Pediatric Nursing: Caring for Children

Front Cover
Jane Ball
Prentice Hall, 2003 - Medical - 984 pages
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Pediatric nursing, like all of health care, is changing rapidly. Student nurses must learn what helps them to provide safe and effective care today while integrating new knowledge and skills needed for nursing practice in the future. Faculty have the responsibility of teaching students to provide pediatric nursing care today, while equipping them to meet tomorrow's unknown health care challenges.

The goal of the third edition of this textbook is to provide core pediatric nursing knowledge that prepares students for practice, and to offer the tools of critical thinking needed to apply this learning to future challenges. Students must learn to question, to evaluate the research and experiences of others, to apply information in many settings, and to constantly adapt while providing high-quality nursing care.

This textbook reflects a multitude of approaches to learning that can be helpful to all students. We acknowledge that many students learn pediatric nursing in a very short time period. Therefore, the approaches in this textbook are designed to help all students assess the child's needs and to make decisions based on the standards of pediatric nursing practice.

Realities of Pediatric Nursing

The first edition of this textbook focused on the nursing care of children and their families in acute care environments. In the second edition, the focus was broadened to reflect the dramatic shift of pediatric health care out of the hospital and into ambulatory, home, and community settings. Many procedures are performed in short-stay units, and long-term care is often provided at home for children with complex health conditions. In the third edition, the trend for provision of care in a wide variety of settings is a continuing focus. Families are often the providers of care and case managers for children with complex health care challenges. Technological advances are resulting in earlier diagnoses and new therapies, and this content is integrated throughout the textbook.

Pediatric-nursing care is provided within the context of a rapidly changing society. An examination of the major morbidities and mortalities of childhood guided the addition of new material and topics throughout the text. A new chapter on childhood nutrition addresses the influences of nutrition and associated conditions on long-term health of the individual. Another new chapter focuses on the common societal and environmental influences on health care that all nurses must understand when designing interventions to promote health. A continuing emphasis on the influence of injury is integrated throughout the book, with descriptions about the necessity of prevention and the impact of injury on mortality, hospitalization, disability, and health care needs.

Many graduating nurses practice in acute care facilities, and this textbook continues to emphasize the information necessary to prepare students for working in those settings. In addition, the information provided in this textbook will enable graduates to assume positions in ambulatory care facilities, home health nursing, schools, and a variety of other settings. Effective communication methods, principles of working with families, and knowledge of pathophysiologic, psychologic, and environmental factors found in this book can all be applied to a wide variety of settings.

Another major change in our society involves access to information and reliance on the Internet. In this edition, MediaLink icons send the student online to obtain the very latest information available on many topics. Nurses must learn to obtain information and then to analyze and judge the quality of information they find. Nurses must also assist children and family members to use the Internet wisely to help them in making health care decision Integration of websites throughout the book and exercises to examine and evaluate various sites assist the students applying this technology.

Organization and Integrated Themes

This book is organized by body system, as it is an easy approach for students to use when peeking information, studying, and preparing to care for children and families. This organizational framework also eliminates redundancy, which occurs when a developmental approach is used, thereby contributing to the concise approach in this textbook.

Several topics essential to comprehensive nursing care of children do not directly relate to body systems. Separate chapters with these important concepts provide foundational information for nursing care. These include growth and development, physical assessment, nutrition, societal and environmental influences on health, and mental health. Other chapters address care of the child in the hospital and in community settings, pain management, and needs of child and family during life-threatening conditions. Throughout the textbook, we integrate information that is pertinent to care for children related to age, culture, and family.

The nursing process is used as the framework for nursing care.Nursing Managementis the major heading, with subheadings ofNursing Assessment and Diagnosis, Planning and Implementation,andEvaluation.When it is appropriate to focus on care in a specific setting, Care in the Community, Hospital-based Care, and Discharge Planning and Home Care Teaching are separated into sections. We feature nursing care plans throughout the text to help students approach care from the nursing process perspective. These nursing care plans include Nursing Intervention Classifications (NIC) and Nursing Outcome Classifications (NOC).

Several major concepts are integrated throughout the textbook to encourage the student to think creatively and critically about nursing care. These major themes are interwoven through narrative, margin boxes, art figures and captions, CD-ROM offerings, and Companion Website activities. This layout results in a comprehensive and unique presentation that engages students and makes them active participants in the learning process. The major concepts integrated throughout the learning materials are as follows:

  • Nursing careis the critical and central core of this textbook. Nursing assessment and management are emphasized in all sections of the book, with nurses shown providing care in a variety of settings.
  • Critical thinking and problem-solving principlesare integrated in the organization, pedagogy, writing style, CD exercises, and art captions. Students practice critical thinking in their everyday lives, but need help to apply these concepts to the practice of nursing. This book and the accompanying learning materials help students understand how their normal curiosity and problem-solving ability can be applied to pediatric nursing. Students learn what questions to ask, how to ask them, where to find answers, and how to provide information to others.
  • Communicationis one of the most important skills that students need to learn. Effective communication with children is challenging because they communicate differently according to their developmental levels. Family members have communication needs in addition to those of their children. This book integrates communication skills by applied examples that help the student to communicate effectively with children and their families.
  • Teachingabout health care is an integral part of the pediatric nurse's responsibilities. Since hospitalizations are short and families increasingly care for children at home, information about health care needs and procedures have become even more important.
  • Developing cultural competenceis critical for all nurses in the increasingly diverse community of today's world. Students have all met people from different ethnic and cultural groups but they need help to understand, respect, and integrate differing beliefs, practices, and health care needs when providing care.
  • Growth-and development considerations and physical assessmentare central to the effective practice of pediatric nursing. A separate chapter is devoted to each area, Chapters 2 and 4 respectively. In addition, both topics are integrated where appropriate in narrative, figures, captions, and on the CD.
  • Legal and ethical considerationsare provided throughout the text to sensitize students to thinking about the implications of nursing care. They are encouraged to learn the legal ramifications of actions, the ethical decision-making process in difficult situations, and their own personal and professional responsibilities.
  • Home care considerations and community rare considerationsare an increasing part of nursing responsibilities. To assist students in transferring knowledge to caring for children in community settings, both narrative and boxes address this information in nursing management sections of chapters. In addition, an entire chapter is devoted to nursing care in the community and directly addressing the nurse's roles in these settings.

Each chapter has undergone significant revision to update clinical information and resources. Content has been shifted and added to reflect current pediatric issues and care. New chapters include nutrition, and environmental and societal influences on health. There is an increased emphasis on home and community care, and families are integrated when possible.

Each chapter begins with achapter opening scenarioand photo illustrating a child with specific nursing care needs. This is accompanied by a list ofkey terms.A new feature,MediaLink,identifies specific content, animations, activities, and resources available to students on the accompanying student CD-ROM and Companion Website. Each chapter ends with a chapter review that consists of a summary ofchapter highlights,a list ofreferences,and a new section entitledExplore MediaLink.This last section encourages students to use the additional chapter-specific NCLEX review, exercises, and resources available on the accompanying free student CD-ROM and the Companion Website

We have integrated features into the body systems chapters to enhance student learning. Based on feedback from prior users of the textbook, newPathophysiology Illustratedboxes visually explain the pathophysiology of certain conditions in a format that the student can understand and apply.As They Growboxes illustrate the anatomic and physiologic differences between children and adults. This enhances students' knowledge in association with a specific topic and helps them to apply theoretical information in practical situations. TheClinical Manifestationfeature presents the etiology, clinical presentation, and clinical therapy for selected conditions.Medications Used to Treatboxes feature drug information for specific conditions when appropriate.

Numerous margin boxes relate directly to nursing care. These includeClinical Tips, Safety Precautions,andNursing Alerts.To reflect the growing cultural diversity of the United States and Canada,Cultureboxes are also integrated throughout the narrative, offering diverse perspectives and highlighting cultural variations in health care when appropriate. An added feature in this edition is the inclusion of boxes oncomplementary and alternative practices,which may be connected with cultural groups or other belief and practices, thus influencing health care practices.Law and Ethics, Community Care, Research,andHome Careboxes highlight the issues challenging nurses today, whileGrowth and Developmentboxes help to highlight nursing care at various stages of development.

Since nurses are frequent teachers of children and families, we are introducing theFamilies Want to Knowfeature, which offers information about the specific teaching that nurses will need to provide. This feature provides teaching that can benefit families as they care for children.

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About the author (2003)

Dr. Jane W. Ball graduated from the Johns Hopkins Hospital School of Nursing, and subsequently received a Bachelor of Science degree from the Johns Hopkins University. She worked in the surgical, pediatric emergency, and, outpatient units of the Johns Hopkins Children's Medical and Surgical Center, first as a staff nurse and then as a pediatric nurse practitioner. This began her career as a pediatric nurse and advocate for children's health needs.

Jane obtained both Master of Public Health and Doctor of Public Health degrees from the Johns Hopkins University Bloomberg School of Public Health with a focus on maternal and child health. After graduation she became the chief of child health services for the Commonwealth of Pennsylvania Department of Health. In this capacity she oversaw the state-funded well-child clinics and explored ways to improve education for the state's community health nurses. After relocating to Texas, Jane joined the faculty at the University of Texas at Arlington School of Nursing to teach community pediatrics to registered nurses returning to school for a Bachelor of Science in Nursing degree. During this time she became involved in writing her first textbook, Mosby's Guide to Physical Examination, which is currently in its fifth edition.

After relocating to the Washington, D.C., area, she joined Children's National Medical Center to manage a federal project to teach instructors of emergency medical technicians from all states about the special care children need during an emergency. Exposure to the shortcomings of the emergency medical services system in the late 1980s with regard to pediatric care was, a career-changing event. With federal funding, she developed educational curricula for emergency medical technicians and emergency nurses to help them provide improved care for children. A textbook, entitled Pediatric Emergencies, A Manual for Preh-ospital Providers, was developed from these educational ventures.

For the past 10 years, Jane has managed the federally funded Emergency Medical Services for Children National Resource Center. As executive director, she directs the provision of consultation and resource development for state health agencies, health professionals, families and advocates about successful methods to improve the health care system so that children receive optimal emergency care in all health care settings.

Dr. Ruth Bindler received her Bachelor of Science in Nursing degree from Cornell University-New York Hospital School of Nursing in New York. She worked in oncology nursing at Sloan Kettering Cancer Center in New York, and then moved to Wisconsin and became a public health nurse there in Dane County. Thus began her commitment to work in pediatrics as she visited children and their families at home, and served as a school nurse for several elementary, middle, and high schools. Due to this interest in child health care needs, she earned a Master of Science degree in Child Development from the University of Wisconsin.

A move to Washington State was accompanied by a new job as a faculty member at the Intercollegiate Center for Nursing Education in Spokane. Ruth has been fortunate to be involved for 28 years in the growth of this nursing education consortium, which is a combination of public and private universities and colleges and is now the Intercollegiate College of Nursing/Washington State University College of Nursing. Presently she teaches the theory course in child health and a course on cultural diversity and health, and serves as lead faculty for the theory and clinical components of child health nursing. Her first professional book, Pediatric Medications, was published in 1981, and she has continued to publish articles and books in the areas of pediatric medications and pediatric health. Special research interests are cardiovascular risk factors and diabetes in children, topics that were the focus of her recent Doctor of Philosophy work in Human Nutrition at Washington State University. Ethnic diversity has been another theme in Ruth's work. She facilitates international and other diversity experiences for students, performs research with culturally diverse children, and works with underserved populations.

Ruth believes that her role as a faculty member has enabled her to learn continually, to foster the development of students in nursing, and to participate fully in the profession of nursing. In addition to teaching, research, publication, and leadership, she enhances her life by service in several professional and community organizations, and through activities with her family.

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