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Medical Surgical Nursing III

By Sherry Jackson,2014-04-26 19:30
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Medical Surgical Nursing III

Nursing Care of Children and Families - Pediatrics

    Nursing Care of Children and Families - Pediatrics

3 Module 3 Caring for Children with Alterations in Nutrition/Elimination

Suggested Time Frame: 6 Hours

Goal Statement

    The goal of this module is to present a comparison of the differences between the

    gastrointestinal and genitourinary system in the child and adult, examine various

    alterations in nutrition and elimination, and the role of the nurse, using the nursing

    process to intervene appropriately and optimize the health and welfare of the pediatric

    client with dysfunctions of the gastrointestinal and genitourinary systems.

Module Description

    Module 3 provides an overview of the anatomy and physiology and principles of

    assessment of the gastrointestinal and genitourinary systems in the pediatric client. It

    includes common alterations in nutrition and elimination, the treatment, nursing

    management and medications used in the therapeutic regime. The nursing process is used

    as the organizing framework.

Objectives

     Upon completion of Module 3, the student will be able to:

    1. Delineate the differences between the anatomy and physiology of the gastrointestinal

    system of the infant and the adult.

    2. Describe the pathophysiology, etiology, signs and symptoms of common disorders of

    nutrition and elimination and the nursing management using the nursing process as an

    organizing framework.

    3. Determine the nursing management for children and their families requiring surgery

    for specific disorders of nutrition and elimination.

    4. Determine the nursing management for children and their families with specific

    medical problems related to nutrition.

    5. Delineate the differences in the anatomy, physiology and functioning of the

    genitourinary system of children and adults.

    6. Describe the pathophysiology, clinical manifestations, treatment and nursing

    management in the role of caregiver, teacher and manager of care with common

    alterations in elimination related to the genitourinary system: Acute

    glomerulonephritis, nephritic syndrome, urinary tract infection, Wilm’s Tumor and

    related fluid and electrolyte imbalances using the nursing process as the organizing

    framework.

    7. Describe the actions of medications that are commonly used in the treatment of

    alterations in gastrointestinal and genitourinary functions.

    8. Discuss nutritional requirements for the pediatric client according to age groups.

Associate Degree Nursing (RN) Curriculum Model 3.1

Nursing Care of Children and Families - Pediatrics

Associate Degree Nursing (RN) Curriculum Model 3.2

    Nursing Care of Children and Families - Pediatrics

    Module 3 Caring for Children with Alterations in Nutrition/Elimination

    Column I Column II Column III Column IV

    Content Outline Theory Suggested Learning Activities Clinical Clinical Activities

     Objectives Objectives (Competencies Skills)

    Required Reading Objective 1 ; Relate the anatomy and ; Accurately perform and

    In Primary text chapters related to: Delineate the differences between physiology of the document an assessment of

    ; Anatomy and Physiology of the the anatomy and physiology of the gastrointestinal system the GI System with an

    Pediatric Gastrointestinal gastrointestinal system of the assigned client or in a ; Demonstrate physical

    System infant and the adult. simulated setting, report and examination of the GI

     ; Assessment of the nose, mouth, document appropriately. system

    A. Review the differences in oro and nasopharynx, stomach

    anatomy and physiology of the and anus.

    GI System between the infant ; Maternal-Child Nursing

    and adult. McKinney, Ch. 43

    1. Stomach capacity

    2. Peristalsis

    3. Emptying time

    4. Metabolic requirements

    5. Length of small intestines

    6. Surface area of small

     intestines

    7. Length of large intestines

    8. Digestive enzymes

    B. Describe the basic principles of

    assessment for the GI system in

    the pediatric client.

    Associate Degree Nursing (RN) Curriculum Model 3.3

Nursing Care of Children and Families - Pediatrics

    Module 3 Caring for Children with Alterations in Nutrition/Elimination

    Column I Column II Column III Column IV

    Content Outline Theory Suggested Learning Activities Clinical Clinical Activities

     Objectives Objectives (Competencies Skills)

    Required Reading Objective 2 ; Plan and implement ; Perform and document an

    In Primary text chapters related to: Describe the pathophysiology, nursing care utilizing age-appropriate assessment

    ; Upper and Lower etiology, signs and symptoms of the nursing process for and provide appropriate

    gastrointestinal alterations common disorders of nutrition the child and family nursing care for an assigned and elimination and the nursing ; Postoperative care of the with an alteration in child, including the family in management using the nursing pediatric client with nutrition and the plan of care with an process as an organizing gastrointestinal alterations and elimination alteration in nutrition and framework. general principles of elimination. ; Incorporate medical

     postoperative care. diagnosis and treatment, ; Explain the rationale for the A. Explain the pathophysiology of ; Maternal-ChildNursing child’s developmental use of a prescribed special

    the following and apply the McKinney, Ch. 43 level, family and formula in relationship to the

    nursing process to each: cultural factors diagnosis of an assigned

    1. Appendicitis Resources infant ; Discuss the etiology and

    2. Cleft Lip/Palate ATI ch. 35, 36, 37 ; Obtain a stool specimen psychosocial dynamics

    3Failure to thrive of failure to thrive ; Implement nursing care for 4. Gastroesophageal reflux Wongs Essentials of Pediatric ; Outline a plan of care the child with gastroenteritis. 5. Gastroenteritis Nursing pgs. 84, 119, 175, 179, 184, for the child with ; Calculate the fluid needs for 6. Hirshsprung’s Disease 197, 214 gastroenteritis. an assigned client. 7. Intussusception ; Specify the health ; Accurately report and 8. Lactose Intolerance teaching needs of the document assessment data, 9. Pyloric Stenosis infant with cleft lip and interventions, outcomes and

    palate, pre and post follow through related to

    repair child’s nutritional status

     ; Feed an infant with and

    without a cleft lip or palate

Associate Degree Nursing (RN) Curriculum Model 3.4

    Nursing Care of Children and Families - Pediatrics

    Module 3 Caring for Children with Alterations in Nutrition/Elimination

    Column I Column II Column III Column IV

    Content Outline Theory Suggested Learning Activities Clinical Clinical Activities

     Objectives Objectives (Competencies Skills)

    B. Explain the diagnostics tests for ; Identify the fluid and ; Implement nursing care to nutririon and elimination electrolyte deficits and assist the infant with disorders based on anatomical replacement needs for esophageal reflux and teach location and child’s age. children with the family appropriate

    esophageal reflux, measures to alleviate this.

    gastroenteritis, ; Provide interventions to

    malabsorption and monitor and maintain fluid

    pyloric stenosis and electrolyte balance

    ; Provide supportive ; Explain the nursing

    interventions for child interventions associated with

    and family. therapeutic management of

    the child with an intestinal

    obstruction

    ; Explain the rationales for

    diangositic tests for nutrition

    and elimination disorders.

    Associate Degree Nursing (RN) Curriculum Model 3.5

Nursing Care of Children and Families - Pediatrics

    Module 3 Caring for Children with Alterations in Nutrition/Elimination

    Column I Column II Column III Column IV

    Content Outline Theory Suggested Learning Activities Clinical Clinical Activities

     Objectives Objectives (Competencies Skills)

    Required Reading Objective 3 ; Develop a plan of care ; Perform an appropriate

    In Primary text chapters related to: Determine the nursing for a pediatric patient postoperative assessment.

    ; Treatment of cleft lip, palate, management for children and undergoing surgery for observations.

    hirschprung’s disease, pyloric their families requiring surgery alterations in the upper ; Identify nursing diagnoses

    stenosis, and appendicitis for specific disorders of nutrition and lower and related interventions and and elimination. ; Maternal-Child Nursing gastrointestinal disorder. provide care as indicated

     McKinney, Ch. 43 ensuring that aseptic A. Discuss the observations and techniques, comfort measures

    nursing interventions for clients fluid/nutritional needs and

    undergoing surgery for: pain management are

    1. Cleft lip effective for assigned

    2. Cleft palate client(s).

    3. Hirschprung’s disease

    4. Pyloric stenosis

    5. Appendicitis

    B. Review the nutritional/fluid

    needs for various age groups

    and determine nursing

    interventions for alterations to

    nutritional/fluid needs based on

    underlying disorder.

    Associate Degree Nursing (RN) Curriculum Model 3.6

Nursing Care of Children and Families - Pediatrics

    Module 3 Caring for Children with Alterations in Nutrition/Elimination

    Column I Column II Column III Column IV

    Content Outline Theory Suggested Learning Activities Clinical Clinical Activities

     Objectives Objectives (Competencies Skills)

    Required Reading Objective 4 ; Discuss parental beliefs ; Assess and discuss the

    In Primary text chapters related to: Determine the nursing related to addressing nutritional needs of the

     management for children and nutritional needs of assigned client in relation to

    ; Maternal-Child Nursing their families for specific medical failure to thrive, gastroenteris pediatric clients.

    McKinney, Ch. 43, 42 problems related to nutrition. and lactose intolerance their

     developmental level and A. Discuss the observations and identified alteration in

    nursing interventions for clients nutrition and elimination.

    with medical problems of: ; Collaborate with the family

    1. Failure to thrive to set goals and develop a

    2. Gastroenteritis teaching plan to assist them

    3. Lactose Intolerance with caring for the needs of B. Compare and contrast types of the child with alterations in

    dehydration. nutrition and elimination.

     ; Develop and Implement a

    nursing care plan addressing

    hydration status.

    Associate Degree Nursing (RN) Curriculum Model 3.7

    Nursing Care of Children and Families - Pediatrics

    Module 3 Caring for Children with Alterations in Nutrition/Elimination

    Column I Column II Column III Column IV

    Content Outline Theory Suggested Learning Activities Clinical Clinical Activities

     Objectives Objectives (Competencies Skills)

    Required Reading Objective 5 ; Relate the anatomy and ; Perform age-appropriate

    In Primary text chapters related to: Delineate the differences in the physiology of the assessment of the

    ; Anatomy and Physiology of the anatomy, physiology and genitourinary system to genitourinary system.

    Pediatric genitourinary system functioning of the genitourinary disease processes. ; Accurately report and system of children and adults. ; Maternal-Child Nursing document assessment

     McKinney, Ch. 44 findings. A. Review the anatomy and

    physiology of the genitourinary

    and related systems, including

    age-related differences.

    1. Identify the structures of the

     genitourinary system

    2. Differences between

    children and adults

    3. Discuss the functions of

    each of the components of

    the genitourinary system

    B. Describe the basic assessment

    of the genitourinary system and

    the variances between children

    and adults.

    Associate Degree Nursing (RN) Curriculum Model 3.8

Nursing Care of Children and Families - Pediatrics

    Module 3 Caring for Children with Alterations in Nutrition/Elimination

    Column I Column II Column III Column IV

    Content Outline Theory Suggested Learning Activities Clinical Clinical Activities

     Objectives Objectives (Competencies Skills)

    Required Reading Objective 6 ; Plan and implement ; During initial and ongoing

    In Primary text chapters related to: Describe the pathophysiology, assessment for a child assessments, evaluate

    ; Genitourinary Alterations clinical manifestations, treatment and family with an assigned clients, for signs and and nursing management in the ; Maternal-Child Nursing alteration in symptoms related to the role of caregiver, teacher and McKinney, Ch. 44, 42 genitourinary elimination diagnosis and manager of care with common elimination. response to treatment.

    alterations in elimination related Resources ; Specify the health care ; Develop nursing diagnoses to the genitourinary system: ATI ch 41, 42 teaching needs for the related to genitourinary Acute glomerulonephritis, child with a urinary tract problems and needs for the nephritic syndrome, urinary tract Wong’s Essentials of Pediatric infection. child and family.

    infection, Wilm’s Tumor and Nursing pgs. 188, 265, 375, 383, ; Calculate daily ; Plan and implement nursing related fluid and electrolyte 179 maintenance fluid care that is age-appropriate imbalances using the nursing requirements for and culturally sensitive, process as the organizing utilizing the nursing process children of various ages. framework. for a child and their family or

     caregiver with alterations in A. Acute glomerulonephritis genitourinary elimination.

    B. Nephrotic syndrome ; List the minimal urine output C. Urinary tract infection per kg per hour for the infant, D. Wilm’s Tumor toddler, preschooler, school-E. Related fluid and electrolyte age, and adolescent.

    imbalances. ; Compare and contrast the

    etiology and pathophysiology

    clinical manifestations, and

    nursing care of the child with

    acute glomerulonephritis and

    nephritic syndrome.

    Associate Degree Nursing (RN) Curriculum Model 3.9

    Nursing Care of Children and Families - Pediatrics

    Module 3 Caring for Children with Alterations in Nutrition/Elimination

    Column I Column II Column III Column IV

    Content Outline Theory Suggested Learning Activities Clinical Clinical Activities

     Objectives Objectives (Competencies Skills)

     ; Implement the teaching plan

    for a child and family /

    caregiver with a urinary tract

    infection.

    ; Identify nursing diagnoses

    and related interventions in

    planning the care of a child

    undergoing treatment for

    Wilm’s Tumor.

    ; Implement a teaching plan

    that describes the signs and

    symptoms of fluid-electrolyte

    and acid-base imbalances to

    the child (if age-appropriate)

    and to the family/caregiver

    with identified alteration in

    genitourinary elimination.

    Associate Degree Nursing (RN) Curriculum Model 3.10

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