Introduction – My client name is Arum he is admitted in hospital with the complain of bleeding from head

as fall down from bike after the physical examination he was shifted to paediatric unit at 8 am on 15/3/2018.

Client profile

 Name ─ Master Arum

 Age ─ 10 years
 Sex ─ male
 Religion ─ hindu
 Date of admission ─ 15/ 3/ 2024
 I.P.D. no. ─ 8745
 Diagnosis ─ Head injury
 Informants ─ parents
 Date of care started ─ 15/3/2024
 Date of care ended ─ 22/3/2024

Family history

 Family pedigree

30years ,Salesman 25years,Housewife

10 year arum

S.no Name of family Age Sex Relation with Occupation Education Health status
member patient
1 Master Arum 10 yrs Male Self - - Unhealthy

2 Mr.suresh 30yrs Male Father Salesman 10th class Healthy

3 Mrs.seema 25yrs Female Mother Housewife 9th class Healthy

Family habbits – no bad habbits in family.

Family medical history –

  Patient’s father have history of hypertension, diabetes

Socio economic history –

 Type of family ─ nuclear

 Source of income ─ salesman job
 Locality ─ crowed
 Water sources ─ tap water
 Toilet facility ─ available
 Home environment ─ good

Present medical history –

 Child was brought to hospital due to pain and bleeding from head.
 Child complaints that he was having pain in head.
 Patient admitted in the hospital on 15/3/2018 at 8 am

Surgical history –

 Craniotomy

Past medical history –

 Patient was admitted in hospital before 3months with the complain of fever and cough
 Child emotionally disturbed by hospitalization .

Past surgical history –

 No history of surgical procedure.

Birth history –

 Ante natal history

1. Health status of mother during pregnancy – good
2. Illness during pregnancy – no illness
3. Infection during pregnancy – no any type of infection occur in pregnancy.
4. Immunization – mother was receive TT. Vaccine
5. Past obstetric – mother have not having history of miscarriage
 Natal history
1. Palace of delivery – hospital
2. Conducted by – nurses
3. Type of delivery – normal
4. Complication – no complication
 5. Gestational time – 9 month
 Post natal history
1. First cry – immediately after birth
2. Birth weight – 3kg.
3. Birth injury – no
4. Basic health problem – no health issues

Immunization –

S.No. Age Vaccine Remark

1. At birth BCG , OPV - 0 dose Received

2. At 6 weeks BCG (if not given ) Received

OPV – 1 ,Hep B – 1 ,DPT – 1

3. At 10 weeks DPT – 2 ,Hep B – 2 ,OPV – 2 Received

4. At 14 weeks DPT – 3 ,OPV – 3 ,Hep B – 3 Received

5. 9 month Measles , vit. A. – 1 dose Received

6. 16 – 24 month DPT – 1st booster ,OPV – booster Received

Measles – 2nd , Vit. A. – 2nd

7. 5 year DPT Booster 2nd Received

History of allergies –

 No any history of allergy .

Psychosocial history –

a. Behavioural history
 History of nail biting – no
 History of thumb sucking – no
 Pica – no
b. Play activity
 Type of play – patient like outdoor games such as cricket, football
 Reaction towards play – happy and relaxed
c. Relationship with family and friends – patient relationship with family and friends is good and
normal.
d. School performance – my patient is average in study
 e. Hobbies – my patient hobby is playing cricket, football
f. Activities of daily living
My patient sleep 11 hrs and arise at 6 am daily.
g. Bladder habbits – good
h. Bowel habbits – normal

Nutritional history –

 Duration of breast feeding – 1 year

 Time of weaning – 6 month
 History of bottle feeding – started bottle feeding in 2 year
 Time when additional food started – in 7 month

Physical examination –

Anthropometry

• Weight – 35 kg.
• Height – 130 cm.
• Head circumferences – 48 cm.
• Chest circumferences – 76 cm.

Vital sign

• Temperature –101 degree F.

• Pulse –90beats/min
• Respiration – 25 b/min
• Blood pressure –110/80 mm hg.

General observation

• General appearance : –well nourished

• Body build : - obese
• Co-cooperativeness of child :–co-operative

Head and face

Skull

• Shape – normal shape

Scalp

• Condition of hair – soft and good

 • Drandruff – present
• Infection – no infection on scalp

Face

• Colour – flushing
• Puffiness – no puffiness on face

Eyes

• Eyebrow – normal
• Eye lashes – present
• Eyelids – no lesion present
• Conjunctiva – normal
• Vision – normal

Ears

• External ear – cerumen obstruction

• Hearing – hearing is normal

Nose

• External nares – clean

• Nostrils – normal

Mouth

• Lips – pink and soft

• Odour of mouth – foul smelling
• Teeth – dental caries
• Gums – swelling or pus not present
• Tongue – no lesion present
• Throat – normal

Neck

• Range of motion – flexion ,extension and rotation present

Chest

• Thorax – normal
• Breath sound – regular
• Heart – no abnormality present

Abdomen

• Scar – no scar
• Bowel sound – present
• Tenderness – no tenderness

Extremities

• Movement of joint – mobile

• Reflexes – present
• Ankle oedema – present

Back
 • Curve – no abnormality

Genitals and rectum

For male child

• Scrotum – normal
• Testis – normal
• Inguinal lymph nodes – palpable
• Anus – normal

For female child

 Vagina
Discharge - white discharge/no discharge
Bleeding - absent/present
Anus - normal
Development reflexes
 S.NO Major milestones Normal age Achieved at which
. Sn. Reflexes name Seen in month
child
During infancy
1. Rooting reflexes Disappear
1 Social smile 2 month 1.5 month
2. Extrusion reflex Disappear
2 3. HeadBlinking
raised reflex 3 month Present3 month
4. TurnPlantar
over reflex 5-8 month 7 month
Disappears
3
5. Seat Flexor withdrawal
with support 5 month Disappear
6 month
4 6. Extensor thrust Disappear
Seat without support 8 month 8 month
5 7. Asymemetric tonic neck Disappear
8. StoodMoro’s
with support
reflex 9 month 9month
Disappear
6
9. Neck righting reflex Disappear
Stood without support 12 month 12 month
10. Babanski reflex Disappear
7 11. Walked withgrasp
Palmar support 10 month 10 month
Disappear

8 12. Parachute
Walked withoutreflex
support 13 month Disappear
12 month

9 First tooth 5-7 month 7 month

First words 3 month Ma,ma

10
During toddler and pre –school
11
Brushes teeth 3 year 3 year

Washes 5 year 5 year

1
Dresses 4-5 year 4 year
2
Feeds 15 month 15 month
3
Talk in sentences 24 month 26 month

4 Bowel control 2 year 2 year

5 Bladder control 3-5 year 3 year

6 Play – paralled associative 3-5 year 5 year

Growth and development – according to age

I. Physical growth and development

 Gross motor

According to book Seen in patient

  Perform trick on bicycles My patient just do cycling
 Participate in organized sports- My patients play soccer
baseball, soccer
 Throws a ball skill fully He is able to throws ball overhand

 Fine motor

According to book Seen in patient

 Uses both hand independently My patient uses both hand
 Draws a person with 18-20 parts My patient draw a person
 Dress self completely Patient select own dress and wear self
 Handles eating utensils skillfully Patient able to use utensils in eating

II. Cognitive development

According to book Seen in patient

 Understands explanation and tries to Patient understand what I am say and follow
follow through. instructions.
 Can read simple sentences. Patient can read sentences
 Tell the differences between right and Patient able to tell right and wrong
wrong differences
 Know what day of the week it is. Patient know about no of day and name of
day in week.

III. Psychosocial development

According to book Seen in patient

 Concerned about relationship with My patient concerned about his parents and
others. sister
 Are impatient.they like immediate My patient can’t wait for things they want.
gratification and find it hard to wait
for things they want.
 Helping when mother is busy and My patient relationship with his cousins is
improve relationship with siblings. good.
IV. Psychosexual development

According to book Seen in patient

 Spends most of time interacting with My patient Arum spend his time with friends.
 same sex peers.
 Engaging in hobbies and acquiring He is engaging in his hobby playing cricket.
skills.
V. Language development

According to book Seen in patient

 Have well developed speech and use My patient use correct grammar.
correct grammar most of the time.
 Follow suggestions better than Arum follow suggestion properly.
commands
 Begins to use shorter and more Arum use shorter sentences.
compact sentences.

Investigation

Test In patient Normal

Haemoglobin 11gm % Male-13-18gm %
Female-11.5-16.5gm %
Wbc 9900/cumm 4000-11000/cumm
Lymphocyte 65% 20-45%
Monocyte 01% 1-10%
Neutrophil 55% 40-60%
Eosinophil 01% 1-6%
Basophil 0% 0-1%

DISEASE CONDITION

INTRODUCTION

Head injury is an infection of one or both lungs which is usually caused by bacteria,viruses,or fungi. Prior to
the discovery of antibiotics, one-third of all people who developed head injury subsequently died from the
infection. Currently, over 3 million people develop head injury each year in the united states. Over a half a
million of these people are admitted to a hospital for treatment. Although most of these people recover,
approximately 5% will die from head injury.head injury is the sixth leading cause of death in the united
states.

DEFINITION
Head injury is an inflammatory condition of the lung, especially inflammation of the alveoli (microscopic air
sacs in the lungs) or when the lungs fill with fluid (called consolidation and exudation.

ANATOMY AND PHYSIOLOGY OF LUNGS

Lungsj

 Location. The lungs occupy the entire thoracic cavity except for the most central area,
the mediastinum, which houses the heart, the great blood vessels, bronchi, esophagus, and other
organs.
 Apex. The narrow, superior portion of each lung, the apex, is just deep to the clavicle.
 Base. The broad lung area resting on the diaphragm is the base.
 Division. Each lung is divided into lobes by fissures; the left lung has two lobes, and the right
lung has three.
 Pleura. The surface of each lung is covered with a visceral serosa called the pulmonary,
or visceral pleura and the walls of the thoracic cavity are lined by the parietal pleura.
 Pleural fluid. The pleural membranes produce pleural fluid, a slippery serous secretion which
allows the lungs to glide easily over the thorax wall during breathing movements and causes the
two pleural layers to cling together.
 Pleural space. The lungs are held tightly to the thorax wall, and the pleural space is more of a
potential space than an actual one.
 Bronchioles. The smallest of the conducting passageways are the bronchioles.
  Alveoli. The terminal bronchioles lead to the respiratory zone structures, even smaller conduits
that eventually terminate in alveoli, or air sacs.
 Respiratory zone. The respiratory zone, which includes the respiratory bronchioles, alveolar
ducts, alveolar sacs, and alveoli, is the only site of gas exchange.
 Conducting zone structures. All other respiratory passages are conducting zone structures that
serve as conduits to and from the respiratory zone.
 Stroma. The balance of the lung tissue, its stroma, is mainly elastic connective tissue that allows
the lungs to recoil passively as we exhale.

The Respiratory Membrane

 Wall structure. The walls of the alveoli are composed largely of a single, thin layer of squamous
epithelial cells.
 Alveolar pores. Alveolar pores connecting neighboring air sacs and provide alternative routes for
air to reach alveoli whose feeder bronchioles have been clogged by mucus or otherwise blocked.
 Respiratory membrane. Together, the alveolar and capillary walls, their fused basement
membranes, and occasional elastic fibers construct the respiratory membrane (air-blood barrier),
which has gas (air) flowing past on one side and blood flowing past on the other.
 Alveolar macrophages. Remarkably efficient alveolar macrophages sometimes called “dust cells”,
wander in and out of the alveoli picking up bacteria, carbon particles, and other debris.
 Cuboidal cells. Also scattered amid the epithelial cells that form most of the alveolar walls are
chunky cuboidal cells, which produce a lipid (fat) molecule called surfactant, which coats the gas-
exposed alveolar surfaces and is very important in lung function.

PHYSIOLOGY OF THE RESPIRATORY SYSTEM

The major function of the respiratory system is to supply the body with oxygen and to dispose of carbon
dioxide. To do this, at least four distinct events, collectively called respiration, must occur.

Respiration

 Pulmonary ventilation. Air must move into and out of the lungs so that gasses in the air sacs are
continuously refreshed, and this process is commonly called breathing.
 External respiration. Gas exchange between the pulmonary blood and alveoli must take place.
 Respiratory gas transport. Oxygen and carbon dioxide must be transported to and from the lungs
and tissue cells of the body via the bloodstream.
 Internal respiration. At systemic capillaries, gas exchanges must be made between the blood and
tissue cells.
Mechanics of Breathing

 Rule. Volume changes lead to pressure changes, which lead to the flow of gasses to equalize
pressure.
 Inspiration. Air is flowing into the lungs; chest is expanded laterally, the rib cage is elevated, and
the diaphragm is depressed and flattened; lungs are stretched to the larger thoracic volume,
causing the intrapulmonary pressure to fall and air to flow into the lungs.
 Expiration. Air is leaving the lungs; the chest is depressed and the lateral dimension is reduced,
the rib cage is descended, and the diaphragm is elevated and dome-shaped; lungs recoil to a
smaller volume, intrapulmonary pressure rises, and air flows out of the lung.
 Intrapulmonary volume. Intrapulmonary volume is the volume within the lungs.
 Intrapleural pressure. The normal pressure within the pleural space, the intrapleural pressure, is
always negative, and this is the major factor preventing the collapse of the lungs.
 Nonrespiratory air movements. Nonrespiratory movements are a result of reflex activity, but
some may be produced voluntarily such as cough, sneeze, crying, laughing, hiccups, and yawn.

CAUSES

S.N IN BOOK IN PATIENT

O
1 Viruses
Viral head injury is commonly caused by viruses such as
influenza virus, respiratory syncytial virus (rsv), adenovirus, and Present
parainfluenza. herpes simplex virus is a rare cause of head injury
except in newborns. People with weakened immune systems are
also at risk of head injury caused by cytomegalovirus (cmv).
2 Bacteria
Bacteria are the most common cause of community acquired
head injury with streptococcus head injurye the most commonly
isolated bacteria. Another important gram-positive cause of head
injury is staphylococcus aureus, with streptococcus agalactiae Present
being an important cause of head injury in newborn babies.
Gram-negative bacteria cause head injury less frequently than
gram-positive bacteria. Some of the gram-negative bacteria that
cause head injury include haemophilus influenzae, klebsiella
head injurye, escherichia coli, pseudomonas aeruginosa and
moraxella catarrhalis. These bacteria often live in the stomach or
intestines and may enter the lungs if vomit is inhaled. "atypical"
bacteria which cause head injury include chlamydophila head
 injurye, mycoplasma head injurye, and legionella pneumophila.
3 Fungi
Fungal head injury is uncommon, but it may occur in individuals
with immune system problems due to aids, immunosuppresive
drugs, or other medical problems. The pathophysiology of head
injury caused by fungi is similar to that of bacterial head injury. Absent
Fungal head injury is most often caused by histoplasma
capsulatum, blastomyces, cryptococcus neoformans,
pneumocystis jiroveci, and coccidioides immitis.
4 Parasites
The most common parasites causing head injury are toxoplasma
gondii, strongyloides stercoralis, and ascariasis.
Absent
5 Idiopathic
Idiopathic interstitial head injurys (iip) are a class of diffuse lung
diseases. In some types of iip, e.g. some types of usual interstitial Present
head injury, the cause, indeed, is unknown or idiopathic. In some
types of iip the cause of the head injury is known, e.g.
desquamative interstitial head injury is caused by smoking, and
the name is a misnomer.

PATHOPHYSIOLOGY OF HEAD INJURY

SIGNS AND SYMPTOMS

S.N IN BOOK IN PATIENT

O
1 Fever Present
2 Chills Present
3 Cough Present
4 Rapid breathing Present
5 Breathing or wheezing sounds Present
6 Vomiting Absent
7 Chest pain Present
8 Decreased activity Present
9 Loss of appetite Present

DIAGNOSTIC EVALUATION

S.N IN BOOK IN PATIENT

O
1 Chest X-ray Present
2 Sputum samples Present
3 Blood test Present
 4 Bronchoscopy Absent

Treatment

Bacterial

 antibiotics improve outcomes in those with bacterial head injury. Initially antibiotic choice depends
on the characteristics of the person affected such as age, underlying health, and location the infection
was acquired.in the uk empiric treatment is usually with amoxicillin, erythromycin, or azithromycin
for community-acquired head injury. In north america, where the "atypical" forms of community-
acquired head injury are becoming more common, macrolides (such as azithromycin), and
doxycycline have displaced amoxicillin as first-line outpatient treatment for community-acquired
head injury. The use of fluoroquinolones in uncomplicated cases is discouraged due to concerns of
side effects and resistance. The duration of treatment has traditionally been seven to ten days, but
there is increasing evidence that short courses (three to five days) are equivalent. Antibiotics
recommended for hospital-acquired head injury include third- and fourth-generation cephalosporins,
carbapenems, fluoroquinolones, aminoglycosides, and vancomycin. These antibiotics are often given
intravenously and may be used in combination.

Viral

 No specific treatments exist for most types of viral head injury including sars coronavirus,
adenovirus, hantavirus, and parainfluenza virus with the exception of influenza a and influenza b.
Influenza a may be treated with rimantadine or amantadine while influenza a or b may be treated
with oseltamivir or zanamivir. These are beneficial only if they are started within 48 hours of the
onset of symptoms. Many strains of h5n1 influenza a, also known as avian influenza or "bird flu,"
have shown resistance to rimantadine and amantadine.

MEDICATIONS

S. Name of Dos Ro Ti Action Side effect Nursing responsibility

no drug e ute me
1 Inj.ampicilli 500 Iv Bd Interferes with Cns- -to report sore
ne mg cellwall lethargy,anxiety,d throat,fever,fatigue,diarrho
replication of epression ea
 susceptible Gi- -renal studies must be done
organisms.the nausea,vomiting,di ,urinalysis.protein,bun
cellwall rendered arrhoea -to assess respiratory
osmotically Hema- status,rate,character,wheezi
unstable anemia,increased ng,hightness in chest
bleeding time
2 Inj.aminoph 5cc Iv Sta Relaxes smooth Cns-anxiety, -assess theophylline blood
ylline with t muscle of restlessness , level,toxicity may occur
dextrose 5 respiratory insomnia,dizziness with small increase
percent system by . -monitor
blocking Gi- diuresis,dehydration may
phosphdiesterase. nausea,vomiting,di occur in children
Increase camp arrhoea -avoid im injection
that produces Gu-increased -avoid giving with feed
bronchodilation,i urinary frequency
ncreased
pulmonary blood
flow

Remarks of findings –

Problem/needs Nursing diagnosis

 Irregular breathing  Infective breathing pattern related to low intake of
oxygen evidence by cyanosis difficult in breathing
 Fever  Alteration in thermoregulation related to disease
condition
 Infection  Risk Of Infections Related to Invasive Procedures And
Immaturity Of Baby System

 Knowledge  Knowledge deficit related to baby care after

hospitalization evidenced by parents verbalizing
indicating lack of knowledge on care of sick new born
baby at home .
S.n Assessment Nursing diagnosis Goal planning Implementation Rational Evaluation
o
1 Subj data- Infective He will be -clear airway  airway was  Clearing of  the
my patient Breathing Able to -give oxygen cleared airways airway
complained Pattern related to breath by  oxygen was given  Helps Remaine
about low With ease. Mask 8 Litres /minute remove d Clear
having Intake of Attain -monitor by face Mask mucus and -
breathing Oxygen Normal Vital  vital Observation Secretions Patent
difficulty Evidence by Respiratory Signs ½ hourly  Taken ½ hourly and Oxygen
Obj data- cyanosis rate Temperature then 2 maintain  Remaine
by Difficult in Of 40-50 Pulse Hourly. Patent d on Till
observation breathing beats / And  8am temp 35.80c airway 3.30 pm
i found that minute Respiration pulse  supplementa
he feels 100Beat/minute l oxygen
suffocated  Respiration 24  Help to meet
/minutes 8:30 am All
temp 36.10c Metabolism
 Pulse demand in
120 /minute The body
 Respiration30/ tissue
minute 9am  close
 Temperature monitoring
 36.20c of Vital
 Pulse 130/minute signs
respiration 34  Help to
/minute Detect any
abnormal
Condition and act
as a Guide if there
is
Improvement.

2 Subj data- Alteration in Patient will -monitor vital -monitor vital signs -to know the After these
my patient thermoregulation be able to signs -to give sponge bath condition of patient interventions
complained related to disease maintain -to give sponge -to administer antipyretic -to reduce patient’s body
about condition normal body bath drugs temperature and temperature
having temperature -to administer make comfortable maintained to
fever antipyretic -helps to reduce normal.
Obj data- drugs fever
by
touching i
found that
her body
temperatur
 e is
increased
3 Sub data Risk Patient will -hand -hard Washing And -hand Washing Baby General
My client Of Not show Washing Gloving by All Stuff Condition
complain Infections Any sign of -use Before Handling The Maintaining Improving As
that having Related to Infection Antiseptic patient Personal Hygiene Sign Of Infection
fever due Head injury Techniques And aseptic noted
to infection Patient will - give treatment Given Under Techniques
Not Antibiotics Aseptic Technique. As vital signs
Obj data Acquire - maintain Prevent Secondary Remained with
On Infections Personal Iv Amikacin 600mg od Infection Normal range
observation Hygiene X 7/7, iv bestrum 200mg Temperature
i found that -observe Twice daily. antibiotic Kill 36.60c
having Or monitor micro- Organism Heart rate 142/
continuo’s Signs And Enhance Minute
fever Of Quick Recovery Respiration
Infections 40/minute

5 Sub data Knowledge Both father Assess Health Messages Health Education Parent
Patient’s Increases
parents Deficit related And mother Parents Included. knowledge about Showed
feels lack Head injury After Will Knowledge head injury Appreciation
of Hospitalization Have By keeping patient Warm Of The
knowledge Characterized Adequate The And Clean always Knowledge
By Knowledge Asking Gained
Obj data Parent On head What they Prevent from Infectious
On Verbalizing injury Know Diseases Which Are To
observation Indicating After About the Immunisable Continue
i found that Lack Discharge Head injury With
parents are Of follow Up Clinic At Follow
looking Knowledge on Patient clinic after 2 Ups
confused Head injury weeks
DIETARY MANAGEMENT

(Requirement 2200 kcal)

Food group N0. Of Carbohydrates Protein Fat Energy

exchange (gram) (gram) (gram) (kcals)

1 Milk 3 15.0 15.0 15.0 300

2 Legume and 2 30.0 12.0 - 200
pulse

3 Flesh food 1 - 10.0 15.0 100

4 Vegetable A 2 - - - -
5 Vegetable B 2 30.0 - - 100
3 Fruit 2 20.0 - - 100
5 Sprouted seeds 1 6 - 5.2 30
6 Sugar 40g 30.0 - - 160
7 Cereal 8 160.0 16.0 - 800
9 Fat 3 - - 34 400
Total 291.0 53.0 69.0 2224
MENU PLANNING

Tea: 1 cup
Breakfast: egg fry-1
Milk -1/2 cup
Banana- 1 small
Mid morning: sprouted seeds - 1 serving

Lunch: Chapaties-2
Mung usal-1 cup
Alu palak-1 cup
Dal-1cup
Curd-1 cup
Orange - 1 cup
Tea: tea-1 cup
Dinner: chapattis-2
Lady’s finger curry-1 cup
 Green salad- 1 small plate
Rice-1 cup
Dal palak – 1 cup
Curd-1 cup

Health education –

• Maintenance of general hygiene to promote child health and prevent infection

• Follow up immunization for the baby according to keeping schedule as instructed.

• To bring back baby for follow up in pediatric outpatient clinic after 2 weeks.

• To take well nutritious diet (family) to promote health

DAY TO DAY PROGNOSIS

1st Day
Date: 15/03/24
 General condition was not good
 Vital sign was stable
 Child was eating more than body requirement.
 Activity was dull

Management
 Medication and injection given as per doctor’s order

2nd Day

Date: 16/03/24

 The child’s general condition was improving

 Taking food in short.
 Vital signs stable

Management
 Encouraged for fiber and iodine reach food in short intervals but frequently
 Medication and injection continued as per doctor’s order
 Provide a food diary to the client
rd
3 day
Date: 17/03/2024
 The child’s general condition was improving
 Taking food in short and frequently.
 Vital signs stable

Management

 Encouraged for fiber and iodine reach food in short intervals but frequently
 Medication and injection continued as per doctor’s order

4th day
Date: 18/03/2024
 The child’s general condition was improving
 Taking food in short and frequently.
 Vital signs stable

Management

 Encouraged for fiber and iodine reach food in short intervals but frequently
 Medication and injection stopped as per doctor’s order
BIBLIOGRAPHY –

 “Achar’s” The text book of pediatrics;4th edition;page no:112-116.

 Agrawal Mukesh “Textbook of Pediatrics”Bhalani Publisher, Page no: 209-215
 Basavanthappa BT “Child health nursing’’Jaypee brothers medical publishers
PVT.LTD.
 Bhat Swarn Rekha “Achar’s Textbook of Pediatrics”Fourth Edition.Universities press
(India) (P)LTD.
 “Dorothy r marlow & barbara a redding”; The text book of pediatric nursing;6th
edition;page no:348-352.
 Dutta Parul “Pediatric Nursing”Third Edition.Jaypee Brothers Medical Publisher.
 “Jaypees;nurse’s dictionary;3rd edition;page no:54.
 Ghai OP “Essential Pediatrics’’seventh edition.CBS publisher.
 Gupte Suraj “The short Textbook of Pediatrics’’ Twelfth Edition,2016.Jaypee
Brothers Medical Publishers (P)LTD.
 Sudhakar A “Essential of Pediatric Nursing’’Jaypee Brothers Medical Publishers
(P)LTD.

Internet

 http://www.medicinenet.com
 http://nurseslabs.com
 SUBJECT : CHILD HELATH NURSING
CASE PRESENTATION
ON

PNEUMONIA

SUBMITTED TO :- SUBMITTED BY :-
MS. SHIKHA TIRKEY NEETU SAHU
HOD M.Sc NURSING PREVIOUS YEAR
(CHILD HEALTH NURSING ) SHRISHTI NURSING COLLEGE,
SHRISHTI NURSING COLLEGE, RAIPUR
RAIPUR