learning Objectives - Demonstrate skills in providing comprehensive nursing care to children with various disorders & diseases
Hours - 15
Teaching and Learning Activities - Lecture cum discussions Presentation Clinical teaching, Simulation, Videos, Visit to Blind, Deat & dumb school & rehabilitation centre
Assessment Methods - Short answers Objective type Essay type
Content of the chapter
Etiology, signs and symptoms,
complications, prevention, medical,
surgical &nursing management of :
a) Renal System
– Nephrotic Syndrome
– Acute Glomerulonephritis
– ARF & CRF
b) Resp. System
– URI and LRI
– Asthma, Pneumonia
c) GI System
– Intestinal obstruction
(Mechanical)
– Hirschsprung’s disease
– Malabsorption Syndrome
– Inflammatory conditions
– appendicitis, Meckel’s
divertculum, ulcerative colitis
– Worm infestation
d) CVS System
– Rheumatic fever
– CCF
– Infective endocarditis
e) Hematological System
– Anemia
– Leukemia,
– Thalassemia
– Hemophilia
– Sickle cell anemia
– Thrombocytopenic purpura
f) Neurological System
– Meningitis
– Encephalitis
– Convulsive disorders
– Cranio-cerebral trauma
g) Endocrine
– Pituitary disorders
– Hypo & Hyperthyroidism
– Juvenile Diabetes
– Adrenal disorders
h) Developmental problem
– Handicapped children
– Mental Retardation
– Dyslexia
– Hearing & Vision impairment
i) Others:
– Fluid and electrolyte imbalance
– Burns
j) Problems with locomotion:
– Poliomyelitis
– Osteomyelitis
– Kyphosis, lordosis, scoliosis
– Fractures
k) Pre and post operative care of
children undergoing surgery
Children with Various Disorders and Diseases
Children are vulnerable to a variety of disorders affecting multiple systems. Effective pediatric nursing involves early recognition, preventive strategies, therapeutic interventions, and family support.
a) Renal System
1. Nephrotic Syndrome
- Etiology: Idiopathic, minimal change disease, infections, autoimmune disorders
- Signs & Symptoms: Edema (periorbital, generalized), proteinuria, hypoalbuminemia, hyperlipidemia, ascites
- Complications: Infections, thrombosis, acute renal failure, relapse
- Prevention: Early treatment of infections, proper nutrition
- Medical Management: Corticosteroids, immunosuppressants, diuretics, ACE inhibitors
- Nursing Management: Monitor edema, I&O, daily weight, dietary counseling, infection prevention, parent education
2. Acute Glomerulonephritis (AGN)
- Etiology: Post-streptococcal infection, autoimmune reactions
- Signs: Hematuria, proteinuria, edema, hypertension, oliguria
- Complications: Hypertensive encephalopathy, renal failure
- Prevention: Treat streptococcal infections promptly
- Medical Management: Antihypertensives, diuretics, supportive care
- Nursing Care: Monitor BP, fluid restriction, daily weight, observe for complications
3. Acute & Chronic Renal Failure (ARF & CRF)
- Etiology: Infection, nephrotoxic drugs, congenital anomalies
- Signs: Oliguria/anuria, edema, fatigue, electrolyte imbalance
- Complications: Hypertension, electrolyte disturbances, growth retardation
- Prevention: Early detection, infection control
- Management: Dialysis, renal transplantation, medications
- Nursing Care: Monitor vitals, I&O, electrolyte balance, nutrition, family counseling
b) Respiratory System
1. Upper and Lower Respiratory Infections (URI & LRI)
- Etiology: Viral (common cold, influenza), bacterial (pneumonia, tonsillitis)
- Signs: Fever, cough, nasal discharge, dyspnea, wheezing
- Complications: Pneumonia, bronchitis, hypoxia
- Prevention: Immunization, hygiene, avoid smoke exposure
- Management: Antibiotics (if bacterial), antipyretics, hydration, oxygen therapy if needed
- Nursing Care: Monitor respiratory status, provide comfort, encourage fluids, educate parents
2. Asthma
- Etiology: Genetic, allergens, infection, pollutants
- Signs: Wheezing, cough, dyspnea, chest tightness
- Complications: Status asthmaticus, hypoxia
- Prevention: Avoid triggers, adherence to medications
- Management: Bronchodilators, corticosteroids, oxygen therapy
- Nursing Care: Monitor respiratory rate and oxygen saturation, educate on inhaler use, emergency preparedness
3. Pneumonia
- Etiology: Bacterial, viral, fungal
- Signs: Fever, cough, tachypnea, chest indrawing
- Complications: Empyema, sepsis, respiratory failure
- Management: Antibiotics, oxygen therapy, hydration
- Nursing Care: Monitor vitals, administer medications, encourage nutrition and fluids
c) Gastrointestinal System
1. Intestinal Obstruction (Mechanical)
- Etiology: Malrotation, intussusception, adhesions
- Signs: Abdominal distension, vomiting, constipation, colicky pain
- Complications: Perforation, sepsis
- Management: Surgical intervention, IV fluids
- Nursing Care: Pre/postoperative care, monitor bowel sounds, hydration, pain management
2. Hirschsprung’s Disease
- Etiology: Congenital absence of ganglion cells in colon
- Signs: Chronic constipation, abdominal distension, ribbon-like stools
- Management: Surgical resection, colostomy care
- Nursing Care: Monitor bowel function, stoma care, nutrition counseling
3. Malabsorption Syndrome
- Etiology: Celiac disease, chronic diarrhea
- Signs: Steatorrhea, weight loss, abdominal distension
- Management: Dietary modifications, vitamin supplementation
- Nursing Care: Educate on gluten-free diet, monitor growth
4. Inflammatory Conditions
- Appendicitis: RLQ pain, fever, nausea; surgical appendectomy
- Meckel’s Diverticulum: Bleeding, obstruction; surgical removal
- Ulcerative Colitis: Chronic diarrhea, blood in stools; medical & surgical management
- Nursing Care: Pre/postoperative care, monitor vitals, prevent infection, educate family
5. Worm Infestation
- Etiology: Poor hygiene, contaminated food/water
- Signs: Anemia, abdominal pain, malnutrition
- Management: Anti-helminthic medications
- Prevention/Nursing Care: Hygiene education, deworming programs
d) Cardiovascular System
1. Rheumatic Fever
- Etiology: Post-streptococcal infection
- Signs: Fever, joint pain, carditis, rash
- Complications: Rheumatic heart disease
- Management: Antibiotics, anti-inflammatories
- Nursing Care: Bed rest, monitor cardiac status, educate family
2. Congestive Cardiac Failure (CCF)
- Signs: Tachypnea, hepatomegaly, edema
- Management: Digoxin, diuretics, low-sodium diet
- Nursing Care: Monitor vitals, daily weight, fluid restriction, support family
3. Infective Endocarditis
- Etiology: Bacterial infection
- Signs: Fever, heart murmur, fatigue
- Management: IV antibiotics, surgery if severe
- Nursing Care: Administer meds, monitor for emboli, infection control
e) Hematological System
1. Anemia
- Etiology: Iron deficiency, vitamin deficiency, chronic disease
- Signs: Pallor, fatigue, tachycardia
- Management: Iron supplements, nutrition counseling
- Nursing Care: Monitor hemoglobin, diet education
2. Leukemia
- Signs: Pallor, fever, bleeding, lymphadenopathy
- Management: Chemotherapy, bone marrow transplant
- Nursing Care: Infection prevention, monitor labs, emotional support
3. Thalassemia
- Signs: Pallor, growth retardation, splenomegaly
- Management: Blood transfusions, chelation therapy
- Nursing Care: Monitor iron overload, educate family
4. Hemophilia
- Signs: Bleeding, hemarthrosis
- Management: Factor replacement therapy
- Nursing Care: Prevent injury, educate parents
5. Sickle Cell Anemia
- Signs: Pain crises, anemia, jaundice
- Management: Hydration, analgesics, blood transfusion
- Nursing Care: Pain management, monitor for infection
6. Thrombocytopenic Purpura
- Signs: Bruising, petechiae, bleeding
- Management: Steroids, platelet transfusion
- Nursing Care: Prevent trauma, monitor labs
f) Neurological System
1. Meningitis
- Etiology: Bacterial/viral infection
- Signs: Fever, neck stiffness, irritability, seizures
- Complications: Seizures, hearing loss, hydrocephalus
- Management: Antibiotics, supportive care
- Nursing Care: Monitor neurological status, isolation, fluid management
2. Encephalitis
- Etiology: Viral infections
- Signs: Fever, confusion, seizures
- Management: Supportive care, antivirals if indicated
- Nursing Care: Monitor CNS status, prevent complications
3. Convulsive Disorders
- Etiology: Epilepsy, infection, metabolic disorders
- Management: Anticonvulsants, ketogenic diet
- Nursing Care: Seizure precautions, educate family, medication adherence
4. Cranio-Cerebral Trauma
- Signs: Loss of consciousness, vomiting, neurological deficits
- Management: Stabilization, surgery if needed
- Nursing Care: Monitor ICP, neurological assessment, prevent secondary injury
g) Endocrine Disorders
- Pituitary Disorders: Growth hormone deficiency/excess
- Hypo/Hyperthyroidism: Delayed growth, weight changes
- Juvenile Diabetes (Type 1): Polyuria, polydipsia, polyphagia
- Adrenal Disorders: Addison’s/Cushing’s disease
- Management: Hormone replacement, insulin therapy, lifelong monitoring
- Nursing Care: Monitor growth, administer medications, educate family
h) Developmental Problems
- Handicapped Children / Mental Retardation / Dyslexia: Supportive care, therapy, educational interventions
- Hearing & Vision Impairment: Early identification, corrective devices, communication strategies
- Nursing Care: Promote independence, support family, rehabilitation
i) Other Problems
1. Fluid & Electrolyte Imbalance
- Causes: Diarrhea, vomiting, burns
- Management: IV fluids, electrolyte replacement
- Nursing Care: Monitor I&O, daily weight, vital signs
2. Burns
- Management: Fluid resuscitation, wound care, pain management
- Nursing Care: Infection prevention, nutritional support, emotional support
j) Problems with Locomotion
- Poliomyelitis: Muscle weakness; prevention via immunization
- Osteomyelitis: Bone infection; antibiotics, immobilization
- Kyphosis, Lordosis, Scoliosis: Postural deformities; physiotherapy, bracing, surgery
- Fractures: Immobilization, traction, post-surgical care
- Nursing Care: Pain management, rehabilitation, teaching exercises
k) Pre- and Post-Operative Care
Preoperative Care
- Assessment (vitals, labs, allergies)
- Child & parent education
- NPO status and medication review
- Emotional support, play therapy
Postoperative Care
- Monitor vitals and surgical site
- Pain management
- Prevent infection and complications
- Encourage early mobilization
- Nutrition and hydration
- Family education on home care
Conclusion
Pediatric nursing requires holistic care across multiple systems. Nurses must assess, prevent, and manage disorders, provide family education, ensure growth and developmental needs, and support pre/postoperative care to promote child health and well-being.