NURS 4423 Pediatric Nursing *
COURSE DESCRIPTION: This course introduces the student to the care of the well child, the child with special needs and the child
with acute and chronic health care needs. A strong emphasis on maintaining the dignity of the child and promoting healthy growth and
development, even during illness, will be evident. Students will also examine the role of the family and the importance of it to the care
of the child. Clinicals will focus on both well children and children with health care needs. Students will be required to take an
assessment exam at the end of this course, but it will not be a part of the course grade.
CREDIT: 4 Hours Credit (3 hrs. class/week, 8 hrs. clinical/week)
PROGRAM LEVEL: II
Instructor: Heather Flores, RN, MSN
719-235-1257/ M-F 9:00-5:00 pm and other times by appointment.
Email: heather.flores@email.wayland.wbu.edu (This is the easiest way to contact me.)
TEXTBOOKS: Essentials of Pediatric Nursing/ Hockenberry, and Wilson- 8th edition/ Mosby
COURSE OBJECTIVES:
At the end of this course, the student will be able to:
1. Define the role of the professional registered nurse in the care of the pediatric client.
2. Identify normal and abnormal growth and development of the child.
3. Identify health care needs of children.
4. Establish nursing diagnosis for the client in the acute care arena as well as in the Community.
5. Identify the nursing process in caring for the child utilizing evidence-based practice.
6. Discuss nursing care according to the child’s age and developmental stage.
7. Identify teaching strategies for the client and the family about the care required for their disease process.
8. Describe the importance of the client’s and the families’ culture when planning and implementing care.
9. Discuss ethical and legal principles when caring for the client.
CLINICAL OBJECTIVES:
At the end of this course, the student will be able to:
1. Identify the role of the nurse in the pediatric care setting.
2. Perform a head to toe assessment of the pediatric client.
3. Develop a plan of care in collaboration with client, family, as well as the interdisciplinary health care team, using the nursing
process for a pediatric client with health care needs.
4. Deliver appropriate nursing care to the pediatric client based on diagnosis, age and developmental stage.
5.
6.
7.
8.
Consider the culture of the pediatric client and the family when planning care.
Utilize appropriate teaching strategies when instructing the Pediatric client and family.
Apply ethical and legal principles when caring for the Pediatric client and family.
Educate the client and his/her family about agencies in the community that can help with difficulties concerning the child’s
diagnosis, as well as provide support.
EVALUATION AND GRADING: A point system is used to determine the grade in Pediatric Nursing.
A = 90-100
B = 80-89
C = 75-79
D = 60-74
F = 59 and below
Exam One
20%
Exam Two
20%
Exam Three
20%
Final Exam
20%
Power point Presentation 10%
ATI
10% (actual exam)
---------------Total
100%
*Denver Developmental tool part of clinical participation
* Comprehensive final exam
ATI Score Scale
Below Level One
Level One
Level Two
Level Three
70
80
90
100
The clinical portion of the course is on a pass/fail basis and must be passed to pass the course. The level two clinical evaluation forms
will be used to determine the students pass or fail performance for this course.
Testing:
Test dates and content will be published in the course syllabi purchased by the students at the beginning of each term from the
bookstore. A test blueprint will be prepared by the faculty and distributed to the student at least one week prior to the exam. The
blueprint will provide the student with the subject content of the exam, the number of questions in that subject area and the type of
question. The type of question will be categorized two ways. First the question will be categorized by the areas of the nursing process;
assessment, planning, implementation and evaluation. The question will also be categorized by cognitive level; knowledge, analysis,
application, and comprehension. In the event a faculty must change a test date, they must notify the students at least one week before
the scheduled exam. If the student must miss an exam, they must notify the faculty that
They will not be present for the exam and schedule a date for the make-up exam within one week of the date of the exam. Student
may have 1 week to review exam by appointment only. Remember to choose the best answer on the exams, there may be times when
more then one answer may be correct, this mimics real life situations in hospitals/clinical settings, as well as NCLEX questions, please
choose the best answer. Students may challenge a question up to 48 hours after exam, please follow University protocol for this
procedure.
Make-up Tests:
Occasionally a student will miss a test that is scheduled for a class. A student should contact his/her instructor to arrange the make-up
test. The make-up test may be administered by the staff at Wayland within one week, on an agreed date by both the instructor and the
individual student. These students will receive an alternate exam.
Participation Requirements:
Participation is very important online. You will be expected to participate in the online discussion threads by posting at least two
substantive discussion messages each week. This is a required part of your grade. Participation consists of notes you send above and
beyond graded assignments.
Expectations for Discussion Question Responses/Participation Posts
Discussion question responses/participation posts should be about 150-200 words. Please post responses to the threads provided. To
respond, highlight the appropriate thread, click on Reply, type your response, and send. Please do not start a new thread for the weekly
discussion question. In order to earn full participation points, you must add something of substance to the discussion by posting 2
times/week minimum—this would consist of new ideas, your perspectives, etc.
Unlike your formal written assignments, I do not require that your responses adhere to specific formatting requirements. However,
please make sure to proofread carefully. Grammar and spelling errors may impact the grading. Please be sure to add a reference to
your participation posts.
I expect your discussion question responses/participation posts to reflect critical thought. Whenever possible, please try to relate the
course content to real-world applications from your work experience. Please note that both quantity and quality are important
considerations when it comes to participation. For example, a message which says simply, "I agree," does not constitute participation,
because it does not add anything of substance to the discussion. Please also note that your posts need to have a reference in APA
format, be relevant to the week’s content, and add to the discussion by tying in the week’s readings to an article or observation or
experience.
Care Plans:
A care plan will be turned in at the beginning of clinic: due dates will be posted by clinical faculty.
PowerPoint Presentation: PowerPoint presentations are a critical part of learning in all professions, especially in nursing, where
components of advancement (career ladder) are contingent on good communication skills, research skills, professionalism, and
collaboration skills. There will be groups of two presenting a PowerPoint Presentation of 10-15 slides of content (references and
cover slide not counted as content) or a total of 30 minutes, a rubric will be provided. This will be due in week 9 for presentation in
week 10. Each member will present two NCLEX questions related to your topic to group, the class will answer questions and
rationale will be explained to group in the discussion forum. A rubric will be provided and topics will be provided on the first day of
class. No make ups for this assignment.
In the event of course changes or course TBD:
In the event that there is a change to assignments or dates, faculty will post a note in the announcements section of the classroom
BlackBoard as soon as possible.
Class Attendance
1. The student must attend the class (es) for which he/she is enrolled.
2. A student who misses twenty-five percent (25%) (Including lecture and clinical), or more of the regularly scheduled class
meetings will receive a grade of “F” for that class.
3. When a student reaches a number of absences considered by the instructor to be excessive, the instructor will so advise the
student and file an Unsatisfactory Progress Report at the San Antonio Campus.
4. Please respect others during participation, clinical, and activities. A professional tone and collaborative online presence will be
expected.
Clinical Attendance:
Attendance to clinical is critical. This is the opportunity for the student to learn and practice skills in a Simulation Lab and then apply
them later in patient care. All time spent in the simulation lab and receiving instruction is considered clinical time. Any student missing
a clinical must call in to the instructor prior to the scheduled clinical so arrangements can be made for their patient assignment to be
taken care of. Any clinical missed must be made up.
Students are required to attend and participate during Pre and Post Clinical Conferences. Students are expected to attend all clinical
experience sessions at the clinical agency/hospital and in the simulation laboratory on the scheduled day and at the scheduled time. In
the case of illness, appropriate health precautions are to be taken. Students must protect pediatric clients and their families/caregivers
from exposure to diseases. Students are expected to notify their clinical instructor (and clinical agency if applicable) if they are ill and
unable to attend a given clinical experience session.
Clinical Failing Behaviors
Clinical failing behaviors are linked to the Texas Board of Nursing Standards of Professional Practice. Issues related to professional
conduct, management of stress, clarification of course, clinical assignment, and/or professional role expectations, may warrant clinical
warnings, contracts for remediation, or course failure.
Clinical Failing Behaviors
1. Performance is unsafe.
2. Questionable decisions are often
made.
3. Lacks insight into own behaviors
and that of others.
4. Difficulty in adapting to new
ideas/functions.
5. Continues to need additional
guidance and direction.
Matched to NPA
1,2,3,5,6,7,9,10,11,12,13,14,15
1,2,3,4,5,6,7,8,9,10,11,12,13,14,15
1,2,3,4,5,6,8,9,10,11,12,13,14,15
4,5,6,7,8,9,10,11,13,14,15
1,2,3,5,6,7,8,9,10,11,14,15
Standards of Professional Nursing Practice (BON 213.27, 217.11, 217.12)
1. Knows rationale for side effects of medications and treatments, and correctly administers same 217.00 (1) (C).
2. Documents nursing care accurately and completely, including signs and symptoms, nursing care rendered medication
administration. Contacts health care team concerning significant events in patient health 217.11 (1) (D).
3. Implements a safe environment for patients and/or others, i.e., bed rails up, universal precautions 217.11 (1) (B).
4. Respects client confidentiality 217.11 (1) (E).
5. Accepts assignments commensurate with educational level, preparation, experience and knowledge 217.11(1) (T).
6. Obtains instruction and supervision as necessary when implementing nursing procedures or practices 217.11(1) (H).
7. Notifies the appropriate supervisor when leaving an assignment 217.11(1) (I).
8. Recognizes and maintains professional boundaries of the nurse/patient relationship 217.11(1) (J).
9. Clarifies orders, treatments, that nurse has reason to believe are inaccurate, non-effective or contraindicated 217.11(1) (N).
10. Able to distinguish right from wrong 213.27(b) (2) (A).
11. Able to think and act rationally 213.27(b) (2) (B).
12. Able to keep promises and honor obligations 213.27(b) (2) (C).
13. Accountable for own behavior 213.27(b) (2) (D).
14. Able to promptly and fully self-disclose facts, circumstances, events, errors and omissions when these disclosures will enhance
health status of patients or protect patients from unnecessary risk or harm 213.27(b) (2)(G).
Please refer to the Board of Nursing at www.BON.state.tx.us for any additional information regarding the Texas Nursing Practice Act
Date
Week 1
Orientation
Course Outline/Calendar
Topic/Event
Unit 1: Children, Their Families and the Nurse
Pediatric Pharmacology Self-Study Module, may keep as a reference- (chapter 4 in Pharmacology
review)
Week 2
Chapters: Essentials in Pedi- EP( Chp. 18,19,20)
Unit 2: Special Needs, Illness, and Hospitalization
Week 3
Unit 3: Respiratory Dysfunction EP (Chp. 23).
Unit 4: Cardiovascular Dysfunction/no formal cardiac lecture
EP (chip. 25).
Week 4
Test #1
Unit 5: GI and Unit 6 GU / EP (Chp. 24 and 27).
Unit 6: GU / EP
Week 5
Unit 7: Heme/Immunological
Week 6
Unit 7: Hematologic and Immunologic
Week 7
Unit 8: Cerebral Dysfunction EP (chp. 28)
Week 8
Test 2
Unit 9: Endocrine Dysfunction EP (chp. 29)
Unit 10: Integumentary Dysfunction- No formal integumentary lecture read on own EP (chp. 30)
Week 9
Unit 11: Musculoskeletal/Articular Dysfunction
Week 10
Test # 3Clinical: ATI Last clinical date
Comprehensive Final Exam
Week 11
EP (chp. 26)
Unit 1: Children, Their Families and the Nurse
Unit Objectives
Student Assignments Learning Activities
1. Identify two ways that knowledge of mortality and morbidity can improve child
Required Reading:
Lecture and
health.
Wong see above
discussion.
chapters
2. List three major causes of illness/ death during infancy, early childhood, later
childhood, and adolescence.
Recommended
3. Identify areas of potential conflict of values and customs for a nurse interacting Reading:
with a family from a different cultural/ethnic group.
ATI:
4. Review of growth and development.
5. Identify communication strategies for communicating with children of different
age groups.
6. List three areas that are evaluated as part of nutritional assessment.
Unit 2: Special Needs, Illness, and Hospitalization
Unit Objectives
Student Assignments Learning Activities
1. Identify the scope of and changing trends in care of children with special
Required Reading:
Lecture and
needs/illness and hospitalization.
Wong: see above
discussion.
2. Define the stages of adjustment to the diagnosis of a chronic condition.
.
Recommended
3. Outline nursing interventions that support the family at the time of death.
Reading:
4. Define the classifications of mental retardation.
ATI:
.
5. List the general classifications of hearing impairment and the effect on speech.
6. Outline nursing interventions for the child with hearing impairment, including
during hospitalization /list the common types of visual disorders in children.
.
Unit 3: Respiratory Dysfunction
Unit Objectives
1. Identify the factors leading to respiratory tract infection in the infant or young
child.
2. Describe the postoperative nursing care of the child with a
tonsillectomy/croup/otitis media
3. Describe the ways in which the various therapeutic measures relieve the
symptoms for asthma.
Student Assignments Learning Activities
Required Reading:
Lecture and
Wong see above
discussion.
Case studies.
Recommended
Reading:
ATI:
4. Describe the physiologic effects of cystic fibrosis on the gastrointestinal and
pulmonary systems.
5. List the major signs of respiratory distress in infants and children.
Unit 4: Cardiovascular Dysfunction (In class group activities)
Unit Objectives
1. Design a plan for assisting a child during a cardiac diagnostic procedure.
2. Demonstrate an understanding of the hemodynamics, distinctive
manifestations, and therapeutic management of congenital heart
disease/surgical repair
3. Outline a plan of care for an infant or a child with congestive heart failure.
Student Assignments
Required Reading:
Wong see above
.
Learning
Activities
Lecture and
discussion.
Case studies.
Recommended Reading:
ATI:
4. Differentiate between rheumatic fever and rheumatic heart disease/Kawasaki
disease
5. List the criteria for selected cholesterol screening/HTN of children.
6. Describe the emergency treatment for shock, including anaphylaxis.
Unit 5: Gastrointestinal Dysfunction
Unit Objectives
Student Assignments
1. Describe the characteristics of infants that affect their ability to adapt to fluid
loss or gain/acute diarrhea.
2. Compare and contrast the inflammatory diseases of the gastrointestinal tract.
3. Describe the nursing care of the child with hepatitis.
4. Formulate a plan for teaching parents preoperative and postoperative care of
the child with a cleft lip or palate.
5. Formulate a plan of care for the child with an obstructive disorder.
6. Identify nutritional therapies for the child with a malabsorption syndrome.
Learning
Activities
Required Reading:
Lecture and
Wong see above
discussion.
Recommended Reading: Case studies.
ATI:
Unit 6: Genitourinary Dysfunction
Unit Objectives
Student Assignments
1. Describe the various factors that contribute to urinary tract infections in infants
and children.
2. Discuss the preoperative preparation of the child and parents when the child
has a structural defect of the genitourinary tract.
3. Demonstrate an understanding of the causes and mechanisms of edema
formation in nephrotic syndrome/acute glomerulonephritis
Required Reading:
Wong see above
Recommended Reading:
ATI:
Learning
Activities
Lecture and
discussion.
4. Contrast the causes, complications, and management of acute and chronic
renal failure.
5. List the types of renal dialysis.
6. Recognize signs of kidney transplant rejection.
Unit 7: Hematologic and Immunologic Dysfunction
Unit Objectives
Student Assignments
1. Distinguish between the various categories of anemia.
2. Describe the prevention of iron deficiency anemia and the care of the child
with iron deficiency anemia.
3. Compare sickle cell anemia and B-thalassemia major in relation to
pathophysiology and nursing care.
4. Describe the mechanisms of inheritance and nursing care of the child with
hemophilia/leukemia/neoplastic disease
Required Reading:
Wong see above
Learning
Activities
Lecture and
discussion
Recommended Reading:
ATI:
5. Demonstrate an understanding of the rationale of therapies for neoplastic
disease.
6. Contrast the pathophysiology and management of the immunodeficiency
disorders.
Unit 8: Cerebral Dysfunction
Unit Objectives
Student Assignments
1. Describe the various modalities for assessment of cerebral function.
2. Differentiate between the stages of consciousness/unconscious child
3. Distinguish between the types of head injuries and the serious
complications/hydrocephalus
4. Describe the nursing care of a child with a tumor of the central nervous
system.
5. Outline a plan of care for the child with bacterial meningitis.
6. Differentiate between the various types of seizure disorder and management
Unit 9: Endocrine Dysfunction
Required Reading:
Wong:
See above
Recommended Reading:
ATI:
Learning
Activities
Lecture and
discussion.
Unit Objectives
1. Differentiate between the disorders caused by hypopituitary and hyperpituitary
dysfunction.
2. Describe the manifestations of thyroid hypofunction and hyperfunction and the
management of children with the disorders.
3. Distinguish between the manifestations of adrenal hypofunction and
hyperfunction.
4. Differentiate among the various categories of diabetes mellitus.
5. Discuss the management and nursing care of the child with diabetes mellitus
in the acute care setting.
6. Distinguish between a hypoglycemic and a hyperglycemic reaction.
Student Assignments
Required Reading:
Wong: see above
Recommended Reading:
ATI:
Unit 10: Integumentary Dysfunction
Unit Objectives
Student Assignments
1. Describe the distribution and configuration of the various skin lesions.
2. List the benefits of a moist environment for wound healing.
3. Contrast the manifestations of and therapies for bacterial, viral, and fungal
infections of the skin.
4. Outline a plan of care for a child with atopic dermatitis.
5. Formulate a teaching plan for an adolescent with acne.
6. Describe the methods of assessing a burn wound.
Learning
Activities
Lecture and
Discussion.
Required Reading:
Wong: see above
Learning
Activities
Lecture and
discussion.
Recommended Reading:
ATI:
Unit 11: Musculoskeletal or Articular Dysfunction and Neuromuscular or Muscular Dysfunction
Unit Objectives
1. Outline a plan for the care of a child immobilized with an injury or a
degenerative disease/cast and traction
Student Assignments
Required Reading:
Wong: see above
Learning
Activities
Lecture and
Discussion
2. Differentiate among the various congenital skeletal defects, design a teaching
plan for the parents of a child with a congenital skeletal deformity/rheumatoid
arthritis
3. Describe the therapies and nursing care of a child with
scoliosis/osteomyelitis/Ewing Sarcoma
4. Demonstrate an understanding of the management of systemic lupus
erythematosus.
5. Outline a plan of care for a child with Duchenne muscular dystrophy/Spinal
cord injuries/cerebral palsy/mycelomeningocele
6. Discuss the prevention and treatment of tetanus/botulism.
Case studies.
Recommended Reading:
ATI: