Maternal-Child Nursing

Front Cover
Endsheet 2
Evolve page
Maternal-Child Nursing
Copyright Page
Section Editors
Contributors
Reviewers
Preface
	Concepts
	Features
	Objectives
	Nursing Process
	Critical Thinking Exercises
	Evidence-Based Practice
	Critical Alerts
	Want to Know
	Health Promotion
	Clinical Reference Pages
	Pathophysiology
	Procedures
	Drug Guides
	Key Concepts
		For Students
		For Instructors
Acknowledgments
In Memory of Emily S. McKinney
Table Of Contents
Unit I Introduction to Maternal-Child Health Nursing
	1 Foundations of Maternity, Women’s Health, and Child Health Nursing
		Learning Objectives
		Historic Perspectives
			Maternity Nursing
				“Granny” Midwives
				Emergence of Medical Management
				Government Involvement in Maternal–Infant Care
				Impact of Consumer Demands on Healthcare
				Development of Family-Centered Maternity Care
			Current Settings for Childbirth
				Traditional Hospital Setting
					Labor, delivery, and recovery rooms.
					Labor, delivery, recovery, and postpartum rooms.
				Birth Centers
				Home Births
			Nursing of Children
				Historic Perspectives
				Societal Changes
				Hygiene and Hospitalization
				Development of Family-Centered Child Care
		Current Trends in Child Healthcare
			Cost Containment
				Diagnosis-Related Groups
				Managed Care
				Capitated Care
			Effects of Cost Containment
				Case Management
				Evidence-Based Nursing Care
				Outcomes Management
					Nurse-sensitive indicators.
					Variances.
					Clinical pathways.
		Home Care
		Community Care
			Access to Care
				Public Health Insurance Programs
				Preventive Health
		Healthcare Assistance Programs
		Statistics on Maternal, Infant, and Child Health
			Maternal and Infant Mortality
				Pregnancy-Related Mortality
				Infant Mortality
					Racial disparity for mortality.
					International infant mortality.
			Adolescent Births
			Childhood Mortality
			Morbidity
		Ethical Perspectives on Maternity, Women’s Health, and Child Nursing
			Ethics and Bioethics
			Ethical Dilemmas
				Ethical Principles
				Solving Ethical Dilemmas
			Ethical Concerns in Reproduction
				Elective Pregnancy Termination
					Belief that induced abortion is a private choice.
					Belief that elective pregnancy termination is taking a life.
					Implications for nurses.
				Fetal Injury
			Ethical Concerns in Child Health Nursing
				Withholding or Ceasing Life-Sustaining Treatment
				Terminating Life Support
		Social Issues
			Poverty
			Homelessness
			Prenatal Care in the United States
			Government Programs for Healthcare: Medicaid
			Allocation of Healthcare Resources
			Care versus Cure
			Healthcare Rationing
			Violence
		Legal Issues
			Safeguards for Healthcare
				Nurse Practice Acts
				Standards of Care
				Agency Policies
			Accountability
			Malpractice
				Prevention of Malpractice Claims
					Informed consent.
						Competence.
						Full disclosure.
						Understanding information.
					Voluntary consent.
				Refusal of Care
				Adoption
				Documentation
					Documenting discharge teaching.
					Documenting incidents.
				The Nurse as an Advocate
				Maintaining Expertise
		Current Trends and Their Legal and Ethical Implications
			Use of Unlicensed Assistive Personnel
			Concerns About Early Discharge
			Dealing With Early Discharge
		Key Concepts
		References and Readings
	2 The Nurse’s Role in Maternity, Women’s Health, and Pediatric Nursing
		Learning Objectives
		The Role of the Professional Nurse
			Care Provider
			Teacher
				Factors Influencing Learning
				Principles of Teaching and Learning
			Collaborator
			Researcher
			Advocate
			Manager of Care
		Advanced Preparation for Maternity and Pediatric Nurses
			Certified Nurse Midwives
			Nurse Practitioners
			Clinical Nurse Specialists
			Clinical Nurse Leaders
		Implications of Changing Roles for Nurses
			Therapeutic Communication
				Guidelines for Therapeutic Communication
				Therapeutic Communication Techniques
			Critical Thinking
				The Purpose of Critical Thinking
				Steps in Critical Thinking
					A. Recognizing assumptions.
					B. Examining biases.
					C. Analyzing the need for closure.
					D. Managing data.
						Collecting data.
						Validating data.
						Organizing and analyzing data.
					E. Evaluating other factors.
		The Nursing Process in Maternity and Pediatric Care
			Assessment
				Screening Assessment
				Focused Assessment
			Nursing Diagnosis
			Planning
				Setting Priorities
				Establishing Goals and Expected Outcomes
			Implementation
			Evaluation
		Complementary and Integrative Health
		Nursing Research and Evidence-Based Practice
		Key Concepts
		References and Readings
	3 The Childbearing and Child-Rearing Family
		Learning Objectives
		Family-Centered Care
		Family Structure
			Types of Families
				Traditional Families
				Nontraditional Families
					Single-parent families.
					Blended families.
					Adoptive families.
					Multigenerational families.
					Same-sex–parent families.
					Communal families.
			Characteristics of Healthy Families
		Factors That Interfere With Family Functioning
			High-Risk Families
				Marital Conflict and Divorce
				Adolescent Parenting
				Violence
				Substance Abuse
				Child With Special Needs
		Healthy Versus Dysfunctional Families
			Coping With Stress
			Coping Strategies
		Cultural Influences on Maternity and Pediatric Nursing
			Implications of Cultural Diversity for Nurses
			Western Cultural Beliefs
			Cultural Influences on the Care of People From Specific Groups
				Asians and Pacific Islanders
				Hispanics
				African-Americans
				American Indians and Alaska Natives
				Middle Easterners
			Cross-Cultural Health Beliefs
				Traditional Methods of Preventing Illness
				Traditional Practices to Maintain Health
				Traditional Practices to Restore Health
					Cultural assessment.
		Parenting
			Parenting Styles
			Parent–Child Relationship Factors
				Parental Characteristics
				Characteristics of the Child
				Temperament and Parental Expectations
		Discipline
			Dealing With Misbehavior
				Redirection
				Reasoning
				Time-Out
				Consequences
				Behavior Modification
				Corporal Punishment
		Nursing Process and the Family
			Family Assessment
			Nursing Diagnosis and Planning
			Intervention and Evaluation
		Key Concepts
		References and Readings
	4 Communicating With Children and Families
		Learning Objectives
		Components of Effective Communication
			Touch
			Physical Proximity and Environment
			Listening
				Attentiveness
				Clarification Through Reflection
				Empathy
				Impartiality
			Visual Communication
			Tone of Voice
			Body Language
			Timing
		Family-Centered Communication
			Establishing Rapport
			Availability and Openness to Questions
			Family Education and Empowerment
			Effective Management of Conflict
			Feedback From Children and Families
			Spirituality
		Transcultural Communication: Bridging the Gap
		Therapeutic Relationships: Developing and Maintaining Trust
		Nursing Care
			Communicating With Children and Families
				Assessment
				Nursing Diagnosis and Planning
					Expected outcomes.
					Expected outcome.
					Expected outcomes.
					Expected outcomes.
					Expected outcomes.
				Interventions
					Play.
					Storytelling.
					Explaining procedures and treatments.
					Strategies for enhancing self-esteem.
				Evaluation
		Communicating With Children With Special Needs
			The Child With a Visual Impairment
		The Child With a Hearing Impairment
			The Child Who Speaks Another Language
			The Child With Other Communication Challenges
			The Child With a Profound Neurologic Impairment
		Key Concepts
		References and Readings
	5 Health Promotion for the Developing Child
		Learning Objectives
		Overview of Growth and Development
			Definition of Terms
			Stages of Growth and Development
			Parameters of Growth
		Principles of Growth and Development
			Patterns of Growth and Development
			Critical Periods
			Factors Influencing Growth and Development
				Genetics
				Environment
				Culture
				Nutrition
				Health Status
				Family
				Parental Attitudes
					Child-rearing philosophies.
			Theories of Growth and Development
			Piaget’s Theory of Cognitive Development
				Nursing Implications of Piaget’s Theory
			Freud’s Theory of Psychosexual Development
				Nursing Implications of Freud’s Theory
			Erikson’s Psychosocial Theory
				Nursing Implications of Erikson’s Theory
			Kohlberg’s Theory of Moral Development
				Nursing Implications of Kohlberg’s Theory
		Theories of Language Development
		Assessment of Growth
		Assessment of Development
			Denver Developmental Screening Test II (DDST-II)
		Nurse’s Role in Promoting Optimal Growth and Development
			Developmental Assessment
				Interview
			Play
				Classifications of Play
				Social Aspects of Play
					Solitary play.
					Parallel play.
					Associative play.
					Cooperative play.
					Onlooker play.
				Types of Play
					Dramatic play.
					Familiarization play.
				Functions of Play
					Physical development and play.
					Play and cognitive development.
					Play and emotional development.
					Play and social development.
					Play and moral development.
		Health Promotion
			Immunizations
				Active and Passive Immunity
				Obstacles to Immunizations
				Informed Consent
				Children With an Uncertain History of Immunization
				Administration of Vaccines
				Precautions and Contraindications
				Immunocompromised Children
				Education
			Nutrition and Activity
				Carbohydrates
				Fats
				Proteins
				Water
				Vitamins and Minerals
				Dietary Guidelines
				Energy, Calories, and Servings
			Cultural and Religious Influences on Diet
			Assessment of Nutritional Status
				Anthropometric Data
				Clinical Evaluation
				Dietary History
					Twenty-four-hour recall.
					Food frequency questionnaire.
					Food diary.
			Physical Activity
			Safety
				Injury Prevention
				Anticipatory Guidance
				Teaching Strategies
		Key Concepts
		References and Readings
	6 Health Promotion for the Infant
		Learning Objectives
		Growth and Development of the Infant
			Physical Growth and Maturation of Body Systems
				Neurologic System
				Respiratory System
				Cardiovascular System
				Immune System
				Gastrointestinal System
				Renal System
			Motor Development
			Cognitive Development
			Sensory Development
				Vision
				Hearing
			Language Development
			Psychosocial Development
				Parent-Infant Attachment
				Stranger Anxiety
		Health Promotion for the Infant and Family
			Immunization
			Feeding and Nutrition
				Factors Influencing Choice of Feeding Method
					Breastfeeding.
					Formula feeding.
						Types of formula.
						Cow’s milk.
						Formula feeding techniques.
				Weaning
				Juices
				Water
				Solid Foods
					Finger foods.
					Snacks.
				Food Allergies
			Dental Care
				Teething
				Assessment of Dental Risk
				Cleaning Teeth
				Fluoride
				Bottle-Mouth Caries
			Sleep and Rest
			Safety
				Motor Vehicle Safety
				Providing a Safe Home Environment
				Burn Prevention
				Safe Baby Furnishings
				Preventing Falls
				Preventing Asphyxiation
				Preventing Lead Exposure
			Concerns During Infancy
				Patterns of Crying
				The Infant With Colic
					Etiology.
					Management.
					Nursing considerations.
		Key Concepts
		References and Readings
	7 Health Promotion During Early Childhood
		Learning Objectives
		Growth and Development During Early Childhood
			Physical Growth and Development
				The Toddler
				The Preschooler
			Motor Development
				The Toddler
				The Preschooler
			Cognitive and Sensory Development
				The Toddler
				The Preschooler
			Language Development
				The Toddler
				The Preschooler
			Psychosocial Development
				The Toddler
					Negativism.
					Ritualism and the importance of routine.
					Separation anxiety.
					Play.
					Psychosexual development.
				The Preschooler
					Play.
					Psychosexual development.
					Spiritual and moral development.
		Health Promotion During Early Childhood
			Nutrition
				Nutritional Requirements
				Solid Foods
				Age-Related Nutritional Challenges
					Food jags.
					Physiologic anorexia.
					Obesity risk.
			Dental Care
			Sleep and Rest
			Discipline
			Toddler Safety
				Car Safety
				Airplane Safety
				Fire and Burn Safety
				Preventing Falls
				Water Safety
				Preventing Poisoning
			Preschooler Safety
				Car Safety
				Fire and Burn Safety
				Firearm Safety
				Personal Safety
				Sexual Abuse
			Selected Issues Related to the Toddler
				Toilet Training
				Temper Tantrums
				Sibling Rivalry
			Selected Issues Related to the Preschooler
				Stuttering
				Preschool and Daycare Programs
				Preparing the Child for School
		Key Concepts
		References and Readings
	8 Health Promotion for the School-Age Child
		Learning Objectives
		Growth and Development of the School-Age Child
			Physical Growth and Development
				Body Systems
				Dentition
				Sexual Development
			Motor Development
				Development of Gross Motor Skills
				Importance of Active Play
				Preventing Fatigue and Dehydration
				Development of Fine Motor Skills
			Cognitive Development
				Intuitive Thought Stage
				Concrete Operations Stage
					Reversibility.
					Conservation.
					Classification and logic.
					Humor.
			Sensory Development
				Vision
				Hearing
			Language Development
			Psychosocial Development
				Development of a Sense of Industry
				Fostering Self-Esteem
			Spiritual and Moral Development
				Piaget
				Kohlberg
				Family Influence
				Spirituality and Religion
		Health Promotion for the School-Age Child and Family
			Nutrition During Middle Childhood
				Nutritional Requirements
				Age-Related Nutritional Challenges
			Dental Care
				Malocclusion
				Preventing Dental Injuries
				Dental Health Education
			Sleep and Rest
			Discipline
			Safety
				Car Safety
				Water Safety
				Fire and Burn Safety
				Bicycle, in-Line Skating, Scooter, and Skateboard Safety
				Pedestrian Safety
			Selected Issues Related to the School-Age Child
				Adjustment to School
					Peer influence.
					Influence of teachers.
					Parents’ role.
					School refusal.
						Helping a child overcome school refusal.
				Self-Care Children
				Obesity
					Assessing the scope of the problem.
					Prevention.
					Interventions and anticipatory guidance.
				Stress
					Sources of stress in children.
						School pressures.
						Physical threats.
						Competitive sports.
						Tight schedules and adaptation overload.
						Family pressures.
						Media influence.
					Interventions and anticipatory guidance to reduce childhood stress.
				Peer Victimization
		Key Concepts
		References and Readings
	9 Health Promotion for the Adolescent
		Learning Objectives
		Adolescent Growth and Development
			Physical Growth and Development
			Psychosexual Development, Hormonal Changes, and Sexual Maturation
				Female Sexual Maturation
				Male Sexual Maturation
			Motor Development
			Cognitive Development
			Sensory Development
			Language Development
			Psychosocial Development
				Early Adolescence
				Middle Adolescence
					Vocational exploration.
				Late Adolescence (18 to 21 Years)
			Moral and Spiritual Development
		Health Promotion for the Adolescent and Family
			Nutrition During Adolescence
				Age-Related Nutritional Challenges
				Nutritional Guidance for the Adolescent
			Hygiene
			Dental Care
			Sleep and Rest
			Exercise and Activity
			Safety
				Car Safety
				Water Safety
				Suicide
				Violence Toward Others
			Selected Issues Related to the Adolescent
				Body Art
				Tanning
				E-Cigarettes (“Vaping”)
				Sexual Activity
					Adolescent sexuality.
					Sexual behaviors.
						Sexual behavior and the media.
						Relationship violence.
					Pregnancy risk.
					Contraception.
			Parenting Adolescents
		Key Concepts
		References and Readings
	10 Hereditary and Environmental Influences on Development
		Learning Objectives
		Hereditary Influences
			Structure of Genes and Chromosomes
				DNA
				Genes
				Chromosomes
			Transmission of Traits by Single Genes
				Alleles
				Dominance
				Chromosome Location
			Patterns of Single-Gene Inheritance
				Autosomal Dominant Traits
				Autosomal Recessive Traits
				X-Linked Traits
					X-linked recessive disorders.
			Chromosome Abnormalities
				Numerical Abnormalities
					Trisomy.
					Monosomy.
					Polyploidy.
				Structural Abnormalities
		Multifactorial Disorders
			Characteristics of Multifactorial Disorders
			Risk of Occurrence
		Environmental Influences
			Teratogens
				Avoiding Fetal Exposure
					Infections.
					Drugs and other substances.
					Ionizing radiation.
					Maternal hyperthermia.
				Manipulating the Fetal Environment
			Mechanical Disruptions to Fetal Development
		Genetic Counseling
			Availability
			Focus on the Family
			Process of Genetic Counseling
			Supplemental Services
		Nursing Care for Families Concerned About Birth Defects
			Nurses as Part of a Genetic Counseling Team
			Nurses in General Practice
				Women’s Health Nurses
				Antepartum Nurses
					Identifying families for referral.
					Helping the woman decide about genetic counseling.
					Teaching about lifestyle.
					Providing emotional support.
					Helping the woman and family deal with abnormal results.
				Intrapartum and Neonatal Nurses
				Pediatric Nurses
		Key Concepts
		References and Readings
Unit II Maternity Nursing Care
	11 Reproductive Anatomy and Physiology
		Learning Objectives
		Sexual Development
			Prenatal Development
			Childhood
			Sexual Maturation
				Initiation of Sexual Maturation
				Female Puberty Changes
					Breast changes.
					Body contours.
					Body hair.
					Skeletal growth.
					Reproductive organs.
					Menarche.
				Male Puberty Changes
					Growth of the testes and penis.
					Nocturnal emissions.
					Body hair.
					Body composition.
					Skeletal growth.
					Voice changes.
			Decline in Fertility
		Female Reproductive Anatomy
			External Female Reproductive Organs
				Mons Pubis
				Labia Majora and Labia Minora
				Clitoris
				Vestibule
				Perineum
			Internal Female Reproductive Organs
				Vagina
				Uterus
					Divisions of the uterus.
						Corpus.
						Isthmus.
						Cervix.
					Layers of the uterus.
						Perimetrium.
						Myometrium.
						Endometrium.
				Fallopian Tubes
				Ovaries
			Support Structures
				Pelvis
				Muscles
				Ligaments
					Lateral support.
					Anterior support.
					Posterior support.
				Blood Supply
				Nerve Supply
		Female Reproductive Cycle
			Ovarian Cycle
				Follicular Phase
				Ovulatory Phase
				Luteal Phase
				Endometrial Cycle
				Proliferative Phase
				Secretory Phase
				Menstrual Phase
			Changes in Cervical Mucus
		The Female Breast
			Structure
			Function
		Male Reproductive Anatomy and Physiology
			External Male Reproductive Organs
				Penis
				Scrotum
			Internal Male Reproductive Organs
				Testes
				Accessory Ducts and Glands
		Key Concepts
		References and Readings
	12 Conception and Prenatal Development
		Learning Objectives
		Gametogenesis
			Oogenesis
			Spermatogenesis
		Conception
			Female Preparation for Conception
			Release of the Ovum
			Ovum Transport
			Male Preparation for Conception
			Ejaculation
			Transport of Sperm in the Female Reproductive Tract
			Preparation of Sperm for Fertilization
			Fertilization
			Entry of One Spermatozoon Into the Ovum
			Fusion of the Nuclei of Sperm and Ovum
		Pre-Embryonic Period
			Initiation of Cell Division
			Entry of the Zygote Into the Uterus
			Implantation in the Decidua
			Maintaining the Decidua
			Location of Implantation
			Mechanism of Implantation
		Embryonic Period
			Differentiation of Cells
				Second Week
				Third Week
				Fourth Week
				Fifth Week
				Sixth Week
				Seventh Week
				Eighth Week
		Fetal Period
			Weeks 9 Through 12
			Weeks 13 Through 16
			Weeks 17 Through 20
			Weeks 21 Through 24
			Weeks 25 Through 28
			Weeks 29 Through 32
			Weeks 33 Through 38
		Auxiliary Structures
			Placenta
				Maternal Component
					Development.
					Circulation in the maternal side.
				Fetal Component
					Development.
					Circulation in the fetal side.
				Metabolic Functions
				Transfer Functions
					Gas exchange.
					Nutrient transfer.
					Waste removal.
					Antibody transfer.
					Transfer of maternal hormones.
				Endocrine Functions
			Fetal Membranes and Amniotic Fluid
				Fetal Circulation
				Umbilical Cord
				Fetal Circulatory Circuit
				Changes in Blood Circulation After Birth
		Multifetal Pregnancy
			Monozygotic Twinning
			Dizygotic Twinning
		Key Concepts
		References and Readings
	13 Adaptations to Pregnancy
		Learning Objectives
		Physiologic Responses to Pregnancy
			Changes in Body Systems
				Reproductive System
					Uterus
						Growth.
						Pattern of uterine growth.
						Contractility.
						Uterine blood flow.
					Cervix
					Vagina and Vulva
						Ovaries.
						Breasts.
				Cardiovascular System
					Heart
						Heart size and position.
						Heart sounds.
					Blood Volume
						Total volume.
						Plasma volume.
						Red blood cell mass.
					Cardiac Output
					Systemic Vascular Resistance
					Blood Pressure
						Effect of position on blood pressure.
						Supine hypotension.
					Blood Flow
					Blood Components
					Respiratory System
						Oxygen consumption.
					Hormonal Factors
						Progesterone.
						Estrogen.
					Physical Changes
				Gastrointestinal System
					Mouth
					Esophagus
					Stomach
					Large and Small Intestine
					Liver and Gallbladder
				Urinary System
					Bladder
					Kidneys and Ureters
						Changes in size and shape.
						Functional changes.
				Integumentary System
					Skin
						Hyperpigmentation.
						Cutaneous vascular changes.
					Connective Tissue
					Hair
				Musculoskeletal System
					Calcium Storage
					Postural Changes
					Abdominal Wall
				Endocrine System
					Pituitary Gland
					Thyroid Gland
					Parathyroid Glands
					Pancreas
					Adrenal Glands
					Changes Caused by Placental Hormones
						Human chorionic gonadotropin.
						Estrogen.
						Progesterone.
						Human chorionic somatomammotropin (hCS).
						Relaxin.
					Changes in Metabolism
						Weight gain.
						Water metabolism.
						Dependent edema.
						Carpal tunnel syndrome.
						Carbohydrate metabolism.
				Sensory Organs
					Eye
					Ear
				Immune System
			Confirmation of Pregnancy
				Presumptive Indications of Pregnancy
					Amenorrhea
					Nausea and Vomiting
					Fatigue
					Urinary Frequency
					Breast and Skin Changes
					Vaginal and Cervical Color Changes
					Fetal Movement
				Probable Indications of Pregnancy
					Abdominal Enlargement
					Cervical Softening
					Changes in the Uterus
						Uterine consistency.
						Ballottement.
						Braxton hicks contractions.
						Palpation of the fetal outline.
						Uterine souffle.
					Pregnancy Tests
						Agglutination inhibition test.
						Radioreceptor assay.
						Radioimmunoassay.
						Inaccurate pregnancy test results.
				Positive Indications of Pregnancy
					Auscultation of Fetal Heart Sounds
					Fetal Movements Felt by Examiner
					Visualization of the Fetus
			Antepartum Assessment and Care
				Preconception and Interconception Care
					Initial Visit
					History
						Obstetric history.
						Menstrual history and estimated date of delivery.
						Gynecologic and contraceptive history.
						Medical and surgical history.
						Family health history.
						Partner’s health history.
						Psychosocial history.
					Physical Examination
						Vital signs
							Blood pressure.
							Pulse.
							Respiratory effort.
							Temperature.
						Cardiovascular system
							Venous congestion.
							Edema.
						Musculoskeletal system
							Posture and gait.
							Height and weight.
							Abdomen.
						Neurologic system.
						Integumentary system.
						Endocrine system.
						Gastrointestinal system
							Mouth.
							Intestine.
						Urinary system.
							Protein.
							Glucose.
							Ketones.
							Bacteria.
						Reproductive system
							Breasts.
							External reproductive organs.
							Internal reproductive organs.
							Pelvic measurements.
					Laboratory Data
					Risk Assessment
				Subsequent Assessments
					Vital Signs
					Weight
					Urinalysis
					Fundal Height
					Leopold’s Maneuvers
					Fetal Heart Rate
					Fetal Activity
					Signs of Labor
					Ultrasound Screen
					Glucose Screen
					Isoimmunization
					Pelvic Examinations
					Multifetal Pregnancy
					Diagnosis
					Maternal Adaptation to Multifetal Pregnancy
					Antepartum Care in Multifetal Pregnancy
				Common Discomforts of Pregnancy
					Nausea and Vomiting
					Heartburn
					Backache
					Round Ligament Pain
					Urinary Frequency
					Varicosities
					Constipation
					Hemorrhoids
					Leg Cramps
			Nursing Care
				Family Responses to Physical Changes of Pregnancy
					Assessment
					Nursing Diagnosis and Planning
						Expected outcomes.
					Interventions
						Teaching health behaviors.
							Bathing.
							Hot tubs and saunas.
							Douching.
							Breast care.
							Clothing.
							Exercise.
							Sleep and rest.
							Nutrition.
							Employment.
								Maternal safety.
								Exposure to teratogens.
							Travel.
							Immunizations.
						Teaching necessary lifestyle changes.
							Prescription and over-the-counter drugs.
							Complementary and alternative therapies.
							Tobacco.
							Alcohol.
							Illegal drugs.
						Signs of possible complications.
					Evaluation
		Psychological Responses to Pregnancy
			Maternal Responses
				First Trimester
					Uncertainty
					Ambivalence
					The Self as Primary Focus
				Second Trimester
					Physical Evidence of Pregnancy
					The Fetus as Primary Focus
					Narcissism and Introversion
					Body Image
					Changes in Sexuality
				Third Trimester
					Vulnerability
					Increasing Dependence
					Preparation for Birth
			Maternal Role Transition
				Transitions Experienced Throughout Pregnancy
				Steps in Adjusting to the Maternal Role
					Mimicry
					Role Play
					Fantasy
					The Search for a Role Fit
					Grief Work
					Maternal Tasks of Pregnancy
						Seeking Safe Passage
						Securing Acceptance
						Learning to Give of Herself
						Committing Herself to the Unknown Child
			Paternal Adaptation
				Variations in Paternal Adaptation
				Developmental Processes
				Grappling With the Reality of Pregnancy and the Child
					Struggling for Recognition as a Parent
					Creating the Role of Involved Father
						Parenting information.
						Couvade.
			Adaptation of Grandparents
				Age
				Number and Spacing of Other Grandchildren
				Perceptions of the Role of Grandparents
			Adaptation of Siblings
				Toddlers
				Older Children
				Adolescents
			Factors That Influence Psychosocial Adaptations
				Age
				Multiparity
				Social Support
				Absence of a Partner
				Socioeconomic Status
				Abnormal Situations
			Barriers to Prenatal Care
			Cultural Influences on Childbearing
				Differences Within Cultures
				Cultural Differences That May Cause Conflict
					Health Beliefs
						Health maintenance during pregnancy.
						Belief in fate.
						Preventing illness.
						Restoring health.
						Modesty.
						Female genital cutting.
					Communication Techniques
						Language.
						Communication style.
						Decision making.
						Eye contact.
						Touch.
					Time Orientation
				Culturally Competent Nursing Care
					Cultural Assessment
					Cultural Negotiation
			Nursing Care
				Psychosocial Concerns
					Assessment
					Nursing Diagnosis and Planning
						Expected outcomes.
					Interventions
						Providing information.
						Adapting nursing care to pregnancy progress.
						Discussing resources.
						Helping the family prepare for the birth.
						Modeling communication techniques.
						Identifying cultural factors that can cause conflict.
					Evaluation
			Perinatal Education
				Providers of Education
				Class Participants
				Choices for Childbearing
				Setting and Healthcare Provider
				Support Person
				Education
				Types of Classes Available
					Preconception Classes
					Early Pregnancy Classes
					Exercise Classes
					Childbirth Preparation Classes
					Cesarean Birth Preparation Classes
					Breastfeeding Classes
					Parenting Classes
					Classes for Fathers
					Postpartum Classes
			Key Concepts
		References and Readings
	14 Nutrition for Childbearing
		Learning Objectives
		Weight Gain During Pregnancy
			Recommendations for Total Weight Gain
			Pattern of Weight Gain
			Maternal and Fetal Distribution
			Factors That Influence Weight Gain
		Nutritional Requirements During Pregnancy
			Dietary Reference Intakes
			Energy
				Carbohydrates
				Fats
				Calories
			Protein
			Vitamins
			Folic Acid
			Minerals
				Iron
				Calcium
				Sodium
			Nutritional Supplementation
				Purpose
				Disadvantages and Dangers of Nutritional Supplementation
			Water
			Food Plan
				Whole Grains
				Vegetables and Fruits
				Dairy Group
				Protein Group
				Other Elements
		Food Precautions
		Factors That Influence Nutrition
			Age
			Nutritional Knowledge
			Exercise
			Culture
				Southeast Asian Dietary Practices
					Effect of culture on diet during childbearing.
					Increasing nutrients with traditional foods.
				Hispanic Dietary Practices
		Nutritional Risk Factors
			Socioeconomic Status
				Poverty
				Food Supplement Programs
			Adolescence
				Nutrient Needs
				Common Problems
				Teaching the Adolescent
			Vegetarianism
				Meeting the Nutritional Requirements of the Pregnant Vegetarian
					Energy.
					Protein.
					Calcium.
					Iron.
					Zinc.
					Vitamin B12.
					Vitamin A.
			Lactose Intolerance
			Pregnancy-Related Nausea and Vomiting
			Anemia
			Abnormal Prepregnancy Weight
			Eating Disorders
			Food Cravings and Aversions
			Pica
			Multiparity and Multifetal Pregnancy
			Substance Use and Abuse
				Smoking
				Caffeine
				Alcohol
				Drugs
			Other Risk Factors
		Nutrition After Birth
			Nutrition for the Lactating Mother
				Energy
				Protein
				Fats
				Vitamins and Minerals
				Specific Nutritional Concerns
					Dieting.
					Adolescence.
					Vegan diet.
					Avoidance of dairy products.
					Inadequate diet.
					Alcohol.
					Caffeine.
				Fluids
				Foods to Avoid
			Nutrition for the Nonlactating Mother
			Weight Loss
		Nursing Care
			Nutrition for Childbearing
				Assessment
					Interview.
						Appetite.
						Eating habits.
						Food preferences.
						Identify potential problems.
						Diet history.
							Twenty-four-hour diet history.
							Food intake records.
							Food-frequency questionnaires.
					Physical assessment.
						Weight at initial visit.
						Weight at subsequent visits.
						Signs of nutrient deficiency.
					Laboratory tests.
					Reassessing nutritional status at each visit.
				Nursing Diagnosis and Planning
					Expected outcomes.
				Interventions
					Explaining nutrient needs.
					Providing reinforcement.
					Evaluating weight gain.
					Encouraging supplement intake.
					Making referrals.
				Evaluation
		Key Concepts
		References and Readings
	15 Prenatal Diagnostic Tests
		Learning Objectives
		Indications for Prenatal Diagnostic Tests
		Ultrasound
			Emotional Responses
			First Trimester
				Procedure
				Purposes
			Second and Third Trimesters
				Procedure
				Purposes
			Advantages
			Disadvantages
		Doppler Ultrasound Blood Flow Assessment
			Purpose
		Color Doppler
		Alpha-Fetoprotein Screening
			Purpose
			Procedure
			Advantages
			Limitations
		Multiple-Marker Screening
		Chorionic Villus Sampling
			Purpose
			Indications
			Procedure
			Advantages
			Limitations
		Amniocentesis
			Purposes
				Second-Trimester Amniocentesis
				Third-Trimester Amniocentesis
					Tests to determine fetal lung maturity.
					Test for fetal hemolytic disease.
			Procedure
			Advantages
			Disadvantages
			Risks
		Percutaneous Umbilical Blood Sampling
			Procedure
			Risks
		Antepartum Fetal Surveillance
			Nonstress Test
				Purpose
				Procedure
				Interpretation
				Advantages
				Disadvantages
			Vibroacoustic (Acoustic) Stimulation
				Purpose and Procedure
				Fetal Responses
				Risks
			Contraction Stress Test
				Purpose
				Procedure
				Interpretation
				Advantages
				Disadvantages
			Biophysical Profile
				Purpose
				Procedure and Interpretation
			Modified Biophysical Profile
				Advantages
				Disadvantages
		Maternal Assessment of Fetal Movement
			Advantages
			Disadvantages
		Nursing Care
			The Patient Who Has Diagnostic Testing
				Assessment
				Nursing Diagnosis and Planning
					Expected outcomes.
				Interventions
					Providing information.
					Providing support.
						Helping patients set realistic goals.
						Supporting the woman’s decision.
				Evaluation
		Key Concepts
		References and Readings
	16 Giving Birth
		Learning Objectives
		Issues for New Nurses
			Pain Associated With Birth
			Inexperience or Negative Experiences
			Unpredictability
			Intimacy
		Physiologic Effects of the Birth Process
			Maternal Response
				Reproductive System
					Characteristics of contractions.
						Coordinated contractions.
						Involuntary contractions.
						Intermittent contractions.
					Contraction cycle.
					Uterine body.
					Cervical changes.
						Effacement.
						Dilation.
				Cardiovascular System
				Respiratory System
				Gastrointestinal System
				Urinary System
				Hematopoietic System
			Fetal Response
				Placental Circulation
				Cardiovascular System
				Pulmonary System
		Components of the Birth Process
			Powers
				Uterine Contractions
				Maternal Pushing Efforts
			Passage
			Passenger
				Fetal Head
					Bones, sutures, and fontanels.
					Fetal head diameters.
				Variations in the Passenger
					Fetal lie.
					Attitude.
					Presentation.
						Cephalic presentation.
							Vertex.
							Military.
							Brow.
							Face.
						Breech presentation.
							Frank breech.
							Full (or complete) breech.
							Footling breech.
						Shoulder.
					Position.
						Right (R) or left (L).
						Occiput (O), mentum (M), or sacrum (S).
						Anterior (A), posterior (P), or transverse (T).
			Psyche
			Interrelationships Between the Components of Birth
				Individual and Cultural Values
				Birth as an Experience
		Normal Labor
			Theories of Onset
			Premonitory Signs
			True Labor and False Labor
			Mechanisms of Labor
			Stages and Phases of Labor
				First Stage of Labor
					Latent phase.
					Active phase.
				Second Stage of Labor
				Third Stage of Labor
				Fourth Stage of Labor
			Duration of Labor
		Nursing Care During Labor and Birth
			Admission to the Birth Center
			Nursing Responsibilities During Admission
				Establishing a Therapeutic Relationship
					Making the family feel welcome.
					Determining family expectations about birth.
					Conveying confidence.
					Assigning a primary nurse.
					Using touch for comfort.
					Respecting cultural values.
				Assessments at the Time of Admission
					Focused assessment.
						Fetal assessment.
						Maternal vital signs.
						Impending birth.
					Database assessment.
						Basic information.
						Fetal assessments.
						Labor status.
						Physical examination.
				Admission Procedures
					Notifying the physician or midwife.
					Consent forms.
					Laboratory tests.
					Intravenous access.
				Assessments After Admission
					Fetal assessments.
						FHR.
						Amniotic fluid.
					Maternal assessments.
						Vital signs.
						Contractions.
						Progress of labor.
						Intake and output.
						Response to labor.
					The support person’s response.
		Nursing Care
			The Woman With False or Early Labor
				Assessment
				Nursing Diagnosis and Planning
					Expected outcomes.
				Interventions
					Providing reassurance.
						Teaching.
				Evaluation
		Nursing Care
			The Woman in True Labor
		Fetal Oxygenation
			Assessment
			Nursing Diagnosis and Planning
				Expected outcome.
			Interventions
				Promoting placental function.
				Observing for conditions associated with fetal compromise.
			Evaluation
		Discomfort
			Assessment
			Nursing Diagnosis and Planning
				Expected outcomes.
			Interventions
				Providing comfort measures.
					Lighting.
					Temperature.
					Cleanliness.
					Mouth care.
					Bladder.
					Positioning.
					Water.
				Teaching.
					First stage of labor.
					Second stage of labor.
						Laboring down.
						Positions.
						Method and breathing pattern.
				Labor support
					Providing encouragement.
					Giving of self.
					Offering pharmacologic measures.
					Caring for the birth partner.
			Evaluation
		Preventing Injury
			Assessment
			Nursing Diagnosis and Planning
				Expected outcome.
			Interventions
				Transfer to a delivery room.
				Positioning for birth.
				Observing the perineum.
			Evaluation
			Nursing Care During the Late Intrapartum Period
				Responsibilities During Birth
				Responsibilities After Birth
					Care of the Infant
						Maintaining cardiopulmonary function.
						Supporting thermoregulation.
						Identifying the infant.
					Care of the Mother
						Observing for hemorrhage.
						Vital signs.
							Fundus.
							Bladder.
							Lochia.
						Relieving discomfort.
							Ice packs.
							Analgesics.
							Warmth.
					Promoting Early Family Attachment
			Key Concepts
		References and Readings
	17 Intrapartum Fetal Surveillance
		Learning Objectives
		Fetal Oxygenation
			Uteroplacental Exchange
			Fetal Circulation
			Fetal Heart Rate Regulation
				Autonomic Nervous System
				Baroreceptors
				Chemoreceptors
				Adrenal Glands
				Central Nervous System
			Pathologic Influences on Fetal Oxygenation
				Maternal Cardiopulmonary Alterations
				Uterine Activity
				Placental Disruptions
				Interruptions in Umbilical Flow
				Fetal Alterations
			Risk Factors for Fetal Compromise
		Auscultation and Palpation
			Advantages
			Limitations
		Evaluating Auscultated Fetal Heart Rate Data
		Electronic Fetal Monitoring
			Advantages
			Limitations
		Electronic Fetal Monitoring Equipment
			Bedside Monitor Unit
			Paper Strip
			Remote Surveillance
			Devices for External Fetal Monitoring
				Fetal Heart Rate Monitoring With an Ultrasound Transducer
				Monitoring Uterine Activity With a Tocotransducer
			Devices for Internal Fetal Monitoring
				Fetal Heart Rate Monitoring With a Scalp Electrode
				Uterine Activity Monitoring With an Intrauterine Pressure Catheter
		Evaluating Electronic Fetal Monitoring Strips
			Baseline Fetal Heart Rate
			Baseline FHR Variability
			Periodic Patterns in FHR
				Accelerations
				Decelerations
					Early decelerations.
					Late decelerations.
					Variable decelerations.
			Uterine Activity
		Significance of FHR Patterns
			Reassuring Patterns
			Indeterminate Patterns
			Nonreassuring Patterns
				Clarification of Data
					Fetal scalp stimulation.
					VAS.
					Fetal scalp blood sampling.
					Cord blood gases and pH.
				Interventions for Nonreassuring Patterns
					Identifying the cause of a nonreassuring pattern.
					Increasing placental perfusion.
					Increasing maternal blood oxygen saturation.
					Reducing cord compression.
		Nursing Care
			The Woman Having Intrapartum Fetal Monitoring
		Learning Needs
			Assessment
			Nursing Diagnosis and Planning
				Expected outcome.
			Interventions
				Explaining FHR auscultation with uterine palpation.
				Explaining the electronic fetal monitor.
				Addressing parents’ safety concerns.
				Coping with misleading data.
				Including the labor partner.
				Enhancing comfort.
			Evaluation
		Fetal Oxygenation
			Assessment
			Nursing Diagnosis and Planning
			Interventions
				Taking corrective actions.
				Reassuring parents.
				Reporting nonreassuring patterns.
				Documenting assessments and care.
			Evaluation
		Key Concepts
		References and Readings
	18 Pain Management for Childbirth
		Learning Objectives
		Unique Nature of Pain During Birth
		Adverse Effects of Excessive Pain
			Physiologic Effects
			Psychologic Effects
		Variables in Childbirth Pain
			Physical Factors
				Sources of Pain
					Tissue ischemia.
					Cervical dilation.
					Pressure and pulling on pelvic structures.
					Distention of the vagina and perineum.
				Factors Influencing the Perception or Tolerance of Pain
					Intensity of labor.
					Fetal position and size.
					Characteristics of the pelvis.
					Fatigue.
					Intervention of caregivers.
			Psychosocial Factors
				Culture
				Anxiety and Fear
				Previous Experiences With Pain
				Preparation for Childbirth
				Support System
		Standards for Pain Management
		Nonpharmacologic Pain Management
			Advantages
			Limitations
			Preparation for Pain Management
			Application of Nonpharmacologic Techniques
				General Comfort
				Reducing Anxiety and Fear
				Relaxation
					Implementing specific relaxation techniques.
				Mind-Body Stimulation
					Self-massage.
					Massage by others.
					Thermal stimulation.
					Acupressure.
				Hydrotherapy
				Mental Stimulation
					Imagery.
					Focal point.
				Breathing Techniques
					First-stage breathing.
						Cleansing breath.
						Slow-paced breathing.
				Modified-Paced Breathing
					Pattern-paced breathing.
					Controlling the urge to push.
					Common problems.
					Second-stage breathing.
		Pharmacologic Pain Management
			Special Considerations When Medicating a Pregnant Woman
				Effects on the Fetus
				Maternal Physiologic Alterations
					Cardiovascular changes.
					Respiratory changes.
					Gastrointestinal changes.
					Nervous system changes.
				Effects on the Course of Labor
				Pregnancy Complications
				Interactions With Other Substances
			Regional Pain Management Techniques
				Regional Anesthesia
				Pudendal Block
				Local Infiltration Anesthesia
				Epidural Block
					Technique.
					Dural puncture.
					Contraindications and precautions.
					Adverse effects of epidural block.
						Maternal hypotension.
						Bladder distention.
						Prolonged second stage.
						Migration of the epidural catheter.
						Fever.
					Adverse effects of epidural opioids.
						Nausea and vomiting.
						Pruritus.
						Respiratory depression.
					Nursing care
						Nursing care for epidural placement.
				Combined Spinal-Epidural Analgesia
					Technique.
					Adverse effects of intrathecal opioids.
					Nursing care.
				Subarachnoid (Spinal) Block
					Technique.
					Contraindications and precautions.
					Adverse effects of an SAB.
			Systemic Drugs for Labor
				Inhalants
				Nursing Considerations
				Opioid Analgesics
				Opioid Antagonists
				Adjunctive Drugs
				Sedatives
			General Anesthesia
				Technique
				Adverse Effects of General Anesthesia
					Maternal aspiration of gastric contents.
					Respiratory depression.
					Uterine relaxation.
				Methods to Minimize Adverse Effects
		Nursing Management
			Pain Management
		Pain
			Assessment
				Labor status.
			Nursing Diagnosis and Planning
				Expected outcomes.
			Interventions
				Promoting relaxation.
				Reducing outside sources of discomfort.
				Reducing anxiety and fear.
				Helping the woman use nonpharmacologic techniques.
					Massage.
					Mental stimulation.
					Breathing.
				Incorporating pharmacologic methods.
			Evaluation
		Respiratory Compromise
			Assessment
			Nursing Diagnosis and Planning
				Expected outcome.
			Interventions
				Identifying risk factors.
				Reducing risk of aspiration or lung injury.
					Perioperative care.
					Postoperative care.
			Evaluation
			Key Concepts
		References and Readings
	19 Nursing Care During Obstetric Procedures
		Learning Objectives
		Amniotomy
			Indications
			Risks
				Prolapse of the Umbilical Cord
				Infection
				Abruptio Placentae
			Technique
			Nursing Considerations
				Obtaining Baseline Information
				Assisting With Amniotomy
				Providing Care After Amniotomy
					Identifying complications.
					Promoting comfort.
		Induction and Augmentation of Labor
			Indications
			Determining Whether Induction Is Indicated
			Contraindications
			Risks
			Technique
				Cervical Ripening
					Medical methods.
					Mechanical methods.
				Oxytocin Administration
			Nursing Considerations
				Observing the Fetal Response
				Observing the Mother’s Response
		Version
			Indications
				External Cephalic Version
				Internal Version
			Contraindications
			Risks
			Technique
				External Version
				Internal Version
			Nursing Considerations
				Providing Information
				Promoting Maternal and Fetal Health
				Reducing Anxiety
		Operative Vaginal Birth
			Indications
			Contraindications
			Risks
			Technique
			Nursing Considerations
		Episiotomy
			Technique
			Nursing Considerations
		Cesarean Birth
			VBAC
			Indications
			Contraindications
			Risks
			Technique
				Preparation
				Incisions
			Nursing Considerations
				Providing Emotional Support
				Teaching
				Promoting Safety
				Providing Postoperative Care
		Key Concepts
		References and Readings
	20 Postpartum Adaptations
		Learning Objectives
		Reproductive System
			Involution of the Uterus
				Descent of the Uterine Fundus
				Afterpains
					Etiology.
					Nursing considerations.
				Lochia
					Changes in color.
					Amount.
			Cervix
			Vagina
			Perineum
				Discomfort
				Nursing Considerations
		Cardiovascular System
			Cardiac Output
			Plasma Volume
			Blood Values
			Coagulation
		Gastrointestinal System
		Urinary System
		Musculoskeletal System
			Muscles and Joints
			Abdominal Wall
		Integumentary System
		Neurologic System
		Endocrine System
			Resumption of Ovulation and Menstruation
			Lactation
			Weight Loss
		Postpartum Assessments
			Clinical Pathways
			Initial Assessments
			Chart Review
				Need for Rho(D) Immune Globulin
				Need for Vaccines
					Rubella vaccine.
					Pertussis vaccine.
				Risk Factors for Hemorrhage and Infection
			Focused Assessments After Vaginal Birth
				Vital Signs
					Blood pressure.
					Orthostatic hypotension.
					Pulse.
					Respirations.
					Temperature.
					Pain.
				Fundus
				Lochia
				Perineum
				Bladder Elimination
				Breasts
				Lower Extremities
				Homans Sign
				Edema and Deep Tendon Reflexes
		Care in the Immediate Postpartum Period
			Providing Comfort Measures
				Ice Packs
				Sitz Baths
				Perineal Care
				Topical Medications
				Sitting Measures
				Analgesics
			Promoting Bladder Elimination
			Providing Fluids and Food
			Preventing Thrombophlebitis
		Nursing Care After Cesarean Birth
			Assessment
				Pain Relief
				Respirations
				Abdomen
				Intake and Output
			Interventions
				The First 24 Hours
					Providing pain relief.
					Overcoming the effects of immobility.
					Providing comfort.
				After 24 Hours
					Resuming normal activities.
					Assisting the mother with infant care.
					Preventing abdominal distention.
		Nursing Care
			Teaching After Birth
				Assessment
				Nursing Diagnosis and Planning
					Expected outcomes.
				Interventions
					Preparing for teaching.
					Determining teaching topics.
					Teaching the process of involution.
					Teaching self-care.
						Handwashing.
						Breast care for lactating mothers.
						Measures to suppress lactation.
						Care of the cesarean incision.
						Perineal care.
						Kegel exercises.
					Promoting rest and sleep.
						Rest at the birth facility.
						Rest at home.
					Providing nutrition counseling
						Food supply.
						Diet.
					Promoting regular bowel elimination.
					Promoting good body mechanics
						Exercise.
						Preventing back strain.
					Counseling about sexual activity.
					Instructing about follow-up appointments.
					Teaching about signs and symptoms that should be reported.
					Ensuring that all elements have been taught.
					Documenting teaching.
				Evaluation
		The Process of Becoming Acquainted
			Bonding
			Attachment
			Maternal Touch
			Verbal Behaviors
		The Process of Maternal Role Adaptation
			Puerperal Phases
				Taking-in Phase
				Taking-Hold Phase
				Letting-Go Phase
			Maternal Role Attainment
				Heading Toward a New Normal
					Appreciating the body.
					Settling in.
					Becoming a new family.
				Redefining Roles
				Role Conflict
			Major Maternal Concerns
				Body Image
				Smoking
				Postpartum Blues
		The Process of Family Adaptation
			Fathers
			Siblings
			Grandparents
			Factors Affecting Family Adaptation
				Discomfort and Fatigue
				Knowledge of Infant Needs
				Previous Experience
				Expectations About the Newborn
				Maternal Age
				Maternal Temperament
				Temperament of the Infant
				Availability of a Strong Support System
				Other Factors
					Cesarean birth.
					Preterm or ill infant.
					Birth of multiple infants.
		Cultural Influences on Adaptation
			Communication
			Dietary Practices
			Health Beliefs
		Nursing Care
			Maternal Adaptation
				Assessment
				Nursing Diagnosis and Planning
					Expected outcomes.
				Interventions
					Assisting the mother through recovery phases
						“Mother” the mother.
						Monitor and protect.
						Listen to the birth experience.
						Foster independence.
						Promote bonding and attachment.
						Involve parents in infant care.
				Evaluation
		Nursing Care
			Family Adaptation
				Assessment
					Fathers.
					Siblings.
					Support system.
					Nonverbal behavior.
				Nursing Diagnosis and Planning
					Expected outcomes.
				Interventions
					Infant needs.
					Infant signals.
					Helping the family adapt
						Providing anticipatory guidance about stress reduction.
						Helping the father co-parent.
						Providing ways to reduce sibling rivalry.
						Identifying resources.
				Evaluation
		Postpartum Home and Community Care
			Criteria for Discharge
		Community-Based Care
		Key Concepts
		References and Readings
	21 The Normal Newborn
		Learning Objectives
		Initiation of Respiration
			Development of the Lungs
			Causes of Respiration
				Chemical Factors
				Mechanical Factors
				Thermal Factors
				Sensory Factors
			Continuation of Respiration
		Cardiovascular Adaptation: Transition From Fetal to Neonatal Circulation
			Ductus Venosus
			Foramen Ovale
			Pulmonary Blood Vessels
			Ductus Arteriosus
			Changes at Birth
		Neurologic Adaptation: Thermoregulation
			Newborn Characteristics Leading to Heat Loss
			Methods of Heat Loss
			Nonshivering Thermogenesis
			Effects of Cold Stress
			Neutral Thermal Environment
			Hyperthermia
		Hematologic Adaptation
			Factors Affecting the Blood
			Blood Values
				Erythrocytes and Hemoglobin
				Hematocrit
				Leukocytes
			Risk of Clotting Deficiency
		Gastrointestinal System
			Stomach
			Intestines
			Digestive Enzymes
			Stool
		Hepatic System
			Blood Glucose Maintenance
			Conjugation of Bilirubin
				Source and Effect of Bilirubin
				Normal Conjugation
				Risk Factors for Elevated Bilirubin
			Hyperbilirubinemia
				Physiologic Jaundice
				Nonphysiologic (Pathologic) Jaundice
				Jaundice Associated With Breastfeeding
					Breastfeeding or early-onset jaundice.
					True breast-milk jaundice.
			Blood Coagulation
			Iron Storage
			Drug Metabolism
		Urinary System
			Kidney Development
			Kidney Function
			Fluid Balance
				Water Distribution
				Insensible Water Loss
				Urine Dilution and Concentration
			Acid-Base and Electrolyte Balance
		Immune System
			IgG
			IgM
			IgA
		Psychosocial Adaptation
			Periods of Reactivity
				First Period of Reactivity
				Period of Sleep or Decreased Activity
				Second Period of Reactivity
			Behavioral States
				Deep or Quiet Sleep State
				Light or Active Sleep State
				Drowsy State
				Quiet Alert State
				Active Alert State
				Crying State
		Early Assessments
			History
		Assessment of Cardiorespiratory Status
			Airway
				Respiratory Rate
				Breath Sounds
				Signs of Respiratory Distress
					Tachypnea.
					Retractions.
					Flaring of the nares.
					Cyanosis.
					Grunting.
					Seesaw or paradoxical respiration.
					Asymmetry.
				Choanal Atresia
			Color
				Pallor
				Ruddy Color
			Heart Sounds
				Rhythm and Murmurs
			Brachial and Femoral Pulses
			Blood Pressure
			Capillary Refill
		Assessment of Thermoregulation
		Assessing for Anomalies
			Head
				Molding
				Fontanels
				Caput Succedaneum
				Cephalhematoma
			Face
			Neck and Clavicles
			Cord
			Extremities
				Hands and Feet
				Hips
			Vertebral Column
			Measurements
				Weight
				Length
				Head and Chest Circumference
		Assessment of Body Systems
			Neurologic System
				Reflexes
				Sensory Assessment
					Ears.
					Eyes.
				Sense of Smell and Taste
				Other Neurologic Signs
		Assessment of Hepatic Function
			Blood Glucose
			Bilirubin
			Gastrointestinal System
				Mouth
				Suck
				Initial Feeding
				Abdomen
				Stools
			Genitourinary System
				Kidney Palpation
				Urine
				Genitalia
					Female.
					Male.
			Integumentary System
				Skin
					Color.
					Harlequin color change.
					Mottling.
					Vernix caseosa.
					Lanugo.
					Milia.
					Erythema toxicum.
					Birthmarks.
					Marks from delivery.
					Other skin assessments.
					Documentation.
				Breasts
				Hair and Nails
		Assessment of Gestational Age
			Assessment Tools
			Neuromuscular Characteristics
				Posture
				Square Window
				Arm Recoil
				Popliteal Angle
				Scarf Sign
				Heel to Ear
			Physical Characteristics
				Skin
				Lanugo
				Plantar Surface
				Breasts
				Eyes and Ears
				Genitals
			Scoring
			Gestational Age and Infant Size
		Assessment of Behavior
			Periods of Reactivity
			Behavioral Changes
				Orientation
				Habituation
				Self-Consoling Activities
				Parents’ Response
		Key Concepts
		References and Readings
	22 The Normal Newborn
		Learning Objectives
		Early Care
			Administering Vitamin K
		Providing Eye Treatment
		Nursing Care
			Cardiorespiratory Status
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
				Interventions
					Positioning and suctioning.
					Providing continuing care.
				Evaluation
		Nursing Care
			Thermoregulation
			Assessment
			Nursing Diagnosis and Planning
				Expected outcome.
			Interventions
				Preventing heat loss
					Preparing the environment before birth.
					Providing immediate care.
					Providing ongoing prevention.
				Restoring thermoregulation.
				Performing expanded assessments.
			Evaluation
		Nursing Care
			Hepatic Function
			Blood Glucose
				Assessment
				Nursing Diagnosis and Planning
				Interventions
					Maintaining safe glucose levels.
					Repeating glucose tests.
					Providing other care.
				Evaluation
			Bilirubin
				Assessment
				Nursing Diagnosis and Planning
					Expected outcomes.
				Interventions
				Evaluation
		Ongoing Assessments and Care
			Providing Skin Care
				Bathing
				Cleansing the Diaper Area
			Providing Cord Care
			Assisting With Feedings
			Positioning the Infant
			Protecting the Infant
				Identifying the Infant
				Preventing Infant Abduction
				Preventing Infection
		Circumcision
			Reasons for Choosing Circumcision
			Reasons for Rejecting Circumcision
			Pain Relief
			Methods
			Nursing Considerations
				Assisting in Decision Making
				Providing Care During Circumcision
				Evaluating Pain
				Providing Postprocedure Care
				Teaching Parents
		Nursing Care
			Parents’ Knowledge of Newborn Care
				Assessment
				Nursing Diagnosis and Planning
					Expected outcomes.
				Interventions
					Determining who teaches.
					Setting priorities.
					Using various teaching methods.
					Modeling behavior.
					Teaching intermittently.
					Including the father.
					Documenting teaching.
					Incorporating cultural considerations.
					Providing for follow-up care.
				Evaluation
		Immunization
		Newborn Screening
			Hearing Screening
			Other Screening Tests
		Discharge and Newborn Follow-Up Care
			Discharge
			Follow-Up Care
				Home Visits
					Content of the home visit.
					Identification of jaundice.
					Feeding concerns.
					General considerations in home visits.
					Outpatient Visits
					Telephone Counseling
						Follow-up calls.
						Warm lines.
						Telephone techniques.
						Guidelines and documentation.
		Key Concepts
		References and Readings
	23 Newborn Feeding
		Learning Objectives
		Nutritional Needs of the Newborn
			Calories
			Nutrients
			Water
		Breast Milk and Formula Composition
			Breast Milk
				Changes in Composition
					Lactogenesis I.
					Lactogenesis II.
					Lactogenesis III.
				Nutrients
					Protein.
					Carbohydrate.
					Fat.
					Vitamins.
					Minerals.
				Enzymes
				Infection-Preventing Components
				Effect of Maternal Diet
			Formulas
				Cow’s Milk
				Formulas for Infants With Special Needs
		Considerations in Choosing a Feeding Method
			Breastfeeding
			Formula Feeding
			Combination Feeding
			Factors Influencing Choice
				Support From Others
				Culture
				Employment
				Staff Knowledge
				Other Factors
		Normal Breastfeeding
			Breast Changes During Pregnancy
			Milk Production
			Hormonal Changes at Birth
				Prolactin
				Oxytocin
			Continued Milk Production
			Preparation of Breasts for Breastfeeding
		Nursing Care
			Breastfeeding
				Assessment
					Maternal Assessment.
						Breasts and nipples.
						Knowledge.
					Assessment of infant feeding behaviors.
						LATCH scoring tool.
				Nursing Diagnosis and Planning
					Expected outcomes.
					Interventions.
					Assisting with the first feeding.
					Teaching feeding techniques
						Position of the mother and infant.
						Position of the mother’s hands.
						Latch-on techniques.
						Eliciting latch-on.
						Position of the mouth.
						Suckling pattern.
						Removal from the breast.
						Frequency of feedings.
						Length of feedings.
					Preventing problems.
						Teaching.
						Minimizing interruptions.
						Formula gift packs.
						Formula supplements.
						Insufficient milk supply.
					Increasing confidence.
					Providing resources.
				Evaluation
		Common Breastfeeding Concerns
			Infant Problems
				Sleepy Infant
				Nipple Confusion
				Latch-on Problems
				Infant Complications
					Jaundice.
					Prematurity.
					Late preterm infants.
					Illness and congenital defects.
			Maternal Concerns
				Common Breast Problems
					Engorgement.
					Nipple pain.
					Flat and inverted nipples.
					Plugged ducts.
				Illness in the Mother
					Drug transfer to breast milk.
					Conditions in which breastfeeding should be avoided.
				Previous Breast Surgery
				Employment
				Milk Expression and Storage
					Hand expression.
					Use of a breast pump.
					Milk storage.
				Breastfeeding After Multiple Births
				Weaning
				Home Care
				Other Concerns
		Formula Feeding
		Nursing Care
			Formula Feeding
				Assessment
				Nursing Diagnosis and Planning
					Expected outcomes.
				Interventions
					Teaching about Formula.
						Types of formula.
						Ready-to-use.
						Concentrated liquid.
						Powdered formula.
						Equipment.
						Preparation.
					Explaining feeding techniques
						Positioning.
						Burping.
						Frequency and amount.
						Cautions.
						Infant variations.
				Evaluation
		Key Concepts
		References and Readings
	24 The Childbearing Family With Special Needs
		Learning Objectives
		Adolescent Pregnancy
			Incidence of Teenage Pregnancy
			Factors Associated With Teenage Pregnancy
			Sex Education
			Preconception Counseling
			Options When Pregnancy Occurs
			Socioeconomic Implications of Teenage Pregnancy
			Implications for Maternal Health
			Implications for Fetal-Neonatal Health
			The Teenage Expectant Father
			Impact of Teenage Pregnancy on Parenting
		Nursing Care
			The Pregnant Teenager
				Assessment
					Physical assessment.
					Cognitive development.
					Knowledge of infant needs.
					Family assessment.
				Nursing Diagnosis and Planning
					Expected outcomes.
					Interventions
						Eliminating barriers to healthcare.
						Applying teaching or learning principles.
					Counseling.
						Nutrition.
						Self-care.
						Stress reduction.
						Attachment to the fetus.
						Breastfeeding.
					Promoting family support.
					Providing support during labor.
					Providing referrals.
				Evaluation
		Delayed Pregnancy
			Maternal and Fetal Implications of Delayed Pregnancy
			Advantages of Delayed Childbearing
			Disadvantages of Delayed Childbearing
			Nursing Considerations
				Preconception Care
				Reinforcing and Clarifying Information
				Facilitating Expression of Emotions
				Providing Parenting Information
		Substance Abuse
			Incidence
			Maternal and Fetal Effects
				Tobacco
				Alcohol
				Marijuana
				Cocaine
					Actions.
					Maternal and fetal effects.
					Neonatal effects.
				Amphetamines and Methamphetamines
					Maternal and fetal effects.
					Neonatal effects.
				Antidepressants
					Maternal and fetal effects.
					Neonatal effects.
				Opioids
					Fetal effects.
					Neonatal effects.
			Diagnosis and Management of Substance Abuse
		Nursing Care
			Maternal Substance Abuse
				Antepartum Period
					Assessment.
						Medical and obstetric history.
						History of substance abuse.
					Nursing diagnosis and planning.
						Expected outcomes.
					Interventions.
						Examining attitudes.
						Preventing substance abuse.
						Communicating with the woman.
						Helping the woman identify strengths.
						Providing ongoing care.
					Evaluation
				Intrapartum Period
					Assessment.
						Cocaine.
						Heroin.
					Nursing diagnosis and planning.
						Expected outcome.
					Interventions
						Preventing injury.
							Admitting procedure.
							Setting limits.
							Initiating seizure precautions.
						Maintaining effective communication.
						Providing pain control.
						Preventing heroin withdrawal.
					Evaluation
				Postpartum Period
		Birth of an Infant With Congenital Anomalies
			Factors Influencing Emotional Responses of Parents
				Timing and Manner of Being Told
				Previous Knowledge of the Defect
				Type of Defect
				Irreparable Defect
			Grief and Mourning
			Nursing Considerations
				Assisting With the Grieving Process
				Promoting Bonding and Attachment
				Providing Accurate Information
				Facilitating Communication
				Participating in Infant Care
				Planning for Discharge
				Providing Referrals
		Perinatal Loss
			Early Pregnancy Loss
			Concurrent Death and Survival in Multifetal Pregnancy
			Previous Pregnancy Loss
		Nursing Care
			Pregnancy Loss
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
				Interventions
					Allowing expression of feelings.
					Acknowledging the infant.
						Presenting the infant to the parents.
						Preparing a memory box or packet.
						Respecting cultural practices.
					Assisting with other needs.
					Providing referrals.
				Evaluation
		Adoption
		Intimate Partner Violence
			Effects of Intimate Partner Violence During Pregnancy
			Factors That Promote Violence
			Characteristics of the Abuser
			Cycle of Violence
			Nurses’ Role in Prevention of Abuse
		Nursing Care
			The Battered Woman
				Assessment
				Nursing Diagnosis and Planning
					Expected outcomes.
				Interventions
					Listening.
					Developing a personal safety plan.
					Affirming that she is not to blame.
					Providing education.
					Providing referrals.
				Evaluation
		Key Concepts
		References and Readings
	25 Pregnancy-Related Complications
		Learning Objectives
		Hemorrhagic Conditions of Early Pregnancy
			Abortion
				Spontaneous Abortion
					Threatened abortion
						Manifestations.
						Therapeutic management.
					Inevitable abortion
						Manifestations.
						Therapeutic management.
					Incomplete abortion
						Manifestations.
						Therapeutic management.
					Complete abortion
						Manifestations.
						Therapeutic management.
					Missed abortion
						Manifestations.
						Therapeutic management.
					Disseminated intravascular coagulation (consumptive coagulopathy).
				Recurrent Spontaneous Abortion
					Manifestations.
					Therapeutic management.
				Nursing Considerations
			Ectopic Pregnancy
				Incidence and Etiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
				Nursing Considerations
			Gestational Trophoblastic Disease (Hydatidiform Mole)
				Incidence and Etiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
				Nursing Considerations
		Nursing Care
			The Woman With a Hemorrhagic Condition of Early Pregnancy
				Assessment
				Nursing Diagnosis and Planning
					Expected outcomes.
				Interventions
					Providing information about tests and procedures.
					Teaching measures to prevent infection.
					Providing dietary information.
					Teaching signs of infection to report.
					Emphasizing the importance of follow-up care.
				Evaluation
		Hemorrhagic Conditions of Late Pregnancy
			Placenta Previa
				Incidence and Etiology
				Manifestations
				Therapeutic Management
				Nursing Considerations
					Home care.
					Inpatient care.
			Abruptio Placentae
				Incidence and Etiology
				Manifestations
				Therapeutic Management
				Nursing Considerations
		Nursing Care
			The Woman With a Hemorrhagic Condition of Late Pregnancy
				Assessment
				Nursing Diagnosis and Planning
				Interventions
					Monitoring for signs of hypovolemic shock.
					Monitoring the fetus.
					Promoting tissue oxygenation.
					Collaborating with the physician for fluid replacement.
					Providing emotional support.
					Care related to surgery.
				Evaluation
		Hyperemesis Gravidarum
			Etiology
			Therapeutic Management
			Nursing Considerations
				Reducing Nausea and Vomiting
				Maintaining Nutrition and Fluid Balance
				Providing Emotional Support
		Hypertension During Pregnancy
			Preeclampsia
				Risk Factors
				Pathophysiology
				Preventive Measures
				Manifestations
					Classic signs.
					Additional signs.
					Symptoms.
				Therapeutic Management
					Home care for mild preeclampsia.
						Activity restrictions.
						Fetal activity.
						Blood pressure.
						Weight.
						Urinalysis.
						Diet.
						Fetal assessment.
					Inpatient management for severe preeclampsia.
						Antepartum management.
							Bed rest.
							Anticonvulsant medications.
							Antihypertensive medications.
						Intrapartum management.
						Postpartum management.
				Therapeutic Management of Eclampsia
		Nursing Care
			The Woman With Preeclampsia
				Assessment
					Assessments for magnesium toxicity.
					Psychosocial assessment.
				Nursing Diagnosis and Planning
				Interventions
					Interventions for seizures
						Initiating preventive measures.
						Monitoring for signs of impending seizures.
						Preventing seizure-related injury.
						Protecting the woman and fetus during a seizure.
						Providing information and support for the family.
					Interventions for magnesium toxicity
						Monitoring for signs of magnesium toxicity.
						Responding to signs of magnesium toxicity.
				Evaluation
		HELLP Syndrome
		Chronic Hypertension
		Incompatibility Between Maternal and Fetal Blood
			Rh Incompatibility
				Pathophysiology
				Fetal and Neonatal Implications
				Prenatal Assessment and Management
				Postpartum Management
			ABO Incompatibility
		Key Concepts
		References and Readings
	26 Concurrent Disorders During Pregnancy
		Learning Objectives
		Diabetes Mellitus
			Pathophysiology
				Etiology
				Effect of Pregnancy on Fuel Metabolism
					Early pregnancy.
					Late pregnancy.
			Classification
			Incidence
			Pathology
			Preexisting Diabetes Mellitus
				Maternal Effects
				Fetal Effects
					Congenital malformation.
					Variations in fetal size.
				Neonatal Effects
					Hypoglycemia.
					Hypocalcemia.
					Hyperbilirubinemia.
					Respiratory distress syndrome.
				Maternal Assessment
					History.
					Physical examination.
					Laboratory tests.
				Fetal Surveillance
				Therapeutic Management
					Preconception care.
					Diet.
					Self-monitoring of blood glucose (SMBG).
					Insulin therapy.
						First trimester.
						Second and third trimesters.
						During labor.
						Postpartum.
					Timing of delivery.
			Gestational Diabetes Mellitus
				Risk Factors
				Identifying Gestational Diabetes Mellitus
					Glucose challenge test.
					Oral glucose tolerance test.
				Maternal, Fetal, and Neonatal Effects
				Therapeutic Management
					Diet.
					Exercise.
					Glucose level monitoring.
					Fetal surveillance.
				Nursing Considerations
					Increasing effective communication.
					Providing opportunities for control.
					Providing normal pregnancy care.
		Nursing Care
			The Pregnant Woman With Diabetes Mellitus
				Assessment
				Nursing Diagnosis and Planning
					Expected outcomes
				Interventions
					Teaching self-care skills.
						Self-monitoring of blood glucose.
						Insulin administration.
						Continuous subcutaneous insulin infusion.
					Teaching dietary management.
					Recognizing and correcting hypoglycemia and hyperglycemia.
						Hypoglycemia.
						Hyperglycemia.
					Explaining procedures, tests, and plan of care.
				Evaluation
		Cardiac Disease
			Incidence and Classification
				Rheumatic Heart Disease
				Congenital Heart Disease
					Left-to-right shunt
						Atrial septal defect.
						Ventricular septal defect.
						Patent ductus arteriosus.
					Right-to-left shunt
						Tetralogy of Fallot.
						Eisenmenger syndrome.
						Mitral valve prolapse.
				Peripartum and Postpartum Cardiomyopathy
			Diagnostic Evaluation of Cardiac Disease
			Therapeutic Management
				Class I and Class II Heart Disease
				Class III and Class IV Heart Disease
				Drug Therapy
					Anticoagulants.
					Antidysrhythmics.
					Antiinfectives.
					Drugs for heart failure.
				Intrapartum Management
				Postpartum Management
			Nursing Considerations
		Anemias
			Iron Deficiency Anemia
				Maternal Effects
				Fetal and Neonatal Effects
				Therapeutic Management
			Folic Acid Deficiency (Megaloblastic) Anemia
				Maternal Effects
				Fetal and Neonatal Effects
				Therapeutic Management
			Sickle Cell Disease
				Maternal Effects
				Fetal and Neonatal Effects
				Therapeutic Management
			Thalassemias
				Maternal Effects
				Fetal and Neonatal Effects
				Therapeutic Management
		Immune Complex Diseases
			Systemic Lupus Erythematosus
			Antiphospholipid Syndrome
			Hashimoto’s Thyroiditis
		Seizure Disorders: Epilepsy
		Infections During Pregnancy
			Viral Infections
				Cytomegalovirus
					Fetal and neonatal effects.
					Therapeutic management.
				Rubella
					Fetal and neonatal effects.
					Therapeutic management.
				Varicella-Zoster Virus
					Fetal and neonatal effects.
					Therapeutic management.
				Herpesvirus Serotypes 1 and 2
					Fetal and neonatal effects.
					Therapeutic management.
				Parvovirus B19
					Fetal and neonatal effects.
					Therapeutic management.
				Hepatitis B
					Fetal and neonatal effects.
					Therapeutic management.
				Human Immunodeficiency Virus (HIV)
					Pathophysiology.
					Fetal and neonatal effects.
					Prevention.
					Therapeutic management.
					Nursing considerations.
			Nonviral Infections
				Toxoplasmosis
					Fetal and neonatal effects.
					Therapeutic management.
				Group B Streptococcus Infection
					Fetal and neonatal effects.
					Therapeutic management.
				Tuberculosis
					Fetal and neonatal effects.
					Therapeutic management.
		Key Concepts
		References and Readings
	27 The Woman With an Intrapartum Complication
		Learning Objectives
		Dysfunctional Labor
			Problems of the Powers
				Ineffective Contractions
					Hypotonic labor dysfunction.
					Hypertonic labor dysfunction.
				Ineffective Maternal Pushing
			Problems With the Passenger
				Fetal Size
					Macrosomia.
					Shoulder dystocia.
				Abnormal Fetal Presentation or Position
					Rotation abnormalities.
					Deflexion abnormalities.
					Breech presentation.
				Multifetal Pregnancy
				Fetal Anomalies
			Problems of the Passage
				Pelvis
				Maternal Soft-Tissue Obstructions
			Problems of the Psyche
			Abnormal Labor Duration
				Prolonged Labor
				Precipitate Labor
		Nursing Care
			The Woman in Dysfunctional Labor
				Intrauterine Infection
					Assessment.
					Nursing diagnosis and planning.
						Expected outcomes.
					Interventions
						Reducing the risk of infection.
						Identifying infection.
					Evaluation
				Maternal Exhaustion
					Assessment.
					Nursing diagnosis and planning.
						Expected outcomes.
					Interventions
						Conserving maternal energy.
						Promoting coping skills.
					Evaluation
		Premature Rupture of the Membranes
			Etiology
			Complications
			Therapeutic Management
				Determining True Membrane Rupture
				Gestation Near Term
				Preterm Gestation
			Maternal Antibiotics
			Nursing Considerations
		Preterm Labor
			Associated Factors
			Manifestations
			Preventing Preterm Birth
				Community Education
				During Pregnancy
					Improving access to care.
					Identifying risk factors.
					Progesterone supplementation.
					Promoting adequate nutrition.
					Educating women and their partners about preterm labor.
					Empowering women and their partners.
			Therapeutic Management
				Predicting Preterm Birth
					Cervical length.
					Fetal fibronectin.
					Infections.
				Identifying Preterm Labor
				Stopping Preterm Labor
					Initial measures.
					Identifying and treating infections.
					Identifying other causes for preterm contractions.
					Limiting activity.
					Hydrating the woman.
				Tocolytics
					Magnesium sulfate.
					Calcium antagonists.
					Prostaglandin synthesis inhibitors.
					Beta-adrenergic drugs.
			Accelerating Fetal Lung Maturation
		Nursing Care
			The Woman in Preterm Labor
				Psychosocial Concerns
					Assessment.
					Nursing diagnosis and planning.
						Expected outcome.
					Interventions
						Providing information.
						Promoting expression of concerns.
						Teaching what may occur during a preterm birth.
					Evaluation
				Management of Home Care
					Assessment.
					Nursing Diagnosis and planning.
						Expected outcomes.
					Interventions.
						Caring for children.
						Maintaining the household.
					Evaluation.
				Boredom
					Assessment.
					Nursing diagnosis and planning.
						Expected outcome.
					Interventions
						Identifying appropriate activities.
						Changing the physical surroundings.
					Evaluation
		Prolonged Pregnancy
			Complications
			Therapeutic Management
			Nursing Considerations
		Intrapartum Emergencies
			Placental Abnormalities
			Prolapsed Umbilical Cord
				Etiology
				Manifestations
				Therapeutic Management
				Nursing Considerations
			Uterine Rupture
				Etiology
				Manifestations
				Therapeutic Management
				Nursing Considerations
			Uterine Inversion
				Etiology
				Manifestations
				Therapeutic Management
				Nursing Considerations
			Anaphylactoid Syndrome
		Trauma
			Therapeutic Management
			Nursing Considerations
		Key Concepts
		References and Readings
	28 The Woman With a Postpartum Complication
		Learning Objectives
		Postpartum Hemorrhage
			Early Postpartum Hemorrhage
				Uterine Atony
					Predisposing factors.
					Manifestations.
					Therapeutic management.
				Trauma
					Predisposing factors.
					Lacerations.
					Hematomas.
					Therapeutic management.
			Late Postpartum Hemorrhage
				Predisposing Factors
				Therapeutic Management
		Hypovolemic Shock
			Pathophysiology
			Manifestations
			Therapeutic Management
			Nursing Considerations
				Immediate Care
		Nursing Care
			The Woman With Excessive Bleeding
				Assessment
					Uterine atony.
					Trauma.
				Nursing Diagnosis and Planning
				Interventions
					Preventing hemorrhage.
					Collaborating with the healthcare provider.
					Providing support for the family.
					Posthemorrhage care.
					Home care.
				Evaluation
		Subinvolution of the Uterus
			Therapeutic Management
			Nursing Considerations
		Thromboembolic Disorders
			Incidence and Etiology
				Venous Stasis
				Hypercoagulation
				Blood Vessel Injury
				Additional Predisposing Factors
			Superficial Venous Thrombosis
				Manifestations
				Therapeutic Management
			Deep Venous Thrombosis
				Diagnostic Evaluation
				Therapeutic Management
					Preventing thrombus formation.
					Initial treatment.
					Subsequent treatment.
		Nursing Care
			The Mother With Deep Venous Thrombosis
				Assessment
				Nursing Diagnosis and Planning
					Expected outcomes.
				Interventions
					Monitoring for signs of bleeding.
					Explaining continued therapy.
					Helping the family adapt to home care.
				Evaluation
		Pulmonary Embolism
			Pathophysiology
			Manifestations
			Therapeutic Management
			Nursing Considerations
				Monitoring for Signs
				Facilitating Oxygenation
				Seeking Assistance
		Puerperal Infection
			Definition
			Pathophysiology
			Etiology
			Specific Infections
				Endometritis
					Etiology.
					Manifestations.
					Therapeutic management.
					Complications.
					Nursing considerations.
				Wound Infection
					Manifestations.
					Therapeutic management.
					Nursing considerations.
				Urinary Tract Infections
					Etiology.
					Manifestations.
					Therapeutic management.
					Nursing considerations.
				Mastitis
					Etiology.
					Manifestations.
					Therapeutic management.
					Nursing considerations.
				Septic Pelvic Thrombophlebitis
					Manifestations.
					Therapeutic management.
		Nursing Care
			The Woman With an Infection
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
		Affective Disorders
			Mood Disorders
			Peripartum Depression
				Incidence and Etiology
				Manifestations
				Impact on the Family
				Therapeutic Management
			Postpartum Psychosis (PPP)
			Bipolar II Disorder
			Postpartum Anxiety Disorders
		Nursing Care
			Postpartum Affective Disorders
				Assessment
				Nursing Diagnosis and Planning
					Expected outcomes.
				Interventions
					Providing anticipatory guidance.
					Demonstrating caring.
					Helping the mother verbalize feelings.
					Increasing sensitivity to infant cues.
					Helping family members.
					Discussing options and resources.
				Evaluation
		Key Concepts
		References and Readings
	29 The High-Risk Newborn:
		Learning Objectives
		Care of High-Risk Newborns
		Late Preterm Infants
			Incidence and Etiology
			Characteristics of Late Preterm Infants
			Therapeutic Management
			Nursing Considerations
				Assessment and Care of Common Problems
					Thermoregulation.
					Feedings.
					Discharge.
		Preterm Infants
			Incidence and Etiology
				Scope of the Problem
				Causes
				Prevention
			Characteristics of Preterm Infants
				Appearance
				Behavior
			Assessment and Care of Common Problems
				Problems With Respiration
					Assessment.
					Nursing interventions.
						Working with respiratory equipment.
						Positioning the infant.
						Suctioning secretions.
						Maintaining hydration.
				Problems With Thermoregulation
					Assessment.
					Nursing interventions.
						Maintaining a neutral thermal environment.
						Weaning to an open crib.
				Problems With Fluid and Electrolyte Balance
					Assessment.
						Urinary output.
						Weight.
						Signs of dehydration or overhydration.
					Nursing interventions.
				Problems With the Skin
					Assessment.
					Nursing interventions.
				Problems With Infection
					Assessment.
					Nursing interventions.
				Problems With Pain
					Assessment.
					Nursing interventions.
		Nursing Care
			The Preterm Infant
				Environmentally Caused Stress
					Assessment.
					Nursing diagnosis and planning.
						Expected outcomes.
					Interventions.
						Scheduling care.
						Reducing stimuli.
						Promoting rest.
						Promoting motor development.
						Individualizing care.
						Communicating infants’ needs.
					Evaluation
				Nutrition
					Assessment
						Feeding tolerance.
						Readiness for nipple feeding.
					Nursing diagnosis and planning.
						Expected outcomes.
					Interventions
						Administering parenteral nutrition.
						Administering enteral feedings.
						Administering gavage feedings.
						Administering oral feedings.
							Preparing for feedings.
							Giving bottle feedings.
						Facilitating breastfeeding.
						Making ongoing assessments.
					Evaluation
				Parenting
					Assessment.
					Nursing diagnosis and planning.
						Expected outcomes.
					Interventions
						Making advance preparations.
						Assisting parents at birth.
						Supporting parents during early visits.
						Providing information.
						Instituting kangaroo care (KC).
						Facilitating interaction.
						Increasing parental decision making.
						Alleviating concerns.
						Helping with ongoing problems.
						Preparing for discharge.
					Evaluation
		Common Complications of Preterm Infants
			Respiratory Distress Syndrome (RDS)
				Pathophysiology
				Manifestations
				Therapeutic Management
				Nursing Considerations
			Bronchopulmonary Dysplasia (Chronic Lung Disease)
			Intraventricular Hemorrhage
				Pathophysiology
				Manifestations
				Therapeutic Management
				Nursing Considerations
			Retinopathy of Prematurity
				Pathophysiology
				Therapeutic Management
				Nursing Considerations
			Necrotizing Enterocolitis (NEC)
				Pathophysiology
				Manifestations
				Therapeutic Management
				Nursing Considerations
		Postterm Infants
			Scope of the Problem
			Assessment
			Therapeutic Management
			Nursing Considerations
		Small-for-Gestational-Age Infants
			Etiology
			Scope of the Problem
			Characteristics of Small-for-Gestational-Age (SGA) Infants
			Therapeutic Management
			Nursing Considerations
		Large-for-Gestational-Age Infants
			Etiology
			Scope of the Problem
			Therapeutic Management
			Nursing Considerations
		Key Concepts
		References and Readings
	30 The High-Risk Newborn
		Learning Objectives
		Respiratory Complications
			Asphyxia
				Manifestations
				Infants at Risk
				Neonatal Resuscitation
			Transient Tachypnea of the Newborn
				Etiology
				Manifestations
				Therapeutic Management
				Nursing Considerations
			Meconium Aspiration Syndrome
				Etiology
				Manifestations
				Therapeutic Management
				Nursing Considerations
			Persistent Pulmonary Hypertension of the Newborn
				Etiology
				Manifestations
				Therapeutic Management
				Nursing Considerations
		Hyperbilirubinemia
			Etiology
			Therapeutic Management
				Phototherapy
				Exchange Transfusions
					Procedure.
					Complications.
					Role of the nurse.
		Nursing Care
			The Infant With Hyperbilirubinemia
			Assessment
			Nursing Diagnosis and Planning
				Expected outcomes.
			Interventions
				Maintaining a neutral thermal environment.
				Providing optimal nutrition.
				Protecting the eyes.
				Enhancing response to therapy.
				Detecting complications.
				Teaching parents.
			Evaluation
		Infection
			Transmission of Infection
			Sepsis Neonatorum
				Etiology
				Therapeutic Management
					Diagnostic testing.
					Treatment.
				Nursing Considerations
					Assessment
						Risk factors.
						Signs of infection.
					Nursing interventions
						Preventing infection.
						Providing antibiotics.
						Providing other supportive care.
						Supporting parents.
		Infant of a Diabetic Mother
			Scope of the Problem
			Characteristics of Infants of Diabetic Mothers
			Therapeutic Management
			Nursing Considerations
				Assessment
				Nursing Interventions
		Polycythemia
			Causes
			Manifestations
			Therapeutic Management
			Nursing Considerations
		Hypocalcemia
			Etiology
			Manifestations
			Therapeutic Management
			Nursing Considerations
		Prenatal Drug Exposure
			Identification of Drug-Exposed Infants
			Therapeutic Management
			Nursing Considerations
				Feeding
					Assessment.
					Nursing interventions.
				Rest
					Assessment.
					Nursing interventions.
				Bonding
					Assessment.
					Nursing interventions.
		Phenylketonuria
			Etiology
			Manifestations
			Therapeutic Management
			Nursing Considerations
		Key Concepts
		References and Readings
	31 Management of Fertility and Infertility
		Learning Objectives
		Contraception
		Role of the Nurse
		Considerations When Choosing a Contraceptive Method
			Safety
			Protection From Sexually Transmitted Diseases
			Effectiveness
			Acceptability
			Convenience
			Education Needed
			Benefits
			Side Effects
			Effect on Spontaneity
			Availability
			Expense
			Preference
			Religious and Personal Beliefs
			Culture
			Other Considerations
		Informed Consent
		Adolescents
			Adolescent Knowledge
				Misinformation
				Risk-Taking Behavior
			Counseling Adolescents
		Perimenopausal Women
		Methods of Contraception
			Sterilization
				Tubal Sterilization
				Vasectomy
			Intrauterine Devices (IUDs)
				Action
				Side Effects
				Teaching
			Hormonal Contraceptives
				Hormone Implants
				Hormone Injections
				Oral Contraceptives
					Progestin only.
					Combination.
					Benefits, risks, and cautions.
					Side effects.
					Teaching.
					Blood hormone levels.
						Missed doses.
						Postpartum and lactation.
						Other medications.
						Follow-up.
				Emergency Contraception
				Transdermal Contraceptive Patch
				Contraceptive Vaginal Ring
			Barrier Methods
				Chemical Barriers
				Mechanical Barriers
					Male condom.
					Female condom.
					Sponge.
					Diaphragm.
					Cervical cap.
					Lea’s Shield.
			Natural Family Planning Methods
				Calendar or Rhythm Method
				Standard Days Method
				Cervical Mucus and Two-Day Method
				Symptothermal Method
			Abstinence
			Least Reliable Methods of Contraception
				Breastfeeding
				Coitus Interruptus
		Nursing Care
			Choosing a Contraceptive Method
				Assessment
					Introducing the subject.
					Determining the woman’s understanding.
					Assessing the woman’s satisfaction.
					Assessing appropriate choices.
				Nursing Diagnosis and Planning
					Expected outcomes.
				Interventions
					Increasing understanding of the chosen method.
					Teaching about other methods.
					Protecting against sexually transmitted diseases.
					Including the woman’s partner.
					Ongoing teaching.
				Evaluation
		Role of the Nurse in Infertility Care
			Extent of Infertility
			Factors Contributing to Infertility
				Factors in the Man
					Abnormalities of the sperm.
					Abnormal erections.
					Abnormal ejaculation.
					Abnormalities of seminal fluid.
				Factors in the Woman
					Disorders of ovulation.
					Abnormalities of the fallopian tubes.
					Abnormalities of the cervix.
			Repeated Pregnancy Loss
				Abnormalities of the Fetal Chromosomes
				Abnormalities of the Cervix or Uterus
				Endocrine Abnormalities
				Immunologic Factors
				Environmental Agents
				Infections
			Evaluation of Infertility
				Preconception Counseling
				History and Physical Examination
					History
					Physical examination.
						Diagnostic tests.
			Therapies to Facilitate Pregnancy
				Medications
				Surgical Procedures
				Therapeutic Insemination
				Egg Donation
				Surrogate Parenting
			Assisted Reproductive Techniques
				In Vitro Fertilization (IVF)
				Gamete Intrafallopian Transfer (GIFT)
				Zygote Intrafallopian Transfer (ZIFT)
				Comparison of In Vitro Fertilization, Gamete Intrafallopian Transfer, and Zygote Intrafallopian Transfer
				Intracytoplasmic Sperm Injection (ICSI)
			Responses to Infertility
				Assumption of Fertility
				Growing Awareness of a Problem
				Seeking Help for Infertility
					Identifying the importance of having a baby.
					Sharing intimate information.
					Considering financial resources.
					Ethical issues.
					Committing to involvement in care.
			Reactions During Evaluation and Treatment
				Influences on Decision Making
					Social, cultural, and religious values.
					Difficulty of treatment.
					Probability of success.
					Financial concerns.
				Psychological Reactions
					Guilt.
					Isolation.
					Depression.
					Stress on the relationship.
			Outcomes After Infertility Therapy
				Pregnancy Loss After Infertility Therapy
				Parenthood After Infertility Therapy
				Choosing to Adopt
				Menopause After Infertility
		Nursing Care
			The Infertile Couple
				Assessment
				Nursing Diagnosis and Planning
					Expected outcomes.
				Interventions
					Assisting communication.
					Increasing the couple’s sense of control.
					Reducing isolation.
					Promoting a positive self-image.
				Evaluation
		Key Concepts
		References and Readings
	32 Women’s Healthcare
		Learning Objectives
		Women’s Health Initiative
		Healthy People 2020
		Health Maintenance
			Health History
			Physical Assessment
			Preventive Counseling
			Screening Procedures
				Breast Self-Examination
				Clinical Breast Examination
					Inspection.
					Palpation.
				Mammography
				Vulvar Self-Examination
				Pelvic Examination
					External organs.
					Speculum examination.
					Bimanual examination.
				Pap Test
					Purpose.
					Procedure.
					Classification of cervical cytology.
				Rectal Examination
		Breast Disorders
			Benign Disorders of the Breast
				Fibrocystic Breast Changes
				Fibroadenoma
				Ductal Ectasia
				Intraductal Papilloma
				Diagnostic Evaluation
				Nursing Considerations
			Malignant Tumors of the Breast
				Incidence
				Predisposing Factors
				Pathophysiology
				Manifestations
				Staging
				Therapeutic Management
					Surgical treatment.
					Adjuvant therapy.
					Radiation therapy.
					Chemotherapy.
					Hormonal therapy.
					Immunotherapy.
				Breast Reconstruction
					Timing.
					Methods.
				Psychosocial Consequences of Breast Cancer
				Nursing Considerations
		Cardiovascular Disease
			Recognition of Coronary Artery Disease (CAD)
			Risk Factors
			Prevention
				Hypertension
				Smoking Cessation
				Diet and Glucose Control
				Increased Activity
				Aspirin
		Menstrual Cycle Disorders
			Amenorrhea
				Primary Amenorrhea
					Etiology.
					Therapeutic management.
				Secondary Amenorrhea
				Nursing Considerations
			Abnormal Uterine Bleeding
				Etiology
				Management
				Nursing Considerations
			Pain Associated With the Menstrual Cycle
				Mittelschmerz
				Primary Dysmenorrhea
					Manifestations.
					Etiology.
					Therapeutic management.
				Endometriosis
					Etiology.
					Pathophysiology.
					Manifestations.
					Therapeutic management.
					Nursing considerations.
				Premenstrual Syndrome (PMS)
					Etiology.
					Manifestations
					Therapeutic management.
					Nursing considerations.
		Elective Termination of Pregnancy
			Methods of Induced Abortion
			Nursing Considerations Related to Elective Pregnancy Termination
		Menopause
			Age at Menopause
			Physiologic Changes
			Psychological Responses
			Therapy for Menopause
			Nursing Considerations Related to Menopause
			Osteoporosis
				Predisposing Factors
				Manifestations
				Prevention and Therapeutic Management
					Drug therapy.
					Calcium and vitamin D.
					Exercise.
				Nursing Considerations
				Nursing Diagnoses
		Pelvic Floor Dysfunction
			Vaginal Wall Prolapse
				Cystocele
				Enterocele
				Rectocele
			Uterine Prolapse
				Manifestations
				Therapeutic Management
				Nursing Considerations
					Pelvic exercises.
					Urinary incontinence.
		Disorders of the Reproductive Tract
			Benign Disorders
				Cervical Polyps
				Uterine Leiomyomas
				Ovarian Cysts
			Malignant Disorders
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
					Cervical cancer.
					Endometrial cancer.
					Ovarian cancer.
		Infectious Disorders of the Reproductive Tract
			Candidiasis
			Sexually Transmitted Diseases (STDs)
				Incidence
			Types of Sexually Transmitted Diseases (STDs)
				Trichomoniasis
				Bacterial Vaginosis
				Chlamydial Infection
				Gonorrhea
				Syphilis
				Herpes Genitalis
				Human Papillomavirus (HPV)
				Acquired Immunodeficiency Syndrome
				Nursing Considerations
			Pelvic Inflammatory Disease (PID)
				Etiology and Pathophysiology
				Manifestations
				Therapeutic Management
				Nursing Considerations
			Toxic Shock Syndrome
				Nursing Considerations
		Key Concepts
		References and Readings
Unit III Pediatric Nursing Care
	33 Physical Assessment of Children
		Learning Objectives
		General Approaches to Physical Assessment
			Infants From Birth to 6 Months
			Infants From 6 to 12 Months
			Toddlers
			Preschoolers
			School-Age Children
			Adolescents
		Techniques for Physical Examination
			Inspection
			Palpation
			Percussion
			Auscultation
			Smell
		Sequence of Physical Examination
			General Appearance
			History Taking
			Recording Data
			Vital Signs
				Temperature
				Pulse
				Respirations
				Blood Pressure
				Pain Assessment
			Anthropometric Measurement
				Use of Growth Charts
				Height
				Weight
				Head Circumference
				Chest Circumference
				Midarm Circumference
				Triceps Skinfold
			Skin, Hair, and Nails
				Skin
					Inspection.
					Palpation.
				Hair
				Nails
			Lymph Nodes
			Head, Neck, and Face
				Head
				Neck
				Face
			Nose, Mouth, and Throat
				Nose
				Mouth and Throat
			Eyes
				External Eye
				Ophthalmoscopic Examination
				Binocular Vision and Strabismus
					Corneal light reflex test.
					Field-of-vision test.
					Tests for eye muscle function.
				Peripheral Vision
				Visual Acuity
				Color Vision
			Ears
				External Ear
				Otoscopic Examination
				Hearing Acuity
					Infant assessment.
					Preschool and school-age assessment by audiometry.
					Preschool, school-age, and adolescent assessment: the whisper test.
					Conduction tests (tuning fork hearing tests).
			Thorax and Lungs
				Inspection
				Palpation
				Auscultation
				Adventitious Breath Sounds
			Heart
				Inspection
				Palpation
				Auscultation
					Normal rate and rhythm.
					Extra heart sounds, including murmurs.
			Peripheral Vascular System
			Breast
			Abdomen
				Inspection
				Auscultation
				Percussion
				Palpation
			Male Genitalia
			Female Genitalia
			Musculoskeletal System
				Infants
				Toddlers, Preschoolers, and School-Age Children
				Adolescents
				Range of Motion
				Muscle Strength and Mass
				Joints
				Gait
			Neurologic System
				Cerebral Function
				Cranial Nerves
				Cerebellar Function
				Motor System
				Sensory System
				Reflex Status
				Neurologic “Soft” Signs
		Conclusion and Documentation
		Key Concepts
		References and Readings
	34 Emergency Care of the Child
		Learning Objectives
		Clinical Reference
			General Guidelines for Emergency Nursing Care
			Growth and Development Issues in Emergency Care
				The Infant
				The Toddler
				The Preschooler
				The School-Age Child
				The Adolescent
			The Family of a Child in Emergency Care
			Emergency Assessment of Infants and Children
				Primary Assessment
					Airway Assessment
					Breathing Assessment
					Cardiovascular Assessment
					Disability: Neurologic Assessment
					Exposure
				Secondary Assessment
					Vital Signs
					History and Head-to-Toe Assessment
					Diagnostic Tests
					Weight
					Parent-Child Relationship
			Cardiopulmonary Resuscitation of the Child
				Airway and Breathing
					Initial Assessment and Intervention
					Obstructed Airway Management
				Circulation
			The Child in Shock
				Etiology
					Hypovolemic Shock
					Distributive Shock
					Cardiogenic Shock
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
					Hypovolemic Shock
					Distributive Shock
					Cardiogenic Shock
			Nursing Care
				The Child in Shock
					Assessment
						Hypovolemic shock.
						Distributive shock.
						Cardiogenic shock.
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions
						Maintaining tissue perfusion.
						Ensuring oxygenation.
						Preventing infection.
						Enhancing coping.
					Evaluation
			Pediatric Trauma
				Mechanism of Injury
					Blunt Trauma
						Motor vehicle trauma.
						Pedestrian injury.
					Penetrating Trauma
				Multiple Trauma
					Primary Survey
						Airway assessment and management.
						Breathing assessment and management.
						Circulation assessment and management.
						Disability.
					Secondary Survey
						Obtaining a history of the injury.
						Trauma scoring.
						Assessing for child abuse.
				Nursing Considerations
					The Child and Family
					The Child During Recovery
			Ingestions and Poisonings
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
					Removal of Dermal and Ocular Toxins
					Diluting the Ingested Toxin
					Activated Charcoal
					Antidotes
			Nursing Care
				The Child Who Has Ingested a Toxic Substance
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcomes.
						Expected outcome.
					Interventions
					Evaluation
			Environmental Emergencies
				Animal, Human, Snake, and Spider Bites
					Etiology
						Animal and human bites.
						Snake and spider bites.
					Incidence
					Manifestations
						Animal and human bites.
						Snake bites.
						Spider bites.
					Therapeutic Management
						Animal bites.
						Snake bites.
						Spider bites.
					Nursing Considerations
				Submersion Injuries (Near Drowning)
					Etiology
					Incidence
					Manifestations
					Therapeutic Management
						Prehospital emergency management.
						Hospital management.
			Nursing Care
				The Child With a Submersion Injury
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions
						Providing respiratory support.
						Restoring appropriate circulatory status.
						Identifying and preventing neurologic consequences.
						Restoring fluid balance.
						Controlling infection.
						Maintaining nutritional status.
						Providing emotional care for the family.
					Evaluation
			Heat-Related Illnesses
				Incidence
				Manifestations and Therapeutic Management
				Nursing Considerations
			Dental Emergencies
				Incidence and Etiology
				Therapeutic Management
				Nursing Considerations
			Key Concepts
		References and Readings
	35 The Ill Child in the Hospital and Other Care Settings
		Learning Objectives
		Settings of Care
			The Hospital
				Pediatric Observation Units or 24-Hour Observation
				Emergency Hospitalization
				Outpatient and Day Facilities
				Rehabilitative Care
				The Medical-Surgical Unit
				The Intensive Care Unit
			School-Based Clinics
			Community Clinics
			Home Care
		Stressors Associated With Illness and Hospitalization
			The Infant and Toddler
				Separation Anxiety
				Fear of Injury and Pain
				Loss of Control
			The Preschooler
				Separation Anxiety
				Fear of Injury and Pain
				Loss of Control
				Guilt and Shame
			The School-Age Child
				Separation
				Fear of Injury and Pain
				Loss of Control
			The Adolescent
				Separation
				Fear of Injury and Pain
				Loss of Control
			Fear of the Unknown
			Regression
		Factors Affecting a Child’s Response to Illness and Hospitalization
			Age and Cognitive Development
			Parental Response
			Preparing the Child and Family
			Coping Skills of the Child and Family
			Psychological Benefits of Hospitalization
		Play for the Ill Child
			Playrooms
			Therapeutic Play
			Emotional Outlet Play
			Teaching Through Play
			Enhancing Cooperation Through Play
			Unstructured Play
			Evaluation of Play
		Admitting the Child to a Hospital Setting
			Taking the History
			Physical Examination
				Initial Inspection
				Baseline Data
		The Ill Child’s Family
			Parents
			Siblings
		Key Concepts
		References and Readings
	36 The Child With a Chronic Condition or Terminal Illness
		Learning Objectives
		Chronic Illness Defined
		The Family of the Child With Special Healthcare Needs
			Family Dynamics and Impact on the Family
			Coping and the Grieving Process
		The Child With Special Healthcare Needs
			Coping and Growth and Development Concerns
			Coping and Parental Responses to Developmental Issues
		The Child With a Chronic Illness
			Ongoing Care
				Education
				Communication
			Caring for Parents
				Grief Education and Support
				Cultural and Religious Beliefs
				Referrals
				Schooling
				The Nurse as Liaison
			Caring for Siblings
		The Terminally Ill or Dying Child
			Coping and the Child’s Concept of Death
				Infants and Toddlers
				Preschoolers
				School-Age Children
				Adolescents
			Coping and Responses to Death and Dying
				The Child’s Response
				The Parents’ Response
				The Siblings’ Response
			Caring for the Dying Child
				Nursing Professionalism and Boundaries
				Communication
				Family Dynamics, Beliefs, and Practices
				Pain Control
				Hospice Care
				The Dying Process and the Time of Death
					Privacy for the child and family.
					Changes in family routines.
					Family concerns about oral intake.
					Fluids and oral care.
					Responsiveness and communication.
					Indicators of imminent death.
					The family after death.
				The Nurse’s Response to the Dying Child
		Key Concepts
		References and Readings
	37 Principles and Procedures for Nursing Care of Children
		Learning Objectives
		Preparing Children for Procedures
			Explaining Procedures
			Consent for Procedures
		Holding and Transporting Infants and Children
		Safety Issues in the Hospital Setting
		Infection Control
			Hand Hygiene
			Standard Precautions
			Implementing Precautions
			Family Teaching
		Bathing Infants and Children
			Special Considerations
			Documentation
			Parent Teaching
		Oral Hygiene
		Feeding
			Special Considerations
			Documentation
			Parent Teaching
		Vital Signs
			Measuring Temperature
			Measuring Pulse
			Evaluating Respirations
			Measuring Blood Pressure
			Documenting Vital Sign Measurement
			Preparing the Child and Family
			Parent Teaching
			Special Considerations: Cardiorespiratory Monitors
		Fever-Reducing Measures
			Description of Fever
			Medications and Environmental Management
		Specimen Collection
			Urine Specimens
				Voided Specimens
				Urinary Catheterization
			Stool Specimens
			Blood Specimens
				Jugular and Femoral Venipuncture
				Capillary Blood Sampling
			Sputum Specimens
			Throat and Nasopharyngeal Specimens
			Cerebrospinal Fluid Specimens
			Bone Marrow Aspiration
		Gastrointestinal Tubes and Enteral Feedings
			Tube Route and Placement
			Tube Selection
			Safety Issues Related to Tube Placement
			Contraindications to Tube Placement
			Enteral Feedings
			Gastrostomy Tubes and Buttons
		Enemas
			Enema Administration
			Solutions and Volumes
		Ostomies
		Oxygen Therapy
			Oxygen Administration
			Documentation
			Parent Teaching
		Assessing Oxygenation
		Tracheostomy Care
			Suctioning
			Stoma Care
		Surgical Procedures
			Preparation for Surgery
			Preoperative Medication and Anesthesia Induction
			Postanesthesia Care
			Postoperative Care
		Key Concepts
		References and Readings
	38 Medication Administration and Safety for Infants and Children
		Learning Objectives
		Pharmacokinetics in Children
			Absorption
				Oral Route
					Gastric acidity.
					Gastric emptying.
					Gastrointestinal motility.
					Enzyme activity.
				Other Routes
			Distribution
				Differences in Body Fluids
				Differences in Fat Percentages
				Differences in Proteins
				Blood–Brain Barrier
			Metabolism
			Excretion
			Concentration
		Psychological and Developmental Factors
			Infants
			Toddlers and Preschoolers
			School-Age Children
			Adolescents
		Calculating Dosages
		Medication Administration Procedures
			Medication Reconciliation
			Administering Oral Medications
				Preparation
				Administration
				Alternative Routes for Oral Medications
			Administering Injections
				Intramuscular Injections
				Subcutaneous Injections
				Intradermal Injections
			Rectal Administration
			Vaginal Administration
			Ophthalmic Administration
			Otic Administration
			Nasal Administration
			Topical Administration
			Inhalation Therapy
		Intravenous Therapy
			Intravenous Catheter Insertion
			Intravenous Catheter Monitoring
			Intravenous Infusion Monitoring
			Infusion Rates and Methods
			Administering Intravenous Medications
				Intravenous Bolus Administration
				Intravenous Intermittent Infusion Administration
			Venous Access Devices
				Intermittent Infusion Ports
				Central Venous Access Devices
		Administration of Blood Products
		Child and Family Education
		Key Concepts
		References and Readings
	39 Pain Management for Children
		Learning Objectives
		Definitions and Theories of Pain
			Gate Control Theory
			Acute and Chronic Pain
			Research on Pain in Children
		Obstacles to Pain Management in Children
		Assessment of Pain in Children
			Assessment According to Developmental Level
				Neonates and Infants
				Toddlers
				Preschoolers
				School-Age Children
				Adolescents
			Assessment Tools
		Non-Pharmacologic and Pharmacologic Pain Interventions
			Non-Pharmacologic Interventions
			Pharmacologic Interventions
				Administration of Analgesics
					Patient-controlled analgesia.
					Topical anesthetic agents.
				Acetaminophen and Antiinflammatory Drugs
				Opioids
				Procedural Sedation
				Epidural Analgesia
				Key Concepts
		References and Readings
	40 The Child With a Fluid and Electrolyte Alteration
		Learning Objectives
		Clinical Reference
			Review of Fluid and Electrolyte Imbalances in Children
			Alterations in Acid–Base Balance in Children
			Dehydration
				Etiology and Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
					Minimal Dehydration
					Mild to Moderate Dehydration
					Severe Dehydration
			Nursing Care
				The Child With Dehydration
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcomes.
					Interventions
					Evaluation
			Diarrhea
				Etiology and Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
				Prognosis
			Nursing Care
				The Child With Diarrhea
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
			Vomiting
				Etiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Nursing Care
				The Vomiting Child
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
			Key Concepts
		References and Readings
	41 The Child With an Infectious Disease
		Learning Objectives
		Clinical Reference
			Review of Disease Transmission
				Chain of Infection
				Transmission of Pathogens
				Epidemiologic Investigations
			Infection and Host Defenses
			Immunity
		Viral Exanthems
			Nursing Considerations for the Child With a Viral Exanthem Infection
			Rubeola (Measles)
				Manifestations
				Complications
				Therapeutic Management
			Rubella (German Measles, 3-Day Measles)
				Manifestations
				Complications
				Therapeutic Management
			Erythema Infectiosum (Fifth Disease, Parvovirus B19)
				Complications
				Therapeutic Management
			Roseola Infantum (Exanthem Subitum, 3-day fever)
				Manifestations
				Complications
				Therapeutic Management
			Enterovirus (Nonpolio) Infections (Coxsackieviruses, Group A and Group B), Echoviruses, and Enteroviruses
				Manifestations
				Complications
				Therapeutic Management
				Nursing Considerations
			Varicella-Zoster Infections (Chickenpox, Shingles)
				Manifestations
					Varicella.
					Herpes zoster (shingles).
				Complications
				Therapeutic Management
				Nursing Considerations
		Other Viral Infections
			Mumps
				Manifestations
				Complications
				Therapeutic Management
				Nursing Considerations
			Cytomegalovirus (CMV)
				Therapeutic Management
				Nursing Considerations
			Epstein-Barr Virus (Infectious Mononucleosis)
				Manifestations
				Complications
				Therapeutic Management
				Nursing Considerations
			Rabies
				Manifestations
				Therapeutic Management
				Nursing Considerations
		Bacterial Infections
			Pertussis (Whooping Cough)
				Manifestations
				Complications
				Therapeutic Management
				Nursing Considerations
			Scarlet Fever
				Manifestations
				Complications
				Therapeutic Management
				Nursing Considerations
			Methicillin-Resistant Staphylococcus aureus (MRSA)
				Manifestations
				Therapeutic Management
				Nursing Considerations
			Clostridium difficile
				Manifestations
				Therapeutic Management
				Nursing Considerations
			Serious Bacterial Illness in Infants
			Rare Viral and Bacterial Infections
		Fungal Infections
		Rickettsial Infections
			Rocky Mountain Spotted Fever
				Manifestations
				Therapeutic Management
				Nursing Considerations
		Borrelia Infections
			Relapsing Fever
				Manifestations
				Therapeutic Management
				Nursing Considerations
			Lyme Disease
				Manifestations
				Therapeutic Management
				Nursing Considerations
		Helminths
			Therapeutic Management
			Nursing Considerations
		Sexually Transmitted Diseases
			Chlamydial Infection
				Manifestations
				Therapeutic Management
			Gonorrhea
				Manifestations
				Therapeutic Management
			Herpes Simplex Virus
				Manifestations
				Therapeutic Management
			Human Papillomavirus
				Manifestations
				Therapeutic Management
			Bacterial Vaginosis
				Manifestations
			Syphilis
				Manifestations
				Therapeutic Management
			Trichomoniasis
				Manifestations
				Therapeutic Management
				Nursing Considerations
		Key Concepts
		References and Readings
	42 The Child With an Immunologic Alteration
		Learning Objectives
		Clinical Reference
			Review of the Immune System
				Nonspecific Immune Functions
				Specific Immune Functions
					The Humoral Response
					The Cell-Mediated Response
				Development of Immunity
					Active Acquired Immunity
					Passive Acquired Immunity
			Common Laboratory and Diagnostic Tests of Immune Function
				Immunodeficiencies
				Allergy
			Human Immunodeficiency Virus Infection
				Etiology
				Incidence
				Manifestations
				Diagnostic Evaluation
					Diagnosing HIV-Exposed Infants
					Ongoing Diagnostic Monitoring
				Therapeutic Management
					HIV-Exposed Infants
					HIV-Infected Infants and Children
						Treatment considerations.
						Treatment initiation.
					Additional Issues Related to the Child With HIV Infection
						Multigenerational problems.
						Disclosure.
						HIV and school settings.
			Corticosteroid Therapy
				Incidence
				Pathophysiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Nursing Care
				The Child Receiving Corticosteroids
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
			Immune Complex and Autoimmune Disorders
				Immune Complex Disorders
				Autoimmune Disorders
			Systemic Lupus Erythematosus
				Etiology
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Nursing Care
				The Child With Systemic Lupus Erythematosus
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
			Allergic Reactions
			Anaphylaxis
				Etiology
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Nursing Care
				The Child With Anaphylaxis
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
			Key Concepts
		References and Readings
	43 The Child With a Gastrointestinal Alteration
		Learning Objectives
		Clinical Reference
			Review of the Gastrointestinal System
				Upper Gastrointestinal System
				Lower Gastrointestinal System
				Prenatal Development
		Disorders of Prenatal Development
			Cleft Lip and Palate
				Incidence
				Manifestations and Diagnostic Evaluation
				Therapeutic Management
			Esophageal Atresia With Tracheoesophageal Fistula
				Etiology and Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Infant With Tracheoesophageal Fistula
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
					Minimizing aspiration risk.
					Postoperative care.
					Gastrostomy tube use.
					Home care.
				Evaluation
			Upper Gastrointestinal Hernias
			Other Developmental Disorders
		Motility Disorders
			Gastroesophageal Reflux Disease
				Etiology
				Incidence
				Manifestations and Diagnostic Evaluation
				Therapeutic Management
					Diet.
					Positioning.
					Medications.
					Treatment of acute bleeding.
					Surgery.
		Nursing Care
			The Infant With Gastroesophageal Reflux Disease
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcomes.
					Expected outcome.
					Expected outcomes.
					Expected outcomes.
				Interventions
					Minimizing reflux.
					Family education and support.
				Evaluation
			Constipation and Encopresis
				Etiology and Incidence
				Manifestations
					Constipation.
					Encopresis.
				Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Child With Constipation or Encopresis
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
					Overcoming withholding.
					Dietary changes.
					Changing the retention habit.
					Emotional support.
					Home care.
				Evaluation
			Recurrent Abdominal Pain/Irritable Bowel Syndrome
				Etiology and Incidence
				Manifestations and Diagnostic Evaluation
					Therapeutic management and nursing considerations.
		Inflammatory and Infectious Disorders
			Ulcers
				Etiology
				Incidence
				Manifestations and Diagnostic Evaluation
				Therapeutic Management
				Nursing Considerations
					Providing information.
					Home care.
			Infectious Gastroenteritis
				Etiology
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Child With Infectious Gastroenteritis
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
					Maintaining fluid balance.
					Decreasing risk.
					Home care.
				Evaluation
			Appendicitis
				Etiology and Incidence
				Manifestations and Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Child With Appendicitis
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
					Uncomplicated appendicitis.
					Ruptured appendix.
					Home care.
				Evaluation
			Inflammatory Bowel Disease
				Etiology
				Incidence, Manifestations, and Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Child With Inflammatory Bowel Disease
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
					Medications.
					Nutritional management.
					Family education and support.
					Home care.
				Evaluation
		Obstructive Disorders
			Hypertrophic Pyloric Stenosis
				Etiology and Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Child With Hypertrophic Pyloric Stenosis
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
					Preoperative care.
					Postoperative care.
					Home care.
				Evaluation
			Intussusception
				Etiology and Incidence
				Manifestations and Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Child With Intussusception
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
					Initial care.
					Post reduction care.
					Family education and support.
				Evaluation
			Volvulus
			Hirschsprung Disease
				Etiology and Incidence
				Manifestations and Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Child With Hirschsprung Disease
				Assessment
				Nursing Diagnoses and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
					Preparing the child for surgery.
					Preventing infection and maintaining skin integrity.
					Maintaining nutritional and hydration status.
					Reducing pain.
					Providing education and relieving anxiety.
				Evaluation
		Malabsorption Disorders
			Lactose Intolerance
				Etiology and Incidence
				Manifestations and Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Child With Lactose Intolerance
				Assessment
				Nursing Diagnosis and Planning
					Expected outcomes.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
			Celiac Disease
				Etiology and Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Child With Celiac Disease
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
			Short Bowel Syndrome
				Etiology and Incidence
				Pathophysiology
				Manifestations
				Therapeutic Management
				Nursing Considerations
		Hepatic Disorders
			Viral Hepatitis
				Etiology
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
					Hepatitis A.
					Hepatitis B.
		Nursing Care
			The Child With Viral Hepatitis
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
					Child and parent teaching.
					Home care.
				Evaluation
			Biliary Atresia
				Etiology and Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
				Nursing Considerations
					Nutritional support.
					Skin care.
					Developmental stimulation.
					Continued assessment.
					Family education and support.
					Home care.
			Cirrhosis
				Etiology
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
				Nursing Considerations
					Nutritional support.
					Skin care.
					Prevention of complications.
					Developmental and parental support.
					Home care.
		Key Concepts
		References and Readings
	44 The Child With a Genitourinary Alteration
		Learning Objectives
		Clinical Reference
			Review of the Genitourinary System
				Structure
				Function
		Enuresis
			Etiology
			Incidence
			Manifestations
				Nocturnal Enuresis
				Diurnal Enuresis
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With Enuresis
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Urinary Tract Infections
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With a Urinary Tract Infection
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Cryptorchidism
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With Cryptorchidism
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Hypospadias and Epispadias
			Etiology and Incidence
			Manifestations and Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With Hypospadias
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Miscellaneous Disorders and Anomalies of the Genitourinary Tract
		Acute Poststreptococcal Glomerulonephritis
			Etiology and Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With Acute Poststreptococcal Glomerulonephritis
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
					Preventing the consequences of fluid excess.
					Providing adequate rest.
					Maintaining skin integrity.
					Maintaining nutritional status.
					Relieving anxiety.
				Evaluation
		Nephrotic Syndrome
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
				Remission Induction
				Additional Therapy
		Acute Kidney Injury
			Etiology and Incidence
			Manifestations
			Diagnostic Evaluation
				History
				Fluid Volume Status
				Laboratory Data
				Physical Examination
				Imaging Studies
			Therapeutic Management
				Fluid Imbalances
				Electrolyte Imbalances
					Potassium.
					Sodium.
					Acid–base imbalances.
				Nutrition
				Dialysis
			Nursing Considerations
		Chronic Kidney Disease (CKD) and End-Stage Renal Disease
			Etiology
			Incidence
			Pathophysiology
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
				CKD
				End-Stage Renal Disease
				Kidney Transplantation
		Nursing Care
			The Child With Chronic Kidney Disease and End-Stage Renal Disease
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Key Concepts
		References and Readings
	45 The Child With a Respiratory Alteration
		Learning Objectives
		Clinical Reference
			Review of the Respiratory System
				The Upper Airway
				The Lower Airway
				Prenatal Respiratory Development
				Postnatal Respiratory Changes
				Gas Exchange and Transport
			Diagnostic Tests
				Blood Gas Analysis
				Pulmonary Function Tests
				Pulse Oximetry
				Transcutaneous Monitoring
				End-Tidal Carbon Dioxide Monitoring
		Respiratory Illness in Children
		Allergic Rhinitis
			Etiology and Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
			Nursing Considerations
		Sinusitis
			Etiology and Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
			Nursing Considerations
		Otitis Media
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With Otitis Media
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Pharyngitis and Tonsillitis
			Etiology
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
			Nursing Considerations
		Nursing Care
			The Child Undergoing a Tonsillectomy
				Assessment: Preoperative Period
				Nursing Diagnosis and Planning: Preoperative Period
					Expected outcome.
					Expected outcome.
				Interventions: Preoperative Period
				Evaluation: Preoperative Period
				Assessment: Postoperative Period
				Nursing Diagnosis and Planning: Postoperative Period
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions: Postoperative
				Evaluation: Postoperative
		Laryngomalacia (Congenital Laryngeal Stridor)
			Manifestations
			Therapeutic Management
			Nursing Considerations
		Croup
			Etiology and Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With Croup
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
					Facilitating airway clearance.
					Maintaining fluid balance.
					Decreasing fear.
					Providing teaching.
				Evaluation
		Epiglottitis (Supraglottitis)
			Etiology and Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
			Nursing Considerations
		Bronchitis
			Etiology and Incidence
			Manifestations and Diagnostic Evaluation
			Therapeutic Management
			Nursing Considerations
		Bronchiolitis
			Etiology and Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With Bronchiolitis
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
					Facilitating gas exchange.
					Preventing transmission.
					Maintaining fluid balance.
					Reducing fever.
					Decreasing anxiety.
				Evaluation
		Pneumonia
		Nursing Care
			The Child With Pneumonia
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Foreign Body Aspiration
			Etiology and Incidence
			Pathophysiology
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
			Nursing Considerations
		Pulmonary Noninfectious Irritation
			Acute Respiratory Distress Syndrome
				Pathophysiology
			Passive Smoking
				Pathophysiology
			Smoke Inhalation
				Pathophysiology
		Apnea
			Manifestations
			Diagnostic Evaluation
		Nursing Care
			The Infant With Apnea
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Sudden Infant Death Syndrome
			Etiology and Incidence
			Manifestations
			Diagnostic Evaluation
		Nursing Care
			The Family of the Infant Who Has Died of SIDS
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Asthma
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
				Acute Asthma Episode
				Long-Term Management
					Environmental control
						Irritants and allergens.
						Exercise.
						Infection.
						Emotions.
					Monitoring symptoms.
					Medications.
						Rescue medications.
						Routine medications.
						Medication delivery.
		Bronchopulmonary Dysplasia
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
				Oxygen Therapy
				Medications
				Nutrition
			Prognosis
			Nursing Considerations
		Cystic Fibrosis
			Etiology
			Incidence
			Manifestations
				Respiratory System
				Digestive System
				Exocrine Glands
				Reproductive System
			Diagnostic Evaluation
			Therapeutic Management
				Respiratory Problems
				Digestive Problems
		Nursing Care
			The Child With Cystic Fibrosis
				Assessment
					Respiratory assessment.
					Digestive assessment.
					Reproductive assessment.
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
					Facilitating airway clearance and gas exchange.
					Preventing infection.
					Providing optimal nutrition for growth.
					Promoting increased exercise tolerance.
					Meeting the child’s and family’s emotional needs.
					Home care.
				Evaluation
		Tuberculosis
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management and Nursing Considerations
				Tuberculosis Infection
				Tuberculosis Disease
				Prevention and Screening
		Key Concepts
		References and Readings
	46 The Child With a Cardiovascular Alteration
		Learning Objectives
		Clinical Reference
			Review of the Heart and Circulation
				Normal Cardiac Anatomy and Physiology
				Fetal Circulation
				Transitional and Neonatal Circulation
		Congenital Heart Disease
			Classification of CHD
				Shunting: Saturation Considerations
				Blood Flow Considerations
		Physiologic Consequences of CHD in Children
			Heart Failure
				Etiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Pulmonary Hypertension
			Cyanosis
				Hypercyanotic Episode
		Nursing Care
			The Child With Cyanosis
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Assessment of the Child With a Cardiovascular Alteration
		Cardiovascular Diagnosis
			Cardiac Catheterization
				Complications
				Nursing Care
				Congenital Cardiac Defects
		The Child Undergoing Cardiac Surgery
			Preoperative Preparation
			Postoperative Management
				Monitoring Cardiac Output
				Supporting Respiratory Function
				Maintaining Fluid and Electrolyte Balance
				Promoting Comfort
				Promoting Healing and Recovery
		Acquired Heart Disease
			Infective Endocarditis
				Etiology
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Child With IE
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Dysrhythmias
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
				Fast Pulse Rate
					Supraventricular tachycardia.
					Ventricular tachycardia.
				Slow Pulse Rate
					Bradydysrhythmias.
					Absent rhythms.
		Nursing Care
			The Child With a Dysrhythmia
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Rheumatic Fever
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With RF
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Kawasaki Disease
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With Kawasaki Disease
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Hypertension
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
				Primary Hypertension
					Weight reduction.
					Physical conditioning.
					Dietary modification.
					Relaxation techniques.
					Pharmacologic treatment.
				Secondary Hypertension
		Nursing Care
			The Child With Hypertension
				Assessment
					Blood pressure screening.
					Physical assessment.
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Cardiomyopathies
		High Cholesterol Levels in Children and Adolescents
			Assessment of Children at Risk
			Therapeutic Management
			Nursing Considerations
		Key Concepts
		References and Readings
	47 The Child With a Hematologic Alteration
		Learning Objectives
		Clinical Reference
			Review of the Hematologic System
			Iron Deficiency Anemia
				Etiology and Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Sickle Cell Disease
				Etiology
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Thalassemia
				Etiology and Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Nursing Care
				The Child With Beta-Thalassemia
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
			Hemophilia
				Etiology and Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Von Willebrand Disease
				Etiology
				Pathophysiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Nursing Care
				The Child With Von Willebrand Disease
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
			Immune Thrombocytopenic Purpura
				Etiology and Incidence
				Pathophysiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Nursing Care
				The Child With Immune Thrombocytopenic Purpura
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
			Disseminated Intravascular Coagulation
				Etiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
				Nursing Considerations
			Aplastic Anemia
				Etiology and Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Nursing Care
				The Child With Aplastic Anemia
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
			Key Concepts
		References and Readings
	48 The Child With Cancer
		Learning Objectives
		Clinical Reference
			Review of Cancer
			The Child With Cancer
				Incidence
				Childhood Cancer and Its Treatment
				Therapeutic Management
					Chemotherapy
					Surgery
					Radiation Therapy
					Hematopoietic Stem Cell Transplantation
					Steroid Therapy
					Biologic Agents
					Complementary and Alternative Medical (CAM) Therapies
					Follow-Up Care After Cancer Treatment
			Leukemia
				Etiology
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Brain Tumors
				Etiology
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Nursing Care
				The Child With a Brain Tumor
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
			Malignant Lymphomas
				Non-Hodgkin Lymphoma
					Etiology
					Manifestations
					Diagnostic Evaluation
					Therapeutic Management
			Nursing Care
				The Child With Non-Hodgkin Lymphoma
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
				Hodgkin Disease
					Etiology
					Manifestations
					Diagnostic Evaluation
					Therapeutic Management
					Nursing Considerations
			Neuroblastoma
				Etiology
				Incidence
				Pathophysiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Nursing Care
				The Child With Neuroblastoma
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
			Osteosarcoma
				Etiology
				Incidence
				Pathophysiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Nursing Care
				The Child With Osteosarcoma
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
			Ewing Sarcoma
				Etiology
				Incidence
				Pathophysiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
				Nursing Considerations
			Rhabdomyosarcoma
				Etiology
				Incidence
				Pathophysiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
				Nursing Considerations
			Wilms Tumor
				Etiology
				Incidence
				Pathophysiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Nursing Care
				The Child With Wilms Tumor
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
			Retinoblastoma
				Etiology
				Incidence
				Pathophysiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Nursing Care
				The Child With Retinoblastoma
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
			Rare Tumors of Childhood
			Key Concepts
		References and Readings
	49 The Child With an Alteration in Tissue Integrity
		Learning Objectives
		Clinical Reference
			Review of the Integumentary System
		Variations in the Skin of Newborn Infants
		Common Birthmarks
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
			Nursing Considerations
		Skin Inflammation
			Seborrheic Dermatitis
			Contact Dermatitis
				Etiology
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Child With Contact Dermatitis
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
			Atopic Dermatitis
				Etiology
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Child With Atopic Dermatitis
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Skin Infections
			Impetigo
				Etiology
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Child With Impetigo
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
			Cellulitis
				Etiology and Incidence
				Pathophysiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Child With Cellulitis
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
			Candidiasis
				Etiology
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Child With Candidiasis
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
			Tinea Infection
				Etiology
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
					Tinea capitis.
					Tinea corporis.
					Tinea cruris.
					Tinea pedis.
		Nursing Care
			The Child With a Tinea Infection
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
			Herpes Simplex Virus Infection
				Etiology
				Incidence
				Manifestations
					Herpes labialis (“cold sore,” “fever blister”).
					Herpetic gingivostomatitis.
					Herpetic ocular infection.
					Herpetic whitlow.
				Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Child With a Herpes Simplex Infection
				Assessment
				Nursing Diagnoses and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Skin Infestations
			Lice Infestation
				Etiology
				Incidence
				Manifestations
					Pediculosis capitis (head lice).
					Pediculosis corporis (body lice).
					Pediculosis pubis (pubic lice, crab lice).
				Diagnostic Evaluation
				Therapeutic Management
					Killing active lice and nits.
					Addressing the environment.
		Nursing Care
			The Child With Pediculosis
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
			Mite Infestation (Scabies)
				Etiology
				Incidence
				Pathophysiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
				Nursing Considerations
		Acne Vulgaris
			Etiology
			Incidence
			Manifestations and Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Adolescent With Acne Vulgaris
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Miscellaneous Skin Disorders
		Insect Bites or Stings
		Burn Injuries
			Etiology
			Incidence
			Pathophysiology
				Depth of Burn Injury
				Extent of Burn Injury
				Severity of Burn Injury
			Manifestations
			Therapeutic Management
				Superficial Burn Injuries
				Superficial Partial-Thickness Burn Injuries
					Wound cleaning.
					Débridement.
					Application of antimicrobial agents and dressings.
		Conditions Associated With Major Burn Injuries
		Conditions Associated With Electrical Injury
			Cardiac Arrest or Dysrhythmia
			Tissue Damage
			Myoglobinuria
			Metabolic Acidosis
			Other Complications
		Key Concepts
		References and Readings
	50 The Child With a Musculoskeletal Alteration
		Learning Objectives
		Clinical Reference
			Review of the Musculoskeletal System
				Skeletal System
				Articular System
				Muscular System
				Cartilage
				Growth and Development
				Diagnostic and Laboratory Tests
		Casts, Traction, and Other Immobilizing Devices
			Splints
			Casts
			Traction
				Skin Traction
				Skeletal Traction
			External Fixation Devices
			Nursing Considerations
				Neurovascular Status
				Special Considerations for the Child in Halo Traction
					Assessing and managing compartment syndrome.
				Immobility
				Special Considerations for the Child in Traction
				Home Care
		Fractures
			Etiology
			Incidence
			Manifestations
			Therapeutic Management
				Reduction Methods
				Retention
			Nursing Considerations
				Initial Trauma Assessment
				Assessing and Managing Complications
		Soft-Tissue Injuries: Sprains, Strains, and Contusions
			Etiology
			Incidence
			Manifestations and Diagnostic Evaluation
			Therapeutic Management
			Nursing Considerations
		Osteomyelitis
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With Osteomyelitis
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
					Administering IV antibiotics.
					Providing wound care.
					Maintaining nutritional status.
					Teaching home management.
					Promoting optimal development.
				Evaluation
		Scoliosis
			Adolescent Idiopathic Scoliosis
				Prevalence and Etiology
				Manifestations
				Diagnostic Evaluation
					School screening.
					Physical examination.
					Radiographs.
				Treatment
					Nonsurgical interventions.
					Surgical intervention.
					Surgical complications.
					Postoperative management.
					Follow-up care.
		Kyphosis
			Scheuermann’s Kyphosis
			Other Causes of Hyperkyphosis
		Limb Differences
			Etiology and Incidence
			Diagnostic Evaluation
			Therapeutic Management
			Nursing Considerations
		Developmental Dysplasia of the Hip
			Etiology and Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With Developmental Dysplasia of the Hip
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
					Teaching about the pavlik harness.
					Teaching about spica cast care.
					Alleviating anxiety.
					Preventing injury.
				Evaluation
		Legg–Calvé–Perthes Disease
			Etiology and Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With Legg–Calvé–Perthes Disease
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
				Interventions
					Facilitating appropriate activity.
					Teaching home management.
				Evaluation
		Slipped Capital Femoral Epiphysis
			Etiology and Incidence
			Pathophysiology
			Manifestations and Diagnostic Evaluation
			Therapeutic Management and Nursing Considerations
		Clubfoot
			Etiology and Incidence
			Manifestations and Diagnostic Evaluation
			Therapeutic Management
				Ponseti Casting Method
				Clubfoot Recurrence
			Nursing Considerations
				Education and Anticipatory Guidance
				Reduction of Discomfort and Pain
				Patient Advocacy
		Muscular Dystrophies
			Etiology
			Incidence
			Pathophysiology
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
			Nursing Considerations
		Juvenile Idiopathic Arthritis
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
				Drug Therapy
				Physical and Occupational Therapy
				Surgical Treatment
		Nursing Care
			The Child With JIA
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
					Managing pain.
					Promoting mobility.
					Managing potential infections.
					Facilitating emotional and social development.
					Family education.
				Evaluation
		Syndromes and Conditions With Associated Orthopedic Anomalies
		Key Concepts
		References and Readings
	51 The Child With an Endocrine or Metabolic Alteration
		Learning Objectives
		Clinical Reference
			Review of the Endocrine System
			Diagnostic Tests and Procedures
		Phenylalanine Hydroxylase Deficiency (Formally Phenylketonuria)
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
			Nursing Considerations
		Inborn Errors of Metabolism
		Congenital Adrenal Hyperplasia
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
			Nursing Considerations
		Congenital Hypothyroidism
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Infant With Congenital Hypothyroidism
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Acquired Hypothyroidism
			Etiology
			Pathophysiology
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With Acquired Hypothyroidism
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Hyperthyroidism (Graves’ Disease)
			Incidence
			Pathophysiology
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With Hyperthyroidism
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Diabetes Insipidus
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
			Nursing Considerations
		Syndrome of Inappropriate Antidiuretic Hormone
			Etiology
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
			Nursing Considerations
		Precocious Puberty
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With Precocious Puberty
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Growth Hormone Deficiency
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With Growth Hormone Deficiency
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Diabetes Mellitus
			Type 1 Diabetes Mellitus
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
				Insulin Therapy
					Schedule.
					Administration.
				Nutrition Therapy
				Physical Activity
				Blood Glucose Monitoring
				Developmental Issues
					Infant and toddler.
					Preschooler.
					School-age child.
					Adolescent.
				Delegating Diabetes Management Responsibilities
		Diabetic Ketoacidosis
			Etiology
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Long-Term Healthcare Needs for the Child With Type 1 Diabetes Mellitus
		Type 2 Diabetes Mellitus
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
				Medication Therapy
				Nutrition Therapy
				Physical Activity
				Blood Glucose Monitoring
				Prevention
		Key Concepts
		References and Readings
	52 The Child With a Neurologic Alteration
		Learning Objectives
		Clinical Reference
			Review of the Central Nervous System
				Embryologic Development
				The Myelin Sheath
				The Neural System
				The Axial Skeleton
				The Meninges
				The Brain
				The Cranial Nerves
				The Spinal Cord
				Cerebrospinal Fluid
				Cerebral Blood Flow and Intracranial Regulation
			Increased Intracranial Pressure
				Etiology
				Manifestations
					Level of Consciousness
					Behavior
					Pupil Evaluation
					Motor Function
					Vital Signs
				Diagnostic Evaluation and Therapeutic Management
			Spina Bifida
				Etiology and Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Hydrocephalus
				Etiology
				Incidence
				Manifestations and Diagnostic Evaluation
				Therapeutic Management
			Cerebral Palsy
				Etiology and Incidence
				Manifestations
				Diagnostic Evaluation and Therapeutic Management
			Head Injury
				Types of Head Injuries
					Skull Fractures
					Contusion
					Concussion
					Intracranial Hemorrhage
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
				Nursing Considerations
			Spinal Cord Injury
				Etiology
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Nursing Care
				The Child With a Spinal Cord Injury
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
			Seizure Disorders
				Etiology
				Incidence
				Pathophysiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Status Epilepticus
				Etiology
				Incidence
				Pathophysiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Nursing Care
				The Child With Status Epilepticus
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions and Evaluation
			Meningitis
				Etiology
				Incidence
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Nursing Care
				The Child With Meningitis
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
					Interventions
					Evaluation
			Guillain-Barré Syndrome
				Incidence
				Pathophysiology
				Manifestations
				Diagnostic Evaluation
				Therapeutic Management
			Nursing Care
				The Child With Guillain-Barré Syndrome
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
			Neurologic Conditions Requiring Critical Care
			Headaches
				Etiology
				Incidence
				Manifestations
					Migraine
					Tension-Type Headaches
				Diagnostic Evaluation
			Nursing Care
				The Child With Headaches
					Assessment
					Nursing Diagnosis and Planning
						Expected outcome.
						Expected outcome.
						Expected outcome.
					Interventions
					Evaluation
			Key Concepts
		References and Readings
	53 Psychosocial Problems in Children and Families
		Learning Objectives
		Clinical Reference
			Overview of Psychosocial Disorders of Childhood
				Prevalence
				Precipitating Factors
				Diagnostic Evaluation
					Screening Questionnaires and Standardized Assessment Tools
		Internalizing Disorders
			Anxiety Disorders
				Social Anxiety Disorder
				Separation Anxiety
				Panic Disorder
				Posttraumatic Stress Disorder
				Obsessive–Compulsive Disorder
			Mood Disorders
				Major Depressive Disorder and Dysthymic (Persistent Depressive) Disorder
				Adjustment Disorder
				Bipolar Disorder
			Etiology and Physiology of Internalizing Disorders
				Biologic Factors
				Environmental Factors
				Traumatic Brain Injury
			Manifestations
			Therapeutic Management of Children With Internalizing Disorders
		Nursing Care
			The Child With an Internalizing Disorder
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Suicide
			Manifestations and Risk Factors
			Therapeutic Management
				Prevention
				When Prevention and Intervention Fail
		Nursing Care
			The Child or Adolescent at Risk for Suicide
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Externalizing Disorders
			Etiology
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With ADHD
				Assessment
				Nursing Diagnosis and Planning
					Expected outcomes.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Eating Disorders: Anorexia, Bulimia, and Obesity
			Etiology
			Manifestations
				Anorexia
				Bulimia
				Obesity
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child or Adolescent With an Eating Disorder
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Substance Abuse
			Etiology
			Manifestations
			Therapeutic Management
		Nursing Care
			The Child or Adolescent With a Substance Abuse Problem
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Childhood Physical and Emotional Abuse and Child Neglect
			Etiology
			Incidence
			Manifestations
				Indicators of Physical Abuse
				Indicators of Neglect
				Indicators of Emotional Abuse
				Indicators of Sexual Abuse
				Other Specific Abusive Situations
					Abusive head trauma.
					Factitious disorder by proxy (munchausen syndrome by proxy, or medical child abuse).
		Key Concepts
		References and Readings
	54 The Child With an Intellectual Disability or Developmental Disability
		Learning Objectives
		Clinical Reference
			Genetics and Genomics
		Intellectual and Developmental Disorders
			Developmental Disability and the Americans With Disabilities Act: the Impact of Public Policy
			Terminology
				Mental Age, Functional Age, Adaptive Functioning
				Intellectual Impairment and Intellectual Disability
				Intellectual Development Disorder versus Mental Retardation
				Autism Spectrum Disorders versus Pervasive Developmental Disorders
			Etiology of Intellectual Disabilities and Pervasive Developmental Disorders
			Incidence of Intellectual and Developmental Disorders
			Manifestations
			Diagnostic Evaluation
			Management
				General Strategies
				Safety Challenges
		Disorders Resulting in Intellectual or Developmental Disability
		Down Syndrome
			Etiology
			Incidence
			Manifestations
			Diagnostic Evaluation
			Therapeutic Management
		Nursing Care
			The Child With DS
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcomes.
				Interventions
				Evaluation
		Fragile X Syndrome
			Etiology
			Incidence
			Manifestations
				Physical Characteristics
				Social and Emotional Relatedness
				Speech and Language Capability and Sensory Impairment
				Co-Morbid Disorders
			Diagnostic Evaluation
			Therapeutic Management
			Nursing Considerations
		Rett Syndrome
		Fetal Alcohol Spectrum Disorder (FASD)
			Etiology and Incidence
			Manifestations
			Diagnostic Evaluation
		Nursing Care
			The Infant With FASD
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcome.
					Expected outcome.
					Expected outcome.
				Interventions
				Evaluation
		Failure to Thrive
			Etiology
			Incidence
			Manifestations and Risk Factors
			Diagnostic Evaluation
			Therapeutic Management
			Nursing Considerations
		Autism Spectrum Disorders
			Asperger Syndrome
			Autism
				Etiology
				Incidence
				Manifestations
					Social
						Language
						Restricted behavioral repertoire.
				Diagnostic Evaluation
				Therapeutic Management
		Nursing Care
			The Child With Autism
				Assessment
				Nursing Diagnosis and Planning
					Expected outcome.
					Expected outcomes.
					Expected outcomes.
				Interventions
				Evaluation
		Key Concepts
		References and Readings
	55 The Child With a Sensory Alteration
		Learning Objectives
		Clinical Reference
			Review of the Eye
				Structure and Function
				Neonatal Development
			Review of the Ear
				Structure and Function
				Neonatal Development
			Speech Development
		Disorders of the Eye
			Nursing Considerations for the Child With a Blocked Lacrimal Duct
			Nursing Considerations for the Child With a Refractive Error
			Nursing Considerations for the Child With Color Deficiency
			Nursing Considerations for the Child With Amblyopia
			Nursing Considerations for the Child With Strabismus
			Nursing Considerations for the Child With Glaucoma
			Nursing Considerations for the Child With a Cataract
		Eye Surgery
		Eye Infections
			Nursing Considerations for the Child With Conjunctivitis
			Nursing Considerations for the Child With Orbital Cellulitis
			Nursing Considerations for the Child With a Corneal Ulcer
		Eye Trauma
			Nursing Considerations for the Child With a Corneal Abrasion
			Nursing Considerations for the Child With Hemorrhage
			Nursing Considerations for the Child With Hyphema
			Nursing Considerations for the Child With a Chemical Splash Injury
		Hearing Loss in Children
			Etiology
			Incidence
			Diagnostic Evaluation
			Therapeutic Management
			Nursing Considerations for the Child With Hearing Loss
		Language Disorders
		Key Concepts
		References and Readings
Appendix A NANDA-I Diagnoses and Definitions
	References and Readings
Glossary
	A
	B
	C
	D
	E
	F
	G
	H
	I
	J
	K
	L
	M
	N
	O
	P
	Q
	R
	S
	T
	U
	V
	W
	Z
Index
	A
	B
	C
	D
	E
	F
	G
	H
	I
	J
	K
	L
	M
	N
	O
	P
	Q
	R
	S
	T
	U
	V
	W
	X
	Y
	Z
Features 1
Features
	Patient-Centered Teaching
	Pathophysiology
	Procedure
	Safety Alert
	Want to Know
Inside Back Cover