Lecture Notes - Pediatric Nursing - 2nd Year - PDF

‫قسم التمريض‬ ‫المعهد التقني ‪/‬كركوك‬ ‫سجل المحاضرات‬ ‫تمريض أطفال‬ ‫المرحلة الثانية‬ ‫‪0200-0202‬‬ ‫أعداد‬ ‫الست نجيبة حنا يلدا‬ ‫مدرس‪/‬قسم التمريض‬ ‫بكالوريوس تمريض‬ ‫‪1‬‬ Ministry of Higher Education & Scientific Research Institute of Technical Teachin...

‫قسم التمريض‬ ‫المعهد التقني ‪/‬كركوك‬ ‫سجل المحاضرات‬ ‫تمريض أطفال‬ ‫المرحلة الثانية‬ ‫‪0200-0202‬‬ ‫أعداد‬ ‫الست نجيبة حنا يلدا‬ ‫مدرس‪/‬قسم التمريض‬ ‫بكالوريوس تمريض‬ ‫‪1‬‬ Ministry of Higher Education & Scientific Research Institute of Technical Teaching Nursing Department Hour Weekly Year study Subject name Total Practice Topics Second Nursing Pediatric 6 4 2 General Subjects :- General :- The student to able knowledge :- 1- Growth and development of normal baby 2- The nursing care to premature and new born and fetal baby 3- Feeding baby Special : 1- The nursing care of malnutrition diseases to children 2- Nursing care for handicap children 3- Child care for orphan 4- Child care and prevention from accident Theory Topics Weeks Topics Covered 1st The new born baby (fetal) Characteristic of new born 1- Wight 2- Length 3- Skin 4- born 5- Head 6- Chest 7- Musles 8- Vital signs 9- senses (eye and sight , hearing , , taste , smell , touch) 10- nervous system (reflexes) (grasping , clones , Darwinian reflex , coughing , sneezing , yawing , sucking , swelling , rooting reflex). 2 Weeks Topics Covered 2 The premature baby :- 1- Definition of premature baby 2- Cause of premature baby 3- Nursing care of premature baby 4- Nursing care during the delivery A- Nursing care in incubator. B- Giving oxygen by (in cubator , nasattub or mask) 3 - Keep premature with stable temperature - The premature feeding (Tub feeding , Tea spoon feeding , Drop feeding , Gavages feeding) - Giving drugs - Handling the premature in bed - Monitoring the premature 4 The growth and development stages of normal baby. - The new born stage , infant stage , Toddler stage pre – school stage , school age stage , Adolescent stage , Adulthood stage. 5 The factors of growth and development (Heredity , constructional makup , Racial & National characteristics A- Sex. B- Prénatal environment & post natal environ. C- External environment. 6 The type of growth & development. 1- Growth the body. 2- Development of capacity of muscels. 3- Mentally development. 4- Emotionally development. 5- Socially development. 6- Teething. 7 Feeding of baby. 1- Breast feeding. 2- Artificial feeding. 3- Types of weaning. 4- Feeding baby with deferent ages. 3 Weeks Topics Covered 8 Malnutrition Diseases : 1- Marasms 2- Rickets 3- Kwasshiokor. 4- Tetancy 5- Scurvy disease , Causes , The factors influence , Nursing care , prevention. 9 Nursing care with Respirtory disease. 1- Acut Nasophryingitis (Common cold). 2- Tonsillitis. 3- Otitismedia. 10 - Pneumonia , staph or strep pneumonia. - Viral pneumonia , Mechanical pneumonia. - Asthma. 11 Nursing care of gastro – Intestinal disorder. 1- Acute (Gastritis). 2- Gastro - - enteritis. 3- Colic. 12 4- Vomiting 5- diarrhea 6- Constipation. 13 Congenital digestive. 1- Cleft lip. 2- Cleft palate. 3- Rectum obstruction. 14 Nursing care of urinary condition system. 1- Acute Glomerulonephritis. 2- Nephritic syndrome (nephrosis). 3- Pye lonephritis (pyelitis). 4- Renal failure. 15 The nursing care of heart and blood disease 1- Anemia 2-Thalassem'a 3-leukem'a 4-Hemophilia 5-Christmas 6-congenital heart disease 7- Congestive heart failure 16 The nursing cure of nervouse system 1. mastoiditis 2. brain abcess and meningitis 3. hydrocephlitis 4. spina bifida 17 Nursing care at communicable disease 4 Weeks Topics Covered 18 1. pulmonary tuberculosis 19 2. measles 3. Germany measles 4. mumps 20 5. diphtheria 6. Pertusis 7. tetanus 8. Poliomyelitis 9.chickenpox 10.Infection hepatitis 11.Typhoid fever 21 Nursing cure at endocarine disorders 1. hypothyrodism 2. hyper thyroidism 3. diabetes 22 The contaminated environment influence of health baby 1. cholera 2-malta fever 23 The endemic disease and influence of health child :- 1. malaria 2- trematoda 3. tina solium ,tina saginata ,oxyuris ,anglistoma 24 Handicap children :- 1- Definition the handicap or hindrance child. 2- Types of handicap including :- (Physical , psychsocial , mental). 25 Rehabilitation center. - Handicap prevention. 26 Prevention of hand icap child from accident. 1- Poisoning 2- Burns 3- injuries 4- Jumping on a high level or accident or run over. 27 The children care of orphan include :- 28 - Development and depended stages. - Religion , norms depend on type of society. - Learn child to make independence. 29 - Imported role of educational status or establishment with care of orphanage. 30 - The nursing care of the dying child. 5  -: ‫املصــــادر‬ -: ‫الكتــب املنهجيـــــة‬ ‫ بغداد‬- ‫ تمريض األطفال‬، ‫ سميرة شاكر‬، ‫ العبدلي‬-0. 0191 / ‫ الطبعة الثالثة‬، ‫مطبعة العمال المركزي‬ – ‫ تمريض األطفال‬، ‫ سهام بطرس سروان‬، ‫ مراد‬-0. ‫ الطبعة األولى‬- 0191 / ‫ بغداد‬/ ‫هيئة التعليم التقني‬ -: ‫الكتــب املساعدة‬ 1- Broadribb , Violet , Foundations of pediatric Nursing – Lippincott Company , Philadelphia , 1973. – )‫ سعاد حسين (الطفل وتمريضه الشامل‬، ‫حسن‬ -0. 0199 / ‫بيروت – دار القلم – الطبعة األولى‬ -: ‫املراجــــــع‬ 1- Eiger , M. S & 01ds , S. W, The Complete Book Breast feeding New York – Workman Publishing Company , Inc / 1972. 2- Hamilton , persis Mary – Basic pediatric Nursing – Mosby Company , Saint Louis / 1978. 3- Marlow , Dorothy R. Textbook of pediatric Saunders Company Philadelphia , 4th Edition / 1973. 6  ‫األسبوع األول‬ Theory Topics Weeks Topics Covered 1st The new born baby (fetal) Characteristic of new born 1- Wight 2- Length 3- Skin 4- born 5- Head 6- Chest 7- Musles 8- Vital signs 9- senses (eye and sight , hearing , , taste , smell , touch) 10- nervous system (reflexes) (grasping , clones , Darwinian reflex , coughing , sneezing , yawing , sucking , swelling , rooting reflex). The newborn ------------------- :- Days -4- weeks -weight (2700-4000 gm) -Height (47.5-53.5 cm) -Skin: soft, pinkish colour covered with hair (Lanugo and vernix caseosa) Bones: cartilage with ca++ -Head 1/4 of the body - Head circumference= (33-37cm). -Fontanel. Anterior fontanel closed at 18 months Posterior fontanel closed at 2-4 months 7 Chest = ball shaped - Muscles =small get reactions for action - Vital signs * temp :( 36-37.7C˚) after 8 hrs. * Pulse: (120-150 b/min) increase in crying * Respiration: (35-50 b/min) - Senses * Vision: not clearly at the beginning, gradually focuses on the light. * Hearing: good hearing after delivery. * Taste: develop taste. *Smelling: good smelling * Touch: comfort for worm bed, soft clothes Nervous system * Reflexes: an voluntary till 4 months * Motor reflexes: grasping, Moro (4-5 months-disappear) *Protective: coughing, sneezing, yawing, blinking * Feeding: retching, sucking 8  ‫األسبوع الثاني‬ Theory Topics Weeks Topics Covered 2 The premature baby :- 5- Definition of premature baby 6- Cause of premature baby 7- Nursing care of premature baby 8- Nursing care during the delivery C- Nursing care in incubator. D- Giving oxygen by (in cubator , nasattub or mask) The premature baby. * Premature:- Is a live borne infant delivered after gestational period from (28-37 weeks), with a birth weight (1000-2500 gm ) or less. Characteristics of premature baby. I - physical characteristics Wt- (1000-2500gm) Ht- (37cm) or less, body small Skin-Wrinkle with milieu and vernix caseosa Head: big with bulgy eyes and soft ears, small limbs and muscles, bulgy abdomen, small genital organs. II - Physiological characteristics - Little ability to balance the body temp. due to immature nervous system. 9 _Difficulty to respiration due to immature lungs. - Cyanosis of fingers and around the mouth due to insufficiency of blood vascular system. - Little immunity against infections. -Disability to sucking and swallowing well due to immature nervous system. - Imbalance of UT function due to immature kidney Causes of prematurity. 1- Maternal disease: Toxemia, antipartum hemorrhage, D.M, chronic nephritis 2- Maternal age: primigravida (less than 20 yrs. Age) 3- Social and economical status: poor nutrition and low income groups 4- Fetal abnormalities and disease 5- Multiple pregnancy 6- Sex of the infants Nursing care A- At delivery room observe physical and physiological characteristic of premature infant B- Prepare incubator: supply with heater and O2(30-40%), suctioning the fluid from nose and mouth 11  ‫األسبوع الثالث‬ Theory Topics Weeks Topics Covered 3 - Keep premature with stable temperature - The premature feeding (Tub feeding , Tea spoon feeding , Drop feeding , Gavages feeding) - Giving drugs - Handling the premature in bed - Monitoring the premature Premature infant feeding In order the premature grows well, feeding should started, he needs (120-150) calories Kg/day Protein 4-6 gm/kg/day Vit. K (0.5 to 1 mg at birth) - Firs feeding start after few hours from birth - The milk giving by nasogastric tube and spoon or pipette or bottle (artificial feeding) -Observe any abnormalities such as cyanosis, chocking, vomiting during feeding - Complication NG tube and pipette or spoon - Breast feeding is the most natural feeding 11 Protection against infection 1- Put the premature in an incubator 2- Clean the incubator daily by disinfectant solution or soap or water 3- The nurse should wash her hand before giving any treatment or milk 4- Should isolate the ill babies 5- Keep the premature in isolated incubator 6- Wear gown and gloves by doctors and nurses 7- Prevent crowding in the unit Premature infant care 1- Keep the premature in a worm bed 2- Provide him by O2 3-change the linen and cloths daily 4-Cheek the premature for any abnormalities 12  ‫األسبوع الرابع‬ Theory Topics Weeks Topics Covered 4 The growth and development stages of normal baby. - The new born stage, infant stage , Toddler stage pre – school stage , school age stage , Adolescent stage , Adulthood stage. Growth and development of normal baby * growth :- the process by which the human body larger in size as result of an increase in the number of the size of body cells, it can measure by cm, kg, gm *development: - the process of increase in skill and capacity of function. Stage of growth and development 1-Emberionic fetal stage →conception to birth 2- Infancy period →birth to 12 months oral stage 3- Early childhood 1-6 years a- toddler stage (1-3 years) → slow growth and development b- Preschool stage (3-6 years) →initiative period 4- Middle childhood (6-11 years)- - School age →sense of industry Vs inferiority Peer play and leader ship 5- Later childhood (11-18 years) a- pre puberty 11-13 tears b- Increase rapidly in growth and development in female and male c- Adolescence 13-18 years 13  ‫األسبوع الخامس‬ Theory Topics Weeks Topics Covered 5 The factors of growth and development (Heredity , constructional makup , Racial & National characteristics D- Sex. E- Prénatal environment & post natal environ. F- External environment. Factor effects on growth and development 1- Hereditary and constitutional make up 2- Racial characteristic -sex - Nationality - Body built 3- Environmental characteristics A- Prenatal environmental (diet, Radiation, Hormonal changes, medication, Genetics, twins, Infections, syphilis ) B-Post natal environmental (diet, TB) 14 - Internal environmental:- 1- Hormonal disturbance 2- Emotional disturbance 3- Genetic factors - External environmental:- 1- Nutrition 2- Illness 3- Injuries 4-climate 15  ‫األسبوع السادس‬ Theory Topics Weeks Topics Covered 6 The type of growth & development. 7- Growth the body. 8- Development of capacity of muscels. 9- Mentally development. 10- Emotionally development. 11- Socially development. 12- Teething. Types of growth And Development 1- physical development - height 48- 53 cm - weight 3.17- 304 gm -H.C. ( 32- 35) CM - Muscular Tone and control - pelvic measurement and abdomen measure - chest measurement 2- Emotional development → personality development 16 3- social development : Training a child in the culture of the group Socializing learned by:- - living and meeting with various age group - participating in the family activities - Traveling ,picnic - activities with peers - play ( group) 4- Mental development - intelligent : ability to adjust to new situation to think abstractly or profile from experience _ problem solving mental age 1Q: --------------------- * 100 : 1Q between 90 and 109 Chronologic age - Teething : 1st eruption appears at age 6-8 months average child should have 20 decidual teeth by age 3 years 17  ‫األسبوع السابع‬ Theory Topics Weeks Topics Covered 7 Feeding of baby. 5- Breast feeding. 6- Artificial feeding. 7- Types of weaning. 8- Feeding baby with deferent ages. Baby feeding Breast feeding : It is the process of feeding the baby from the breast of mother It start a few hours from delivery * Benefits of breast feeding _ Not costly – empty from bacteria –easy to suck –easy to digest – provide the baby With immunity – give love and security – no needs for efforts to prepare. * Artifial feeding (bottle feeding) The process of giving milk to the baby from the bottle * Baby weaning It is process of prevent the natural and artificial feeding from the baby 4 months age start the food (soup, vegetable) and fluid, weaning start from 6-9 months * Steps of weaning 18 - The weaning begins gradually - One type food - The mother prevent giving more love and security during feeding Feeding of child in various age - Toddler and preschool child feeding a- give small and adequate food b- Simple and different food c- Follow eating habits d- Help the child ( by mother to food him self ) - School child feeding a- school age child need food rich in protein , vitamin , salt b- Calories – 80 calorie/ Kg c- Fluids -75 cm/ Kg Teenage feeding a- the teenage should take balanced rich food in 4 basic needs b- protein 50-60 gm? Day c- Calorie 1000-1200? Day d- Fruits vegetable e- Regulate the teenage sleeping time (8 hrs / day ) 19  ‫األسبوع الثامن‬ Theory Topics Weeks Topics Covered 8 Malnutrition Diseases : 1- Marasms 2- Rickets 3- Kwashiorkor. 4- Tenancy 5- Scurvy disease, Causes , The factors influence , Nursing care , prevention. Mal-nutritional disease -Marasmus: - It is one of mal nutrient disorder that cause by deficiency in adequate Diet – diet (decrease protein – carbohydrate, vitamin, Calories, mineral) Causes _ Defect (cleft lip and cleft pallet) - GIT malformation - Cardiac an abnormality, VSD and ASD - Cystic fibrosis - sever diarrhea and vomiting S / Symptoms 21 1-Loss of weight 2- Sunk in eye 3- Loss of tissue trigger 4- Flabby muscle 5- Poor appetite Treatment and nursing care 1- Plasma IV 2- Iron I.M. 3- Blood transfusion and hemoglobin decrease 4- Antibiotic according need Kwashiorkor: one of the nutritional disorder seen in tropical and sub tropical area , caused by deficiency in protein intake and in adequate diet S/ symptoms 1- Lack of growth 2- Lack of energy 3- Edema 4- Dermatitis 5- Pigmentation of the skin 6- Cardiac and liver enlargement Nursing care 1- Fluid and electrolytes therapy 2- Antibiotic 21 3- Adequate feeding ( protein ,calories) Rickets It is a nutritional disease caused by deficiency of vitamin D and due to disturbance of concentration of ca++ in blood Causes 1- Hereditary 2- Environmental 3- prematurity 4- Artificial feeding 5- Seasonal factor Symptom 1- Enlargement head 2- Dyspnea 3- Dorsal hypnosis 4- Deformity of extremities 5- Frog poison 6- Anemia 22 Treatment and Nursing care 1- 0ral administration of vitamin D tablet 500- 5000I.M. /day for 1 months 2- Splint 3- Encourage breast feeding 4- Physiotherapy Scurvy It is one of nutritional disorder caused by deficiency of water soluble vitamin C this vitamin unstable and destroyed by heat and alkaline , it is found in orange , tomatoes, vegetable, it might occur in any age but specially in 6month- 2 year. Symptoms 1- Tendency to hemorrhage 2- Loss of weight 3- Loss of appetite 4- Delay to growth and development Nursing care and treatment 1- Large dose of vitamin C 90-120ml/day 2- Ascorbic tab. Vitamin C 100-200mg/day 3- Blood transfusion 23 Tetany It is deficiency of vitamin D in infancy period it accompanied with rickets (but not all infants with rickets hurt with tetany Causes: 1- Vitamin D deficiency food. 2- Mal absorption of vitamin D in body 3- Deficiency of ca++ in blood Symptoms: 1-Muscular and nervous potency like facial muscle and mouth 2- Flexion and relaxation of hand and foot 3- Pharynx spasm 4- Apnea Treatment and Nursing care 1- Early treatment given Ca++ and vitamin D orally or injection 2- Prepare emergency instrument for pharynx spasm to give O2 3- Artificial breathing 24  ‫األسبوع التاسع والعاشر‬ Theory Topics Weeks Topics Covered 9 Nursing care with Respiratory disease. 1- Acute Nasophryingitis (Common cold). 2- Tonsillitis. 3- Otitismedia. Theory Topics Weeks Topics Covered 10 - Pneumonia, staph or strep pneumonia. - Viral pneumonia, Mechanical pneumonia. - Asthma. Nursing care of respiratory Disease - Common cold 1- Check Temp. (Cold compress, Antipyrol) 2- Increase fluid 3- Start with mild antibiotic in infancy to prevent complication 4- Nasal drop and anti congestion drop 5- Humidified and worm - Tonsillitis (Sore throat) 1- Complete bed rest 2- High fluid 3- Cold compress 4- Antibiotic * In recurrent tonsillitis →Tonsillectomy 25 Pneumonia 1- Changing the position of the child 2- Increase fluid intake 3- Bed rest 4- Anti biotic to prevent empima Acute bronchiolitis and Interstitial Pneumonia 1- Give O2 2- Increase Humidity in room 3- Bed rest 4- Good position Lipoid Pneumonia 1- Long treatment 2- Away chilled from infected person 3- Physical and psychological needs 4- Change position 5- Toys for baby 6- O2 Asthma 1- Bed rest 2- Treat according of causes 3- Teach the family how to care the baby at home during attack 4- Treatment according doctor orders 5- Give aminophylin and corticosteroid 26  ‫األسبوع الحادي عشر والثاني عش‬ Theory Topics Weeks Topics Covered 11 Nursing care of gastro – Intestinal disorder. 4- Acute (Gastritis). 5- Gastro - - enteritis. 6- Colic. ‫ر‬ Theory Topics Weeks Topics Covered 12 4- Vomiting 5- diarrhea 6- Constipation. Nursing care of Digestive system disorder Acute Gastritis 1- Endoscope 2- Give slight meal 3- Regime 4- Avoid hot food 5- Milk Gastro enteritis 1- Stool and culture 2- Flagyl 3- Slight food 4-avoid cellulose diet 27 Colic 1- Right way of feeding 2- Giving hot water 3- Massage of child back after feeding 4- Avoid child crying for a ling time Vomiting 1- Treatment a according causes 2- Drugs 3- Proper technique in feeding 4- Record fluid intake and output 5- Check weight 6- Record notes on vomiting ( time ,type ,frequency , any abnormality) Oral –requlant solution 28 Diarrhea 1- ORS 2- IV fluid 3- Check vital signs 4- Urine output 5- Prevent infection Constipation 1- Give cellulose diet 2- Enema 3- Caster oil 4- Vegetable and fluid 5- Exercise 29  ‫االسبوع الثالث عشر‬ Theory Topics Weeks Topics Covered 13 Congenital digestive. 4- Cleft lip. 5- Cleft palate. 6- Rectum obstruction. Digestive system anomalies Cleft lip and cleft palate : facial anomalies Causes 1- Genetic 2- environmental treatment Surgical to prevent complication and facilitate , normal growth and development Imperforated anus It is rectal defect consist of stenosis membrane covered the anus open. RX ---------:- Surgical correction - Simple →surgeon make dilatation - Difficult→ colostomy 31  ‫األسبوع الرابع عشر‬ Theory Topics Weeks Topics Covered 14 Nursing care of urinary condition system. 5- Acute Glomerulonephritis. 6- Nephritic syndrome (nephrosis). 7- Pye lonephritis (pyelitis). 8- Renal failure. Nursing care of urinary tract disorder Acute glomerulonephtitis 1- Bed rest 2- Frequent urine examination 3- Soft and regular diet 4- Antibiotic 5- Observe intake and output 6- Hypertensive drug is given 7- Record and check weight daily 8- O2 31 9- Peritoneal dialysis Nephrotic syndrome 1- Control infection by antibacterial therapy 2- Control edema 3- Promotion and good nutrition 4- Hygiene 5- Prednisone 2mg/ K g /24 hr 6- Diuretics 7- Bed rest Pylonephritis 1- Bed rest 2- Give antibiotic as doctor order 3- Baby hygiene 4- Encourage child to increase fluid intake 5- Attractive and easy digested food 6- Urine for test 32 Renal failure Management:- -medically: 1- diet 2- Dialysis - Surgically → Kidney transplantation 1- Assess renal dysfunctions 2- Prevent retention of waste product 3- Restrict salt and potassium 4- Treat hypertension 5- Prevent infection 33  ‫األسبوع الخامس عشر‬ Theory Topics Weeks Topics Covered 15 The nursing care of heart and blood disease 2- Anemia 2-Thalassem'a 3-leukem'a 4-Hemophilia 5-Christmas 6-congenital heart disease 7- Congestive heart failure Nursing care of blood and circulating disease Anemia It is decrease in number of RBC or Hb 1- Good diet with rich iron 2- Green vegetable, liver, treat the anemia according to it causes and to child age and his health status Thalassemia ( cooleys anemia) Congenital hemolytic anemia, abnormal formation of RBC and deficient in Hb Minor Thalassemia (one parent's carrier) Major Thalassemia (both parent) 34 treatment 1- Blood transfusion 2- folic acid 3- Dysferal Leukemia It is malignant disease of the bone marrow and lymphatic system treatment 1- Introduction therapy: after diagnosis and last 4-6 weeks Prednisolone tablet orally + vinicristine →IV 2- Prophylactic→ after 6-8 weeks of diagnosis Radiation 1-2 weeks 3- Maintenance therapy→ after child discharge from hospital Hemophilia It is a recessive sex x linked disorder determined by a deficiency of factor which is characterized by a disturbance of blood clotting factor 35 tratment 1- Give cryoprecipitate ,blood, plasma ,which contain factors 2- Physiotherapy and rehabilitation and exercise after bleeding stop 3- Emergency care should be provide for hemophilia child 4- Clean wound 5- Keep the child quite and comfortable 6- Avoid deformity Congenital heart disease Most common and one cause for death of child especially in 1st years 1- A cyanotic type (valvotomy) 2- Cyanotic type (open surgery → shunt between aorta and pulmonary Congental heart failure In ability of the heart to pump an adequate blood 36 RX 1- Digitals 2- Check pulse after digoxin and observe S/S 3- Diarrhea 4- Anorexia 5- Ventricular fibrillation 37  ‫االسبوع السادس عشر‬ Theory Topics Weeks Topics Covered 16 The nursing cure of nervouse system 5. mastoiditis 6. brain abcess and meningitis 7. hydrocephlitis 8. spina bifida The nursing cure of central nervous system *The disorder Spina bifida Amass occurs in sacrococcygeal area Treatment 1- Prevent trauma 2- Sleep on abdomen 3- Hygiene 4- Prevent cold injury Hydrocephalus It is exercise accumulation of fluid in the ventricles of ventricles of brain 38 RX -------- :- Surgical → shunt from ventricle to left ventricle of heart Convulsion It is a symptoms accompanied under 2 years ,called epilepsy Nursing care 1- Comfortable bed 2- Avoid body injury 3- Record S/S( nervousness disorder ) 4- O2 NEED Febril convulsion Rx:- 1- Give IV fluid 2- Give treatment as doctor order 3- Antibiotic 4- Cold compress 39  ‫االسبوع السابع عشر والثامن عشر والتاسع عشر والعشرون‬ Weeks Topics Covered 17 Nursing care at communicable disease 18 5. pulmonary tuberculosis 19 6. measles 7. Germany measles 8. mumps 20 5. diphtheria 6. Pertusis 7. tetanus 8. Poliomyelitis 9.chickenpox 10.Infection hepatitis 11.Typhoid fever Communicable Disease -TB( Tuberculosis) 1- bed rest 2- Good diet 3- O2 4- Drugs (INH, streptomycin injection, refadin tablet) - Measles 1- bed rest until fever and cough disappesr. 2- dark room , increase humidity and warm 3- irrigate eyes with physiologic saline to reduce itcging 4- increase fluid. 41 Measles ( German measles ,rubella) 1- bed rest 2- maintaining fluid 3- prevent complication - Mumps 1- local application of heat or cold 2- liquid or soft food 3- bed rest _ Diphtheria Aim of the treatment is to 1- inactivate the toxin 2- kill organism as well as to prevent resipritory obstruction 3- antitoxin and antibiotic 4- complete bed rest Pertusis ( whooping cough) 1- protect child from secondary infection 2- sulfonamide and antibiotic 3- rest 4- provid warm and humidity 5- O2 6- sedative 41 Tetanus ( local Jaw) 1- neutralized toxin by antitoxin 2- test for sensitivity 3- tetanus immunity glogin 3- wound should be clean 4- IV fluid 5- O2 6- sedative 7- isolation and aseptic technique -Poliomyelitis ( infant paralysis) 1- support parents 2- firm mattress 3- support feet 4- prevent any pressure on toes 5- change position 6- intake and output 7- maintain alignment - Small pox 1- antibiotics 2- eye care 3- diet 4- IV fluid and blood transfusion 5- sedative 6- O2 therapy 42 Meningitis 1- cold compress 2- antibiotic 3- prevent convulsion 4- IV fluid Typhoid fever( salmonellosis) 1- antibiotics ( ampicillin ) given IV for 10 days then follow orally for 4 weeks 2- diet therapy → increase calcium 3- IV fluid 4- skin care Infectious hepatitis 1- complete bed rest 2- diet rich in protein ,CHO. Decrease in fat 2- small frequent feeding 3- IV fluid 4- isolation 5- Avoid giving large dose of steroids 43  ‫االسبوع الحادي والعشرون‬ Theory Topics Weeks Topics Covered 21 Nursing cure at endocrine disorders 4. hypothyrodism 5. hyper thyroidism 6. diabetes Nursing cure at endocrine disorders - Hypothroidism 1- diet , fish ,high calories , fruit and vegetables 2- maintain good hygiene and prevent infection 3- check vital signs 4- fluid with fluoride - Hyperthroidism 1- medical therapy ( potassium iodide, chemotherapy) 2- radio active therapy 3- comfort environment 4- balance diet 5- be away from caffeine ,tea 44 Diabetes mellitus 1- skin care to prevent infection 2- oral hygein 3- regulaer exercise 4- blood and urine test 5- manage the diet ( moderate amount of CHO and sugar ,fat ,rich with vitamin and mineral ) 6- insulin administration 7- cooperate with family and tell them that child live normally 45  ‫االسبوع الثاني والعشرون‬ Theory Topics Weeks Topics Covered 22 The contaminated environment influence of health baby 2. cholera 2-malta fever Effect and environmental disease on child health - Cholera 1- IV fluid 2- prevent dehydration 3- antibiotic 4- hygiene 5- decrease fever ( cold compress ) 6- prevent complication -Brucellosis 1- antibiotic ( streptomycin, injection –metheprim tablet for 2 weeks and doxydar capsule 2- decrease fever 3- diet ( rich in protein , CHO) 4- brucella test continuously and follow the doctor 46  ‫االسبوع الثالث والعشرون‬ Theory Topics Weeks Topics Covered 23 The endemic disease and influence of health child :- 2. malaria 2- trematoda 3. tina solium ,tina saginata ,oxyuris ,anglistoma Effect and endemic disorder child health Malaria 1- good diet 2- -decrease fever ( cold compress ) 3- give treanment ( Quinine) 4- health education Bilharziasis 1- health education 2- good diet rich in protein 3- follow doctor order 4- treat hematuria by blood transfusion (if needed) Intestinal worms 1- Hygiene 2-wash the vegetable very well 3- clean the chilled inner cloths very well 4- cock the meet very well 5- avoid food scratches 47  ‫األسبوع الرابع والعشرون‬ Theory Topics Weeks Topics Covered 24 Handicap children :- 3- Definition the handicap or hindrance child. 4- Types of handicap including :- (Physical , psychsocial , mental). Handicapped chilled - Handicapped It is inability of person to get physical, mental, social activity, completely or partially due to accident or disease. Type of handicappe 1- Physical hand (deafness, loss of speech , ,blindness) 2- Psycho-mental hand.(behavioral hand and down syndrome) 3- Social hand. Rehabilitation Is useful to maintain the handicap as active person in society and that by involve the handicap in society institution. Physiotherapy Done for physical handicap to return completely or partially the activity of the person 48  ‫األسبوع الخامس والعشرون‬ Theory Topics Weeks Topics Covered 25 Rehabilitation center. - Handicap prevention. 26 Prevention of hand icap child from accident. 1- Poisoning 2- Burns 3- injuries 4- Jumping on a high level or accident or run over. Rehabilitation of Handicap The process of decreasing dependence of the handicapped and disabled person by developing ability needs and function of the Handicap. Rehabilitation centers 1- Diagnostic center of hand 2- physical handicap center 3- mental handicap center 4- completely handicap center Nursing care 1- Give care to handicap 2-Love and security 3- Exercises 4- Follow the handicap continuously by family 49 Prevention 1- Health education 2- rise standard of living (nutrition, cleaning) 3- Immunization 4- Genetic councelling 51  ‫األسبوع السابع والعشرون –االسبوع الثالثين‬ Theory Topics Weeks Topics Covered 27 The children care of orphan include :- 28 - Development and depended stages. - Religion( ‫ )الدين‬, norms depend on type of society. - Learn child to make independence. 29 - Imported role of educational status or establishment with care of orphanage. 30 - The nursing care of the dying child. Nursing care of dying child Be near the child and call Dr. in emergency Keep the parents near their child Provide the child with privacy Make all wishes of the child Suction Ventilation Intake and out put and make catheterization Give drugs according to dr. order Check vital signs 51 Orphanage:- is the name to describe a residential institution devoted to the care of orphans – children whose parents are deceased or otherwise unable to care for them. Parents, and sometimes grandparents, are legally responsible for supporting children, but in the absence of these or other relatives willing to care for the children, they become a ward of the state, and orphanages are a way of providing for their care and housing. Children are educated within or outside of the orphanage. ‫ األطفال الذين يكون والداهما المتوفى أو‬-- ‫دار األيتام هو اسم لوصف مؤسسة السكنية المخصصة لرعاية األيتام‬ ‫ ولكن في غياب‬، ‫ هي المسؤولة قانونا عن األطفال دعم‬، ‫ واألجداد في بعض األحيان‬، ‫ اآلباء‬.‫عجزه عن رعايتهم‬ ‫ ودور األيتام هي طريقة لتقدم لهم‬، ‫ فإنها تصبح وصاية الدولة‬، ‫هذه أقارب أو غيرها على استعداد لرعاية األطفال‬.‫ يتم تعليم األطفال داخل أو خارج من دار لأليتام‬.‫الرعاية والسكن‬ Orphanages provide an alternative to foster care or adoption by giving orphans a community-based setting in which they live and learn. In the worst cases, orphanages can be dangerous and unregulated places where children are subject to abuse and neglect..‫دور األيتام توفير بديل لرعاية األطفال أو التبني من خالل منح األيتام إعداد المجتمعية التي يعيشون فيها والتعلم‬ ‫ يمكن أن يكون دور األيتام أماكن خطرة وغير المنظم حيث أن األطفال يتعروون سإساةة‬، ‫في أسوأ الحاالت‬.‫المعاملة واسإهمال‬ Today, the term orphanage has negative connotations. Other alternative names are group home, children's home, rehabilitation center and youth treatment center. ‫ والعالج الشباب الرئيسية‬، ‫ أسماء بديلة أخرى هي المجموعة الرئيسية‬.‫ ودار األيتام مصطلح له دالالت سلبية‬، ‫اليوم‬ ‫ ومركز التأهيل ومركز‬، ‫للطفولة‬ 52