School of Nursing and Allied Health

SOUTHWESTERN MICHIGAN COLLEGE SCHOOL OF NURSING AND ALLIED HEALTH Dowagiac, Michigan

COURSE SYLLABUS

______Semester, 20__

COURSE TITLE: Nursing Care of Children-Theory COURSE NO.: NURS 202

CREDITS/CONTACTS: Credit Hours: 2 Lecture hours/weekly: 2 Laboratory hours/weekly: 0 A-T hours/weekly: 0

INSTRUCTOR(s): Sandra Cazallis, RN, MSN, CPN Office hours: variable Phone: 269-782-1245 E-mail: [email protected]

PREREQUISITE: NURS 180, 181 and previous enrollments in EDUC 215.

COURSE DESCRIPTION: This course examines the needs of a child from birth through adolescence, the role portrayed and the effect of illness upon the child, the family, and society. The course will include clinical experiences in various pediatric nursing settings.

CORE CURRICULUM: Not applicable

DISTRIBUTION REQUIREMENTS: Required for ADN curriculum.

NOTICE: Information in this syllabus was to the best knowledge of the instructor, considered correct and complete when distributed for use at the beginning of the semester. The instructor, however, reserves the rights, acting within the policies and procedures of Southwestern Michigan College, to make changes in course content or instructional techniques without notice or obligation.

HONESTY POLICY

Cheating or plagiarizing will absolutely not be tolerated at Southwestern Michigan College. Any student found cheating or plagiarizing material in any manner may be assigned a failing semester/session grade in this course. A second such incident while at SMC could result in suspension or expulsion from the institution. A student found in violation of this section of the syllabus will not be allowed to drop this course. Additional detail regarding cheating and/or plagiarism may be found elsewhere in this syllabus.

TEXTBOOK(s): Ball, J. Bindler, R. Pediatric Nursing: Caring for Children. Upper Saddle River NJ. Prentice Hall. Current edition

Wong and Waley. Clinical Manual of Pediatric Nursing. Chicago. Mosby Current Edition

Additional Resources: Southwestern Michigan College Fred L. Mathews Library for references cited in the syllabus.

METHOD OF This course uses discussion, audio-visual materials, clinical INSTRUCTION: conference presentations, selected readings, written assignments, demonstration, case studies, student reports, and role playing.

EVALUATION: Upon completion of this course, the student will demonstrate achievement of the course objectives by obtaining a final minimum grade of seventy-eight (78%), as measured by teacher made quizzes, tests and written assignments.

EVALUATION METHOD: All assignments are mandatory. All assignments must be completed to successfully complete the course.

Examinations (3) 75% Final Exam 25% Total 100%

GRADING SCALE: Per School of Nursing Student Handbook guidelines.

PROGRESSION Progression in the nursing program without interruption is determined POLICY: academically by achieving a minimal grade of "C" (78%).

ATTENDANCE POLICY: Attendance is mandatory. See the School of Nursing Student Handbook for specific guidelines.

TESTING POLICY: Students are expected to take all examinations as they are scheduled. Make- up policy with regard to examinations is described in the School of Nursing Student Handbook.

OTHER COURSE The student is expected to have read the material to be covered EXPECTATIONS: in class PRIOR to class.

Examinations will cover material from audio-visual materials, clinical conference, presentations, discussion, case studies, and selected readings. Therefore, the student is expected to study these sources of material thoroughly.

TERMINAL 1. Provides direct care, based on the nursing process, for OBJECTIVES clients with well-defined nursing diagnoses, within a variety of settings, and who have simple to complex health care needs. 2. Utilizes comprehensive therapeutic communication skills when interacting with clients, families, and other health care team members. 3. Organizes comprehensive aspects of care for clients with simple to complex health needs in a variety of settings. 4. Assesses client's needs for information in order to formulate a teaching plan; implements and modifies individualized teaching plans, and evaluates client's learning. 5. Demonstrates responsibility and accountability to the profession of nursing as well as collecting data for nursing research and utilizing research findings. GUIDELINES FOR Assignments are to be neatly typed with proper grammar and WRITTEN WORK: spelling, following college level requirements for written work. Written work that is below a college level of performance regarding grammar, punctuation, spelling, or sentence structure will not be acceptable.

Assignments are due on the day assigned or before if preferred. See the School of Nursing Student Handbook for rules regarding late written assignments.

COMPUTER ASSIGNMENT: Nursing computers are available during nursing lab open hours. Pediatric simulations are available. It is recommended that each student take the time and complete all simulations. These simulations increase critical thinking skills which will increase understanding and retention of material for this course.

COURSE OBJECTIVES: At the completion of the course, the learner will meet the following objectives. Systems include: Growth and development of children, respiratory, eye, ear, nose and throat, cardiovascular, hematologic, fluid and electrolyte balance, gastrointestinal, genitourinary, endocrine, infectious and communicable diseases, immune function, neurologic, cellular growth, musculoskeletal skin integrity and psychosocial function.

NURSING 202 NURSING CARE OF CHILDREN COURSE OBJECTIVES

At the completion of the course, the learner will meet the following objectives in the areas of growth & development.

1. Uses critical thinking skills in implementing the nurse process. 2. Identifies a nursing history based on subjective and objective data. 3. Identifies basic health care needs/stressor according to nursing assessment. 4. Selects nursing diagnosis from an established list based on identified health care needs. 5. Prioritizes nursing diagnosis for the individual client that reflects biopsychosocial 6. Identifies goals for the individual client according to selected nursing diagnosis and to their level of growth and development. 7. Identifies outcomes criteria specific to each goal to promote adaptation. 8. Identifies nursing interventions for an individual client’s plan of care to meet human needs. 9. Utilizes knowledge from nursing and liberal arts and science courses when contributing to an individual plan of care. 10. Verbalizes understanding of the medical plan of care based on scientific knowledge to promote an integrated plan of care. 11. Recognizes client’s response and adaptation to plan of care based on established nursing interventions and outcomes criteria. NURSING 202 NURSING CARE OF CHILDREN - THEORY UNIT OBJECTIVES

ALTERATIONS IN RESPIRATORY FUNCTION INCLUDING EYE, EAR, NOSE AND THROAT LEARNING OBJECTIVES FOR TEST #1 Chapter 13& 19

1. Explain how the structure and function of the infants or child’s respiratory system increases the risk for respiratory disease. 2. Explain the significance of the differences between adult and pediatric respiratory tracts. 3. Differentiate between early and late symptoms of respiratory distress. 4. Describe the nursing assessments performed on children in respiratory distress. 5. Describe the needs of the family of an infant who has died of sudden infant death syndrome (SIDS). 6. Discuss and display an understanding of the pathophysiology, therapeutic management, nursing care and home care with discharge instructions of children with respiratory disorders. 7. Discuss and display an understanding of the pathophysiology, clinical manifestation and therapeutic management of respiratory alterations. Include screening tests and home care and discharge teaching. 8. Outline the nursing management of children with acute & chronic respiratory alterations. 9. Identify common triggers of asthma symptoms and measures that can be taken to prevent and treat asthma. (include teaching) 10. Describe specific nursing care for children with health problems affecting the eye and ear.

11. Describe how alterations in the sensory organs affect the child’s ability to communicate. 12. Identify potential growth and development interruptions that may occur with problems affecting the sensory organs.

Disease process to know: Apnea Tonsillitis T&A SIDS Self- study Croup syndromes Sinusitis Asthma CPR Status asthmaticus Epistaxis Bronchitis Conjunctivitis Bronchiolitis Aspiration of foreign object Bronchopulmonary dysplasia Pneumonia Cystic fibrosis Sinusitis Otitis media Pharyngitis Nasopharyngitis

ALTERATIONS IN CARDIOVASCULAR FUNCTION LEARNING OBJECTIVES FOR TEST #1 Chapter 14

$ Describe the anatomy and physiology of the normally functioning heart. $ Discuss the nursing implications of common cardiac medications used in children. $ Discuss, display, and understand the condition listed below including pathophysiology, clinical manifestations, therapeutic management, include screening tests and home care/discharge instructions of these children. $ Describe the most common types of shock in children, and the associate therapeutic management of nursing care. $ Differentiate symptoms of right-sided and left-sided heart failure. $ Identify nursing interventions that decrease workload on the heart in children with heart failure. $ Compare the fetal and pulmonary circulation of the heart. $ Describe changes that occur in the fetal cardiovascular structures after birth. $ Discuss the child's response to chronic hypoxemia. $ Differentiate between cyanotic and acyanotic heart defects. $ Discuss the anatomy and clinical manifestations of selected acyanotic heart defects and the medical and nursing management of children with these defects. $ Discuss the anatomy and clinical manifestations of cyanotic heart defects and the clinical and nursing management of children with these defects. $ Outline the diagnostic tests and procedures used to diagnose congenital heart diseases. $ Describe the etiology, pathophysiology, and clinical manifestations of discharge instructions medical and nursing management of children with the following disorders.

Heart catherization Congestive heart failure. Cyanosis Patent ductus arteriosus Atrial septal defect Ventricular septal defect Pulmonic stenosis Aortic stenosis Coarctation of aorta Tetralogy of fallot Transposition of the great vessels Tricuspid Atresia Truncus arteriosus Rheumatic fever Endocarditis Kawasaki disease Hypertension Shock-self-study Hypoxemia Thrombocytopenia-self-study

ALTERATIONS IN HEMATOLOGIC FUNCTION LEARNING OBJECTIVES FOR TEST #1 Chapter 15

$ Describe the anatomy and physiology of the hemapoietic system. $ Discuss the pediatric differences related to the hemapoietic system. $ Distinguish among the cells that make up the cellular portion of the blood. $ Describe the etiology, pathophysiology, clinical manifestations, medical and nursing management, and discharge instructions for the following disease process. $ Describe common factors in the care of a child with anemia.

Sickle cell anemia Iron deficiency anemia B-Thalassemia Hemophilia Von Willebrand disease Self-study-Immune thrombocytopenia purpura Aplastic anemia

ALTERATIONS IN GASTROINTESTINAL FUNCTION LEARNING OBJECTIVES FOR TEST #2 Chapter 17

$ Identify the nursing implications of common medications used in the treatment of upper GI alterations. $ Describe the common diagnostic and screening tests used for alternations in GI functions. $ Describe the anatomy and physiology of the GI system in the infant and child. $ Describe the development of gastrointestinal system and its relationship to selected congential disorders. $ Identify significant differences between the adult and pediatric GI systems. $ Compare and contrast the structural defects that cause dysfunction in the GI system. $ Discuss the impact of ostomy on the growth and development of an adolescent. $ Describe the transmission and clinical manifestations of common intestinal parasites. $ Recognize the effects of common toxic agents and describe the treatment of children poisoned by these agents. $ Use the nursing process to develop nursing care plans and teaching guidelines for the child with GI alterations. $ Discuss and display an understanding of the etiology, pathophysiology, clinical manifestations, medical & nursing management, home care, discharge instructions, and diagnostic evaluation of below conditions. $ Compare those differences in body fluid and electrolyte composition and regulation between infants/children and adults that make infants and children more vulnerable to imbalances. $ Describe dehydration and acid-base imbalance. $ Differentiate among the various types of acid-base disturbances. $ Describe the processes of diarrhea and vomiting. $ Integrate assessment findings with nursing implementation to determine the success of therapy. $ Describe nursing interventions to prevent fluid and electrolyte imbalances. $ Discuss principles of body fluid homeostasis in relation to infants and children. $ Describe the clinical assessment of fluid and electrolyte imbalances in children. $ Identify manifestations and treatment of clinical dehydration. $ Identify manifestations and treatment of edema. $ Describe actions that place infants and children at risk for fluid and electrolyte imbalances.

Cleft lip and palate Esophageal atresia & tracheoesophageal fistula Gastroesophageal reflux Failure to thrive Poisoning, Tylenol, ASA, petroleum, cortisone, lead Intussusception Hirschsprung disease Anorectal malformations imperforate anus - self-study Hernias - Self-study Appendicitis Constipation - Self-study Colic Celiac disease Pyloric stenosis Pinworms Giardiasis - self-study Dehydration Diarrhea/vomiting/acidosis/edema Electrolyte imbalance/acidosis - Self-study

ALTERATIONS IN GENITOURINARY FUNCTION LEARNING OBJECTIVES FOR TEST #2 Chapter 18

$ Describe the anatomy and physiology of the urinary tract system of the infant and child. $ Describe the most common diagnostic and screening tests associated with genitourinary system. $ Identify the differences between the adult and pediatric genitourinary systems. $ Discuss the treatment of urinary tract infections and describe the educational plan to prev infections in children of various ages. $ Describe enuresis and the medical and nursing management of children with this disorder. $ Identify nursing implications of common medications used in the treatment of urinary tract alterations. $ Discuss and display an understanding of common alterations in the urinary tract system. $ Use the nursing process to assess, plan, and provide nursing care to children with common genitourinary alterations. $ Describe etiology, pathophysiology, clinical manifestations, medical and nursing management, and discharge instructions and home care of the following conditions.

Hypospadias and Epispadias Cryptorchidism Phimosis Chordee Hydrocele Urinary tract infection (Vesicoureteral reflux) Nephrotic syndrome Acute glomerulonephritis Enuresis

ALTERATIONS IN ENDOCRINE FUNCTION LEARNING OBJECTIVES FOR TEST #2 Chapter 22

$ Discuss the role of various organs and glands of the endocrine system in the growth and development of children. $ Describe the psychosocial issues concerning children with precocious puberty. $ Identify the role of insulin in the metabolism of CHO, Fats, & Proteins and post prenatal states. $ Compare and contrast IDDM & NIDDM. $ Identify the role and nursing implications of insulin therapy, diet therapy, exercise, and self-monitoring in the management of diabetes. $ Describe the signs, symptoms, causes, and treatment of hypo & hyperglycemia. $ Identify the pathophysiology of diabetic ketoacidosis, treatment and nursing care in diabetic ketoacidosis. $ Describe the etiology, pathophysiology, clinical manifestations, diagnostic tests, medical and nursing management and discharge instructions for the following conditions.

Hypopituitarism/Growth hormone deficiency Hyperpituitarism Diabetes mellitus Hypothyroidism/Congenital vs. Acquired Hyperthyroidism PKU (Phenylketonuria) - self-study Precocious puberty - self-study

ALTERATIONS IN IMMUNE FUNCTION LEARNING OBJECTIVES FOR TEST #3 Chapter 11

$ Explain the normal immune response in children. $ Differentiate between B cell and T cell disorders. $ Describe the clinical manifestations and pathophysiology of autoimmune disorders. $ Discuss the nursing management of children with selected autoimmune disorders. $ Severe combined immunodeficiency disease AIDS

ALTERATIONS IN NEUROLOGIC FUNCTION LEARNING OBJECTIVES FOR TEST #3 Chapter 20

$ Describe the anatomy and physiology of the nervosus system. $ Identify significant differences between the adult and pediatric nervous system. $ Describe the assessment of level of consciousness. $ Describe the use of selected neurologic assessment tools. $ Identify signs of increased intracranial pressure. $ Describe the normal compensatory mechanism that keep intracranial pressure within constant range. $ Be able to perform and document a neurologic assessment of a child. $ Discuss the nursing implications of common medications used in the management of neurologic disorders. $ List measures used to prevent and treat cerebral edema. $ Differentiate between abnormal flexion and extension, and discuss the significance of each. $ List the compensatory mechanisms that affect intracranial blood flow and extravascular fluid volume if hydrocephalus develops. $ Discuss care of the immobile child. $ List measures used to keep a child safe during a seizure. $ Describe the etiology, pathophysiology, clinical manifestations, diagnostic tests, medical and nursing management, and discharge instructions for the following disease process.

Seizure disorders - Epilepsy Febrile seizures Infantile spasms Petite mal seizures Grand mal seizures Meningitis/Encephalitis Reye syndrome Hydrocephalus Spina bifida syndrome Cerebral palsy Head Injury Increased intracranial pressure Near drowning p. 296-299 ALTERATIONS IN MUSCULOSKELETAL FUNCTION LEARNING OBJECTIVES FOR TEST #3 Chapter 21 & 11

$ Demonstrate an understanding of the anatomy and physiology of the musculoskeletal system of the infant and young child. $ Identify the differences between the adult and pediatric musculoskeletal systems. $ Select relevant assessment criteria that will be helpful in determining the etiology of common pediatric musculoskeletal alterations. $ Describe the etiology, pathophysiology, clinical manifestations, diagnostic tests, and medical and nursing management along with discharge instructions for the following disease processes. $ Summerize the treatment modalities used to manage the child with musculoskeletal alterations. $ Design, implement and evaluate appropriate nursing interventions for the child with altered musculoskeletal function. $ Club foot Growth & development Developmental hip Legg-Calve-Perthes disease Slipped capital femoral epiphysis Scoliosis Kyphosis Lordosis Fractures Tractions Sprain, strain and contusions - self-study Osteomyelitis Cast care Soft-tissue injury Muscular Dystrophies Osteogenesis Imperfecta Juvenile Arthritis Osgood-schlatter disease - self-study ALTERATIONS IN SKIN INTEGRITY LEARNING OBJECTIVES FOR TEST #3 Chapter 23

$ Describe the anatomy and physiology of normal skin. $ Identify the differences between the skin of infants, children, and adults. $ List the types of burns and the classification of burn severity. $ Discuss common causes of burns in children and the prevention of burn injuries. $ Discuss the classifications of depth, extent, and severity of a burn injury. $ Describe the therapeutic management and nursing care of children with minor burns. $ Apply nursing process to the care of infants and children with skin disorders. $ List and describe complications of burn injuries. $ Describe the etiology, pathophysiology, clinical manifestations, screening tests, medical and nursing management along with discharge instructions for the following disease process.

Dermatitis Eczema Impetigo Pediculosis capitis Scabies Ringworm Acne Burns Poison ivy Bites and stings Diaper dermatitis Seborrheic dermatitis Cellulitis - self-study Candidiasis - self-study Herpes - self-study THE CHILD WITH CANCER LEARNING OBJECTIVES FOR FINAL Chapter 16

$ Discuss bone marrow transplantation in children. $ Explain the significance of the differences between adult and pediatric cancers. $ Describe the general etiology of cancer in children. $ Discuss the various therapies used to treat childhood cancer. $ Describe the effect of a child's cancer diagnosis on the family. $ Demonstrate an understanding of the nursing care associated with caring for a child with cancer. $ Describe the etiology, pathophysiology, clinical manifestations, medical and nursing management, and discharge instructions for the following conditions.

Brain tumors Retinoblastoma Osteosarcoma Ewing sarcoma Leukemia disease Hodgkin disease Rhabdomyosarcoma Wilms Tumor NURSING CARE OF CHILDREN NURSING 202 - THEORY

STUDENTS ARE RESPONSIBLE FOR THE FOLLOWING INFORMATION FOR TESTS.

GROWTH AND DEVELOPMENT: INFANT, TODDLER, PRESCHOOLER, SCHOOL AGE, ADOLESCENTS Chapter 2,3 & 4

Test #1 Infant Test #2 Toddler & Preschooler Test #3 School Age & Adolescent $ Describe methods of assessing growth and development. $ Describe the general principles of growth and development. $ Apply the theories of Piaget, Erikson, and Freud to children ranging in age from birth to adolescence. $ Identify physical and behavioral milestones include motor, psychosocial, language, and cognitive development that are characteristic of children in each age group. $ Recognize coping strategies used by children and adolescents to adapt to stressful situations. $ Describe normal patterns of play exhibited by children. $ List toys that are appropriate for young children. $ Discuss normal nutrition for children in each age group. $ Identify health promotion topics for children. $ Identify various hazards that can cause injuries to children and adolescents. $ Discuss characteristics of children's communication from birth through adolescence. $ Discuss the value and techniques of discipline in child rearing. $ Use knowledge of growth and development to formulate a developmentally appropriate nursing care plan. $ Describe components of effective communication with children. $ Describe communication strategies that assist nurses in working effectively with children. $ Explain the importance of avoiding communication pitfalls in working with children. $ Describe effective family-centered communication strategies. $ Describe effective strategies for communicating with children with special needs.

THE CHILD AND PLAY LEARNING OBJECTIVES Define play. Identify characteristics of various types of play. Discuss how play enhances the child=s growth and development. Discuss the importance of play for the hospitalized child. Describe the categories of play. Explain how play enhances the child=s growth and development. Describe play according to developmental levels. Describe therapeutic play. Describe the role of the nurse in therapeutic play.

Rev. 6/99;9/00,11/00