AFAMS Master Lesson Plan (MLP)
Nursing Program
Health Care Adaptations for the Pediatric Patient
Instructor
Serial/Semester
Location
Start/Finish Time
Date
LESSON OBJECTIVE
Performance: To gain an understanding of health care adaptations for the pediatric patient.
Conditions:
The student will be presented a powerpoint presentation by the instructor and will have
all necessary references made available to him/her.
Standard:
1.
Given a scenario of a pediatric patient by correctly responding to written, oral and
experiential assessment measures.
TEACHING POINTS
1. Contrast elements of a pediatric assessment to
elements of an adult assessment
2. Identify safety measures applicable to nursing
care of the hospitalized child including
restraints, positioning and transporting
3. Identify normal vital signs of infants and
children at various ages
4.
Describe variations in specimen collection for
the pediatric patient; including urine, stool,
blood and lumbar puncture
5.
Compare the absorption, metabolism and
excretion of medications in children to the
absorption, metabolism and excretion of
medications in adults
Compare the absorption, metabolism and
excretion of medications in children to the
absorption, metabolism and excretion of
medications in adults
6.
7.
Calculate a drug dosage using body surface
area and dimensional analysis
8. Determine nursing responsibilities related to
the administration of oral and parenteral
medications to the pediatric patient
9. Describe how to adapt nursing procedures
related to gastrostomy feedings and enema
administration to the pediatric patient
10. Describe how to adapt nursing procedures
related to tracheostomy care, oxygen
administration and airway obstruction to the
pediatric patient
11. Describe how to adapt nursing procedures
related to preoperative and postoperative care
to the pediatric patient
12.
INSTRUCTIONAL STRATEGY
Interactive Lecture
Method:
Instructor
Media:
Classroom
Environment:
OTHER LESSON SPECIFICATIONS
Knowledge Lesson
Type of Lesson:
1/50
Ratio:
Resources:
.
End of Lesson Test: None
Instructional Time: 168
Reference(s):
ISBN 0-323-01727-4
Foundations of Nursing, 4th Edition
01 Jan 2003
Minutes
AFAMS Master Lesson Plan (MLP)
Nursing Program
Health Care Adaptations for the Pediatric Patient
ISBN 0-7216-9334-2
Introduction to Maternity & Pediatric Nursing, 4th
Edition
01 Jan 2003
LESSON PLAN APPROVAL
Signature of Standards Officer
1
Date
AFAMS Master Lesson Plan (MLP)
Nursing Program
Health Care Adaptations for the Pediatric Patient
INTRODUCTION
Allocated Time:
Review:
5 Minutes
You have had previous anatomy and physiology lectures in your combat medic
training, this lecture will build upon prior instruction.
Objective:
To discuss/describe topics related to the nursing process.
Importance:
Nurses work in various health care settings so it is important to gain an
understanding of this subject as it will apply to your clinical practice.
Fit:
When a child is admitted to the hospital, the chief concern is to provide quality
care. In order to accomplish this, the practical nurse must apply knowledge of
normal growth and development, specific disease conditions, an understanding
of the pediatric unit, and the basic needs and daily care of the hospitalized
child.
Approach:
You will be presented the subject in lecture format and will be tested using a
written exam at a later date.
Control Statement:
If you have any questions during the lesson please feel free to ask.
BODY
1. Teaching Point: Contrast elements of a pediatric assessment to elements of an adult assessment
Minutes
Allocated Time:
Introduction:
Learner Participation:
Knowledge Lesson Please follow along with your hand outs and take notes.
Skill Lesson
Powerpoint presentation with associated handouts.
Learning Support:
a. Children are not little adults. They have anatomical and physiological differences that must be
considered when performing an assessment.
b. Communicating with children is different from communicating with adults. Age and developmental
level must be considered when assessing a child.
c. In addition to height and weight, additional measurements may be required for a child.
(1) Head circumference is measured up to 36 months of age. See Figure 29-1, p. 789, Christensen.
Chest and abdominal circumference may also be required. Sometimes skin fold thickness and arm
circumference are measured.
(2) Length rather than height is measured until a child is 2 years of age.
(3) Weight is particularly important in detecting fluid loss and insufficient caloric intake. It is essential
that you maintain privacy of the child when weighing . See Figure 29-2, p. 789, Christensen.
2
AFAMS Master Lesson Plan (MLP)
Nursing Program
Health Care Adaptations for the Pediatric Patient
(4) Vital signs are highly variable in children depending on their age. See Table 29-3 and Table 29-4,
p. 790, Christensen for expected values for vital signs for children.
d. The remainder of the assessment should follow in a head to toe manner taking into account
developmental differences. See Box 29-3, p. 788, Christensen for guidelines related to pediatric
assessment.
Knowledge Lesson:
Question:
Answer:
Check on Learning
In a knowledge lesson, pose questions to the class.
True or false, children are little adults.
False.
Skill Lesson:
In a skill lesson, provide practice and watch students perform a skill.
2. Teaching Point: Identify safety measures applicable to nursing care of the hospitalized child including
restraints, positioning and transporting
Minutes
Allocated Time:
Introduction:
Learner Participation:
Knowledge Lesson Please follow along with your hand outs and take notes.
Skill Lesson
Powerpoint presentation with associated handouts.
Learning Support:
a. Review the list of do's and don'ts related to safety measures in the hospital setting, p. 495-496, Leifer.
b. Review table 29-12- preventing accidents, chapter 29 pages 814-816.
c. Safety related to restraints
(1) Only used as a last resort. Must be applied properly and circulation and skin need to be assessed
regularly during use. Remove every two hours for exercise with caution. Tie to bed frame, not side rails.
Explain use to child/parents.
(2) Elbow restraints (safety reminder devices) are used to prevent flexion of the elbows. They are
useful after cleft lip/palate repair or with scalp vein IVs to protect these sites.
(3) Mummy restraint (safety reminder device) may be used briefly for examinations or treatments.
(4) See Box 22-1, p. 498, Leifer, and demonstrate to class proper application of mummy restraint.
(5) Clove-hitch restraints (safety reminder devices) may be used on all four extremities. See procedure
on p. 272, Christensen.
(6) Jacket restraint (safety reminder device) can be used with a bed or high chair to keep an active older
infant or toddler safely in the bed or chair.
d. Safety related to positioning
3
AFAMS Master Lesson Plan (MLP)
Nursing Program
Health Care Adaptations for the Pediatric Patient
(1) Must support the neck and back of young infants
(2) See Figure 22-4, p. 497, Leifer for cradle, football, and upright positioning of infants.
(3) It is a nursing responsibility to safely position children for examinations and procedures.
(4) See Fig. 29-13, 29-14 and 29-15, p. 808, Christensen for examples of positioning.
d. Safety related to transport
(1) Method used depends on the age of the child, level of consciousness and how far the child is being
transported.
(2) Older children may be transported the same as adults. Good nursing judgment is required to make
this decision.
(3) You may use a crib, wagon, wheelchair or stretcher (side rails up) for younger children.
(4) You must be sure that the child has his/her identification band on prior to transport and document
the transport including where taken, reason, and who went with the child.
Knowledge Lesson:
Question:
Answer:
Check on Learning
In a knowledge lesson, pose questions to the class.
When might elbow restraints be used?
Following repair of a cleft lip/palate or with a scalp vein IV.
Skill Lesson:
In a skill lesson, provide practice and watch students perform a skill.
3. Teaching Point: Identify normal vital signs of infants and children at various ages
Minutes
Allocated Time:
Introduction:
Learner Participation:
Knowledge Lesson Please follow along with your hand outs and take notes.
Skill Lesson
Powerpoint presentation with associated handouts.
Learning Support:
a. Vital signs are highly variable in children depending on their age. See Table 29-3 and Table 29-4, p.
790, Christensen for expected values for vital signs in children.
b. Hypotension is a late sign of shock in children and must be considered an emergency.
c. Bradycardia is also considered an emergency in children because they cannot increase stroke volume
to compensate.
d. Pulse and respirations are usually assessed the same as for an adult. However, an apical pulse should
be taken on children under five.
4
AFAMS Master Lesson Plan (MLP)
Nursing Program
Health Care Adaptations for the Pediatric Patient
e. See Figure 22-6, p. 500, Leifer for common sites used to assess blood pressure in children.
f. Temperature must be carefully assessed and you must be aware that infants and young children may
develop febrile seizures.
g. Temperatures may be assessed by the oral, axillary or tympanic route. An electronic thermometer or
plastic strip thermometer may be used. Mercury thermometers are avoided.
Knowledge Lesson:
Question:
Answer:
Check on Learning
In a knowledge lesson, pose questions to the class.
Why is hypotension in children a significant finding?
It is a late sign of shock.
Skill Lesson:
In a skill lesson, provide practice and watch students perform a skill.
4. Teaching Point: Describe variations in specimen collection for the pediatric patient; including urine,
stool, blood and lumbar puncture
Minutes
Allocated Time:
Introduction:
Learner Participation:
Knowledge Lesson Please follow along with your hand outs and take notes.
Skill Lesson
Powerpoint presentation with associated handouts.
Learning Support:
a. Follow the same general principles as for specimen collection in adults. Age-appropriate adaptations
may be required.
b. Urine specimens
(1) See Figure 22-9, p. 506, Leifer for the application of a urine collection to an infant. You may also
use a cotton ball to collect urine from a very small infant and aspirate the urine from the cotton ball.
Urine should not be aspirated from a diaper because pH and specific gravity may not be accurate.
(2) Age-appropriate supervision is a nursing responsibility in obtaining a clean catch urine specimen.
(a) Clean the perineum from front to back with an antiseptic wipe
c. Stool specimens
(1) Procedure is similar as for adults with older children. Be aware of embarrassment.
(2) A stool specimen may be obtained from an infant by scraping the required amount from a diaper.
d. Blood specimens
5
AFAMS Master Lesson Plan (MLP)
Nursing Program
Health Care Adaptations for the Pediatric Patient
(1) Many times a second person is required to position and restrain the child while the specimen is
collected.
(2) See Figure 29-13, p. 808, Christensen for positioning a child for a jugular venipuncture, and Figure
29-14, p. 808, Christensen for positioning for a femoral venipuncture.
e. Lumbar puncture
(1) Carefully explain the procedure to the child/parents to ease fears.
(2) Nursing responsibility to position the child and to assist with procedure. See Figure 22-11, p. 507,
Leifer.
Knowledge Lesson:
Question:
Answer:
Check on Learning
In a knowledge lesson, pose questions to the class.
Can an accurate urine specimen be obtained by aspirating urine from a diaper?
No, because the pH and specific gravity may not be accurate.
Skill Lesson:
In a skill lesson, provide practice and watch students perform a skill.
5. Teaching Point: Compare the absorption, metabolism and excretion of medications in children to the
absorption, metabolism and excretion of medications in adults
Minutes
Allocated Time:
Introduction:
Learner Participation:
Knowledge Lesson Please follow along with your hand outs and take notes.
Skill Lesson
Powerpoint presentation with associated handouts.
Learning Support:
a. Follow the same general principles as for specimen collection in adults. Age-appropriate adaptations
may be required.
b. Urine specimens
(1) See Figure 22-9, p. 506, Leifer for the application of a urine collection to an infant. You may also
use a cotton ball to collect urine from a very small infant and aspirate the urine from the cotton ball.
Urine should not be aspirated from a diaper because pH and specific gravity may not be accurate.
(2) Age-appropriate supervision is a nursing responsibility in obtaining a clean catch urine specimen.
(a) Clean the perineum from front to back with an antiseptic wipe
c. Stool specimens
(1) Procedure is similar as for adults with older children. Be aware of embarrassment.
(2) A stool specimen may be obtained from an infant by scraping the required amount from a diaper.
6
AFAMS Master Lesson Plan (MLP)
Nursing Program
Health Care Adaptations for the Pediatric Patient
d. Blood specimens
(1) Many times a second person is required to position and restrain the child while the specimen is
collected.
(2) See Figure 29-13, p. 808, Christensen for positioning a child for a jugular venipuncture, and Figure
29-14, p. 808, Christensen for positioning for a femoral venipuncture.
e. Lumbar puncture
(1) Carefully explain the procedure to the child/parents to ease fears.
(2) Nursing responsibility to position the child and to assist with procedure. See Figure 22-11, p. 507,
Leifer.
Knowledge Lesson:
Question:
Answer:
Check on Learning
In a knowledge lesson, pose questions to the class.
Can an accurate urine specimen be obtained by aspirating urine from a diaper?
No, because the pH and specific gravity may not be accurate.
Skill Lesson:
In a skill lesson, provide practice and watch students perform a skill.
6. Teaching Point: Compare the absorption, metabolism and excretion of medications in children to the
absorption, metabolism and excretion of medications in adults
Minutes
Allocated Time:
Introduction:
Learner Participation:
Knowledge Lesson Please follow along with your hand outs and take notes.
Skill Lesson
Powerpoint presentation with associated handouts.
Learning Support:
a. Responses to medications are different among children of various ages and are different from adults.
These differences must be understood for safe medication administration.
b. Absorption
(1) Stomach acid doesn’t reach adult levels until two years of age. Formula decreases acid availability
for acid-dependent medications and these medications shouldn’t be given with formula. Giving these
medications with orange juice to older children improves absorption because orange juice increases
gastric acidity.
(2) Delayed or time-released medications may not be completely absorbed in children under five
because of quicker transit time in the intestines.
(3) Topical medications are absorbed more quickly in children because of a thin stratum corneum,
larger skin surface and the use of plastic diapers.
7
AFAMS Master Lesson Plan (MLP)
Nursing Program
Health Care Adaptations for the Pediatric Patient
c. Metabolism
(1) Slower in children related to immature liver and enzymes until age 2-4.
(2) Medications given too frequently may result in toxicity.
d. Excretion - Ineffective excretion of kidney-dependent medications until one year of age because of
immaturity of kidneys.
e. A combination of slower absorption, slower metabolism and slower excretion in children puts them at
a higher risk for toxicity. The nurse must be alert for signs of toxicity when caring for and especially
when medicating children.
Knowledge Lesson:
Question:
Answer:
Skill Lesson:
Check on Learning
In a knowledge lesson, pose questions to the class.
What effects absorption rates in children?
Decreased gastric acidity, increased transit time through the intestines, and
increased topical absorption related to increased surface area and thinner
stratum corneum.
In a skill lesson, provide practice and watch students perform a skill.
7. Teaching Point: Calculate a drug dosage using body surface area and dimensional analysis
Minutes
Allocated Time:
Introduction:
Learner Participation:
Knowledge Lesson Please follow along with your hand outs and take notes.
Skill Lesson
Powerpoint presentation with associated handouts.
Learning Support:
a. A nomogram may be used to estimate body surface area. See Figure 22-12, p. 510, Leifer.
Demonstrate its use with several examples in class.
b. Calculate the appropriate child dose with the following formula:
(1) BSA (body surface area) child X Average adult dose = Child’s dose
BSA (adult) (1.7M2)
(2) Demonstrate in class using several examples.
c. Dimensional Analysis - Calculate dosage using basic arithmetic and algebra. Use this formula:
(1) Unit
Dose on hand
X Dosage wanted
Unit to give
(2) Demonstrate in class using several examples.
8
AFAMS Master Lesson Plan (MLP)
Nursing Program
Health Care Adaptations for the Pediatric Patient
Knowledge Lesson:
Question:
Answer:
Check on Learning
In a knowledge lesson, pose questions to the class.
What tool is used to determine surface area of a child?
A nomogram.
Skill Lesson:
In a skill lesson, provide practice and watch students perform a skill.
8. Teaching Point: Determine nursing responsibilities related to the administration of oral and parenteral
medications to the pediatric patient
Minutes
Allocated Time:
Introduction:
Learner Participation:
Knowledge Lesson Please follow along with your hand outs and take notes.
Skill Lesson
Powerpoint presentation with associated handouts.
Learning Support:
a. See Box 22-2, p. 509, Leifer for age-appropriate techniques related to medication administration.
b. Oral medications
(1) Liquids preferred in children under five who have difficulty swallowing tablets.
(2) Do not disguise the flavor with food or nutritious liquid because the child may then refuse those
items.
(3) Never refer to medication as “candy”.
(4) Anticipate and be prepared for resistance.
(5) Keep the head and shoulders of the child elevated to prevent aspiration.
(6) Offer an appropriate drink after medication given.
(7) See Figures 22-13 and 22-14, p. 513, Leifer for examples.
c. Parenteral medications
(1) Administration of nose drops, eardrops and eye drops essentially the same as for adults. You may
need an assistant to position the child.
(2) Suppositories for children are long and thin but the procedure for administration is essentially the
same. The child may need close supervision after administration depending on his/her age.
(3) Subcutaneous and intramuscular routes require careful administration in children. See Figure 2215, p. 515-516, Leifer for appropriate IM injection sites in children.
(4) Techniques for reducing pain of injections.
9
AFAMS Master Lesson Plan (MLP)
Nursing Program
Health Care Adaptations for the Pediatric Patient
(a) Proper positioning.
(b) Use of EMLA cream.
(c) Refrigerate alcohol swabs or rub site with an ice cube prior to injection.
(d) Insert needle quickly but inject medication slowly.
(e) Proper selection of needle and syringe size depending on size of the child, amount of medication,
condition of muscle, frequency of injections and thickness of medication.
d. Intravenous medications
(1) General principles are the same as with adults.
(2) Infiltration is a concern in active children.
(3) Adverse effects can occur rapidly in children and a volume control device should always be used.
(4) See Figure 22-19, p. 517, Leifer for common IV sites in children.
(5) Use restraints appropriately.
(6) A pacifier may be given to NPO infants for non-nutritive sucking.
(7) Long-term access devices may be used to avoid repeated sticks.
Knowledge Lesson:
Question:
Answer:
Skill Lesson:
Check on Learning
In a knowledge lesson, pose questions to the class.
Is it appropriate to deceive a child into taking medication by saying it's candy
or putting it in their favorite food?
No, because then they may develop a dislike for those things and think that
medicine is candy.
In a skill lesson, provide practice and watch students perform a skill.
9. Teaching Point: Describe how to adapt nursing procedures related to gastrostomy feedings and enema
administration to the pediatric patient
Minutes
Allocated Time:
Introduction:
Learner Participation:
Knowledge Lesson Please follow along with your hand outs and take notes.
Skill Lesson
Powerpoint presentation with associated handouts.
Learning Support:
a. See Box 22-2, p. 509, Leifer for age-appropriate techniques related to medication administration.
b. Oral medications
10
AFAMS Master Lesson Plan (MLP)
Nursing Program
Health Care Adaptations for the Pediatric Patient
(1) Liquids preferred in children under five who have difficulty swallowing tablets.
(2) Do not disguise the flavor with food or nutritious liquid because the child may then refuse those
items.
(3) Never refer to medication as “candy”.
(4) Anticipate and be prepared for resistance.
(5) Keep the head and shoulders of the child elevated to prevent aspiration.
(6) Offer an appropriate drink after medication given.
(7) See Figures 22-13 and 22-14, p. 513, Leifer for examples.
c. Parenteral medications
(1) Administration of nose drops, eardrops and eye drops essentially the same as for adults. You may
need an assistant to position the child.
(2) Suppositories for children are long and thin but the procedure for administration is essentially the
same. The child may need close supervision after administration depending on his/her age.
(3) Subcutaneous and intramuscular routes require careful administration in children. See Figure 2215, p. 515-516, Leifer for appropriate IM injection sites in children.
(4) Techniques for reducing pain of injections.
(a) Proper positioning.
(b) Use of EMLA cream.
(c) Refrigerate alcohol swabs or rub site with an ice cube prior to injection.
(d) Insert needle quickly but inject medication slowly.
(e) Proper selection of needle and syringe size depending on size of the child, amount of medication,
condition of muscle, frequency of injections and thickness of medication.
d. Intravenous medications
(1) General principles are the same as with adults.
(2) Infiltration is a concern in active children.
(3) Adverse effects can occur rapidly in children and a volume control device should always be used.
(4) See Figure 22-19, p. 517, Leifer for common IV sites in children.
11
AFAMS Master Lesson Plan (MLP)
Nursing Program
Health Care Adaptations for the Pediatric Patient
(5) Use restraints appropriately.
(6) A pacifier may be given to NPO infants for non-nutritive sucking.
(7) Long-term access devices may be used to avoid repeated sticks.
Knowledge Lesson:
Question:
Answer:
Skill Lesson:
Check on Learning
In a knowledge lesson, pose questions to the class.
Is it appropriate to deceive a child into taking medication by saying it's candy
or putting it in their favorite food?
No, because then they may develop a dislike for those things and think that
medicine is candy.
In a skill lesson, provide practice and watch students perform a skill.
10. Teaching Point: Describe how to adapt nursing procedures related to tracheostomy care, oxygen
administration and airway obstruction to the pediatric patient
Minutes
Allocated Time:
Introduction:
Learner Participation:
Knowledge Lesson Please follow along with your hand outs and take notes.
Skill Lesson
Powerpoint presentation with associated handouts.
Learning Support:
a. Tracheostomy care
(1) Good nursing care is crucial because blockage of the tube can lead to suffocation. Children lose
the ability to cry with a tracheostomy tube so they should be placed where they are highly visible. In
addition to routine tracheostomy care, nursing care includes teaching of child and parents, close
observation, calming presence and incorporation of routines.
(2) Suctioning should be limited to no more than 15 seconds to prevent hypoxia. You may oxygenate
the child before and after suctioning with a manual resuscitator. The nurse must carefully choose the size
of catheter (half the size of the tube) and the depth to suction (length of tube or slightly beyond). Suction
only when needed and use sterile technique.
(3) A tracheostomy is a surgical wound and should be treated as such. See Figure 22-3, p. 525, Leifer.
Clean as ordered or per unit protocol. Ties should be loose enough to insert one finger between the tie
and the neck. Careful observation of the skin around the stoma and ties is required and needs to be
documented as well.
(4) Observe for complications - restlessness, increased pulse, fatigue, apathy, difficulty breathing,
retractions, pallor, cyanosis and inflammation or drainage around incision. Complications include:
tracheoesophageal fistula, stenosis, tracheal ischemia, infection, atelectasis, cannula occlusion and
accidental extubation. You must do a baseline assessment each shift and prior to suctioning.
Documentation is essential.
12
AFAMS Master Lesson Plan (MLP)
Nursing Program
Health Care Adaptations for the Pediatric Patient
(5) Emergency preparedness - keep a sterile hemostat at the bedside for accidental extubation. The
hemostat is used to spread the airway and maintain patency until a new tube is inserted.
(6) Preparation for discharge with a tube includes teaching the parents how to care for the tube at home
and signs and symptoms of complications to report to healthcare provider.
b. Oxygen therapy - see Box 22-6 for considerations related to oxygen administration to children.
(1) Avoid materials in toys, clothes and blankets that could ignite.
(2) Appropriate infection control measures. Warm, moist oxygen delivery is inviting environment for
organism growth.
(3) Exposure to high doses of oxygen over long periods of time can be toxic to certain body tissues,
especially children with pulmonary disorders. Respiratory therapy should set up the ordered
concentration of oxygen but the nurse should verify.
(4) When discontinuing oxygen therapy, do so gradually because children can’t tolerate sudden
withdrawal of oxygen.
(5) See Table 29-9, p. 809, Christensen to compare various forms of oxygen delivery in children.
c. Airway obstruction
(1) Apply appropriate technique for child’s age.
(2) See Fig. 22-26, p. 529, Leifer for procedures. Demonstrate to class.
Knowledge Lesson:
Question:
Answer:
Check on Learning
In a knowledge lesson, pose questions to the class.
What is the maximum time that should be spent on one suctioning attempt?
No more than 15 seconds.
Skill Lesson:
In a skill lesson, provide practice and watch students perform a skill.
11. Teaching Point: Describe how to adapt nursing procedures related to preoperative and postoperative
care to the pediatric patient
Minutes
Allocated Time:
Introduction:
Learner Participation:
Knowledge Lesson Please follow along with your hand outs and take notes.
Skill Lesson
Powerpoint presentation with associated handouts.
Learning Support:
a. See Tables 22-11 and 22-12, p. 530-531, Leifer for modifications to preoperative and postoperative
care in children compared to adults.
13
AFAMS Master Lesson Plan (MLP)
Nursing Program
Health Care Adaptations for the Pediatric Patient
b. Provide age-appropriate preparation to decrease fears related to surgery. Role-play is beneficial
especially with younger children.
c. The nurse must check on surgery schedule to avoid keeping children NPO for prolonged periods of
time. Infants may be given a pacifier for non-nutritive sucking.
d. The nurse must also be careful to alleviate fears in the post-operative period also.
e. As with all aspects of pediatric care, you must include the parents in teaching and providing care.
Knowledge Lesson:
Question:
Answer:
Check on Learning
In a knowledge lesson, pose questions to the class.
What method of preparing young children for surgery is especially beneficial?
Role-play.
Skill Lesson:
In a skill lesson, provide practice and watch students perform a skill.
END OF LESSON TEST
Allocated Time:
Instructions:
Test Questions or
Performance
Expected:
Test Key:
0 Minutes
You will be tested on this subject at a later date.
You will be expected to review and study the material taught in this session in
order to pass the associated written test. If you have difficulty with the material
please see me so we can review together.
None.
CONCLUSION
Allocated Time:
Summary:
5 Minutes
Review and re-emphasize the difficult Teaching Points below.
1.
2.
3.
4.
5.
6.
7.
8
14
Contrast elements of a pediatric assessment to elements of an adult
assessment
Identify safety measures applicable to nursing care of the hospitalized
child including restraints, positioning and transporting
Identify normal vital signs of infants and children at various ages
Describe variations in specimen collection for the pediatric patient;
including urine, stool, blood and lumbar puncture
Compare the absorption, metabolism and excretion of medications in
children to the absorption, metabolism and excretion of medications
in adults
Compare the absorption, metabolism and excretion of medications in
children to the absorption, metabolism and excretion of medications
in adults
Calculate a drug dosage using body surface area and dimensional
analysis
Determine nursing responsibilities related to the administration of oral
AFAMS Master Lesson Plan (MLP)
Nursing Program
Health Care Adaptations for the Pediatric Patient
9.
10.
11.
and parenteral medications to the pediatric patient
Describe how to adapt nursing procedures related to gastrostomy
feedings and enema administration to the pediatric patient
Describe how to adapt nursing procedures related to tracheostomy
care, oxygen administration and airway obstruction to the pediatric
patient
Describe how to adapt nursing procedures related to preoperative and
postoperative care to the pediatric patient
Closing Statement:
Nurses work in various health care settings so it is important to gain an
understanding of this subject as it will apply to your clinical practice.
Re-motivating
Statement:
When a child is admitted to the hospital, the chief concern is to provide quality
care. In order to accomplish this, the practical nurse must apply knowledge of
normal growth and development, specific disease conditions, an understanding
of the pediatric unit, and the basic needs and daily care of the hospitalized
child.
15