CHILD HEALTH NURSING

(PAEDIATRIC NURSING)

AIM:
This course is designed to assist students in developing expertise and in-depth understanding of
the Pediatric Nursing field. It will help students to develop advanced skills for nursing
intervention in various pediatric medical and surgical conditions. It will help students to
appreciate the child as a holistic individual and develop skill to function as neonatal and
pediatric nurse specialist. It will further enable the student to function as pediatric nurse
practitioner/specialist, educator, manager and researcher in the field of Pediatric nursing.

OBJECTIVES:
At the end of the course the students are be able to:
• Appreciate the history and developments in the field of pediatrics and pediatric nursing
as a specialty
• Apply the concepts of growth and development in providing care to the pediatric clients
and their families.
• Appreciate the child as a holistic individual
• Perform physical, development, and nutritional assessment of pediatric clients
• Apply nursing process in providing nursing care to neonates and children.
• Integrate the concept of family centered pediatric nursing care with related areas such as
genetic disorders, congenital malformations and long term illness.
• Recognize and manage emergencies in neonates.
• Describe various recent technologies and treatment modalities in the management of
high risk neonates.
• Appreciate the legal and ethical issues pertaining to pediatric and neonatal nursing
• Prepare a design for layout and management of neonatal units
• Apply the nursing process in the care of ill infants to pre adolescents in
hospital and community
• Incorporate evidence based nursing practice and identify the areas of research in the field
of pediatric / neonatal nursing
• Recognize the role of pediatric nurse practitioner and as a member of the pediatric and
neonatal health team.
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 • Teach pediatric nursing to undergraduate students and in-service nurses.
• Identify areas of research in the field of pediatric nursing.

COURSE CONTENTS:
Unit I. Introduction & growth and development of children:
 Historical development of Pediatrics and Pediatric Nursing
 Philosophy of pediatric care, Changing trends in Pediatric Nursing.
 Role of family in child care, Community-based nursing of the child and family
 Ethical and cultural issues in pediatric Care, Current principles, practices and
trends in Pediatric Nursing.
 Role of pediatric nurse in various settings – Expanded and extended.
 Role of pediatric nurse in hospital and community for prevention and illness.
 Rights of children and special laws and Ordinance relating to children.
 Current status of child health in India; National goals, Five year plans, National and
international organizations related to child health, National health programs related to
child health.
Growth and development
 Principles of growth and development, Factors affecting growth and development
 Concepts and theories of growth & Development Biophysical Psycho-social theories
Psychosexual theories Moral development theories Cognitive development theories
Spiritual theories
 Development tasks and special needs from infancy to adolescence, developmental
milestones,
 Assessment of growth and development of pediatric clients,
 Growth Monitoring, Role of play in growth and development of children.
Unit II. Pre-natal pediatrics, preventive pediatrics & assessment of pediatric clients:
 Embryological and fetal development, Prenatal factors influencing growth and
development of fetus.
 Genetic patterns of common pediatric disorders, chromosomal aberrations, genetic
assessment and Counseling legal and ethical aspects of genetic, Screening and
counseling
 Role of nurse in genetic counseling Importance of prenatal care and role of pediatric

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 nurse.
Preventive Pediatrics
 Concept, aims and scope of preventive Pediatrics
 Maternal health and its influence on child health antenatal aspects of preventive
pediatrics.
 Mortality among children, MCH indicators, Recent trends in MCH services.
 Revision of common Communicable diseases
 Immunization, expanded program on immunization / universal immunization
program and cold chain.
 Nutrition and Nutritional requirements of children,
 Fluid and electrolyte balance in Children
 Pattern of feeding, breast feeding, baby-friendly hospital initiative, Artificial feeding,
Weaning
 Nutritional Programs and welfare Services.
 Health education, nutritional education for children.
 Organization and setup of cratch.
Assessment of Pediatric clients
 History taking, Developmental assessment, Physical assessment, Nutritional
assessment, Family assessment, Respiratory assessment, Cardiac assessment,
Neurological assessment, Pain assessment.
 Nursing process in care of children.
Unit III. Neonatal nursing:
 Concept and Scope of Neonatology nursing
 Neonatal Screening
 Neonatal resuscitation, New born baby-profile and characteristics of the new born
 Assessment of the new born
 Nursing care of the new born at birth, care of the new born and family
 Planning and organization of level I,II and III neonatal care units NICU and
environment
 Equipment and personnel management
 High risk neonate – pre term and term neonate and growth retarded babies.
 Low birth weight babies
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  Transport of the high risk neonate to NICU
 Neonatal infections prevention and management
 Identification and classification of neonates with infection HIV and AIDS,
Ophthalmic neonatrum, congenital syphilis.
 High risk new born – Identification, classification and nursing management.
 Organization of neonatal care, services (Levels), transport, neonatal intensive care
unit, organization and management of nursing services in NICU.
Management of Neonatal Problems:
 Respiratory distress syndrome & HMD, Neonatal Hypoglycemia, Neonatal Hyper
bilirubinemia, Common metabolic problems, Nutritional requirements, Neonatal
seizures, Neonatal mechanical ventilation, Thermo regulation, follow up care and
assessment of high risk infants, Pierre robin syndrome, Caroli disease.
Unit IV. Behavioral / social pediatrics, developmental disturbances, disease
conditions in children, nursing management of the sick/ hospitalized child & IMNCI
(integrated management of neonatal and childhood illnesses):
 Parent child relationship
 Basic behavioral pediatric principles and specific behavioral pediatric concepts/
disorders, maternal deprivation, failure to thrive, child abuse, the battered child.
 Common behavioral and social problem and their management, Child guidance
clinic.
Developmental disturbances
 Adjustment reaction to school, learning disabilities. Habit disorders, speech
disorders, Conduct disorders, early infantile autism, Attention deficit
hyperactive disorders (ADHD), depression and childhood schizophrenia.
 Physically challenged, causes, features, early detection & management.
Cerebral palsied child, mentally challenged child. Training & rehabilitation
of challenged children.
Disease conditions in children
Pathophysiology, assessment (including interpretation of various invasive and
non-invasive diagnostic procedures) treatment modalities and nursing
intervention in selected pediatric medical surgical problems/Disorders.
Child with respiratory disorders:

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  Upper respiratory tract: choanal atresia, tonsillitis, epistaxis, aspiration.
 Lower respiratory tract: Broncheolitis, Bronchopneumonia, Asthma, cystic
fibrosis.
Child with gastro-intestinal disorders:
 Diarrheal diseases, gastro ·esophageal reflux. Cleft lip, cleft palate and
conditions requiring plastic surgery, Tracheo esophageal fistula/ atresia,
Hirschsprungs' disease / megacolon, malrotation, intestinal obstruction,
duodenal atresia, gastrochisis, exomphalus, anorectal malformation,
omphalocele, diaphragmatic hernia. Hepatic disorders: Hepatitis, Indian
childhood cirrhosis, liver transplantation. Malabsorption syndrome,
Malnutrition.
Child with renal/ urinary tract disorders:
 Nephrotic syndrome, Nephritis, Hydronephrosis, hemolytic-uremic
syndrome, kidney transplantation. Hypospadias, Epispadias, Undescended
testes, Exstrophy bladder.
Child with cardio-vascular disorders:
 Acquired: Rheumatic fever, Rheumatic heart disease, Congnital: Cynotic and
acynotic
Child with endocrine/metabolic disorders:
 Diabetes insipidus, Diabetes Mellitus - IDDM, NIDDM, hyper and hypo
thyroidism, phenylketonuria, galactosemia.
Child with Neurological disorders:
 Convulsions, Meningitis, encephalitis, guillian- Barre syndrome. Anomalies
of the nervous' system: Spina bifida, Meningocele, Myelomeningocele,
hydrocephalus.
Child with blood disorders:
 Anemias, thalassemias, hemophilia, polycythemia.
Child with oncological disorders:
 Leukemias, Lymphomas, Wilms tumor, nephroblastomas, neuroblastomas,
Rhabdomyosarcoma, retinoblastoma, hepatoblastoma, bone tumors.
 Solid tumors of childhood, Nephroblastoma, Neuro blastoma, Hodgkin's/Non
Hodgkin's Lymphoma, Hepatoblastoma, Rhabdomyosarcoma

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  Nursing management of the child with traumatic injuries: General principles
of managing Pediatric trauma.
Nursing Management of hospitalized sick children
 Difference between child and adult Care, Meaning of hospitalization of the child,
preparation for hospitalization, effects of hospitalization on the child and family.
 Stressors and reactions related to developmental stages, play activities for ill /
hospitalized child.
 Nursing care of hospitalized child and FAMILY - principles and practices.
IMNCI
 Concept, Rationale for an evidence based syndromes approach & Components.
 Principles of IMNCI & Case management process, Outpatient management of young
infants’ age up to 2 months & of children age 2 months to 5 years, Principles of
management of sick children in small hospital
 National Population policy 2000, Re productive and child health.
Unit V. Crisis and nursing intervention, drugs used in pediatrics, education and
training in pediatric care & administration and management of pediatric care
unit:
 The hospitalized child, Terminal illness & death during childhood. Nursing
intervention-counseling.
Drugs used in pediatrics
 Criteria for dose calculation, Administration of drugs, oxygen and blood.
 Drug interactions, adverse effects and their management.
Education and training in pediatric care
 Staff orientation, training and development, In-service education, program,
Clinical teaching programs.
Administration and management of pediatric care unit
 Design & layout, Staffing, Equipment, supplies, Norms, policies and
protocols, Practice standards for pediatric care unit Documentation.

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Theme No Theme Name Specific objectives Contents
I Introduction & growth and At the end of unit students are able to  Historical development of Pediatrics
development of children. Knowledge: Know the basic needs of and Pediatric Nursing
child health nursing and Understand  Philosophy of pediatric care, Changing
the programmes of child health. trends in Pediatric Nursing.
Understand the principles and  Role of family in child care,
role of nurse in pediatric care. Community-based nursing of the child
Skill: Practice principles of and family
pediatric nursing in clinical  Ethical and cultural issues in
setting. pediatric Care, Current principles,
Attitude: Develop the positive practices and trends in Pediatric
attitude regarding child health. Nursing.
Adapts to various roles of  Role of pediatric nurse in various
pediatric nurse in different settings – Expanded and extended.
settings.  Role of pediatric nurse in hospital and
community for prevention and illness.
 Rights of children and special laws and
Ordinance relating to children.
 Current status of child health in India;
National goals, Five year plans,
National and international
organizations related to child health,
National health programs related to
child health.
Growth and development
 Principles of growth and development,
Factors affecting growth and
 development
 Concepts and theories of growth &
Development Biophysical Psycho-
social theories Psychosexual theories
Moral development theories Cognitive
development theories Spiritual theories
 Development tasks and special needs
from infancy to adolescence,
developmental milestones,
 Assessment of growth and
development of pediatric clients,
 Growth Monitoring, Role of play in
growth and development of children.
II Pre-natal pediatrics, preventive At the end of unit students are able to  Embryological and fetal development,
pediatrics & assessment of Knowledge: Know the normal Prenatal factors influencing growth
pediatric clients. growth and development of fetus. and development of fetus.
Know the programmes of preventive  Genetic patterns of common pediatric
pediatrics. Understand the deviation of disorders, chromosomal aberrations,
growth and development. genetic assessment and Counseling
Skill: Develop the process of genetic legal and ethical aspects of genetic,
counseling. Prepare the parents to have Screening and counseling
a healthy child. Prepare good nursing  Role of nurse in genetic counseling
care plan in the illness process. Importance of prenatal care and role of
pediatric nurse.
Preventive Pediatrics
 Concept, aims and scope of preventive
Pediatrics
 Maternal health and its influence on
child health antenatal aspects of
preventive pediatrics.
 Mortality among children, MCH
indicators, Recent trends in MCH
services.
 Revision of common Communicable
diseases
 Immunization, expanded program on
immunization / universal
immunization program and cold chain.
 Nutrition and Nutritional requirements
of children,
 Fluid and electrolyte balance in
Children
 Pattern of feeding, breast feeding,
baby-friendly hospital initiative,
Artificial feeding, Weaning
 Nutritional Programs and welfare
Services.
 Health education, nutritional education
for children.
 Organization and setup of cratch.
Assessment of Pediatric clients
 History taking, Developmental
assessment, Physical assessment,
Nutritional assessment, Family
 assessment, Respiratory assessment,
Cardiac assessment, Neurological
assessment, Pain assessment.
 Nursing process in care of children.
III Neonatal nursing. At the end of unit students are able to  Concept and Scope of Neonatology
Knowledge: Understand the nursing
assessment of newborn and identify  Neonatal Screening
the problems of neonate.  Neonatal resuscitation, New born
Skill: Organize the different levels of baby-profile and characteristics of the
neonatal care units and Provide new born
effective nursing care to neonate with  Assessment of the new born
problems. Develop skill in neonatal  Nursing care of the new born at birth,
resuscitation. care of the new born and family
Attitude: Develop considerate  Planning and organization of level I,II
attitude towards problem neonate and and III neonatal care units NICU and
parents of such neonate and develop environment
the neonatal resuscitation.  Equipment and personnel management
 High risk neonate – pre term and term
neonate and growth retarded babies.
 Low birth weight babies
 Transport of the high risk neonate to
NICU
 Neonatal infections prevention and
management
 Identification and classification of
neonates with infection HIV and
AIDS, Ophthalmic neonatrum,
 congenital syphilis.
 High risk new born – Identification,
classification and nursing
management.
 Organization of neonatal care, services
(Levels), transport, neonatal intensive
care unit, organization and
management of nursing services in
NICU.
 Respiratory distress syndrome &
HMD, Neonatal Hypoglycemia,
Neonatal Hyper bilirubinemia,
Common metabolic problems,
Nutritional requirements, Neonatal
seizures, Neonatal mechanical
ventilation, Thermo regulation, follow
up care and assessment of high risk
infants, Pierre robin syndrome, Caroli
disease.
IV Behavioral / social pediatrics, At the end of unit students are able to  Parent child relationship
developmental disturbances, Knowledge: Know the concept of  Basic behavioral pediatric principles
disease conditions in children, behavior and social pediatric nursing. and specific behavioral pediatric
nursing management of the sick/ Understand developmental concepts/ disorders, maternal
hospitalized child & IMNCI. disturbances and their implications deprivation, failure to thrive, child
for pediatric nursing. Understands abuse, the battered child.
and explains the pathopyhsiology
 Common behavioral and social
and treatment modalities for various
systemic diseases in children.
problem and their management, Child
guidance clinic.
Distinguish the difference between the Developmental disturbances
child and adult care. Know the  Adjustment reaction to school,
concept and principles of IMNCI. learning disabilities. Habit
Skill: Develop skills in disorders, speech disorders,
identifying developmental Conduct disorders, early infantile
disturbances at the earliest. autism, Attention deficit
Renders Competent,
hyperactive disorders (ADHD),
comprehensive and culturally
congruent care to the children depression and childhood
suffering from various systemic schizophrenia.
diseases. Create newer approach to  Physically challenged, causes,
the nursing care of child health. features, early detection &
Develop the reproductive and child management. Cerebral palsied
health programme.
child, mentally challenged child.
Attitude: Guide the parents for
corrective therapeutic modalities for Training & rehabilitation of
developmental disturbances. challenged children.
Develops competence in rendering Disease conditions in children
care to children with different levels Pathophysiology, assessment
of dependency and serious nature of (including interpretation of various
disease condition. Provides the invasive and non-invasive diagnostic
comprehensive nursing care to patient procedures) treatment modalities and
with infertility. nursing intervention in selected
pediatric medical surgical
problems/Disorders.
Child with respiratory disorders:
 Upper respiratory tract: choanal
atresia, tonsillitis, epistaxis,
aspiration.
 Lower respiratory tract:
 Broncheolitis, Bronchopneumonia,
Asthma, cystic fibrosis.
Child with gastro-intestinal
disorders:
 Diarrheal diseases, gastro
·esophageal reflux. Cleft lip, cleft
palate and conditions requiring
plastic surgery, Tracheo
esophageal fistula/ atresia,
Hirschsprungs' disease /
megacolon, malrotation, intestinal
obstruction, duodenal atresia,
gastrochisis, exomphalus, anorectal
malformation, omphalocele,
diaphragmatic hernia. Hepatic
disorders: Hepatitis, Indian
childhood cirrhosis, liver
transplantation. Malabsorption
syndrome, Malnutrition.
Child with renal/ urinary tract
disorders:
 Nephrotic syndrome, Nephritis,
Hydronephrosis, hemolytic-uremic
syndrome, kidney transplantation.
Hypospadias, Epispadias,
Undescended testes, Exstrophy
bladder.
Child with cardio-vascular
disorders:
 Acquired: Rheumatic fever,
Rheumatic heart disease,
Congnital: Cynotic and acynotic
Child with endocrine/metabolic
disorders:
 Diabetes insipidus, Diabetes
Mellitus - IDDM, NIDDM, hyper
and hypo thyroidism,
phenylketonuria, galactosemia.
Child with Neurological disorders:
 Convulsions, Meningitis,
encephalitis, guillian- Barre
syndrome. Anomalies of the
nervous' system: Spina bifida,
Meningocele, Myelomeningocele,
hydrocephalus.
Child with blood disorders:
 Anemias, thalassemias,
hemophilia, polycythemia.
Child with oncological disorders:
 Leukemias, Lymphomas, Wilms
tumor, nephroblastomas,
neuroblastomas,
Rhabdomyosarcoma,
retinoblastoma, hepatoblastoma,
bone tumors.
 Solid tumors of childhood,
 Nephroblastoma, Neuro blastoma,
Hodgkin's/Non Hodgkin's
Lymphoma, Hepatoblastoma,
Rhabdomyosarcoma
 Nursing management of the child
with traumatic injuries: General
principles of managing Pediatric
trauma.
Nursing Management of
hospitalized sick children
 Difference between child and adult
Care, Meaning of hospitalization of the
child, preparation for hospitalization,
effects of hospitalization on the child
and family.
 Stressors and reactions related to
developmental stages, play activities
for ill / hospitalized child.
 Nursing care of hospitalized child and
FAMILY - principles and practices.
IMNCI
 Concept, Rationale for an evidence
based syndromes approach &
Components.
 Principles of IMNCI & Case
management process, Outpatient
management of young infants’ age up
to 2 months & of children age 2 months
 to 5 years, Principles of management of
sick children in small hospital
 National Population policy 2000, Re
productive and child health.
V Crisis and nursing intervention, At the end unit the students are  The hospitalized child, Terminal
drugs used in pediatrics, able to: illness & death during childhood.
education and training in Knowledge: Understand the Nursing intervention-counseling.
nature of crises situations for
pediatric care & administration Drugs used in pediatrics
pediatric clients. Explain the
and management of pediatric drugs used in pediatric.  Criteria for dose calculation,
care unit. Understand need for staff Administration of drugs, oxygen
orientation and development in and blood.
pediatric nursing care.  Drug interactions, adverse effects
Understand different policies, and their management.
protocols and uses of various
equipments in the pediatric Education and training in pediatric
wards. care
Skill: Recognize the various  Staff orientation, training and
crises situations and perform development, In-service education,
promptly and efficiently. program, Clinical teaching
Administer various medications programs.
to pediatric clients correctly and
Administration and management of
observe for their effects. Plan
and implement in-service pediatric care unit
education programme for staff.  Design & layout, Staffing,
Practice standards for pediatric Equipment, supplies, Norms,
care. policies and protocols, Practice
Attitude: Identify means to standards for pediatric care unit
prevent crises among pediatric Documentation.
population and provide health
education to this effect. Educate
 parents about administration of
medication to children of
various age groups. Participates
in clinical teaching activities.
Plan and design pediatric care
unit.

Suggested Reading Material

1) Achar ST and Viswanathan -“Text book of Pediatrics; A Clinical Approach”
2) Alexander N M, Brown MS;-“Pediatric Physical Diagnosis for Nurses”
3) Ball- “Pediatric Nursing caring for children”
4) Blake G, Florence & Wright- “Essentials of Pediatric Nursing”
5) Barbara EW- “Guidelines in the care of the low birth weight”
6) Bowden Greenberg- “Pediatric Nursing Procedure”
7) Browder J J- “Nursing care of children” F A Davis
8) Ghai O P-“Essential Text Book Of Pediatrics”
9) Gupte Suraj;-“Neonatal Emergencies”
10) Gupte Suraj-“A Short Text book of Pediatrics”