University of The Philippines Manila Palo, Leyte
University of The Philippines Manila Palo, Leyte
University of The Philippines Manila Palo, Leyte
Learning Guide
Related Learning Experience - Pediatric Nursing
“Knowing is not enough; we must apply. Willing is not enough; we must do.”
Overview
The purpose of this course is to provide the student practical nurse the knowledge to care for children in a variety of
settings. Common and complex conditions affecting children will be discussed and care of patients will be applied in
practical clinical settings. The practical nurse’s role in assisting with the patient care plan and the importance of clear,
concise observation, reporting and documentation is stressed. Clinical experiences will include areas generally
specializing in needs of children such as acute care, clinics and pediatric care centers, and day care centers. Practical
nursing skills will be taught and applied with regard to aseptic procedures, communication, comfort and safety, and caring
for children ranging in age from birth to eighteen years old. The importance of maintaining the nutritional needs of patients
in pediatric nursing will be learned in the classroom and applied in the clinical setting. Medication theory related
specifically to pediatric nursing will be learned in the classroom and applied to practice in the clinical setting in a
progressive manner. An emphasis on a family centered holistic approach to nursing care will be stressed at all times.
Learning Outcomes
By the end of clinical posting at pediatric unit, you will be able to:
Utilize concepts of growth and development to provide quality of care to children at different developmental stages.
Perform nursing skills accurately and safely in order to provide safe care to children. Provide nursing students with
basic knowledge related to clinical pediatric nursing for well and ill child.
Giving emphasis and focuses on the principles and concepts for dealing with the child and family as a one unit.
Implement health education topics regarding health promotion and diseases prevention
Applying case studies, nursing notice and nursing process for health maintenance and health prevention of children
Carry out nursing assessment for neonates and premature children, and children with other medical conditions.
Watch:
Pediatric Nursing Introduction:
https://m.youtube.com/watch?v=E_Rwo7BX3_g
Activity 1.
Reflective Writing
Cite at least two journal articles contextualizing Pediatric Nursing and construct a reflection paper in no less than 300
words from your readings.
Submit your output through email at obdepaz@up.edu.ph on or before July 17, 2021.
Activity 2.
Health education is the art of applying an equally basic body of knowledge about the ways in which people acquire
information, develop attitudes, and change their behavior about health. It requires diagnosis of the particular situation
before methods are chosen.
As a nursing student assigned in the area will render health education to the patients and significant others while waiting
for the doctor to arrive, you are task to develop an IEC materials for these individuals which you think suitable and
appropriate for them to learn and understand about health particularly measures on promoting health and preventing
disease while at home. It contains all essential information needed to constitute a simplified and concise health education
materials.
Submit your output through email at obdepaz@up.edu.ph on or before July 22, 2021.
Scoring Rubric for Health Education IEC materials
Objective: Students will comprehend concepts related to health promotion and disease prevention to enhance health.
Post Conference
Case Studies
Nursing Care of the Child with Cardiovascular
Disease-Rheumatic Fever
Case Study 1
Scenario:
An 8-year-old Native American boy, MA, is brought to the emergency department by his father.
The child is complaining of feeling “sick”. “Yesterday, my elbow hurt, now my knees hurt. And I
am scared because my face keeps moving, and I don’t want it to.”
His father adds, “he has been having a fever for the past 2 days now. He had a sore throat 3
weeks ago and was prescribed antibiotics. He didn’t have to take the whole bottle though
because he was feeling much better after just a couple of days. I got scared when he started
complaining of his chest hurting.” MA’s father also states that the boy’s mother is working
during the day as a waitress and that MA takes a children’s multivitamin every morning, has no
drug allergies and had his last checkup 3 years ago when he received his school
immunizations.
Nursing Assessment:
Febrile- temperature of 101.9° F
Pain in elbows and knees with movement
Red, demarcated skin lesion noted on trunk
Facial twitching
Murmur heard primarily at the apex of the heart
Lab Results
Throat Culture Positive for group A streptococcus
ESR: 15 mm/hr (normal3-13 mm/hr)
ECG: Prolonged PR interval
WBC: 12,500 cells/mm3
Provider’s orders
Admit to pediatric floor
Complete bedrest
Blood draw for ASO titer (why?)
Institute continuous cardiac monitoring
Provide normal diet
Administer penicillin V 500 mg PO tid for10 days
Administer aspirin 325 mg PO every 4 hours while in hospital
Institute seizure precautions
Questions
1. What subjective assessments indicate that this child is experiencing a health alteration?
2. What objective assessments indicate that the child is experiencing a health alteration?
3. After analyzing the data that has been collected, what primary nursing diagnosis should the nurse assign to this
patient?
4. What interventions should the nurse plan and/or implement to meet this child’s and his family’s needs?
5. What patient outcomes should the nurse evaluate regarding the effectiveness of the nursing interventions?
6. What physiological characteristics should the child exhibit before being discharged home?
Medication orders:
Recommended: 50-60 mg/kg/day in divided doses every 4 hours for children with RF
Determine maximum and minimum dosages.
Scenario:
A 6-year-old boy, DD, is brought to the clinic by his father.
The child is in his father’s arms, crying in pain. His father states “our son has sickle cell
anemia. He had his first crisis when he was 2 years old. He has had six or seven since
then. He woke up with a fever this morning and now this!” When the nurse asks about
his fluid intake the father tells her that the child has been drinking a little but not as
much as he should. He was given acetaminophen but it hadn’t helped. DD was to get
his flu shot next week and is up to date on all his immunizations. He takes penicillin
and folic acid daily.
Nursing Assessment:
Febrile- temperature of 102.4° F
Profuse pain in elbows and knees and abdomen. Chose “Hurts Worst” on the
Wong-Baker Pain Scale
Elbows and knees are red, swollen, and warm
Spleen is enlarged
No known food or drug allergies
Questions
1. What subjective assessments indicate that this child is experiencing a health alteration?
2. What objective assessments indicate that the child is experiencing a health alteration?
3. After analyzing the data that has been collected, what primary nursing diagnosis should the nurse assign to this
patient?
4. What interventions should the nurse plan and/or implement to meet this child’s and his family’s needs?
5. What patient outcomes should the nurse evaluate regarding the effectiveness of the nursing interventions?
6. What physiological characteristics should the child exhibit before being discharged home?
7. What subjective characteristics should the child exhibit before discharge?
8. What teaching would you initiate with the parents during hospitalization and before discharge?
Medication orders:
Recommended: for infants and children is 100,000 to 400,000 units/kg/day IM/IV divided q4-q6hrs
Determine maximum and minimum dosages.
Scenario:
6-month-old, OJ, is brought to the pediatrician’s office by her mother who tells the
practitioner that her daughter has an “earache”. The infant is crying and shaking her
head back and forth while tugging at her right ear. Mother states “she has had a cold
for past two days. Her nose has been snotty and she has had a hard time breathing
through her nose. She has had diarrhea, too. At three this morning she woke up
crying, I took her temperature with an armpit thermometer, and it was 101.8°F. She
has been miserable all day.” “I think she needs some antibiotics.” The practitioner
asks the mother about factors that put this child at a higher risk for ear infections and
the mother replies, “she takes her formula from a bottle, oh and I try to keep my
husband from smoking in the house, but it’s hard. He hates to have to go out to the
porch to smoke when it is so cold outside.”
Nursing Assessment:
Skin pink
Lungs clear
Rhinorrhea-clear thin mucus
Red, bulging tympanic membrane on the right, small amount of pus-like
drainage
Slight bulging of tympanic membrane on the left
Weight 15lbs. 8oz (consistent growth since last well child visit)
No known food or drug allergies
No diarrhea for past 3 hours.
Provider’s Orders:
Home with family
Acetaminophen 80mg PO every 6 hours-administer first dose in the office
Ampicillin 150 mg PO every 6 hours for 10 days-1 st dose now
Warm or cool packs to ears, as needed
Instill saline nasal drops prior to feedings
Diet change: ORT (e.g. Pedialyte) instead of formula for 2 days
Return for reassessment after completion of the antibiotic course (appointment
to made for 10 days from today) or earlier if OJ shows no improvement.
Questions:
1. What subjective assessments indicate that this child is experiencing a health alteration?
2. What objective assessments indicate that the child is experiencing a health alteration?
3. After analyzing the data that has been collected, what primary nursing diagnosis should the nurse assign to this
patient?
4. What interventions should the nurse plan and/or implement to meet this child’s and his family’s needs?
5. What patient outcomes should the nurse evaluate regarding the effectiveness of the nursing interventions?
6. What subjective signs of improvement should be apparent within 1 hour of treatment?
Medication orders:
Scenario:
BJ, a 3-year, 3-month old female is brought to the clinic by her mother, to be seen by her
practitioner. BJ is playing with her doll in the waiting room while pretending to give her “baby”
a bottle and wrapping her in her up in a blanket. Mother states “Everything seems fine, but I
noticed that my daughter’s urine is pink. I first noticed it yesterday evening.” Mother reports
only a couple of colds this past year but nothing out of the ordinary. She asks the practitioner if
there might be a problem.
Nursing Assessment:
Well child checks within normal limits, including weight, height, and head
circumferences all at the 50th percentile.
Child is up to date on all immunizations.
Mass palpated in left upper quadrant-child exhibits minimal guarding.
Ultrasound ordered and results noted to be presumed Wilms’ tumor in the left kidney.
No known allergies
Vital Signs:
Temperature: 98.8°F
Heart Rate: 100 bpm
Respiratory rate: 26 rpm
Blood pressure: 106/66 mm Hg
Lab Results:
Complete Blood Count
RBC: 3.6 million/mm3
Hemoglobin: 11 g/dL
Hematocrit: 33 %
WBC: 10,000/mm3
Platelet count: 225,000/mm3
Urine: within normal limits with exception of RBCs with exception of RBCs: 10 (normal ≤ 2)
Provider’s Orders:
Admit to pediatric unit
Prepare for surgery in a.m.
NPO after midnight
Modified bedrest
Absolutely no palpation of the abdomen
Questions:
1. What subjective assessments indicate that this child is experiencing a health alteration?
2. What objective assessments indicate that the child is experiencing a health alteration?
3. After analyzing the data that has been collected, what primary nursing diagnosis should the nurse assign to this
patient?
4. What interventions should the nurse plan and/or implement to meet this child’s and his family’s needs?
5. What patient outcomes should the nurse evaluate regarding the effectiveness of the nursing interventions?
6. What physiological characteristics should the child exhibit before being discharged home?
7. What subjective characteristics should the child exhibit before being discharged home from the hospital?
Submit your output through email at obdepaz@up.edu.ph on or before July 23, 2021.
Case Simulation
In health care, simulation may refer to a device representing a simulated patient or part of a patient; such a device can
respond to and interact with the actions of the learner. It also refers to activities that mimic the reality of a clinical
environment and that are designed for use in demonstrating procedures and promoting decision making and critical
thinking. Likewise, it can take many forms, from relatively simple to highly complex.
Instructions
1. After completing all tasks in this learning guide, each group is required to develop a case study method in simulation
that will showcase the ideals of how things get done in Pediatric Nursing.
2. Map out a case scenario depicting the real-life situation and integrate various approaches in providing care under the
new normal.
a) You can select one case scenario presented in Activity 3 for you to utilize during case presentation, and extract some
information or data needed to support your chosen case, AND/OR
b) You have the option to use a real patient if it seems possible on your end. If any member of the group has an access to
a nearby RHU/clinic, you can identify actual child patient to be the subject in your case presentation. Make sure that you
observe the health protocols during the assessment phase and confidentiality of patient data must be considered alike.
3. Refer to the Rubrics below for Case Simulation and Case Presentation.
4. Each group will present their output via ZOOM on the following dates:
Group A - July 24, 2021 at 1-3 PM
Group B - July 24, 2021 at 4-5 PM
1) Prepares for
patient contact
PPE /Hand Performs all Performs all initial Performs less Does not
washing initial steps steps with than two initial perform any of
without difficulty difficulty that are steps required the initial steps
2) Introduces that are required required in the in the skill listed. required in the
him/herself to in the skill listed. skill listed skill listed
the patient.
3) Identifies
his/herself to
patient
Patient
Assessment
Recognizes, Recognizes, Able to Fails to
1) Obtain verbalizes, and verbalizes, and recognize, recognize,
information demonstrates all demonstrates the verbalize, and verbalize,
regarding assessment assessment steps demonstrate the and/or
patient's history steps in a logical in a logical assessment demonstrate the
& chief manner manner 85% of steps in a assessment
complaint consistently the time during logical manner steps in a
without difficulty. this check off. 75% of the time logical manner
2) Measures during this less than 50%
the patient’s check off. of the time
vital signs during this
appropriately check off.
and accurately
selects which
vitals to
perform based
on information
gathered
Rationale
Communicatio
n
1) Tone, clarity,
and use of Demonstrates Demonstrates Able to Fails to
terminology ALL of the MOST of the demonstrate demonstrate
communication communication some of the most of the
2) Nonverbal skills in a logical skills in a logical communication communication
communication manner manner skills, skills
is respectful consistently throughout the throughout the
and without difficulty scenario MOST of scenario.
appropriate for the time. Needs
environment improvement.
3) Uses correct
terminology in
oral
communication
Mannerism
Item to be evaluated:
Contents (6%)
Organization (1%)
Process (2%)
Assessment (2)
Diagnosis (3)
Planning (2)
Interventions (2)
Evaluation (1)
Total mark 30%
Reference links:
https://en.wikipedia.org/wiki/Pediatric_nursing
https://en.wikipedia.org/wiki/Children%27s_Ward
https://m.youtube.com/watch?v=E_Rwo7BX3_g
https://m.youtube.com/watch?v=GT-DGh9lCNs
https://journals.lww.com/nursingmadeincrediblyeasy/fulltext/2011/09000/caring_for_our_pediatric_patients.1.aspx
https://nursingcecentral.com/lessons/caring-for-pediatric-patients-developmentally-appropriate-interventions-and-
techniques/
https://m.youtube.com/watch?v=CYk0o0vQl9g
https://m.youtube.com/watch?v=lS-imG76Nv0
https://m.youtube.com/watch?v=Iort-Vmx2OM
https://online.regiscollege.edu/blog/five-principles-family-centered-care-pediatric-nursing/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2691736/
https://patientengagementhit.com/news/why-patient-education-is-vital-for-engagement-better-outcomes
https://degree.astate.edu/articles/nursing/nurses-role-patient-education.aspx
https://www.childrenshospitals.org/Newsroom/Childrens-Hospitals-Today/Articles/2019/03/Improving-Care-For-Children-
Special-Needs-Healthcare-Environment
https://rn-journal.com/journal-of-nursing/providing-appropriate-nursing-care-for-the-developmentally-disabled-child
https://rcni.com/nursing-children-and-young-people/opinion/comment/covid-19-how-it-affecting-children-and-what-nurses-
can-do-to-help-159566
https://m.youtube.com/watch?v=kS8hnkb5VaI
https://m.youtube.com/watch?v=DlqILw4Br7w
https://www.canada.ca/content/dam/hc-sc/migration/hc-sc/fniah-spnia/alt_formats/pdf/services/nurs-
infirm/clini/pediat/prevention-eng.pdf
https://link.springer.com/article/10.1007/s12519-020-00394-w
https://m.youtube.com/watch?v=nWw2eKLN0gQ
Obdepazjr. 7/15/2021