Textbook of Child Health Nursing

                                                                            Foreword

I am delighted to write this & quot; Foreword & quot; for the first edition of the "Textbook of Child Health
Nursing". The book aims to cover the necessary need of BSc Nursing students. The book content
is well laid down in an easily understandable language. In addition, nursing care boxes and MCQs are other highlighting features of this book that shall make reading an enjoyable experience for the students.
This multi-author book has been meticulously planned and crisply covers the broad spectrum of Pediatric disorders. The book has dedicated sections to cover the recent syllabus for the BSc Nursing course. I am sure that this book would serve as a ready reference for all colleagues involved in the nursing care of children. I congratulate the editors and authors of this book for putting their efforts to bring out this book with the most updated knowledge.

Best wishes.

Dr. Manju Vatsa,
Former Principal,
College of Nursing, All India Institute of Medical Sciences, New Delhi

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                                         TEXT BOOK OF CHILD HEALTH NURSING 

Thoroughly updated and NEW edition has been made with an intention to make error-free. Provides a concise overview of child health nursing of GNM, BSc students and nursing professional working for children. Written in accordance with nursing syllabus as recommended by Indian Nursing Council (INC).

It is 1^st Edition of Textbook on Child Nursing by AIIMS PEDIATRICS FACULTY has been designed to provide today’s students with solid foundations of nursing principles to prepare them to meet the challenges of tomorrow. The comprehensive coverage of the book provides concepts and components of nursing skills and techniques of nursing practice and firm foundation of nursing and also, it presents the theoretical and practical information necessary to make sound judgment white emphasizing cognitive, affective and psychomotor skills needed to carry out fundamentals of nursing activity.

Key Features: –

• Organization of chapters, subject material as per latest semester-wise syllabus exactly according to syllabus which will help student to use as a textbook.
• A simple point-wise attractive presentation of contents.
• Expanded enlarged, enriched and updated edition.
• A brand-new stylish book.
• Relevant wide range of illustrations: Figures, Tables, Boxes, Flowcharts.
• This book assists the beginners in a technical or professional nursing program.
• This book has been designed to be of immense help and information to nursing students.
• This book is useful for BSc Nursing students

Special Features

• Authored & reviewed by top nursing faculties AIIMS India
• More than 50 + Contributors
• 100 + Figures, Illustrations & Tables covered
• NURSING PROCEDURES
• First ever book developed in the Indian context
• Perfect Amalgamation of Theoretical & Clinical Aspects
• Emphasis on critical thinking and clinical judgment through various case scenarios
• Updated NANDA Diagnosis

Salient Features

• Learning Objectives given in the beginning of each Unit will enable the students to know what the students will be able to learn, after reading it.
• Important facts from nursing considerations point of view have been covered under TIPS boxes.
• Text is supplemented with Nursing Intervention from clinical applied point of view.
• Management protocols have been extensively covered in Flow Chart format of easy retention.
• Must know facts are covered throughout the book from clinical practice point of view.
• Important concepts and topic have been supplemented with numerous Figures/ Illustrations/ Tables for easy understanding.
• Each and every chapter ends with summarized one-liner for quick glance of the chapter.
• Important subjective and objective questions under Assess Yourself have been added at the end of every chapter to help the students assess their learning..

Editor in chief: S K Kabra

Editors: Kana Ram Jat, Narendra Kumar Bagri, Aditya Kumar Gupta and Jagdish Prasad Meena

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1. Overview of Child Health Nursing

1.1 Introduction and Scope of Child Health Nursing 1

1.2 Basic Principals of Pediatric Nursing 2

1.3 Interaction with Child and Family 4

1.4 Reactions of Children after Hospital Visit and 6

Hospitalization

1.5 Changing Trends and Modern Concept of 9

Child Health Care

1.6 Pediatric History Taking and Examination 11

1.7 Child Versus Adult 12

2. Ethics in Pediatric Nursing

2.1 Ethics in Nursing 15

2.2 Accountability and Assertiveness 18

2.3 Organization of Nursing Services in Hospital 20

2.4 Evaluation of Nursing Services and Quality 24

Assurance

3. Nutrition

3.1 Normal Nutritional Requirements 28

3.2 Normal Physical Development (Growth) 29

3.3 Anthropometry and Growth Charts 30

3.4 Protein Energy Malnutrition (PEM) and 35

Failure to Thrive

3.5 Obesity 38

3.6 Vitamins and Micro and Macro-Nutrients 39

3.7 Breast Feeding, Complementary and Supplementary 41

Feeding, Pediatric Balanced Diet

3.8 Diet in Difference Diseases 45

3.9 Parenteral Nutrition 46

4. Development and Behavioral Problems

4.1 Principles of Development 49

4.2 Developmental Milestones 51

4.3 Developmental Disorders 53

4.4 Behavioural Disorders 56

5. Immunization

4.5 Developmental and Behavioural Evaluation 61

5.1 Introduction and Principles 65

5.2 National Immunization Schedule (NIS) 70

5.3 Additional Vaccine in Private Market 73

5.4 Adverse Events Following Immunization (AEFI) 74

5.5 Vaccine Storage and Cold Chain 77

6. Principles of Drugs and Fluid Therapy in Children

6.1 Basics of Pharmacokinetics and Pharmacodynamics 82

6.2 Peculiarities of Pediatric Drug Therapy 85

6.3 Principles of Drug Administration and Prevention 87

of Drug Errors

6.4 Maintenance Fluid Therapy for Children 89

6.5 Dyselectrolytemia and Acid Base Disorders 92

7. Care of Newborn

7.1 Transition from Fetal to Neonatal Life 101

7.2 Care Before, During and After Delivery 103

7.3 Care of Normal Newborn 105

7.4 Congenital Malformations 107

7.5 Birth Asphyxia and Hypoxic Ischemic 110

Encephalopathy (HIE)

7.6 Hypothermia in Newborn 111

7.7 Sepsis in Newborn 114

7.8 Systemic Problems in Neonate 115

7.9 Kangaroo Mother Care (KMC) 119

7.10 Pre-Term and Very Preterm Neonates 120

7.11 Low Birth Weight and Intrauterine 123

Growth Retardation (IUGR)

7.12 Neonatal Jaundice 124

7.13 Feeding in Neonates 126

7.14 Organization of Neonatal Care Unit 128

8. Infections 

8.1 Fever in Children 131

8.2 Malaria 132

8.3 Dengue 133

8.4 Measles 134

8.5 Diphtheria 135

8.6 Pertussis 136

8.7 HIV 136

8.8 Worm Infestations (Intestinal Parasites) 138

8.9 Enteric Fever 140

8.10 Prevention of Infection in Ward, NICU, PICU 141

8.11 Antibiotic Stewardship 141

9. Tuberculosis (TB)

9.1 Epidemiology of TB 145

9.2 Diagnosis of Childhood TB 146

9.3 Management of Childhood TB 152

9.4 Latent TB 153

10. Care of Respiratory Problems

10.1 Assessment of Child with Respiratory Problem 157

10.2 Upper Respiratory Tract Infections (URTI) 158

10.3 Lower Respiratory Tract Infections (LRTI) 160

10.4 Asthma 162

10.5 Chronic Suppurative Lung Disease 169

10.6 Pleural Effusion and Empyema 171

11. Care of Gastrointestinal Problems

11.1 Acute Diarrhea 174

11.2 Chronic Diarrhea and Malabsorption Syndromes 177

11.3 Vomiting 179

11.4 GastroEsophageal Reflux and Gastroesophageal 181

Reflux Disease

11.5 Constipation 182

11.6 Pain Abdomen 183

11.7 Jaundice 184

11.8 Acute Viral Hepatitis 187

11.9 Chronic Liver Disease 188

11.10 Upper and Lower Gastrointestinal Bleeding 188

12. Care of Neurological Problems

12.1 Seizures and Epilepsy in Children 191

12.2 Central Nervous System Infections 195

12.3 Coma 199

12.4 Cerebral Palsy 202

12.5 Neuromuscular Disorders 207

12.6 Acute Flaccid Paralysis 211

12.7 Neural Tube Defects 213

13. Care of Musculoskeletal and Rheumatic Disorders

13.1 Approach to a Child with Musculoskeletal 216

Rheumatic Disorders and Rheumatological Problems

13.2 Infections of Bone and Joints 220

13.3 Juvenile Idiopathic Arthritis 221

13.4 Systematic Lupus Erythematosus 222

13.5 Vasculitis 222

13.6 Miscellaneous Connective Tissue Disorders 223

13.7 Physiotherapy in a Child with an Underlying 224

Rheumatic Disorder

13.8 Nursing Care of a Child with Rheumatic Disorder 229

14. Care of Cardiology Problems 

14.1 Assessment of a Child with Congenital 235

Heart Disease

14.2 Common Congenital Heart Diseases 235

14.3 Acute Rheumatic Fever and Rheumatic 241

Heart Disease

14.4 Heart Failure in Children 245

15. Care of Hematology Problems 

15.1 Approach to a Child with Anemia 249

15.2 Iron Deficiency Anemia 250

15.3 Megaloblastic Anemia 251

15.4 Transfusion of Blood Products 252

15.5 Approach to a Child with Bleeding Disorder 254

15.6 Hemophilia 255

15.7 Thalassemia 256

15.8 Aplastic anemia 257

16. Care of Oncology Problems 

16.1 Childhood Leukemias 259

16.2 Childhood Lymphomas 261

16.3 Childhood Solid Tumors 262

16.4 Nursing Care Map for a Child with Malignancy 264

17. Care of Endocrine Problems 

17.1 Disorders of Pituitary Gland 274

17.2 Diabetes Insipidus 276

17.3 Disorders of Thyroid 276

17.4 Disorders of Calcium Metabolism 278

17.5 Disorders of Adrenal Glands 278

17.6 Obesity 280

17.7 Disorders of Puberty 281

17.8 Disorder of Sexual Differentiation 282

17.9 Diabetes Mellitus 282

18.Genetic Disorders-A Primer for Nurses

18.1 Genetic Disorders and Their Testing 290

18.2 Genetic Counseling 294

18.3 Prevention of Genetic Disorders 296

18.4 Treatment of Genetic Disorders 298

19. Care of Renal and Genitourinary Disorders

19.1 Genitourinary Anatomy and Congenital 301

Abnormalities

19.2 Evaluation of Kidney Function 304

19.3 Urinary Tract Infection 307

19.4 Nephrotic Syndrome 309

19.5 Glomerular Diseases 311

19.6 Tubular Diseases 312

19.7 Acute Kidney Injury 313

19.8 Chronic Kidney Disease 315

19.9 Kidney Replacement Therapy 318

19.10 Hypertension 320

20.Care of Skin Problems 

20.1 Approach to a Child with Rash 324

20.2 Scabies 328

20.3 Urticaria 329

21. Care of Eye Problems 

21.1 Refractive Error 332

21.2 Ocular Infections 333

21.3 Pediatric Cataract 335

21.4 Ocular Trauma and Foreign Body 337

21.5 Disorders of Anterior and Posterior Segment 338

21.6 Preventive Ophthalmology 341

22. Care of ENT Problems 

22.1 Otitis Media 344

22.2 Adenoid Hypertrophy 349

22.3 Hearing Loss 351

22.4 Epistaxis 354

23. Care of Orthopedic Problems 

23.1 Approach to a Child with Orthopedic Problems 357

23.2 CTEV 359

23.3 Fracture in Children 363

23.4 Prevention of Trauma 369

24. Care of Dental Problems 

24.1 Examination of Oral Cavity 373

24.2 Common Diseases of Oral Cavity 373

24.3 Nursing Care of Oral Cavity 381

25. Pediatric Surgical Conditions 

25.1 Thoracic Malformations: Tracheo-Esophageal 383

Fistula, Congenital Diaphragmatic Hernia

25.2 Pyloric Stenosis 386

25.3 Appendicitis 387

25.4 Malrotation of the Gut 388

25.5 Intussusception 389

25.6 Rectal Prolapse 389

25.7 Genitourinary Problems 390

25.8 Hernias 394

25.9 Cleft Lip, Cleft Palate 396

25.10 Anorectal Malformation, Abdominal Wall Defects 396

25.11 Wound Dressing and Suture Removal 400

25.12 Pre- and Post-Operative Care 402

26. Pediatric Emergencies 

26.1 General Approach to Pediatric Emergencies 406

26.2 Neonatal Emergencies 410

26.3 Poisoning in Children 412

26.4 Foreign BodyAspiration and Ingestion 414

26.5 Burns 416

26.6 Drowning 418

26.7 Basics of Pediatric Resuscitation 419

26.8 Nursing Care of a Child in Emergency 421

26.9 Simulation Based Learning 422

27. Child Health Nursing in PICU 

27.1 Care of a Child on Ventilator 425

27.2 Ventilator Associated Pneumonia 431

28. Nursing in Palliative Care 

28.1 Principals of Palliative Care 434

28.2 Systemic Palliative Care 436

28.3 Care of Pre-Terminal Child 443

28.4 Pain and Nursing Care for Palliative Care 443

29. Handing of Death 

29.1 Verification and Notification 450

29.2 Care after Death 454

29.3 Communication 456

30. Community Pediatrics and Health Programs

30.1 Pediatrics, Parenthood and Community 462

30.2 Childhood Health Programs 464

30.3 School and Adolescent Health Programs 468

30.4 Child Mortality Statistics and National Policies 470

30.5 International and National Child Agencies 473

30.6 Rights of Child 475

30.7 Child Care Centers 476

30.8 Preventive Pediatrics Including Accident 487

Prevention

33. Environmental Health Hazards 

31.1 Overview of Environmental Health Hazards 481

31.2 What is an Environmental Health Hazard? 482

31.3 Categories of Environmental Health Hazards 483

31.4 Principles of Hazard Management 483

31.5 Environmental Pollution 486

31.6 Principles of Pollution Management 489

32. Nursing Procedures 

32.1 Bathing an Infant 493

32.2 Weighing a Baby 495

32.3 Changing Napkin 495

32.4 Oxygen Administration 496

32.5 Gastric Lavage 497

32.6 Urinary Catheterization 498

32.7 Enema, Bowel Wash 500

32.8 Feeding via Various Devices 501

32.9 Endotracheal Suction 503

32.10 Chest Physiotherapy 504

32.11 Applying Restraints 507

32.12 IV Cannulation and Blood Withdrawal 510

32.13 Nasogastric Tube Insertion 510

32.14 Assisting Doctors in Procedures 511

32.15 Administration of Medications 513

32.16 Ostomy Care