Fluent Essays

Response to question with answers underneath each question. Please find open attached file for homework details. MS/NM Homework 1. When assessing a child’s neurovascular status of a casted limb, what are the key components in the nursing assessment? 2. When providing parent education for developmental dysplasia of the hip, what would the nurse include in the standard treatment plan and therapy for this disorder?  3. Briefly describe the pathophysiology of cerebral palsy and describe the five goals of therapy for children with Cerebral Palsy (CP).  4. Children born with myelomeningocele (MM) require a multi-disciplinary approach to care.  Identify the team members that would be involved in a child’s care who has MM and describe the rationale for the team member’s involvement.  5. Explain 5 key patient education strategies the nurse would include to parents whose child is being treated for “Club Feet”.  2 3 Wongs Essentials of Pediatric Nursing TENTH EDITION Marilyn J. Hockenberry, PhD, RN, PPCNP-BC, FAAN Bessie Baker Professor of Nursing and Professor of Pediatrics Associate Dean for Research Affairs Chair, Duke Institutional Review Board Duke University Durham, North Carolina David Wilson, MS, RNC-NIC (deceased) Staff Childrens Hospital at Saint Francis Tulsa, Oklahoma Cheryl C. Rodgers, PhD, RN, CPNP, CPON Assistant Professor Duke University School of Nursing Durham, North Carolina 4 5 Table of Contents Cover image Title Page Copyright Contributors Reviewers Dedication Preface Organization of the Book Unifying Principles Special Features Acknowledgments Unit 1 Children, Their Families, and the Nurse 1 Perspectives of Pediatric Nursing Health Care for Children The Art of Pediatric Nursing Clinical Reasoning and the Process of Providing Nursing Care to Children and Families NCLEX Review Questions Correct Answers References 2 Family, Social, Cultural, and Religious Influences on Child Health Promotion General Concepts Family Structure and Function Family Roles and Relationships Parental Roles 6 Parenting Special Parenting Situations Sociocultural Influences upon the Child and Family Influences in the Surrounding Environment Broader Sociocultural Influences upon the Child and Family Understanding Cultures in the Health Care Encounter Health Beliefs and Practices NCLEX Review Questions Correct Answers References 3 Developmental and Genetic Influences on Child Health Promotion Growth and Development Development of Personality and Cognitive Function Role of Play in Development Developmental Assessment Genetic Factors That Influence Development Review Questions Correct Answers References Unit 2 Assessment of the Child and Family 4 Communication and Physical Assessment of the Child and Family Guidelines for Communication and Interviewing Communicating with Families History Taking Nutritional Assessment General Approaches Toward Examining the Child Physical Examination Review Questions Correct Answers References 5 Pain Assessment and Management in Children Pain Assessment Assessment of Pain in Specific Populations Pain Management Common Pain States in Children Review Questions Correct Answers 7 References 6 Childhood Communicable and Infectious Diseases Infection Control Communicable Diseases Intestinal Parasitic Diseases Infections of the Skin Systemic Disorders Related to Skin Lesions NCLEX Review Questions Correct Answers References Unit 3 Family-Centered Care of the Newborn 7 Health Promotion of the Newborn and Family Adjustment to Extrauterine Life NCLEX Review Questions Correct Answers References 8 Health Problems of Newborns Birth Injuries Cranial Deformities Common Problems in the Newborn Nursing Care of the High-Risk Newborn and Family High Risk Related to Dysmaturity High Risk Related to Physiologic Factors High Risk Related to Infectious Processes High Risk Related to Maternal Conditions Genetic Evaluation and Counseling NCLEX Review Questions Correct Answers References Unit 4 Family-Centered Care of the Infant 9 Health Promotion of the Infant and Family Promoting Optimal Growth and Development Promoting Optimal Health During Infancy NCLEX Review Questions 8 Correct Answers References 10 Health Problems of Infants Nutritional Imbalances Health Problems Related to Nutrition Skin Disorders Special Health Problems NCLEX Review Questions Correct Answers References Unit 5 Family-Centered Care of the Young Child 11 Health Promotion of the Toddler and Family Promoting Optimal Growth and Development Promoting Optimal Health during Toddlerhood NCLEX Review Questions Correct Answers References 12 Health Promotion of the Preschooler and Family Promoting Optimal Growth and Development NCLEX Review Questions Correct Answers References 13 Health Problems of Toddlers and Preschoolers Sleep Problems Skin Disorders Related to Chemical or Physical Contacts Skin Disorders Related to Animal Contacts Thermal Injury Ingestion of Injurious Agents Child Maltreatment NCLEX Review Questions Correct Answers References Unit 6 Family-Centered Care of the School-Age Child and Adolescent 9 14 Health Promotion of the School-Age Child and Family Promoting Optimal Growth and Development NCLEX Review Questions Correct Answers References 15 Health Promotion of the Adolescent and Family Promoting Optimal Growth and Development Promoting Optimal Health during Adolescence NCLEX Review Questions Correct Answers References 16 Health Problems of School-Age Children and Adolescents Health Problems of School-Age Children Health Problems of Adolescents NCLEX Review Questions Correct Answers References Unit 7 Family-Centered Care of the Child with Special Needs 17 Quality of Life for Children Living with Chronic or Complex Diseases Perspectives on the Care of Children and Families Living with or Dying From Chronic or Complex Diseases The Family of the Child with a Chronic or Complex Condition The Child with a Chronic or Complex Condition Nursing Care of the Family and Child with a Chronic or Complex Condition Perspectives on the Care of Children at the End of Life Nursing Care of the Child and Family at the End of Life NCLEX Review Questions Correct Answers References 18 Impact of Cognitive or Sensory Impairment on the Child and Family Cognitive Impairment Sensory Impairment Communication Impairment NCLEX Review Questions Correct Answers References 10 Unit 8 The Child Who Is Hospitalized 19 Family-Centered Care of the Child During Illness and Hospitalization Stressors of Hospitalization and Childrens Reactions Stressors and Reactions of the Family of the Child Who is Hospitalized Nursing Care of the Child Who is Hospitalized Nursing Care of the Family Care of the Child and Family in Special Hospital Situations NCLEX Review Questions Correct Answers References 20 Pediatric Variations of Nursing Interventions General Concepts Related to Pediatric Procedures Skin Care and General Hygiene Safety Positioning for Procedures Collection of Specimens Administration of Medication Maintaining Fluid Balance Alternative Feeding Techniques Procedures Related to Elimination Procedures for Maintaining Respiratory Function NCLEX Review Questions Correct Answers References Unit 9 The Child with Problems Related to the Transfer of Oxygen and Nutrients 21 The Child with Respiratory Dysfunction Respiratory Infections Upper Respiratory Tract Infections Croup Syndromes Infections of the Lower Airways Other Infections of the Respiratory Tract Pulmonary Dysfunction Caused by Noninfectious Irritants Long-Term Respiratory Dysfunction Respiratory Emergency NCLEX Review Questions 11 Correct Answers References 22 The Child with Gastrointestinal Dysfunction Distribution of Body Fluids Gastrointestinal Dysfunction Inflammatory Disorders Hepatic Disorders Structural Defects Obstructive Disorders Malabsorption Syndromes NCLEX Review Questions Correct Answers References Unit 10 The Child with Problems Related to the Production and Circulation of Blood 23 The Child with Cardiovascular Dysfunction Cardiovascular Dysfunction Congenital Heart Disease Clinical Consequences of Congenital Heart Disease Nursing Care of the Family and Child with Congenital Heart Disease Acquired Cardiovascular Disorders Heart Transplantation Vascular Dysfunction NCLEX Review Questions Correct Answers References 24 The Child with Hematologic or Immunologic Dysfunction Hematologic and Immunologic Dysfunction Red Blood Cell Disorders Defects in Hemostasis Immunologic Deficiency Disorders Technologic Management of Hematologic and Immunologic Disorders NCLEX Review Questions Correct Answers References 25 The Child with Cancer 12 Cancer in Children Nursing Care Management Cancers of Blood and Lymph Systems Nervous System Tumors Bone Tumors Other Solid Tumors The Childhood Cancer Survivor NCLEX Review Questions Correct Answers References Unit 11 The Child with a Disturbance of Regulatory Mechanisms 26 The Child with Genitourinary Dysfunction Genitourinary Dysfunction External Defects of the Genitourinary Tract Glomerular Disease Miscellaneous Renal Disorders Renal Failure Technologic Management of Renal Failure NCLEX Review Questions Correct Answers References 27 The Child with Cerebral Dysfunction Cerebral Dysfunction Evaluation of Neurologic Status The Child with Cerebral Compromise Cerebral Trauma Intracranial Infections Seizure Disorders Cerebral Malformations NCLEX Review Questions Correct Answers References 28 The Child with Endocrine Dysfunction The Endocrine System Disorders of Pituitary Function Disorders of Thyroid Function Disorders of Parathyroid Function 13 Hypoparathyroidism Disorders of Adrenal Function Disorders of Pancreatic Hormone Secretion NCLEX Review Questions Correct Answers References Unit 12 The Child with a Problem that Interferes with Physical Mobility 29 The Child with Musculoskeletal or Articular Dysfunction The Immobilized Child Traumatic Injury Sports Participation and Injury Birth and Developmental Defects Acquired Defects Infections of Bones and Joints Disorders of Joints NCLEX Review Questions Correct Answers References 30 The Child with Neuromuscular or Muscular Dysfunction Congenital Neuromuscular or Muscular Disorders Acquired Neuromuscular Disorders NCLEX Review Questions Correct Answers References Answers to Critical Thinking Case Studies Chapter 8 Chapter 10 Chapter 15 Chapter 16 Chapter 18 Chapter 19 Chapter 21 Chapter 22 Chapter 23 Chapter 25 Chapter 27 14 Chapter 28 Index IBC 15 Copyright 3251 Riverport Lane St. Louis, Missouri 63043 HOCKENBERRY: WONGS ESSENTIALS OF PEDIATRIC NURSING, TENTH EDITION ISBN: 978- 0-323-35316-8 Copyright © 2017 by Elsevier, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publishers permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Details on how to seek permission, further information about the Publishers permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Nursing Diagnoses—Definitions and Classification 2012-2014. Copyright © 2011, 2009, 2007, 2005, 2003, 2001, 1998, 1996, 1994 by NANDA International. Used by arrangement with Wiley-Blackwell Publishing, a company of John Wiley and Sons, Inc. In order to make safe and effective judgments using NANDA-I nursing diagnoses it is essential that nurses refer to the definitions and defining characteristics of the diagnoses listed in the work. 16 http://www.elsevier.com/permissions http://www.elsevier.com/permissions NCLEX®, NCLEX-RN®, and NCLEX-PN® are registered trademarks and service marks of the National Council of State Boards of Nursing, Inc. Previous editions copyrighted 2013, 2009, 2005, 2001, 1997, 1993, 1989, 1985, 1982. International Standard Book Number: 978-0-323-35316-8 Content Strategist: Sandra Clark Content Development Manager: Laurie Gower Content Development Specialist: Heather Bays Publishing Services Manager: Julie Eddy Book Production Specialist: Celeste Clingan Design Direction: Maggie Reid Chapter Opener Art: © iStockphoto.com Printed in Canada Last digit is the print number: 9 8 7 6 5 4 3 2 1 17 http://iStockphoto.com Contributors Rose U. Baker PhD, PMHCNS-BC Assistant Lecturer School of Nursing College of Health Professions Akron, Ohio Annette L. Baker RN, BSN, MSN, CPNP Nurse Practitioner Cardiovascular Program Auburndale, Massachusetts Raymond Barfield MD, PhD Associate Professor of Pediatrics and Christian Philosophy; Director Pediatric Quality of Life and Palliative Care Duke University Durham, North Carolina Amy Barry RN, MSN, PNP-BC Pediatric Nurse Practitioner Leukemia and Lymphoma Service Aflac Cancer and Blood Disorders Center Atlanta, Georgia Heather Bastardi MSN, BSN, PNP Heart Failure/Heart Transplant Coordinator Boston Childrens Hospital Boston, Massachusetts Debra Brandon PhD, RN, CNS, FAAN Associate Professor School of Nursing Duke University Durham, North Carolina Terri L. Brown MSN, RN, CPN Assistant Director Clinical Outcomes & Data Support Texas Childrens Hospital Houston, Texas Meg Bruening PhD, MPH, RD Assistant Professor School of Nutrition and Health Promotion College of Health Solutions Arizona State University Phoenix, Arizona Rosalind Bryant PhD, RN, PPCNP-BC Pediatric Nurse Practitioner Texas Childrens Hospital; 18 Instructor Baylor College of Medicine Houston, Texas Cynthia J. Camille MSN, RN, CPNP, FNP-BC Pediatric Nurse Practitioner Pediatric Urology Duke University Health System Durham, North Carolina Patricia M. Conlon MS, APRN, CNS, CNP Pediatric Clinical Nurse Specialist; Assistant Professor of Nursing Mayo Clinic Childrens Center Rochester, Minnesota Erin Connelly APRN, CPNP Aflac Cancer & Blood Disorders Center; Childrens Healthcare of Atlanta Emory University Atlanta, Georgia Martha R. Curry MS, RN, CPNP Instructor Immunology, Allergy, and Rheumatology Department of Pediatrics Baylor College of Medicine Texas Childrens Hospital Houston, Texas Amy Delaney RN, MSN, CPNP-AC/P Pediatric Nurse Practitioner Boston Childrens Hospital Boston, Massachusetts Sharron L. Docherty PhD, PNP-BC, FAAN Associate Professor School of Nursing; Associate Professor Department of Pediatrics; Director Center for Excellence in Cognitive/Affective Symptom Science Duke University Durham, North Carolina Angela Drummond MS, APRN, CPNP Pediatric Nurse Practitioner-Orthopedics Gillette Childrens Specialty Healthcare St. Paul, Minnesota Jan M. Foote DNP, ARNP, CPNP, FAANP Clinical Associate Professor The University of Iowa College of Nursing Iowa City, Iowa Pediatric Nurse Practitioner Blank Childrens Hospital Des Moines, Iowa Quinn Franklin MS 19 Manager Child, Adolescent, and Young Adult Life Program The University of Texas MD Anderson Childrens Cancer Hospital Houston, Texas Debbie Fraser MN, RNC-NIC Associate Professor Faculty of Health Disciplines Athabasca University Athabasca, Alberta, Canada; Advanced Practice Nurse, NICU ST Boniface General Hospital Winnipeg, Manitoba, Canada Teri Lavenbarg MSN, APRN, PPCNP-BC, FNP-BC, CDE Nurse Practitioner Medical Center University of Kansas Kansas City, Kansas Patricia McElfresh MN, RN, PNP-BC Pediatric Nurse Practitioner Hematology Oncology Childrens Healthcare of Atlanta Atlanta, Georgia Tara Merck CPNP Director of Advanced Practice Providers Childrens Specialty Group Medical College of Wisconsin Milwaukee, Wisconsin Mary A. Mondozzi MSN, BSN, RN Burn Center Education/Outreach Coordinator Akron Childrens Hospital The Paul and Carol David Foundation Burn Institute Akron, Ohio Rebecca A. Monroe MSN, RN, CPNP Certified Pediatric Nurse Practitioner Medical City Childrens Hospital Urgent Care Dallas, Texas Kim Mooney-Doyle PhD, RN, CPNP-AC Postdoctoral Research Fellow School of Nursing University of Pennsylvania Philadelphia, Pennsylvania Patricia OBrien MSN, RN, CPNP-AC Nurse Practitioner Cardiovascular Program Boston Childrens Hospital Boston, Massachusetts Cynthia A. Prows MSN, CNS, FAAN Clinical Nurse Specialist, Genetics Cincinnati Childrens Hospital Medical Center 20 Cincinnati, Ohio Patricia A. Ring MSN, RN, CPNP Pediatric Nurse Practitioner Pediatric Nephrology Childrens Hospital of Wisconsin Milwaukee, Wisconsin Maureen Sheehan MS, CPNP Pediatric Nurse Practitioner Child Neurology and Epilepsy Stanford Childrens Health Palo Alto, California; Clinical Faculty (Volunteer) School of Nursing University of California, San Francisco San Francisco, California Anne Feierabend Stanton MSN, APRN, PCNS-BC Pediatric Clinical Nurse Specialist University of Kansas Medical Center Kansas City, Kansas Barbara J. Wheeler RN, BN, MN, IBCLC Neonatal Clinical Nurse Specialist & Lactation Consultant St. Boniface General Hospital; Professional Affiliate Manitoba Centre for Nursing & Health Research; Instructor II College of Nursing University of Manitoba e-Health Services Winnipeg, Manitoba, Canada Kristina D. Wilson PhD, CCC-SLP Senior Speech Language Pathologist and Clinical Researcher Texas Childrens Hospital; Adjunct Assistant Professor Division of Plastic Surgery Baylor College of Medicine Houston, Texas 21 Reviewers Sharon Anderson MSN, NNP-BC, APNG Instructor School of Nursing Rutgers, The State University of New Jersey Brigit M. Carter PhD, RN, CCRN Assistant Professor; Project Director Health Equity Academy Duke University School of Nursing Durham, North Carolina Enrique Chaves-Carballo MD Clinical Professor, Departments of Pediatrics and History and Philosophy of Medicine The University of Kansas Medical Center Kansas City, Kansas Elizabeth Conoley RN, MSNEd, CPN Assistant Professor Brenau University School of Nursing Gainesville, Georgia Ciara Culhane MS, RN-BC, CPN Professional Development Specialist Childrens Hospital Colorado Aurora, Colorado Jacqueline Sayre Dorsey MS, RN, ANP Assistant Professor Nursing Monroe Community College Rochester, New York Patricia A. Duclos-Miller MSN, RN, NE-BC Professor Capital Community College Hartford, Connecticut Stephanie C. Evans PhD, APRN, PNP Assistant Professor, Nursing Harris College of Nursing and Health Sciences Texas Christian University Fort Worth, Texas Kari Gali DNP, RN, CPN Pediatric Nurse Practitioner Distance Health/MyCare Online Cleveland Clinic Cleveland, Ohio 22 Bonnie Jensen RN, BSN, MSN Faculty Provo College Provo, Utah Christine B. Kavanagh RD, MSN, PNP-BC Instructor Nursing Programs School of Health Sciences Pennsylvania College of Technology Williamsport, Pennsylvania Ann Marie McCarthy RN, PhD, FNASN, FAA Professor & Associate Dean for Research College of Nursing The University of Iowa Iowa City, Iowa Carmella Mikol PhD, CPNP, CNE, RN-BC Instructor College of Lake Country Grayslake, Illinois Deborah A. Roberts MSN, EdD Professor and Chair Department of Nursing Sonoma State University Rohnert Park, California Nicole Shonka MS, RN-BC, CPN Professional Development Specialist Childrens Hospital Colorado Aurora, Colorado 23 Dedication We dedicate the tenth edition of this book to David Wilson who passed away on March 7, 2015, after a long battle with cancer. David had been co-author of the Wong nursing textbooks for over 15 years. He was known as an expert clinical nurse and nurse educator. His last clinical position was at St. Francis Health Services in Tulsa, Oklahoma, where he worked in the Childrens Day Hospital as the coordinator for Pediatric Advanced Life Support (PALS). Students and faculty have recognized Davids contributions to the Wong textbooks for many years. He was known as an outstanding educator and supporter of nursing students; his attention to clinical excellence was evident in all this work. Those who contributed to the books and had the opportunity to work with David realize the important role he played as a leader in nursing education for students and faculty. His clinical expertise provided a critical foundation for ensuring relevant and evidence-based content was used in all the Wong textbooks. David led by example in exemplifying excellence in clinical nursing practice. Those who knew David well will miss his humor, loyalty to friends and colleagues, and his never-ending support. He is missed greatly by those who worked closely with him on the Wong textbook over the years. Most importantly we miss his friendship; he was always there to support and to encourage. We have lost an amazing nurse who worked effortlessly over the years to improve the care of children and families in need. David will not be forgotten. 24 Preface Wongs Essentials of Pediatric Nursing has been a leading book in pediatric nursing since it was first published almost 40 years ago. This kind of support places immense accountability and responsibility on us to earn your future endorsement with each new edition. So, with your encouragement and constructive comments, we offer this extensive revision, the tenth edition of Wongs Essentials of Pediatric Nursing. This tenth edition continues the legacy of Donna Wong and David Wilson; our beloved colleagues. We hold dear their contributions and memories of their pursuit of excellence in all they did for the Wong textbooks. To accomplish this, Marilyn J. Hockenberry, as editor-in-chief, along with Cheryl Rodgers, co- editor, and many expert nurses and multidisciplinary specialists, have revised, rewritten, or authored portions of the text concerning areas that are undergoing rapid and complex change. These areas include community nursing, development, immunizations, genetics, home care, pain assessment and management, high-risk newborn care, adolescent health issues, end-of-life care, and numerous pediatric diseases. We have carefully preserved aspects of the book that have met with universal acceptance—its state-of-the-art research-based information; its strong, integrated focus on the family and community; its logical and user-friendly organization; and its easy-to-read style. We have tried to meet the increasing demands of faculty and students to teach and to learn in an environment characterized by rapid change, enormous amounts of information, fewer traditional clinical facilities, and less time. This text encourages students to think critically. New to this edition is a change in the format and content for nursing care plans throughout the book. We have developed case studies that discuss clinical scenarios allowing the student to visualize how the care plan develops as a clinical situation evolves over time. The Critical Thinking Case Studies ask the nurse to examine the evidence, consider the assumptions, establish priorities, and evaluate alternative perspectives regarding each patient situation. The Critical Thinking Case Studies support our belief that the science of nursing and related health professions is not black and white. In many instances, it includes shades of gray, such as in the areas of genetic testing, resuscitation, cultural issues, end-of-life care, and quality of life. Revised evidence-based practice boxes include the latest knowledge crucial for nurses to practice using quality and safety competencies. Competencies included in the evidence-based practice boxes are designed specifically for prelicensed nurses and are from the Quality and Safety Education for Nurses website. This text also serves as a reference manual for practicing nurses. The latest recommendations have been included from authoritative organizations such as the American Academy of Pediatrics, the Centers for Disease Control and Prevention (CDC), the Institute of Medicine, the Agency for Healthcare Research and Quality, the American Pain Society, the American Nurses Association, and the National Association of Pediatric Nurse Associates and Practitioners. To expand the universe of available information, websites and e-mail addresses have been included for hundreds of organizations and other educational resources. 25 Organization of the Book The same general approach to the presentation of content has been preserved from the first edition, although some content has been added, condensed, and rearranged within this framework to improve the flow; minimize duplication; and emphasize health care trends, such as home and community care. The book is divided into two broad parts. The first part of the book, Chapters 1 through 16, follow what is sometimes called the “age and stage” approach, considering infancy, childhood, and adolescence from a developmental context. It emphasizes the importance of the nurses role in health promotion and maintenance and in considering the family as the focus of care. From a developmental perspective, the care of common health problems is presented, giving readers a sense of the normal problems expected in otherwise healthy children and demonstrating when in the course of childhood these problems are most likely to occur. The remainder of the book, Chapters 17 through 30, presents the more serious health problems of infancy, childhood, and adolescence that are not specific to any particular age group and that frequently require hospitalization, major medical and nursing intervention, and home care. UNIT ONE (Chapters 1 through 3) provides a longitudinal view of the child as an individual on a continuum of developmental changes from birth through adolescence and as a member of a family unit maturing within a culture and a community. Chapter 1 includes the latest discussion of morbidity and mortality in infancy and childhood and examines child health care from a historical perspective. Because unintentional injury is one of the leading causes of death in children, an overview of this topic is included. The nursing process, with emphasis on nursing diagnosis and outcomes and on the importance of developing critical thinking skills, is presented. In this edition, the critical components of evidence-based practice are presented to provide the template for exploring the latest pediatric nursing research or practice guidelines throughout the book. This book is about families with children, and the philosophy of family-centered care is emphasized. This book is also about providing atraumatic care—care that minimizes the psychologic and physical stress that health promotion and illness treatment can inflict. Features such as Evidence-Based Practice, Family-Centered Care, Community Focus, Research Focus, Drug Alert, and Atraumatic Care boxes bring these philosophies to life throughout the text. Finally, the philosophy of delivering nursing care is addressed. We believe strongly that children and families need consistent caregivers. The establishment of the therapeutic relationship with the child and family is explored as the essential foundation for providing quality nursing care. Chapter 2 provides important information on the family, social and cultural and religious influences on child health promotion. The content clearly describes the role of the nurse, with emphasis on cultural and religious sensitivity and competent care. Chapter 3, devoted to the developmental and genetic influences on child health continues to provide the latest information on genetics and also focuses on a theoretic approach to personality development and learning. UNIT TWO (Chapters 4 to 6) is concerned with the principles of nursing assessment, including communication and interviewing skills, observation, physical and behavioral assessment, health guidance, and the latest information on preventive care guidelines. Chapter 4 contains guidelines for communicating with children, adolescents, and their families, as well as a detailed description of a health assessment, including discussion of family assessment, nutritional assessment, and a sexual history. Content on communication techniques is outlined to provide a concise format for reference. Chapter 4 continues by providing a comprehensive approach to physical examination and developmental assessment, with updated material on temperature measurement, body mass index– for-age guidelines, and the latest World …