical Impulse, 225
Abnormal Sensations, 225
Percussion of the Heart Borders, 225
Auscultation of the Heart, 225
Heart Rate and Rhythm, 225
Differentiation of Heart Sounds, 226
Splitting of the Heart Sounds, 227
Third Heart Sound, 227
Murmurs, 227
Venous Hum, 228
Completing the Heart Examination, 228
Blood Pressure, 228
Palpation of the Pulses, 228
Other Signs, 229
Assessing the Abdomen for Shape, Bowel Sounds, and Underlying Organs, 229
Topographic Landmarks of the Abdomen, 229
Inspection of the Abdomen, 229
Shape, 229
Umbilicus, 229
Rectus Muscle, 229
Abdominal Movement, 229
Auscultation of the Abdomen, 230
Percussion of the Abdomen, 230
Palpation of the Abdomen, 230
Light Palpation, 230
Deep Palpation, 231
Other Masses, 231
Assessment of the Inguinal Area, 231
Inspection, 231
Palpation, 231
Assessing the Genital and Perineal Areas for External Structural Abnormalities, 232
Preparation of Children for the Examination, 232
Inspection of the Female Genitalia, 232
Mons Pubis, 232
Labia, 232
Hymen, 232
Urethral and Vaginal Openings, 232
Vaginal Discharge, 232
Palpation of the Female Genitalia, 233
Inspection of the Male Genitalia, 233
Penis, 233
Scrotum, 233
Palpation of the Male Genitalia, 233
Penis, 233
Testicles, 233
Spermatic Cord, 234
Enlarged Scrotum, 234
Inguinal Canal, 234
Cremasteric Reflex, 234
Inspection of the Anus and Rectum, 234
Palpation of the Anus and Rectum, 234
Rectal Examination, 234
Assessment of Pubertal Development and Sexual Maturation, 234
Females, 234
Males, 234
Sexual Maturity Rating, 235
Assessing the Musculoskeletal System for Bone and Joint Structure, Movement, and Muscle Strength, 235
Inspection of the Bones, Muscles, and Joints, 235
Bones and Muscles, 235
Joints, 237
Palpation of the Bones, Muscles, and Joints, 237
Bones and Muscles, 237
Joints, 237
Range of Motion and Muscle Strength Assessment, 237
Active Range of Motion, 237
Passive Range of Motion, 237
Muscle Strength, 237
Posture and Spinal Alignment, 237
Posture, 237
Spinal Alignment, 237
Inspection of the Upper Extremities, 238
Arms, 238
Hands, 238
Nails, 238
Inspection of the Lower Extremities, 239
Hips, 239
Legs, 239
Feet, 240
Assessing the Nervous System for Cognitive Function, Balance, Coordination, Cranial Nerve Function, Sensation, and Reflexes, 240
Cognitive Function, 240
Behavior, 241
Communication Skills, 241
Memory, 241
Level of Consciousness, 241
Cerebellar Function, 241
Balance, 241
Coordination, 242
Gait, 242
Sensory Function, 242
Superficial Tactile Sensation, 242
Superficial Pain Sensation, 242
Cranial Nerve Function, 243
Infant Primitive Reflexes, 243
Superficial and Deep Tendon Reflexes, 243
Superficial Reflexes, 243
Deep Tendon Reflexes, 244
Analyzing Data from the Physical Examination, 244
Newborn Assessment, 248
Newborn Transition, 248
Assessment at Birth, 249
Assessment of the Newborn, 249
Gestational Age Assessment, 250
Size for Gestational Age, 256
General Appearance, 256
Vital Signs, 256
Skin, 257
Head, 257
Eyes, 258
Ears, 259
Nose, 259
Mouth, 259
Neck, 259
Chest and Lungs, 260
Heart, 260
Abdomen, 260
Genitalia and Anus, 261
Extremities, 261
Neurological System, 262
Chapter 8. Infant, Child, and Adolescent Nutrition, 265
Nutrition Concepts, 266
Major Dietary Components, 266
Nutrition Facts Labels, 268
Recommendations for Dietary Intake, 270
Nutritional Needs, 270
Preterm Infant, 270
Infancy–Birth to 6 Months, 273
Breast and Formula Feeding, 274
Infancy–6 to 12 Months, 276
Introduction of Complementary Foods, 276
Dental Care, 278
Toddlerhood, 279
Preschool, 280
School Age, 281
Adolescence, 282
Nutritional Challenges, 283
Nutritional Assessment, 285
Physical and Behavioral Measurement, 285
Growth Measurement, 285
Additional Physical Measurement, 287
Dietary Intake, 288
24-Hour Recall of Food Intake, 288
Food Frequency Questionnaire, 289
Dietary Screening History, 289
Food Diary, 290
Common Nutritional Concerns, 292
Childhood Hunger, 292
Overweight and Obesity, 292
Collaborative Care, 294
Nursing Management, 294
Food Safety, 295
Common Dietary Deficiencies, 298
Iron, 298
Calcium, 299
Vitamin D, 299
Folic Acid, 300
Protein-Energy Malnutrition, 300
Food Reactions, 300
Nursing Management, 301
Feeding and Eating Disorders, 302
Pica, 302
Feeding Disorder of Infancy and Early Childhood (Failure to Thrive), 302
Collaborative Care, 302
Nursing Management, 303
Anorexia Nervosa, 303
Collaborative Care, 304
Diagnostic Tests, 304
Clinical Therapy, 304
Nursing Management, 305
Bulimia Nervosa, 305
Collaborative Care, 308
Diagnostic Tests, 308
Clinical Therapy, 308
Nursing Management, 308
Nutritional Support, 309
Sports Nutrition and Ergogenic Agents, 309
Health-Related Conditions, 310
Vegetarianism, 310
Enteral Therapy, 311
Total Parenteral Nutrition, 311
Unit III. Health Promotion and Health Maintenance Through Childhood, 317
Chapter 9. Concepts of Health Promotion and Health Maintenance, 318
Definitions of Health Promotion and Health Maintenance, 319
Application of Resilience and Ecologic Theories, 321
Health Supervision in the Pediatric Healthcare Home, 323
Components of Health Promotion and Health Maintenance Visits, 326
Contacts with the Family, 326
General Observations, 326
Growth and Developmental Surveillance, 326
Nutrition, 329
Physical Activity, 332
Oral Health, 332
Mental and Spiritual Health, 332
Relationships, 333
Disease Prevention Strategies, 334
Injury Prevention (Safety) Strategies, 334
Additional Topics, 334
Nursing Management, 336
Chapter 10. Health Promotion and Health Maintenance of the Newborn, 343
Early Contacts with the Family, 344
Prenatal, 344
Prenatal Assessment of Risk and Protective Factors, 344
At Birth, 346
Assessment of Risk and Protective Factors, 347
Newborn Visit Following Hospital Discharge, 349
Routine Health Supervision Visits, 349
General Observations, 349
Growth and Developmental Surveillance, 351
At Birth, 351
Assessing Growth and Development in the Outpatient Setting, 352
Nutrition, 352
Breastfeeding, 352
Formula Feeding, 354
Physical Activity, 354
Oral Health, 356
Mental and Spiritual Health, 356
Promoting Maternal Mental Health, 358
Promoting Newborn Mental Health, 358
Relationships, 359
Disease Prevention Strategies, 361
Injury Prevention Strategies, 363
Nursing Management, 365
Chapter 11. Health Promotion and Health Maintenance of the Infant, 369
Early Contacts with the Family, 370
General Observations, 371
Growth and Developmental Surveillance, 372
Nutrition, 374
Physical Activity, 375
Oral Health, 376
Mental and Spiritual Health, 377
Relationships, 379
Family, 379
Social Interactions, 381
Disease Prevention Strategies, 382
Injury Prevention Strategies, 383
Nursing Management, 386
Chapter 12. Health Promotion and Health Maintenance of the Toddler and Preschooler, 391
General Observations, 392
Growth and Developmental Surveillance, 393
Nutrition, 395
Physical Activity, 398
Oral Health, 400
Mental and Spiritual Health, 401
Relationships, 403
Disease Prevention Strategies, 406
Injury Prevention Strategies, 408
Nursing Management, 411
Chapter 13. Health Promotion and Health Maintenance of the School-Age Child, 417
General Observations, 418
Growth and Developmental Surveillance, 419
Nutrition, 420
Physical Activity, 422
Oral Health, 424
Mental and Spiritual Health, 425
Self-Concept, 425
Sexuality, 426
Sleep, 427
School, 427
Mental Health Disorders, 428
Spiritual Health, 428
Nursing Role, 428
Relationships, 428
Disease Prevention Strategies, 430
Injury Prevention Strategies, 431
Nursing Management, 433
Chapter 14. Health Promotion and Health Maintenance of the Adolescent, 439
General Observations, 441
Growth and Developmental Surveillance, 442
Nutrition, 444
Physical Activity, 444
Oral Health, 446
Mental and Spiritual Health, 447
Self-Concept, 447
Sexuality, 448
Sleep, 448
School, 449
Mental Health Disorders, 449
Spiritual Health, 449
Nursing Role, 449
Relationships, 449
Disease Prevention Strategies, 451
Injury Prevention Strategies, 453
Nursing Management, 454
Unit IV. Child Healthcare Settings and Considerations, 459
Chapter 15. Nursing Care of the Child in the Community, 460
Community-Based Health Care, 461
Characteristics of Community-Based Health Care, 461
Roles of Nurses in Community Settings, 462
Role of the Pediatric Nurse in an Office or Health Center Setting, 462
Identifying Severely Ill and Injured Children, 463
Telephone Advice, 463
Educating the Child and Family, 464
Identifying Community Resources, 464
Ensuring a Safe Environment for Children, 465
Role of the Pediatric Nurse in a Hospital Outpatient Setting, 465
Specialty Care Ambulatory Clinics, 465
Urgent Care or Emergency Department Settings, 465
Role of the Nurse in a School Setting, 465
Community Health Focus, 467
School-Based Health Centers, 467
Preparation for Emergencies, 470
Children with Special Healthcare Needs, 470
Facilitating Child’s Return to School, 471
Nursing in Childcare Settings, 471
Reducing Disease Transmission, 472
Health Promotion, 472
Environmental Safety, 473
Care for Children with Illnesses, 473
Emergency Care Planning, 473
Other Community Settings, 473
Role of the Nurse in Camp Settings, 473
Home Healthcare Nursing, 473
Characteristics of Children in Home Care Services, 474
Role of the Pediatric Nurse in Home Care, 474
Nursing Management, 475
Community Health Nursing, 477
Assessment of Community Needs and Resources, 477
Community Assessment, 477
Community Nursing Diagnoses, 479
Planning and Implementation, 479
Community Plan and Intervention Example, 479
Evaluation, 479
Emergency Medical Services for Children, 480
Disaster Preparedness, 480
Pediatric Considerations, 480
Clinical Manifestations, 481
Collaborative Care, 481
Emergency Response System, 482
Nursing Management, 483
Chapter 16. Nursing Care of the Hospitalized Child, 487
Effects of Hospitalization on Children and Their Families, 488
Children’s Understanding of Health and Illness, 488
Newborn, 489
Infant, 489
Toddler, 491
Preschooler, 492
School-Age Child, 492
Adolescent, 493
Family Responses to Hospitalization, 493
Siblings’ Experience, 494
Family Assessment, 494
Nurse’s Role in the Child’s Adaptation to Hospitalization, 496
Planned Hospitalization, 496
Unexpected Hospitalization, 497
Nursing Care of the Hospitalized Child, 498
Special Units and Types of Care, 498
General Pediatric Care Unit, 498
Short-Stay, Outpatient, and Ambulatory Surgical Units, 498
Emergency Care, 499
Intensive Care Unit, 499
Isolation, 499
Rehabilitation, 499
Parental Involvement and Parental Presence, 500
Preparation for Procedures, 502
Psychological Preparation, 502
Physical Preparation, 502
Performing the Procedure, 503
Preparation for Surgery, 504
Preoperative Care, 504
Psychosocial Preparation, 505
Parental Presence During Anesthesia Induction, 505
Physical Preparation, 505
Postoperative Care, 506
Postoperative Home Care Instructions, 506
Strategies to Promote Coping and Normal Development of the Hospitalized Child, 511
Rooming In, 511
Child Life Programs, 511
Therapeutic Play, 511
Newborn and Infant, 513
Toddler, 514
Preschooler, 514
School-Age Child, 514
Adolescent, 514
Strategies to Meet Educational Needs, 515
Child and Family Teaching, 516
Teaching Plans, 516
Teaching for Children with Special Healthcare Needs, 517
Preparation for Home Care, 518
Assessing the Child and Family in Preparation for Discharge, 518
Preparing the Child and Family for Discharge, 518
Preparing the Child and Family for Home Health Care, 519
Preparing the Child and Family for Long-Term Care or Rehabilitation, 519
Chapter 17. Pain Assessment and Management, 523
Acute Pain, 524
Pathophysiology of Pain, 524
Acute Pain Perception, 524
Neonatal Pathophysiology, 526
Physiologic Consequences of Pain, 526
Behavioral Consequences of Pain, 526
Barriers to Pain Management in Children, 527
Developmental Aspects of Pain Perception, Memory, and Response, 528
Cultural Influences on Pain, 528
Clinical Manifestations of Pain, 528
Physiologic Indicators, 528
Behavioral Indicators, 529
Collaborative Care, 530
Diagnostic Procedures, 530
Pain Assessment Scales for Nonverbal Children, 530
Self-Report Pain Rating Tools for Children, 533
Clinical Therapy, 536
Nursing Management, 542
Chronic Pain, 550
Pathophysiology, 550
Clinical Manifestations, 550
Selected Chronic Pain Conditions, 550
Sickle Cell Disease, 550
Cancer Pain, 550
Complex Regional Pain Syndrome I, 550
Collaborative Care, 551
Diagnostic Testing, 551
Clinical Therapy, 551
Nursing Management, 551
Sedation and Pain Management for Medical Procedures, 552
Nursing Management, 554
Unit V. Health Conditions: Episodic to End-of-Life, 559
Chapter 18. Social and Environmental Influences on the Child and Adolescent, 560
Theoretical Frameworks, 561
Social Influences on Child Health, 562
Poverty, 562
Homelessness, 562
Stress, 563
Families, 565
School and Child Care, 566
Community, 567
Culture, 568
Lifestyle Activities and Their Influences on Child Health, 568
Substance Use, 568
Tobacco Use, 568
Collaborative Care, 569
Clinical Therapy, 570
Nursing Management, 570
Alcohol Use, 571
Drug Use, 572
Collaborative Care, 574
Diagnostic Procedures, 574
Clinical Therapy, 574
Nursing Management, 574
Physical Inactivity/Sedentary Behavior, 577
Injury and Protective Equipment, 579
Body Art, 580
Sexual Orientation, 581
Effects of Violence, 582
Schools and Communities, 582
War and Terrorism, 583
Bullying, 584
Incarceration, 584
Abandoned Babies, 584
Hazing, 585
Domestic Violence, 585
Dating Violence, 585
Nursing Management, 585
Child Abuse, 590
Physical Abuse, 590
Physical Neglect, 590
Emotional Abuse, 590
Emotional Neglect, 591
Sexual Abuse, 591
Collaborative Care, 592
Diagnostic Tests, 593
Clinical Therapy, 593
Nursing Management, 594
Munchausen Syndrome by Proxy, 596
Nursing Management, 596
Environmental Influences on Child Health, 597
Disasters, 597
Nursing Management, 597
Environmental Contaminants, 598
Nursing Management, 599
Poisoning, 599
Clinical Manifestations, 600
Collaborative Care, 600
Diagnostic Tests, 600
Clinical Therapy, 600
Nursing Management, 602
Ingestion of Foreign Objects, 602
Nursing Management, 603
Lead Poisoning, 603
Nursing Management, 605
Chapter 19. Immunizations and Communicable Diseases, 611
Communicable Disease as a Health Problem, 612
Vulnerability of Children to Infection, 612
Special Vulnerability of Newborns and Young Infants, 613
Infection Control, 614
Immunization, 615
Etiology and Pathophysiology, 615
Clinical Manifestations, 616
Collaborative Care, 616
Immunization Schedule, 621
Vaccine Injury Compensation, 626
Nursing Management, 627
Infectious and Communicable Diseases in Infants and Children, 635
Epidemiology and Pathophysiology, 635
Bacteria, 636
Viruses, 637
Fever, 637
Clinical Manifestations, 637
Collaborative Care, 653
Diagnostic Procedures, 653
Clinical Therapy, 654
Nursing Management, 654
Sepsis, 657
Epidemiology and Pathophysiology, 657
Clinical Manifestations, 657
Collaborative Care, 657
Diagnostic Procedures, 657
Clinical Therapy, 657
Nursing Management, 658
Emerging Infection Control Threats, 658
Pandemic Flu, 658
Bioterrorism Threats, 659
Nursing Management, 660
Chapter 20. Nursing Care of the Child with a Chronic Condition, 666
General Concepts in the Care of a Child with a Chronic Condition, 667
Overview of Chronic Conditions, 667
The Family of a Child with a Chronic Condition, 670
Informing the Parents, 670
Informing the Child, 670
Parental Reactions, 671
Siblings’ Reactions, 671
Stressors on the Family, 671
Caregiver Burden, 672
Maltreatment of the Child with a Chronic Condition, 673
Family Financial Issues, 673
Promoting Healthy Family Coping, 674
The Child with a Chronic Condition, 675
Developmental Considerations, 675
Newborn and Infant, 675
Toddler, 675
Preschooler, 675
School-Age Child, 676
Adolescent, 676
Education and Schooling, 677
Educational System Planning, 677
The Child’s Response to Entering School, 679
Education for Children Who Are Medically Fragile, 679
Homeschooling, 679
Transition to Adulthood, 680
Collaborative Care, 680
Hospitalization, 680
Ethical Issues, 680
Transition Between Hospital and Home, 680
Health Promotion and Health Maintenance of Children with Chronic Conditions, 681
Nursing Management, 682
Nurse’s Reactions to Care of Children with a Chronic Condition, 689
Chapter 21. Nursing Care of the Child with a Life-Threatening Illness or Injury, 693
Life-Threatening Illness or Injury, 694
Settings Encountered by Children with a Life-Threatening Condition, 694
Emergency Department, 694
Pediatric Intensive Care Unit, 695
Neonatal Intensive Care Unit, 695
Child’s Experience of a Life-Threatening Illness or Injury, 696
Coping Mechanisms, 696
Nursing Management, 697
Parents’ Experience of a Child’s Life-Threatening Illness or Injury, 700
The Family in Crisis, 700
Parental Reactions to Life-Threatening Illness or Injury, 701
Shock and Disbelief, 701
Anger and Guilt, 702
Deprivation and Loss, 703
Anticipatory Waiting, 703
Readjustment or Mourning, 703
Nursing Management, 703
The Siblings’ Experience, 708
Nursing Management, 708
Chapter 22. End-of-Life Care and Bereavement, 712
Concepts of Loss and Death, 713
Loss, 713
Death, 713
The Child’s Experience with Death and Loss, 713
Death of a Parent, 714
Death of a Grandparent, 714
Death of a Friend, 714
Other Potentially Significant Losses, 716
Factors Influencing Family Responses to Death and Loss, 716
Culture, 717
Faith-Based Beliefs and Spirituality, 717
Grief and Bereavement, 717
Stages of Grieving, 718
Social Support System, 719
End-of-Life Considerations and Decision Making, 719
Palliative Care, 719
Advance Care Planning, 720
Hospice Care, 721
Ethical Issues Surrounding a Child’s Death, 721
Withdrawing or Withholding Treatment, 721
Conflicts Regarding Parental Refusal of Treatment, 722
Do Not Resuscitate Orders, 723
Euthanasia, 723
End-of-Life Nursing Care for the Dying Child, 723
Awareness of Dying by Developmental Age, 723
Nursing Management, 724
Family Care After the Death of a Child, 731
Communicating with Parents When a Child Dies Unexpectedly, 731
Parents’ Reactions to a Child’s Death, 732
Nursing Management, 732
The Death of a Newborn or Young Infant, 733
Nursing Management, 733
Siblings’ Reactions to a Child’s Death, 733
Nursing Management, 734
Nurses’ Reactions to Caring for the Children Who Die, 734
Unit VI. Nursing Care of Specific Health Conditions, 739
Chapter 23. Alterations in Fluid, Electrolyte, and Acid–Base Balance, 740
Anatomy and Physiology, 741
Physiology of Fluid and Electrolyte Balance, 741
Physiology of Acid–Base Balance, 742
Buffers, 742
Role of the Lungs, 742
Role of the Kidneys, 743
Role of the Liver, 743
Pediatric Differences, 743
Fluid Volume Imbalances, 745
Extracellular Fluid Volume Imbalances, 746
Extracellular Fluid Volume Deficit (Dehydration), 746
Collaborative Care, 749
Diagnostic Tests, 749
Clinical Therapy, 750
Nursing Management, 750
Extracellular Fluid Volume Excess, 757
Nursing Management, 758
Interstitial Fluid Volume Excess (Edema), 759
Nursing Management, 761
Electrolyte Imbalances, 762
Sodium Imbalances, 762
Hypernatremia, 762
Collaborative Care, 764
Nursing Management, 764
Hyponatremia, 765
Collaborative Care, 765
Diagnostic Tests, 765
Clinical Therapy, 765
Nursing Management, 765
Potassium Imbalances, 766
Hyperkalemia, 766
Collaborative Care, 767
Diagnostic Tests, 767
Clinical Therapy, 767
Nursing Management, 767
Hypokalemia, 768
Collaborative Care, 769
Diagnostic Tests, 769
Clinical Therapy, 769
Nursing Management, 769
Calcium Imbalances, 771
Hypercalcemia, 771
Collaborative Care, 772
Diagnostic Tests, 772
Nursing Management, 772
Hypocalcemia, 773
Collaborative Care, 774
Nursing Management, 774
Magnesium Imbalances, 775
Hypermagnesemia, 775
Nursing Management, 776
Hypomagnesemia, 776
Nursing Management, 776
Clinical Evaluation of Fluid and Electrolyte Imbalance, 777
Acid–Base Imbalances, 779
Respiratory Acidosis, 779
Etiology and Pathophysiology, 779
Clinical Manifestations, 780
Collaborative Care, 780
Nursing Management, 780
Respiratory Alkalosis, 782
Nursing Management, 782
Metabolic Acidosis, 783
Etiology and Pathophysiology, 783
Clinical Manifestations, 783
Collaborative Care, 784
Nursing Management, 784
Metabolic Alkalosis, 785
Nursing Management, 785
Mixed Acid–Base Imbalances, 785
Chapter 24. Alterations in Eye, Ear, Nose, and Throat Function, 788
Anatomy and Physiology, 789
Eye, 789
Ear, 789
Nose, Throat, and Mouth, 790
Pediatric Differences, 790
Eye, 790
Ear, 791
Nose, Throat, and Mouth, 791
Disorders of the Eye, 791
Infectious Conjunctivitis, 791
Ophthalmia Neonatorum, 792
Additional Neonate Eye Conditions, 792
Bacterial Conjunctivitis, 792
Viral Conjunctivitis, 793
Allergic Conjunctivitis, 793
Collaborative Care, 793
Nursing Management, 794
Periorbital Cellulitis, 795
Visual Disorders, 795
Etiology and Pathophysiology, 795
Clinical Manifestations, 797
Collaborative Care, 798
Diagnostic Tests, 798
Clinical Therapy, 798
Nursing Management, 799
Color Blindness, 799
Retinopathy of Prematurity, 800
Etiology and Pathophysiology, 800
Clinical Manifestations, 801
Collaborative Care, 801
Diagnostic Tests, 801
Clinical Therapy, 801
Nursing Management, 802
Visual Impairment, 804
Collaborative Care, 805
Nursing Management, 805
Injuries of the Eye, 808
Nursing Management, 808
Disorders of the Ear, 809
Otitis Media, 809
Etiology and Pathophysiology, 809
Clinical Manifestations, 810
Collaborative Care, 810
Diagnostic Tests, 810
Clinical Therapy, 811
Nursing Management, 813
Otitis Externa, 814
Hearing Impairment, 816
Etiology and Pathophysiology, 816
Clinical Manifestations, 817
Collaborative Care, 818
Diagnostic Tests, 818
Clinical Therapy, 819
Nursing Management, 820
Injuries of the Ear, 825
Disorders of the Nose and Throat, 825
Epistaxis, 825
Nursing Management, 826
Nasopharyngitis, 826
Nursing Management, 826
Sinusitis, 828
Pharyngitis, 829
Collaborative Care, 829
Nursing Management, 830
Tonsillitis and Adenoiditis, 830
Etiology and Pathophysiology, 830
Clinical Manifestations, 830
Collaborative Care, 830
Diagnostic Tests, 830
Clinical Therapy, 830
Nursing Management, 831
Disorders of the Mouth, 832
Mouth Ulcers, 832
Collaborative Care, 832
Diagnostic Tests, 832
Clinical Therapy, 832
Nursing Management, 832
Mouth and Dental Emergencies, 833
Chapter 25. Alterations in Respiratory Function, 838
Anatomy and Physiology, 839
Pediatric Differences, 840
Upper Airway Differences, 840
Lower Airway Differences, 841
Respiratory Assessment, 842
Respiratory Distress and Respiratory Failure, 842
Foreign Body Aspiration, 842
Etiology and Pathophysiology, 842
Clinical Manifestations, 843
Collaborative Care, 843
Diagnostic Tests, 844
Clinical Therapy, 844
Nursing Management, 844
Respiratory Failure and Acute Respiratory Distress Syndrome, 846
Etiology and Pathophysiology, 846
Clinical Manifestations, 846
Collaborative Care, 847
Diagnostic Tests, 847
Clinical Therapy, 847
Nursing Management, 848
Apnea, 849
Apnea of Prematurity, 850
Nursing Management, 850
Apparent Life-Threatening Event (ALTE), 850
Etiology and Pathophysiology, 850
Clinical Manifestations, 850
Collaborative Care, 851
Diagnostic Tests, 851
Clinical Therapy, 851
Nursing Management, 851
Obstructive Sleep Apnea, 852
Etiology and Pathophysiology, 853
Clinical Manifestations, 853
Collaborative Care, 853
Diagnostic Tests, 853
Clinical Therapy, 853
Nursing Management, 854
Sudden Infant Death Syndrome, 854
Etiology and Pathophysiology, 855
Clinical Manifestations, 855
Collaborative Care, 855
Nursing Management, 855
Croup Syndromes, 856
Laryngotracheobronchitis, 856
Etiology and Pathophysiology, 857
Clinical Manifestations, 857
Collaborative Care, 857
Diagnostic Procedures, 857
Clinical Therapy, 857
Nursing Management, 858
Epiglottitis (Supraglottitis), 860
Etiology and Pathophysiology, 860
Clinical Manifestations, 860
Collaborative Care, 860
Diagnostic Procedures, 860
Clinical Therapy, 860
Nursing Management, 860
Bacterial Tracheitis, 861
Nursing Management, 861
Lower Airway Disorders, 861
Neonatal Respiratory Distress Syndrome, 861
Etiology and Pathophysiology, 862
Clinical Manifestations, 862
Collaborative Care, 862
Diagnostic Procedures, 862
Clinical Therapy, 862
Nursing Management, 862
Meconium Aspiration Syndrome, 863
Etiology and Pathophysiology, 863
Clinical Manifestations, 863
Collaborative Care, 863
Diagnostic Procedures, 863
Clinical Therapy, 863
Nursing Management, 863
Transient Tachypnea of the Newborn, 863
Nursing Management, 864
Bronchitis, 864
Nursing Management, 864
Bronchiolitis and Respiratory Syncytial Virus, 864
Etiology and Pathophysiology, 864
Clinical Manifestations, 864
Collaborative Care, 865
Diagnostic Procedures, 865
Clinical Therapy, 865
Nursing Management, 865
Pneumonia, 866
Etiology and Pathophysiology, 868
Clinical Manifestations, 869
Collaborative Care, 869
Diagnostic Procedures, 869
Clinical Therapy, 869
Nursing Management, 869
Tuberculosis, 870
Etiology and Pathophysiology, 871
Clinical Manifestations, 871
Collaborative Care, 871
Diagnostic Procedures, 871
Clinical Therapy, 872
Nursing Management, 873
Chronic Lung Diseases, 874
Bronchopulmonary Dysplasia (Chronic Lung Disease), 874
Etiology and Pathophysiology, 874
Clinical Manifestations, 875
Collaborative Care, 875
Diagnostic Procedures, 875
Clinical Therapy, 875
Nursing Management, 875
Asthma, 878
Etiology and Pathophysiology, 878
Clinical Manifestations, 879
Collaborative Care, 879
Diagnostic Procedures, 879
Clinical Therapy, 881
Nursing Management, 884
Status Asthmaticus, 892
Cystic Fibrosis, 892
Etiology and Pathophysiology, 894
Clinical Manifestations, 895
Collaborative Care, 895
Diagnostic Procedures, 895
Clinical Therapy, 896
Nursing Management, 898
Injuries of the Respiratory System, 902
Smoke Inhalation Injury, 903
Etiology and Pathophysiology, 903
Clinical Manifestations, 903
Collaborative Care, 903
Nursing Management, 903
Blunt Chest Trauma, 904
Pulmonary Contusion, 904
Nursing Management, 904
Pneumothorax, 904
Etiology and Pathophysiology, 904
Clinical Manifestations, 905
Collaborative Care, 905
Nursing Management, 906
Chapter 26. Alterations in Cardiovascular Function, 911
Anatomy and Physiology, 912
Pediatric Differences, 912
Fetal Circulation, 912
Transition from Fetal to Pulmonary Circulation, 913
Heart Hemodynamics, 914
Cardiovascular Changes as the Child Grows, 914
Oxygenation, 916
Cardiac Functioning, 916
Cardiac Assessment, 916
Congenital Heart Disease, 916
Etiology and Pathophysiology, 916
Clinical Manifestations, 918
Collaborative Care, 919
Diagnostic Procedures, 919
Clinical Therapy, 919
Nursing Management of the Child Undergoing a Cardiac Catheterization, 921
Congenital Heart Defects That Increase Pulmonary Blood Flow, 923
Etiology and Pathophysiology, 923
Clinical Manifestations, 923
Collaborative Care, 923
Diagnostic Procedures, 923
Clinical Therapy, 923
Nursing Management Prior to Surgery, 926
Nursing Management at the Time of Surgery, 927
Defects Causing Decreased Pulmonary Blood Flow and Mixed Defects, 929
Etiology and Pathophysiology, 929
Defects Causing Decreased Pulmonary Blood Flow, 929
Mixed Defects, 930
Clinical Manifestations, 930
Defects Causing Decreased Pulmonary Blood Flow, 930
Mixed Defects, 931
Collaborative Care, 931
Diagnostic Procedures, 931
Clinical Therapy, 931
Nursing Management, 936
Defects Obstructing Systemic Blood Flow, 939
Etiology and Pathophysiology, 939
Clinical Manifestations, 939
Collaborative Care, 939
Nursing Management, 939
Congestive Heart Failure, 943
Etiology and Pathophysiology, 943
Clinical Manifestations, 943
Collaborative Care, 944
Diagnostic Procedures, 944
Clinical Therapy, 944
Nursing Management, 944
Cardiomyopathy, 950
Dilated Cardiomyopathy, 950
Hypertrophic Cardiomyopathy, 950
Nursing Management, 952
Heart Transplantation, 952
Nursing Management, 953
Pulmonary Artery Hypertension, 953
Etiology and Pathophysiology, 953
Clinical Manifestations, 953
Collaborative Care, 953
Nursing Management, 953
Acquired Heart Diseases, 954
Infective Endocarditis, 954
Etiology and Pathophysiology, 954
Clinical Manifestations, 954
Collaborative Care, 954
Diagnostic Procedures, 954
Clinical Therapy, 954
Nursing Management, 955
Rheumatic Fever, 956
Clinical Manifestations, 956
Collaborative Care, 956
Diagnostic Procedures, 956
Clinical Therapy, 956
Nursing Management, 957
Kawasaki Disease, 957
Etiology and Pathophysiology, 957
Clinical Manifestations, 957
Collaborative Care, 958
Diagnostic Procedures, 958
Clinical Therapy, 958
Nursing Management, 958
Cardiac Arrhythmias, 959
Etiology and Pathophysiology, 959
Clinical Manifestations, 960
Bradycardias, 960
Tachycardias, 960
Collaborative Care, 960
Diagnostic Procedures, 960
Clinical Therapy, 960
Nursing Management, 960
Long QT Syndrome, 963
Nursing Management, 964
Dyslipidemia, 964
Epidemiology and Pathophysiology, 964
Clinical Manifestations, 964
Collaborative Care, 964
Diagnostic Tests, 964
Clinical Therapy, 965
Nursing Management, 965
Hypertension, 966
Etiology and Pathophysiology, 966
Clinical Manifestations, 966
Collaborative Care, 966
Diagnostic Procedures, 966
Clinical Therapy, 967
Nursing Management, 967
Injuries of the Cardiovascular System, 969
Hypovolemic Shock, 969
Etiology and Pathophysiology, 969
Clinical Manifestations, 969
Collaborative Care, 970
Diagnostic Procedures, 970
Clinical Therapy, 971
Nursing Management, 971
Distributive Shock, 972
Septic Shock, 973
Obstructive Shock, 974
Cardiogenic Shock, 974
Myocardial Contusion, 974
Commotio Cordis, 975
Chapter 27. Alterations in Immune Function, 980
Anatomy and Physiology, 981
Pediatric Differences, 983
Immunodeficiency Disorders, 984
B-Cell and T-Cell Disorders, 985
Severe Combined Immunodeficiency Disease, 985
Etiology and Pathophysiology, 985
Clinical Manifestations, 986
Collaborative Care, 986
Diagnostic Tests, 986
Clinical Therapy, 986
Nursing Management, 986
Wiskott-Aldrich Syndrome, 988
Nursing Management, 988
Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome, 989
Etiology and Pathophysiology, 989
Clinical Manifestations, 989
Collaborative Care, 992
Diagnostic Tests, 992
Clinical Therapy, 992
Medication Therapy, 992
Nursing Management, 993
Autoimmune Disorders, 1002
Systemic Lupus Erythematosus, 1002
Etiology and Pathophysiology, 1002
Clinical Manifestations, 1003
Collaborative Care, 1004
Diagnostic Tests, 1004
Clinical Therapy, 1004
Nursing Management, 1004
Juvenile Arthritis, 1008
Etiology and Pathophysiology, 1008
Clinical Manifestations, 1009
Collaborative Care, 1009
Diagnostic Tests, 1009
Clinical Therapy, 1009
Nursing Management, 1009
Allergic Reactions, 1012
Collaborative Care, 1014
Nursing Management, 1014
Anaphylaxis, 1015
Etiology and Pathophysiology, 1015
Clinical Manifestations, 1015
Collaborative Care, 1015
Nursing Management, 1016
Food Allergy, 1017
Collaborative Care, 1018
Nursing Management, 1018
Latex Allergy, 1019
Collaborative Care, 1019
Nursing Management, 1019
Graft-Versus-Host Disease, 1019
Etiology and Pathophysiology, 1019
Clinical Manifestations, 1021
Collaborative Care, 1021
Diagnostic Tests, 1021
Clinical Therapy, 1021
Nursing Management, 1021
Chapter 28. Alterations in Hematologic Function, 1026
Anatomy and Physiology, 1027
Red Blood Cells, 1027
White Blood Cells, 1028
Platelets, 1028
Pediatric Differences, 1028
Anemia, 1030
Iron Deficiency Anemia, 1030
Etiology and Pathophysiology, 1030
Clinical Manifestations, 1031
Collaborative Care, 1031
Diagnostic Tests, 1031
Clinical Therapy, 1031
Nursing Management, 1032
Normocytic Anemia, 1033
Collaborative Care, 1033
Nursing Management, 1033
Sickle Cell Disease, 1033
Etiology and Pathophysiology, 1033
Clinical Manifestations, 1038
Collaborative Care, 1039
Diagnostic Tests, 1039
Clinical Therapy, 1040
Nursing Management, 1041
Thalassemias, 1047
Etiology and Pathophysiology, 1048
Clinical Manifestations, 1048
Collaborative Care, 1049
Diagnostic Tests, 1049
Clinical Therapy, 1049
Nursing Management, 1049
Hereditary Spherocytosis, 1050
Aplastic Anemia, 1050
Etiology and Pathophysiology, 1050
Clinical Manifestations, 1051
Collaborative Care, 1051
Diagnostic Tests, 1051
Clinical Therapy, 1051
Nursing Management, 1051
Bleeding Disorders, 1051
Hemophilia, 1052
Etiology and Pathophysiology, 1052
Clinical Manifestations, 1052
Collaborative Care, 1052
Diagnostic Tests, 1052
Clinical Therapy, 1052
Nursing Management, 1053
Von Willebrand Disease, 1055
Collaborative Care, 1056
Nursing Management, 1056
Disseminated Intravascular Coagulation, 1056
Etiology and Pathophysiology, 1056
Clinical Manifestations, 1056
Collaborative Care, 1056
Diagnostic Tests, 1056
Clinical Therapy, 1056
Nursing Management, 1056
Idiopathic Thrombocytopenic Purpura, 1057
Collaborative Care, 1058
Nursing Management, 1058
Henoch-Schönlein Purpura, 1058
Collaborative Care, 1058
Nursing Management, 1059
Meningococcemia, 1059
Etiology and Pathophysiology, 1059
Clinical Manifestations, 1059
Collaborative Care, 1059
Diagnostic Tests, 1059
Clinical Therapy, 1059
Nursing Management, 1060
Hematopoietic Stem Cell Transplantation (HSCT), 1060
Collaborative Care, 1060
Clinical Therapy, 1060
Nursing Management, 1061
Chapter 29. Alterations in Cellular Growth, 1066
Anatomy and Physiology, 1067
Pediatric Differences, 1067
Childhood Cancer, 1068
Etiology and Pathophysiology, 1070
External Stimuli, 1070
Immune System and Gene Abnormalities, 1070
Chromosomal Abnormalities, 1071
Clinical Manifestations, 1071
Collaborative Care, 1072
Diagnostic Tests, 1072
Clinical Therapy, 1073
Special Issues in Childhood Cancer, 1080
Nursing Management, 1082
Solid Tumors, 1099
Brain Tumors, 1099
Etiology and Pathophysiology, 1099
Clinical Manifestations, 1099
Collaborative Care, 1101
Diagnostic Tests, 1101
Clinical Therapy, 1102
Nursing Management, 1103
Neuroblastoma, 1104
Etiology and Pathophysiology, 1104
Clinical Manifestations, 1105
Collaborative Care, 1105
Diagnostic Tests, 1105
Clinical Therapy, 1105
Nursing Management, 1106
Wilms Tumor (Nephroblastoma), 1106
Etiology and Pathophysiology, 1106
Clinical Manifestations, 1107
Collaborative Care, 1107
Diagnostic Tests, 1107
Clinical Therapy, 1107
Nursing Management, 1107
Bone Tumors, 1108
Osteosarcoma (or Osteogenic Sarcoma), 1108
Collaborative Care, 1109
Diagnostic Tests, 1109
Clinical Therapy, 1109
Ewing Sarcoma, 1109
Nursing Management, 1110
Leukemia, 1111
Etiology and Pathophysiology, 1111
Clinical Manifestations, 1112
Collaborative Care, 1112
Diagnostic Tests, 1112
Clinical Therapy, 1112
Nursing Management, 1113
Soft Tissue Tumors, 1115
Hodgkin Disease, 1115
Collaborative Care, 1115
Non-Hodgkin Lymphoma, 1116
Collaborative Care, 1116
Rhabdomyosarcoma, 1117
Collaborative Care, 1117
Retinoblastoma, 1118
Collaborative Care, 1118
Nursing Management, 1118
Chapter 30. Alterations in Gastrointestinal Function, 1125
Anatomy and Physiology, 1126
Esophagus and Stomach, 1126
Pancreas, 1126
Liver and Gallbladder, 1126
Spleen, 1127
Small and Large Intestine, 1127
Pediatric Differences, 1127
Structural Defects, 1127
Cleft Lip and Cleft Palate, 1128
Etiology and Pathophysiology, 1128
Clinical Manifestations, 1128
Collaborative Care, 1130
Diagnostic Tests, 1130
Clinical Therapy, 1130
Nursing Management, 1131
Esophageal Atresia and Tracheoesophageal Fistula, 1138
Etiology and Pathophysiology, 1138
Clinical Manifestations, 1138
Collaborative Care, 1139
Diagnostic Tests, 1139
Clinical Therapy, 1139
Nursing Management, 1139
Pyloric Stenosis, 1140
Etiology and Pathophysiology, 1140
Clinical Manifestations, 1140
Collaborative Care, 1140
Diagnostic Tests, 1140
Clinical Therapy, 1141
Nursing Management, 1141
Gastroesophageal Reflux and Gastroesophageal Reflux Disease, 1143
Etiology and Pathophysiology, 1143
Clinical Manifestations, 1143
Collaborative Care, 1144
Diagnostic Tests, 1144
Clinical Therapy, 1144
Nursing Management, 1145
Abdominal Wall Defects, 1146
Omphalocele, 1146
Gastroschisis, 1146
Collaborative Care, 1147
Diagnostic Tests, 1147
Clinical Therapy, 1147
Nursing Management, 1147
Intussusception, 1148
Etiology and Pathophysiology, 1148
Clinical Manifestations, 1148
Collaborative Care, 1149
Diagnostic Tests, 1149
Clinical Therapy, 1149
Nursing Management, 1149
Volvulus, 1149
Nursing Management, 1149
Hirschsprung Disease, 1150
Etiology and Pathophysiology, 1150
Clinical Manifestations, 1150
Collaborative Care, 1150
Diagnostic Tests, 1150
Clinical Therapy, 1150
Nursing Management, 1150
Anorectal Malformations, 1151
Collaborative Care, 1151
Diagnostic Tests, 1152
Clinical Therapy, 1152
Nursing Management, 1152
Hernias, 1153
Congenital Diaphragmatic Hernia, 1153
Etiology and Pathophysiology, 1153
Clinical Manifestations, 1153
Collaborative Care, 1153
Diagnostic Tests, 1153
Clinical Therapy, 1153
Nursing Management, 1154
Umbilical Hernia, 1154
Ostomies, 1155
Nursing Management, 1155
Inflammatory Disorders, 1156
Appendicitis, 1157
Etiology and Pathophysiology, 1157
Clinical Manifestations, 1157
Collaborative Care, 1157
Diagnostic Tests, 1157
Clinical Therapy, 1158
Nursing Management, 1158
Necrotizing Enterocolitis, 1160
Etiology and Pathophysiology, 1160
Clinical Manifestations, 1160
Collaborative Care, 1160
Diagnostic Tests, 1161
Clinical Therapy, 1161
Nursing Management, 1161
Meckel’s Diverticulum, 1162
Collaborative Care, 1162
Nursing Management, 1162
Recurrent Abdominal Pain, 1162
Nursing Management, 1162
Inflammatory Bowel Disease, 1162
Etiology and Pathophysiology, 1162
Clinical Manifestations, 1163
Collaborative Care, 1163
Diagnostic Tests, 1163
Clinical Therapy, 1163
Nursing Management, 1165
Peptic Ulcer, 1166
Etiology and Pathophysiology, 1166
Clinical Manifestations, 1166
Collaborative Care, 1166
Diagnostic Tests, 1166
Clinical Therapy, 1166
Nursing Management, 1166
Disorders of Motility, 1167
Gastroenteritis (Acute Diarrhea), 1167
Etiology and Pathophysiology, 1167
Clinical Manifestations, 1167
Collaborative Care, 1167
Diagnostic Tests, 1167
Clinical Therapy, 1168
Nursing Management, 1168
Constipation, 1171
Etiology and Pathophysiology, 1171
Clinical Manifestations, 1172
Collaborative Care, 1172
Diagnostic Tests, 1172
Clinical Therapy, 1172
Nursing Management, 1173
Encopresis, 1173
Nursing Management, 1174
Intestinal Parasitic Disorders, 1174
Nursing Management, 1174
Feeding Disorders, 1174
Colic, 1174
Etiology and Pathophysiology, 1176
Clinical Manifestations, 1176
Clinical Therapy, 1176
Nursing Management, 1176
Rumination, 1178
Nursing Management, 1178
Disorders of Malabsorption, 1178
Celiac Disease, 1178
Etiology and Pathophysiology, 1178
Clinical Manifestations, 1179
Collaborative Care, 1179
Diagnostic Tests, 1179
Clinical Therapy, 1179
Nursing Management, 1180
Lactose Intolerance, 1181
Nursing Management, 1181
Short Bowel Syndrome, 1181
Nursing Management, 1181
Hepatic Disorders, 1182
Hyperbilirubinemia of the Newborn, 1182
Etiology and Pathophysiology, 1182
Clinical Manifestations, 1182
Diagnostic Tests, 1182
Clinical Therapy, 1182
Nursing Management, 1182
Biliary Atresia, 1184
Etiology and Pathophysiology, 1184
Clinical Manifestations, 1184
Collaborative Care, 1184
Diagnostic Tests, 1184
Clinical Therapy, 1184
Nursing Management, 1185
Viral Hepatitis, 1185
Etiology and Pathophysiology, 1185
Clinical Manifestations, 1186
Collaborative Care, 1187
Diagnostic Tests, 1187
Clinical Therapy, 1187
Nursing Management, 1188
Cirrhosis, 1189
Nursing Management, 1189
Injuries to the Gastrointestinal System, 1189
Abdominal Trauma, 1189
Etiology and Pathophysiology, 1190
Clinical Manifestations, 1190
Collaborative Care, 1190
Diagnostic Tests, 1190
Clinical Therapy, 1190
Nursing Management, 1190
Chapter 31. Alterations in Genitourinary Function, 1196
Anatomy and Physiology, 1197
Pediatric Differences, 1198
Urinary System, 1198
Reproductive System, 1199
Urinary Tract Infection, 1200
Etiology and Pathophysiology, 1200
Clinical Manifestations, 1200
Collaborative Care, 1201
Diagnostic Tests, 1201
Clinical Therapy, 1201
Nursing Management, 1202
Structural Defects of the Urinary System, 1203
Bladder Exstrophy, 1203
Etiology and Pathophysiology, 1203
Clinical Manifestations, 1203
Collaborative Care, 1203
Diagnostic Tests, 1204
Clinical Therapy, 1204
Nursing Management, 1204
Hypospadias and Epispadias, 1205
Etiology and Pathophysiology, 1205
Clinical Manifestations, 1206
Collaborative Care, 1206
Diagnostic Tests, 1206
Clinical Therapy, 1206
Nursing Management, 1206
Obstructive Uropathy, 1207
Etiology and Pathophysiology, 1207
Clinical Manifestations, 1208
Collaborative Care, 1208
Diagnostic Tests, 1208
Clinical Therapy, 1209
Nursing Management, 1209
Vesicoureteral Reflux, 1210
Nursing Management, 1210
Prune-Belly Syndrome, 1210
Nursing Management, 1211
Disorders Affecting Urinary Elimination, 1211
Enuresis, 1211
Etiology and Pathophysiology, 1211
Clinical Manifestations, 1212
Collaborative Care, 1212
Diagnostic Tests, 1212
Clinical Therapy, 1212
Nursing Management, 1213
Renal Disorders, 1213
Nephrotic Syndrome, 1213
Etiology and Pathophysiology, 1215
Clinical Manifestations, 1215
Collaborative Care, 1215
Diagnostic Tests, 1215
Clinical Therapy, 1215
Nursing Management, 1217
Acute Postinfectious Glomerulonephritis, 1219
Etiology and Pathophysiology, 1219
Clinical Manifestations, 1219
Collaborative Care, 1220
Diagnostic Tests, 1220
Clinical Therapy, 1221
Nursing Management, 1221
Hemolytic Uremic Syndrome, 1223
Etiology and Pathophysiology, 1223
Clinical Manifestations, 1224
Collaborative Care, 1224
Diagnostic Tests, 1224
Clinical Therapy, 1224
Nursing Management, 1224
Polycystic Kidney Disease, 1225
Etiology and Pathophysiology, 1225
Clinical Manifestations, 1225
Collaborative Care, 1225
Diagnostic Tests, 1225
Clinical Therapy, 1225
Nursing Management, 1225
Renal Failure, 1226
Acute Renal Failure, 1226
Collaborative Care, 1226
Diagnostic Tests, 1226
Clinical Therapy, 1226
Nursing Management, 1229
Chronic Renal Failure, 1231
Collaborative Care, 1231
Diagnostic Tests, 1231
Clinical Therapy, 1231
Nursing Management, 1232
Renal Replacement Therapy, 1236
Peritoneal Dialysis, 1236
Nursing Management, 1238
Hemodialysis, 1239
Nursing Management, 1239
Continuous Renal Replacement Therapy, 1239
Nursing Management, 1240
Kidney Transplantation, 1240
Nursing Management, 1241
Structural Defects of the Reproductive System, 1241
Phimosis, 1241
Collaborative Care, 1241
Nursing Management, 1242
Cryptorchidism, 1242
Etiology and Pathophysiology, 1242
Clinical Manifestations, 1242
Collaborative Care, 1242
Diagnostic Tests, 1242
Clinical Therapy, 1242
Nursing Management, 1243
Inguinal Hernia and Hydrocele, 1243
Etiology and Pathophysiology, 1243
Clinical Manifestations, 1243
Collaborative Care, 1244
Diagnostic Tests, 1244
Clinical Therapy, 1244
Nursing Management, 1244
Testicular Torsion, 1244
Etiology and Pathophysiology, 1244
Clinical Manifestations, 1245
Collaborative Care, 1245
Diagnostic Tests, 1245
Clinical Therapy, 1245
Nursing Management, 1245
Sexually Transmitted Infections, 1245
Nursing Management, 1246
Pelvic Inflammatory Disease, 1249
Etiology and Pathophysiology, 1249
Clinical Manifestations, 1249
Collaborative Care, 1249
Diagnostic Tests, 1249
Clinical Therapy, 1250
Nursing Management, 1250
Chapter 32. Alterations in Endocrine and Metabolic Function, 1255
Anatomy and Physiology, 1256
Pediatric Differences, 1257
Disorders of Pituitary Function, 1258
Growth Hormone Deficiency, 1259
Etiology and Pathophysiology, 1259
Clinical Manifestations, 1260
Collaborative Care, 1260
Diagnostic Tests, 1260
Clinical Therapy, 1261
Nursing Management, 1262
Growth Hormone Excess (Hyperpituitarism), 1263
Nursing Management, 1263
Diabetes Insipidus, 1263
Etiology and Pathophysiology, 1263
Clinical Manifestations, 1263
Collaborative Care, 1264
Diagnostic Tests, 1264
Clinical Therapy, 1264
Nursing Management, 1265
Syndrome of Inappropriate Antidiuretic Hormone, 1265
Etiology and Pathophysiology, 1266
Clinical Manifestations, 1266
Collaborative Care, 1266
Diagnostic Tests, 1266
Clinical Therapy, 1266
Nursing Management, 1266
Precocious Puberty, 1266
Etiology and Pathophysiology, 1267
Clinical Manifestations, 1267
Collaborative Care, 1267
Diagnostic Tests, 1267
Clinical Therapy, 1267
Nursing Management, 1267
Disorders of Thyroid Function, 1268
Hypothyroidism, 1268
Etiology and Pathophysiology, 1268
Clinical Manifestations, 1268
Collaborative Care, 1269
Diagnostic Tests, 1269
Clinical Therapy, 1269
Nursing Management, 1270
Hyperthyroidism, 1270
Etiology and Pathophysiology, 1270
Clinical Manifestations, 1271
Collaborative Care, 1271
Diagnostic Tests, 1271
Clinical Therapy, 1272
Nursing Management, 1272
Disorders of the Parathyroid, 1273
Hyperparathyroidism, 1274
Collaborative Care, 1274
Nursing Management, 1274
Hypoparathyroidism, 1274
Collaborative Care, 1274
Nursing Management, 1274
Disorders of Adrenal Function, 1275
Cushing Disease, 1275
Etiology and Pathophysiology, 1275
Clinical Manifestations, 1275
Collaborative Care, 1275
Diagnostic Tests, 1275
Clinical Therapy, 1275
Nursing Management, 1276
Congenital Adrenal Hyperplasia, 1276
Etiology and Pathophysiology, 1276
Clinical Manifestations, 1277
Collaborative Care, 1277
Diagnostic Tests, 1277
Clinical Therapy, 1277
Nursing Management, 1278
Adrenal Insufficiency (Addison Disease), 1278
Etiology and Pathophysiology, 1279
Clinical Manifestations, 1279
Collaborative Care, 1279
Diagnostic Tests, 1279
Clinical Therapy, 1279
Nursing Management, 1279
Pheochromocytoma, 1280
Collaborative Care, 1280
Nursing Management, 1280
Disorders of Pancreatic Function, 1280
Diabetes Mellitus, 1281
Type 1 Diabetes, 1281
Collaborative Care, 1284
Diagnostic Tests, 1284
Clinical Therapy, 1284
Nursing Management, 1287
Diabetic Ketoacidosis, 1292
Collaborative Care, 1295
Diagnostic Tests, 1297
Clinical Therapy, 1297
Nursing Management, 1297
Hypoglycemia in the Child with Diabetes, 1299
Nursing Management, 1300
Type 2 Diabetes, 1300
Collaborative Care, 1302
Diagnostic Tests, 1302
Clinical Therapy, 1302
Nursing Management, 1303
Disorders of Gonadal Function, 1304
Gynecomastia, 1304
Nursing Management, 1304
Amenorrhea, 1304
Collaborative Care, 1304
Nursing Management, 1305
Dysmenorrhea, 1305
Nursing Management, 1305
Disorders Related to Sex Chromosome Abnormalities, 1305
Turner Syndrome, 1305
Clinical Manifestations, 1305
Collaborative Care, 1306
Nursing Management, 1306
Klinefelter Syndrome, 1306
Clinical Manifestations, 1307
Collaborative Care, 1307
Nursing Management, 1307
Inborn Errors of Metabolism, 1307
Phenylketonuria, 1307
Etiology and Pathophysiology, 1307
Clinical Manifestations, 1308
Collaborative Care, 1308
Clinical Therapy, 1308
Nursing Management, 1308
Galactosemia, 1309
Collaborative Care, 1309
Nursing Management, 1309
Defects in Fatty Acid Oxidation, 1309
Nursing Management, 1309
Maple Syrup Urine Disease, 1310
Collaborative Care, 1310
Nursing Management, 1310
Chapter 33. Alterations in Neurological Function, 1315
Anatomy and Physiology, 1316
Pediatric Differences, 1317
Neurological Assessment, 1319
Altered States of Consciousness, 1319
Etiology and Pathophysiology, 1320
Clinical Manifestations, 1320
Collaborative Care, 1320
Diagnostic Tests, 1320
Clinical Therapy, 1321
Nursing Management, 1322
Seizure Disorders, 1324
Etiology and Pathophysiology, 1324
Clinical Manifestations, 1325
Collaborative Care, 1327
Diagnostic Testing, 1327
Clinical Therapy, 1327
Nursing Management, 1328
Infectious Diseases, 1333
Bacterial Meningitis, 1333
Etiology and Pathophysiology, 1334
Clinical Manifestations, 1335
Collaborative Care, 1335
Diagnostic Testing, 1335
Clinical Therapy, 1336
Nursing Management, 1336
Viral (Aseptic) Meningitis, 1339
Nursing Management, 1340
Encephalitis, 1340
Nursing Management, 1340
Reye Syndrome, 1341
Nursing Management, 1341
Guillain-Barré Syndrome (Postinfectious Polyneuritis), 1342
Collaborative Care, 1342
Nursing Management, 1342
Headaches, 1343
Collaborative Care, 1343
Nursing Management, 1344
Structural Defects, 1345
Microcephaly, 1345
Hydrocephalus, 1345
Etiology and Pathophysiology, 1345
Clinical Manifestations, 1345
Collaborative Care, 1346
Diagnostic Testing, 1346
Clinical Therapy, 1346
Nursing Management, 1348
Neural Tube Defects, 1349
Myelodysplasia or Spina Bifida, 1349
Collaborative Care, 1351
Diagnostic Testing, 1351
Clinical Therapy, 1351
Nursing Management, 1352
Craniosynostosis, 1355
Positional Plagiocephaly, 1356
Neurofibromatosis, 1357
Etiology and Pathophysiology, 1357
Clinical Manifestations, 1357
Collaborative Care, 1357
Diagnostic Testing, 1357
Clinical Therapy, 1358
Nursing Management, 1358
Cerebral Palsy, 1358
Etiology and Pathophysiology, 1359
Clinical Manifestations, 1359
Collaborative Care, 1359
Diagnostic Testing, 1360
Clinical Therapy, 1360
Nursing Management, 1361
Neonatal Abstinence Syndrome, 1366
Etiology and Pathophysiology, 1366
Clinical Manifestations, 1366
Collaborative Care, 1366
Diagnostic Testing, 1366
Clinical Therapy, 1366
Nursing Management, 1367
Injuries of the Neurological System, 1368
Traumatic Brain Injury, 1368
Etiology and Pathophysiology, 1368
Clinical Manifestations, 1369
Collaborative Care, 1370
Diagnostic Testing, 1370
Clinical Therapy, 1372
Nursing Management, 1374
Specific Head Injuries, 1377
Scalp Injuries, 1377
Concussion, 1377
Skull Fractures, 1378
Penetrating Injuries, 1378
Spinal Cord Injury, 1379
Etiology and Pathophysiology, 1379
Clinical Manifestations, 1380
Collaborative Care, 1380
Diagnostic Testing, 1380
Clinical Therapy, 1380
Nursing Management, 1381
Hypoxic-Ischemic Brain Injury (Drowning), 1382
Etiology and Pathophysiology, 1382
Clinical Manifestations, 1383
Collaborative Care, 1383
Diagnostic Testing, 1383
Clinical Therapy, 1383
Nursing Management, 1383
Chapter 34. Alterations in Mental Health and Cognition, 1390
Mental Health and Cognition, 1391
Pediatric Differences, 1391
Mental Health Alterations, 1392
Etiology and Pathophysiology, 1392
Clinical Manifestations, 1392
Collaborative Care, 1392
Diagnostic Testing, 1392
Clinical Therapy, 1393
Nursing Management, 1396
Developmental and Behavioral Disorders, 1398
Pervasive Developmental Disorders, 1398
Etiology and Pathophysiology, 1399
Clinical Manifestations, 1399
Collaborative Care, 1400
Diagnostic Tests, 1400
Clinical Therapy, 1401
Nursing Management, 1402
Attention Deficit Disorder and Attention Deficit/Hyperactivity Disorder, 1404
Etiology and Pathophysiology, 1404
Clinical Manifestations, 1404
Collaborative Care, 1405
Diagnostic Tests, 1406
Clinical Therapy, 1406
Nursing Management, 1407
Mood Disorders, 1410
Depression, 1410
Etiology and Pathophysiology, 1411
Clinical Manifestations, 1411
Collaborative Care, 1411
Diagnostic Tests, 1411
Clinical Therapy, 1411
Nursing Management, 1413
Bipolar Disorder (Manic Depression), 1415
Collaborative Care, 1416
Diagnostic Tests, 1416
Clinical Therapy, 1416
Nursing Management, 1416
Anxiety and Related Disorders, 1416
Generalized Anxiety Disorder, 1416
Separation Anxiety Disorder, 1417
Panic Disorder, 1417
Obsessive-Compulsive Disorder, 1417
Social Phobia or School Phobia, 1418
Conversion Reaction, 1418
Posttraumatic Stress Disorder, 1418
Etiology and Pathophysiology, 1418
Clinical Manifestations, 1419
Collaborative Care, 1419
Diagnostic Tests, 1419
Clinical Therapy, 1419
Nursing Management, 1419
Suicide, 1420
Nursing Management, 1422
TIC Disorders and Tourette Syndrome, 1423
Trichotillomania, 1423
Schizophrenia, 1424
Nursing Management, 1424
Cognitive Disorders, 1425
Learning Disabilities, 1425
Mental Retardation, 1425
Etiology and Pathophysiology, 1425
Clinical Manifestations, 1427
Collaborative Care, 1427
Diagnostic Tests, 1427
Clinical Therapy, 1428
Nursing Management, 1428
Chapter 35. Alterations in Musculoskeletal Function, 1436
Anatomy and Physiology, 1437
Pediatric Differences, 1438
Bones, 1438
Muscles, Tendons, and Ligaments, 1438
Disorders of the Feet and Legs, 1438
Metatarsus Adductus, 1438
Nursing Management, 1442
Clubfoot, 1442
Etiology and Pathophysiology, 1442
Clinical Manifestations, 1442
Collaborative Care, 1443
Diagnostic Tests, 1443
Clinical Therapy, 1443
Nursing Management, 1445
Genu Varum and Genu Valgum, 1446
Nursing Management, 1447
Disorders of the Hip, 1447
Developmental Dysplasia of the Hip, 1447
Etiology and Pathophysiology, 1447
Clinical Manifestations, 1448
Collaborative Care, 1448
Diagnostic Tests, 1448
Clinical Therapy, 1448
Nursing Management, 1449
Legg-Calvé-Perthes Disease, 1451
Etiology and Pathophysiology, 1451
Clinical Manifestations, 1452
Collaborative Care, 1452
Diagnostic Tests, 1452
Clinical Therapy, 1452
Nursing Management, 1452
Slipped Capital Femoral Epiphysis, 1453
Etiology and Pathophysiology, 1453
Clinical Manifestations, 1454
Collaborative Care, 1454
Diagnostic Tests, 1454
Clinical Therapy, 1454
Nursing Management, 1454
Disorders of the Spine, 1455
Scoliosis, 1455
Etiology and Pathophysiology, 1455
Clinical Manifestations, 1455
Collaborative Care, 1455
Diagnostic Tests, 1456
Clinical Therapy, 1456
Nursing Management, 1456
Torticollis, Kyphosis, and Lordosis, 1461
Additional Disorders of the Bones and Joints, 1461
Osteoporosis and Osteopenia, 1461
Etiology and Pathophysiology, 1462
Clinical Manifestations, 1462
Collaborative Care, 1462
Diagnostic Tests, 1462
Clinical Therapy, 1463
Nursing Management, 1463
Osteomyelitis, 1463
Etiology and Pathophysiology, 1463
Clinical Manifestations, 1464
Collaborative Care, 1464
Diagnostic Tests, 1464
Clinical Therapy, 1464
Nursing Management, 1464
Skeletal Tuberculosis and Septic Arthritis, 1465
Osgood-Schlatter Disease, 1466
Achondroplasia, 1466
Nursing Management, 1467
Marfan Syndrome, 1467
Osteogenesis Imperfecta, 1468
Etiology and Pathophysiology, 1468
Clinical Manifestations, 1468
Collaborative Care, 1468
Diagnostic Tests, 1468
Clinical Therapy, 1468
Nursing Management, 1469
Muscular Dystrophies, 1470
Etiology and Pathophysiology, 1470
Clinical Manifestations, 1470
Collaborative Care, 1470
Diagnostic Tests, 1470
Clinical Therapy, 1470
Nursing Management, 1471
Injuries to the Musculoskeletal System, 1474
Fractures, 1475
Etiology and Pathophysiology, 1475
Clinical Manifestations, 1476
Collaborative Care, 1476
Diagnostic Tests, 1476
Clinical Therapy, 1476
Nursing Management, 1477
Sports Injuries, 1482
Amputations, 1483
Nursing Management, 1483
Chapter 36. Alterations in Skin Integrity, 1488
Anatomy and Physiology, 1489
Function of the Skin, 1489
Pediatric Differences, 1490
Skin Lesions, 1491
Wound Healing, 1491
Dermatitis, 1493
Contact Dermatitis, 1493
Etiology and Pathophysiology, 1493
Clinical Manifestations, 1493
Collaborative Care, 1494
Diagnostic Tests, 1494
Clinical Therapy, 1494
Nursing Management, 1494
Diaper Dermatitis, 1495
Etiology and Pathophysiology, 1495
Clinical Manifestations, 1495
Collaborative Care, 1495
Diagnostic Procedures, 1495
Clinical Therapy, 1495
Nursing Management, 1496
Seborrheic Dermatitis, 1496
Nursing Management, 1496
Infectious Disorders, 1497
Bacterial Infections, 1497
Impetigo, 1497
Collaborative Care, 1497
Diagnostic Tests, 1497
Clinical Therapy, 1498
Nursing Management, 1498
Folliculitis, 1498
Nursing Management, 1498
Cellulitis, 1499
Collaborative Care, 1499
Diagnostic Tests, 1499
Clinical Therapy, 1499
Nursing Management, 1499
Viral Infectious Disorders, 1500
Molluscum Contagiosum, 1500
Nursing Management, 1500
Warts (Papillomavirus), 1500
Nursing Management, 1501
Fungal Infections, 1501
Oral Candidiasis (Thrush), 1501
Nursing Management, 1501
Dermatophytoses (Ringworm), 1501
Collaborative Care, 1502
Diagnostic Tests, 1502
Clinical Therapy, 1502
Nursing Management, 1503
Chronic Skin Conditions, 1504
Atopic Eczema (Atopic Dermatitis), 1504
Etiology and Pathophysiology, 1504
Clinical Manifestations, 1504
Collaborative Care, 1505
Diagnostic Tests, 1505
Clinical Therapy, 1505
Nursing Management, 1507
Psoriasis, 1509
Nursing Management, 1509
Acne, 1510
Etiology and Pathophysiology, 1510
Clinical Manifestations, 1510
Collaborative Care, 1510
Diagnostic Tests, 1510
Clinical Therapy, 1511
Nursing Management, 1512
Vesiculobullous Skin Disorders, 1512
Epidermolysis Bullosa, 1512
Nursing Management, 1513
Drug Reactions, 1515
Nursing Management, 1515
Infestations, 1515
Pediculosis Capitis (Lice), 1515
Etiology and Pathophysiology, 1516
Clinical Manifestations, 1516
Collaborative Care, 1517
Nursing Management, 1517
Scabies, 1519
Nursing Management, 1519
Miscellaneous Skin Conditions, 1520
Birthmarks, 1520
Vascular Tumors (Hemangiomas), 1520
Etiology and Pathophysiology, 1520
Clinical Manifestations, 1521
Collaborative Care, 1521
Diagnostic Tests, 1521
Clinical Therapy, 1521
Nursing Management, 1521
Injuries to the Skin, 1522
Pressure Ulcers, 1522
Etiology and Pathophysiology, 1522
Clinical Manifestations, 1522
Collaborative Care, 1522
Nursing Management, 1522
Burns, 1525
Etiology and Pathophysiology, 1525
Clinical Manifestations, 1526
Collaborative Care, 1526
Diagnostic Tests, 1526
Clinical Therapy, 1527
Nursing Management, 1530
Sunburn, 1537
Nursing Management, 1538
Hypothermia, 1538
Etiology and Pathophysiology, 1538
Clinical Manifestations, 1539
Collaborative Care, 1539
Nursing Management, 1540
Frostbite, 1540
Nursing Management, 1540
Bites, 1540
Animal Bites, 1540
Collaborative Care, 1541
Nursing Management, 1541
Human Bites, 1541
Nursing Management, 1542
Insect Bites and Stings, 1542
Nursing Management, 1542
Snakebites, 1542
Etiology and Pathophysiology, 1542
Clinical Manifestations, 1544
Collaborative Care, 1544
Diagnostic Tests, 1544
Clinical Therapy, 1544
Nursing Management, 1544
Scorpion Bites, 1545
Nursing Management, 1545
Minor Skin Injuries, 1545
Contusions, 1545
Foreign Bodies, 1545
Lacerations, 1545
Appendix A. Physical Growth Charts, 1551
Appendix B. Pediatric Blood Pressure Tables, 1564
Appendix C. Dietary Reference Intakes, 1566
Appendix D. Selected Pediatric Laboratory Values, 1568
Appendix E. Body Surface Area Nomogram, 1575
Appendix F. Emergency Assessment and Initial Management, 1576
Appendix G. Diagnostic Tests and Procedures, 1586
Appendix H. Temperature and Weight Conversion, 1595
Appendix I. NCLEX-RN^® Review Answers, 1596
Glossary, 1615
Index, 1628
Special Features, 1740
Student and Instructor Resources, IFC-1

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