Pediatric Primary Care : A Handbook for Nurse Practitioners

by Burns, Catherine E.

• ISBN13: 9780721680620
• ISBN10: 0721680623
• Edition: 2nd
• Format: Hardcover
• Copyright: 2000-04-01
• Publisher: Elsevier Science Health Science div

Summary

This new third edition covers conditions seen in the primary care of children, emphasizing prevention as well as management of problems from the nurse practitioner perspective. It begins with an overview of the status of children in the United States and a review of developmental theory, followed by guidelines on how to assess children and families. A significant portion of the text is devoted to issues of daily living that are a part of every child's growth and issues that could lead to health problems (nutrition, toilet training) unless appropriate guidance is given. Disease processes often encountered by the pediatric primary provider are addressed through discussions of assessment, differential diagnosis, management, and prevention.

Table of Contents

UNIT 1 Pediatric Primary Care Foundations	1	(76)
Child Health Status in the United States	3	(16)
Catherine E. Burns
Introduction	3	(1)
Child Health Status in America	3	(6)
Infant Mortality	3	(2)
Births	5	(1)
Child Mortality	5	(1)
Child Health and Morbidity	6	(1)
Adolescent Mortality	6	(1)
Adolescent Health	7	(1)
Immunizations	8	(1)
Social Factors Influencing Child Health	8	(1)
Access to Health Care	8	(1)
Managed Care Effects on Child Health	9	(1)
Health, Health Promotion, Disease Prevention, and Primary Care Definitions	9	(1)
Health, Health Promotion, and Disease Prevention	9	(1)
Primary Care	10	(1)
National Health Goals	10	(5)
Clinical Preventive Services: Health Supervision as a Component of Primary Care	11	(1)
Barriers to the Use of Clinical Preventive Services Guidelines	11	(4)
Nurse Practitioners Working in Managed Care Settings	15	(2)
Nursing Standards for Child Health Care	17	(1)
Summary	17	(2)
Child Assessment in Pediatric Primary Care	19	(22)
Catherine E. Burns
Introduction	19	(1)
The Assessment Model	19	(7)
Developmental Problems	20	(5)
Functional Health Problems	25	(1)
Diseases	25	(1)
Problem Interactions	26	(1)
The Database	26	(13)
The Child Health History	26	(10)
The Physical Examination and Laboratory and Other Studies	36	(2)
Creating the Problem List	38	(1)
Creating the Management Plan	38	(1)
Validating Data Collection	38	(1)
Summary	39	(2)
Family Assessment in Pediatric Primary Care	41	(12)
Sheila M. Kodadek
Introduction	41	(1)
Background	42	(1)
The Assessment Model	42	(1)
Family Structure and Roles	43	(1)
Family Life Cycle	43	(1)
Family Functioning	43	(1)
Family Social Network	43	(1)
Family Database	43	(10)
Genograms and Ecomaps	43	(6)
Selected Family Assessment Tools	49	(2)
Creating the Problem List	51	(1)
Creating the Management Plan	51	(2)
Cultural Perspectives for Primary Health Care	53	(24)
Margaret MacDonald
Introduction	53	(2)
The Concept of Culture	53	(1)
Cultural Socialization	53	(2)
Characteristics of Culture	55	(1)
Cultural Identity: Dominant and Minority Groups	55	(1)
Providing Culturally Sensitive Care	55	(5)
Recognizing Culture Shock	56	(1)
Developing Cultural Competence	56	(1)
Communicatiing Cultural Sensitivity	57	(3)
Cultures in American Society	60	(14)
Introduction	60	(1)
Cultural Perspectives of the Major US Population Groups	61	(13)
Conclusion	74	(3)
UNIT 2 Management of Development	77	(110)
Developmental Management in Pediatric Primary Care	79	(17)
Barbara Jones Deloian
Introduction	79	(2)
Developmental Surveillance	79	(1)
Developmental Principles	80	(1)
Developmental Theories	81	(6)
Ethology: Animal Studies	81	(1)
Maturational Theories: Developmental Milestones	81	(1)
Cognitive-Structural Theories: Language and Thought	82	(1)
Psychoanalytical Theories	83	(3)
Behavioral Theories: Human	86	(1)
Humanistic Theories: Innermost Self	86	(1)
Ecological Theories of Development	86	(1)
Temperament	87	(1)
Parent Development	87	(1)
Cultural Factors Influencing Development	88	(1)
Methods of Developmental Assessment	89	(2)
Developmental Screening and Surveillance	89	(2)
When There Are Concerns About Delayed Development	91	(3)
Developmental Red Flags	91	(1)
Talking With Parents About Developmental Delays	92	(1)
Implementing Individualized Interventions	92	(2)
Summary	94	(2)
Developmental Management of Infants	96	(18)
Barbara Jones Deloian
Introduction	96	(1)
Theories of Infant Development	96	(1)
Developmental Screening and Assessment of Infants	97	(1)
Screening Strategies for Infants	97	(1)
Assessment Strategies for Infants	98	(1)
Assessment and Anticipatory Guidance During the First Year of Life	98	(12)
Newborn to 1 Month of Age	98	(2)
6 to 8 Weeks of Age	100	(1)
3 to 4 Months of Age	101	(2)
5 to 6 Months of Age	103	(2)
7 to 8 Months of Age	105	(1)
9 to 10 Months of Age	106	(2)
11 to 12 Months of Age	108	(2)
Common Developmental Issues of Infants	110	(1)
Developmental Delays in Infants	110	(1)
Parent Education and Anticipatory Guidance	110	(2)
Summary	112	(2)
Developmental Management of Toddlers and Preschoolers	114	(28)
Mary A. Murphy
Introduction	114	(1)
Development of Toddlers and Preschoolers	114	(2)
Theories of Toddler and Preschool Psychosocial Development	114	(1)
Physical Development	115	(1)
Developmental Screening and Assessment of Toddlers and Preschoolers	116	(13)
Screening Strategies for Toddlers and Preschoolers	116	(1)
Assessment Strategies for Toddlers and Preschoolers	117	(12)
Anticipatory Guidance During the Toddler and Preschool Years	129	(6)
1- to 3-Year-Olds	129	(4)
Preschool Children (4- and 5-Year-Olds)	133	(2)
Common Developmental Issues of Toddlers and Preschoolers	135	(4)
General Management of Developmental Issues	135	(3)
Language and Speech Disorders	138	(1)
Summary	139	(3)
Developmental Management of School-Age Children	142	(22)
Catherine E. Burns
Patricia Billings
Introduction	142	(1)
Development of School-Age Children	142	(3)
Theories of School-Age Psychosocial Development	142	(3)
Physical Development	145	(1)
Developmental Screening and Assessment of School-Age Children	145	(6)
Screening Strategies for School-Age Children	146	(1)
Assessment Strategies for School-Age Children	146	(5)
Parent Development	151	(1)
Anticipatory Guidance During the School-Age Years	151	(6)
6- and 7-Year-Olds	151	(3)
8- to 10-Year-Olds	154	(2)
11- and 12-Year-Olds	156	(1)
Common Developmental Issues for School-Age Children	157	(7)
First-Grade School Readiness	157	(3)
Learning Problems	160	(1)
School Refusal (Phobia)	161	(1)
Recurrent Symptoms	162	(2)
Developmental Management of Adolescents	164	(23)
Linda Wildey
Judith W. Fisher
Introduction	164	(1)
Developmental Surveillance Parameters	164	(10)
Physical Development	164	(8)
Psychosocial Development	172	(2)
Developmental Screening and Assessment	174	(1)
Physical Growth Assessment	174	(1)
Cognitive Development	175	(1)
Psychosocial Development	175	(1)
Parent Assessment	175	(1)
Intervention by Adolescent Stage	175	(5)
Early Adolescence (11 to 14 Years)	175	(2)
Middle Adolescence (15 to 17 Years)	177	(2)
Late Adolescence (18 to 21 Years)	179	(1)
Common Developmental Issues for Adolescents	180	(5)
Risk Behavior	180	(5)
Conclusion	185	(2)
UNIT 3 Approaches to Health Management in Pediatric Primary Care	187	(356)
Introduction to Health Promotion	189	(17)
Catherine E. Burns
Introduction	189	(1)
Models to Predict Health Behavior	190	(4)
Health Belief Model	190	(1)
Self-Efficacy Model	190	(1)
Health-Promotion Model	190	(2)
Transtheoretical Model	192	(2)
Influences on Children's Health Promotion Behaviors	194	(2)
Children's Concepts of Health and Illness	194	(1)
Other Determinants of Health Behavior of Children	194	(2)
Functional Health Patterns---The Behaviors of Health	196	(2)
Screening and Assessment of Functional Health Pattern Disorders	197	(1)
Nursing Diagnoses---A Way to Label Functional Health Pattern Problems	198	(1)
Management Strategies for Health Promotion	198	(6)
Patient Education	199	(3)
Anticipatory Guidance	202	(1)
Providing Data	203	(1)
Role Modeling	203	(1)
Contracting	203	(1)
Bibliotherapy	203	(1)
Health System Interventions	204	(1)
Conclusion	204	(2)
Health Perception and Health Management Pattern	206	(37)
Ardys M. Dunn
Introduction	206	(2)
Definition of Health Perception and Health Management Pattern	206	(1)
Significance for Nurse Practitioner Practice	206	(1)
Standards of Practice	207	(1)
Normal Patterns of Health Perception and Health Management	208	(4)
Components of Health Perception	208	(1)
Components of Health Management	209	(3)
Assessment of Health Perception and Health Management Pattern	212	(2)
History	212	(2)
Management Strategies for Positive Health Perception and Health Management	214	(12)
Providing Health Maintenance for Children by Developmental Age	214	(1)
Facilitating Communication Between Families and Nurse Practitioners	214	(8)
Helping Families Develop Sound Decision-Making Skills	222	(1)
Helping Families Gain Access to Health Care Resources	223	(3)
Altered Patterns of Health Perception and Health Management	226	(17)
Ineffective Use of Health Care System	226	(2)
Risk-Taking Behaviors	228	(1)
Unintentional Injuries	229	(14)
Nutrition	243	(60)
Ardys M. Dunn
Connie Evers
Introduction	243	(1)
Definition of Nutrition Pattern	243	(1)
Significance for Nurse Practitioner Practice	243	(1)
Standards for Preventive Care	243	(1)
Normal Patterns of Nutrition	244	(20)
General Considerations	244	(7)
Age-Specific Considerations	251	(13)
Assessment of Nutritional Status	264	(2)
History	264	(1)
Physical Examination	265	(1)
Laboratory and Diagnostic Tests	265	(1)
Management Strategies for Optimal Nutrition	266	(5)
Children's Nutritional Requirements	266	(1)
Eating Behaviors	267	(1)
Vegetarian Diets	267	(4)
Altered Patterns of Nutrition	271	(32)
Introduction	271	(1)
Disorders Requiring Increased Caloric Intake	272	(3)
Disorders Requiring Decreased Caloric Intake	275	(1)
Disorders Requiring Restricted or Supplemental Diets	276	(3)
Disorders Requiring Physical Alterations in Diet Management	279	(3)
Eating Disorders	282	(7)
Adverse Food Reactions	289	(3)
Effect of Medications on Nutritional Status	292	(3)
Controversies in Pediatric Nutrition	295	(8)
Breastfeeding	303	(24)
Pamela J. Hellings
Introduction	303	(1)
Breastfeeding Recommendations	303	(1)
The Baby-Friendly Hospital Initiative	303	(1)
Characteristics of Human Milk	304	(2)
Benefits of Breastfeeding	304	(1)
Contraindications to Breastfeeding	304	(1)
Special Situations	305	(1)
Components of Human Milk	305	(1)
Anatomy and Physiology	306	(1)
Assessment of the Breastfeeding Dyad	307	(1)
Maternal History	308	(1)
Infant History	308	(1)
Maternal Examination	308	(1)
Infant Examination	308	(1)
Positions for Breastfeeding	308	(3)
Principles of Correct Positioning	309	(1)
Cradle Position	309	(1)
Side-Lying Position	309	(1)
Football Hold	310	(1)
Dynamics of Breastfeeding	311	(6)
Early Feedings	311	(1)
Frequency and Duration of Feedings	312	(1)
Stool and Urine Output Guidelines	312	(2)
Pumping	314	(1)
Collection and Storage of Breast Milk	314	(1)
Infant Weight Gain	314	(1)
Growth Spurts	315	(1)
Weaning	315	(1)
Maternal Nutritional Needs During Breastfeeding	315	(1)
Returning to Work	316	(1)
Medications for Breastfeeding Mothers	317	(2)
Common Breastfeeding Problems	319	(8)
Flat or Inverted Nipples	319	(1)
Sore Nipples	320	(1)
Severe Engorgement	321	(1)
Mastitis	321	(1)
Nipple Confusion	322	(1)
Breast Milk Jaundice	323	(1)
Thrush	323	(1)
Poor Weight Gain	323	(4)
Elimination Patterns	327	(16)
Ardys M. Dunn
Introduction	327	(1)
Standards	327	(1)
Normal Patterns of Elimination: Bowel and Urinary	327	(2)
Infants	327	(1)
Toddlers and Preschoolers	328	(1)
School-Age Children	328	(1)
Adolescents	329	(1)
Assessment of Patterns	329	(1)
Health History	329	(1)
Physical Examination	330	(1)
Laboratory and Diagnostic Tests	330	(1)
Management Strategies for Normal Patterns	330	(1)
Toilet Training	330	(1)
Altered Patterns of Elimination	331	(12)
Stool Toileting Refusal	332	(1)
Encopresis and Constipation	333	(3)
Enuresis	336	(4)
Dysfunctional Voiding	340	(3)
Activities and Sports for Children and Adolescents	343	(30)
Catherine E. Burns
Introduction	343	(1)
Clinical Preventive Services Guidelines and Standards for Physical Activity and Fitness in Children	343	(1)
Healthy People 2010 Guidelines for Physical Activity and Fitness	343	(1)
American Medical Association Guidelines for Adolescent Preventive Services (GAPS)	344	(1)
Nursing Standards for Activity and Exercise Functional Health Pattern	344	(1)
Assessment	344	(18)
The Preparticipation Sports Examination	344	(12)
Classification of Sports for Risk	356	(1)
Recommendations for Participation in Sports for Children With High-Risk Conditions	356	(6)
Management Strategies to Support Children and Adolescent Activity Patterns	362	(11)
Injury Prevention	362	(1)
Stress and Sports: Keeping Activities Fun	363	(1)
Health Teaching to Prevent Problems	364	(9)
Sleep and Rest	373	(16)
Catherine E. Burns
Introduction	373	(1)
Nursing Standards	374	(1)
Normal Sleep Stages and Cycles	374	(3)
REM Sleep	374	(1)
Non-REM Sleep	374	(1)
Sleep Cycles	375	(1)
Duration of Sleep	375	(1)
Circadian Rhythms and Establishment of Normal Sleep Patterns	376	(1)
Sleep Positioning	377	(1)
Assessment	377	(1)
History	377	(1)
Physical Examination	378	(1)
Diagnostic Studies	378	(1)
Strategies for Prevention and Management of Sleep Problems	378	(2)
Common Sleep Problems	380	(9)
Sleeplessness Problems	381	(3)
Sleep-Cycle Problems	384	(1)
The Parasomnias: Night Terrors, Nightmares, Sleepwalking	385	(1)
Obstructive Sleep Apnea	386	(3)
Cognitive-Perceptual Patterns	389	(29)
Catherine E. Burns
Kathleen C. Shelton
Introduction	389	(1)
Nursing Standards	389	(1)
Conceptual Background	390	(4)
Normal Cognitive-Perceptual Patterns	390	(1)
Information Processing Theories	390	(1)
Cognitive-Perceptual Developmental Patterns	391	(2)
Effects of Cognitive-Perceptual Pattern Problems on the Family	393	(1)
Assessment of Cognitive-Perceptual Patterns	394	(1)
Normal Patterns	394	(1)
Assessment of Children with Cognitive-Perceptual Problems	394	(1)
Management Strategies	394	(1)
Social and Adaptive Strategies	394	(1)
Educational Strategies	394	(1)
Social Support Strategies	395	(1)
Multidisciplinary Team Strategies	395	(1)
Cognitive-Perceptual Problems of Children	395	(23)
Attention-Deficit Hyperactivity Disorder	395	(12)
Deafness	407	(3)
Blindness	410	(2)
Autism	412	(6)
Self-Perception	418	(17)
Nancy Barber Starr
Introduction	418	(1)
Standards of Care	418	(1)
Normal Patterns of Self-Perception	419	(4)
Components of Self-Perception	419	(1)
Developmental Stages	420	(1)
Developmental Assets	421	(1)
Environmental Influences	421	(2)
Assessment of Self-Perception	423	(5)
History	424	(1)
Observation During the History and Examination	425	(3)
Management Strategies for Developing Positive Self-Perception	428	(3)
Facilitate Good Parenting	428	(1)
Maintain Appropriate Expectations of the Child	429	(1)
Use Discipline Techniques That Enhance Self-Esteem	429	(1)
Communicate Positively	430	(1)
Provide Helpful Strategies for the Child and Adolescent	430	(1)
Encourage Asset Building	431	(1)
Specific Self-Perception Problems in Children	431	(4)
Self-Esteem Problems	431	(1)
Personal Identity Problems	432	(1)
Role Performance Problems	432	(1)
Body Image Problems	432	(3)
Role Relationships	435	(38)
Margaret A. Brady
Introduction	435	(2)
Family Life Cycle	435	(1)
Family Resources, Stresses, and Coping Styles	436	(1)
The Interactive Family Life Cycle	436	(1)
Assessment of Family Relationships and Dynamics	437	(1)
Preventive Interventions	438	(1)
Health Promotion and Disease Prevention Objectives and Goals	438	(1)
Role Relationship Problems	439	(16)
Violence	439	(1)
Impact of Violence on the Lives of Children and Their Families	439	(1)
Risk Factors and Predictors of Violence	440	(1)
Assessment	440	(1)
Management	441	(1)
Prevention of Youth Violence	441	(1)
Child Maltreatment	442	(1)
Physical Abuse	442	(6)
Neglect	448	(1)
Psychosocial Failure to Thrive	449	(1)
Sexual Abuse	450	(4)
Emotional Maltreatment	454	(1)
Variations in Family Patterns	455	(11)
Separation and Divorce	455	(3)
Single-Parent Families	458	(1)
Remarriage: The Blended Family	459	(2)
Adoption	461	(1)
Teenage Parents	462	(2)
Other Variations in the Family Unit	464	(2)
Parenting Strategies	466	(1)
Other Challenges in the Family Unit	467	(4)
Sibling Rivalry at the Birth of a New Sibling and Between Other Children	467	(1)
Birth of a New Infant	467	(1)
Sibling Rivalry Between Older Children	467	(1)
Multiple Births	468	(3)
Child Care	471	(2)
Sexuality	473	(28)
Ardys M. Dunn
Jeanete M. Broering
Introduction	473	(1)
Standards	473	(1)
Normal Patterns of Sexuality	474	(3)
Definition of Sexuality, Sexual Health, and Sexual Identity	474	(1)
Developmental Patterns of Sexuality	475	(2)
Assessment of Normal Patterns	477	(3)
History	477	(1)
Physical Examination	478	(2)
Management Strategies of Normal Patterns	480	(12)
Setting the Stage	480	(1)
Sex Education	481	(1)
Contraception	482	(10)
Management of Altered Patterns	492	(9)
Adolescent Pregnancy	492	(4)
Homosexuality	496	(5)
Coping and Stress Tolerance	501	(32)
Gail M. Houck
Introduction	501	(1)
Nursing Standards	501	(1)
Developmental Context	502	(1)
Stress During Childhood	502	(1)
Childhood Coping	503	(3)
Definition	503	(1)
Role of Temperament in Coping	503	(2)
Role of Development in Coping	505	(1)
Stress and Ineffective Coping: General Behavior Problems	506	(1)
Assessment	506	(2)
History	507	(1)
Physical Examination	508	(1)
Diagnostic Studies	508	(1)
Strategies for Management	508	(2)
Primary Prevention	509	(1)
Secondary Prevention	509	(1)
Tertiary Prevention	510	(1)
Common Behavior Problems	510	(14)
Fears, Phobias, and Anxieties	510	(5)
Responses to Trauma	515	(2)
Mood Disorders	517	(4)
The Aggressive Child	521	(3)
The Shy Child	524	(1)
Shyness	524	(1)
Social Withdrawal	524	(1)
Bereavement	525	(1)
Description	525	(1)
Etiology and Incidence	525	(1)
Clinical Findings	525	(1)
Differential Diagnosis	526	(1)
Management	526	(1)
Substance Abuse	526	(7)
Description	526	(1)
Etiology and Incidence	527	(1)
Clinical Findings	527	(1)
Differential Diagnosis	528	(1)
Management	529	(4)
Values and Beliefs	533	(10)
Ardys M. Dunn
Introduction	533	(1)
Standards of Practice	533	(1)
Normal Patterns of Behavior	534	(4)
Values and Beliefs: Definitions and Relationship to Behavior	534	(1)
Expected Patterns of Behavior Related to Values and Beliefs	534	(1)
Development of Moral Integrity or Conscience	534	(1)
Development of Spirituality	535	(3)
Assessment	538	(1)
History	538	(1)
Physical Examination	539	(1)
Management of Normal Patterns	539	(1)
Altered Patterns	540	(3)
Lack of Moral Integrity	540	(1)
Spiritual Distress	541	(2)
UNIT 4 Approaches to Disease Management	543	(810)
Introduction to Disease and Pain Management	545	(16)
Margaret A. Brady
Approaches to Acute Disease in Children	545	(1)
Approaches to Chronic Disease in Children	546	(2)
Assessment	548	(1)
History and Physical Examination	548	(1)
Diagnostic Studies	549	(1)
Use of Medication	549	(2)
Safe Prescription-Writing Practices	549	(1)
Prescribing Pharmacological Agents	550	(1)
Educating Parents and Children About Pharmacological Agents	550	(1)
Prescriptive Authority for Nurse Practitioners	551	(1)
Educational Strategies	551	(1)
Prevention of Illness	552	(1)
Pain in Children	552	(3)
Pain Assessment	553	(1)
Clinical Findings	553	(1)
Management	554	(1)
Fever in Children	555	(1)
Telephone Management of Illnesses	556	(2)
Triage Categories	556	(1)
Documentation	557	(1)
Relating to Parents Via the Telephone	557	(1)
Educating Parents About Telephone Management of Illness	558	(1)
Referrals and Consultative Services	558	(1)
Referrals and Use of Consultants	558	(1)
National and Local Organizations and Resources	559	(2)
Infectious Diseases	561	(64)
Mark H. Goodman
Margaret A. Brady
Introduction	561	(1)
Pathogenesis of Infectious Diseases	561	(1)
Clinical Findings	561	(1)
History	562	(1)
Physical Examination	562	(1)
Diagnostic Aids	562	(1)
Laboratory Studies	562	(1)
General Management Strategies	563	(2)
Principles for Preventing the Spread of Infections	563	(1)
Principles Guiding the Judicious Use of Antimicrobial Agents in Pediatrics	564	(1)
Principles of Treatment	564	(1)
Prevention of Infection Through the Use of Vaccines	565	(1)
Active Immunity	566	(12)
Diphtheria and Tetanus Toxoids With Pertussis Vaccines (DTP/DTaP)	566	(3)
Bacille Calmette-Guerin (BCG) Vaccine	569	(2)
Polio Vaccine	571	(1)
Haemophilus Influenza Type B (HIB) Vaccine	571	(2)
Measles-Mumps-Rubella (MMR) Vaccine	573	(1)
Hepatitis A (HA) Vaccine	574	(1)
Hepatitis B (HB) Vaccine	575	(1)
Influenza Vaccine	576	(1)
Varicella Vaccine	577	(1)
Pneumococcal and Meningococcal Vaccines	577	(1)
Rotavirus Vaccine	578	(1)
Passive Immunity	578	(2)
Hepatitis A	578	(1)
Hepatitis B	579	(1)
Measles	579	(1)
Mumps	579	(1)
Polio	579	(1)
Respiratory Syncytial Virus (RSV) Prophylaxis	579	(1)
Rubella	579	(1)
Tetanus	580	(1)
Varicella Vaccine	580	(1)
Specific Infectious Diseases	580	(40)
Viral Diseases	580	(29)
Bacterial Infections	609	(11)
Temperature and Fever	620	(5)
Fever Without Source in Infants and Young Children	620	(2)
Fever of Unknown Origin (FUO)	622	(3)
Atopic Disorders and Rheumatic Diseases	625	(37)
Margaret A. Brady
Introduction	625	(1)
Anatomy and Physiology	625	(1)
Pathophysiology and Defense Mechanisms	625	(4)
Atopic or Allergic Disorders	625	(1)
Rheumatic Diseases	626	(1)
Considerations in the Pathogenesis of Juvenile Arthritis	626	(1)
Considerations in the Pathogenesis of Systemic Lupus Erythematosus	627	(2)
Specific Immunological Problems of Children: Common Atopic Disorders	629	(24)
Asthma	629	(16)
Allergic Rhinitis	645	(4)
Atopic Dermatitis	649	(4)
Diseases with an Autoimmune Basis	653	(9)
Juvenile Arthritis	653	(3)
Systemic Lupus Erythematosus	656	(1)
Fibromyalgia	657	(2)
Chronic Fatigue Syndrome	659	(1)
Acute Rheumatic Fever	659	(3)
Endocrine and Metabolic Diseases	662	(27)
Jean Betschart
Introduction	662	(1)
Standards for Screening	662	(1)
Anatomy and Physiology	663	(1)
Pathophysiology	663	(2)
Assessment	665	(2)
History	665	(2)
Physical Examination	667	(1)
Diagnostic Studies	667	(1)
Management Strategies	667	(1)
General Measures	667	(1)
Genetic Counseling	668	(1)
Medications	668	(1)
Dietary Considerations	668	(1)
Patient and Parent Education	668	(1)
Specific Endocrine and Metabolic Disorders of Children	668	(21)
Common Disorders Detected in the Newborn Period	668	(3)
Growth Hormone Disorders	671	(7)
Thyroid Disorders	678	(3)
Pubertal Disorders	681	(8)
Hematological Diseases	689	(25)
Martha K. Swartz
Introduction	689	(1)
Anatomy and Physiology	689	(4)
Erythrocytes	689	(1)
Hemoglobin	690	(1)
Antigenic Properties of Red Blood Cells	690	(1)
Leukocytes	690	(1)
Granular Leukocytes	691	(1)
Monocytes	691	(1)
Lymphocytes	692	(1)
Platelet Cells and Coagulation Factors	692	(1)
Pathophysiology	693	(4)
Classification of the Anemias	693	(3)
White Blood Cell Dysfunction	696	(1)
Alterations of Granulocytes	696	(1)
Lymphocytic Disorders	696	(1)
Malignant White Blood Cell Disorders	696	(1)
Platelet and Coagulation Disorders	697	(1)
Assessment	697	(2)
History	697	(1)
Physical Examination	698	(1)
Screening	698	(1)
White Blood Cell Count	699	(1)
Tests for Coagulation Disorders	699	(1)
Bone Marrow Aspiration	699	(1)
Management Strategies	699	(2)
Specific Hematological Problems	701	(13)
Anemias	701	(1)
Anemias Caused by Inadequate Production of Red Blood Cells	701	(2)
Hemolytic Anemias	703	(1)
Bleeding Disorders	703	(8)
Lymphomas	711	(3)
Neurological Disorders	714	(30)
Catherine E. Burns
Introduction	714	(1)
Anatomy and Physiology	714	(1)
Anatomy	714	(1)
Physiology	715	(1)
Pathophysiology and Defense Mechanisms	715	(2)
Pathophysiology	715	(2)
Defense Mechanisms	717	(1)
Assessment of the Nervous System	717	(4)
History	717	(1)
Physical Examination	718	(2)
Diagnostic Studies	720	(1)
Management Strategies	720	(1)
Specific Neurological Problems of Children	721	(23)
Cerebral Palsy	721	(7)
Epilepsy and Seizure Disorders	728	(6)
Febrile Seizures	734	(1)
Headaches	735	(4)
Head Injury	739	(1)
Macrocephaly, Hydrocephaly, and Microcephaly	739	(1)
Craniosynostosis	740	(1)
Central Nervous System Infections	740	(1)
The Floppy Infant	741	(1)
Reye Syndrome	741	(1)
Rett Syndrome	742	(1)
Tic Disorders	742	(2)
Eye Problems	744	(39)
Margaret MacDonald
Nancy Barber Starr
Introduction	744	(1)
Standards for Visual Screening and Care	744	(1)
Development and Physiology of the Eye	745	(2)
Development of the Ocular Structures	745	(1)
Anatomy and Physiology of the Eye	746	(1)
Pathophysiology of the Eyes	747	(1)
Assessment	747	(5)
History	747	(1)
Physical Examination	748	(1)
Screening Tests	748	(4)
Diagnostic Studies	752	(1)
Management Strategies	752	(4)
Referral for Ophthalmological and Specialty Management	752	(2)
Ophthalmic Medications	754	(1)
Eye Injury Prevention	755	(1)
Vision Therapy, Lenses, and Prisms	756	(1)
Common Eye Disorders	756	(27)
Visual Disorders	756	(7)
Infections	763	(12)
Emergency Care of the Injured Eye	775	(8)
Ear Disorders	783	(25)
Ann M. Petersen-Smith
Introduction	783	(1)
Standards for Hearing Screening	783	(1)
Development, Anatomy, and Physiology	784	(1)
Development	784	(1)
Anatomy and Physiology	784	(1)
Pathophysiology and Defense Mechanisms	784	(1)
Pathophysiology	784	(1)
Defense Mechanisms	784	(1)
Assessment	785	(2)
History	785	(1)
Physical Examination	785	(1)
Common Diagnostic Studies	786	(1)
Management Strategies	787	(3)
Medications	787	(1)
Education and Counseling	788	(1)
Prevention of Noise-Induced Hearing Loss	788	(1)
Removal of Cerumen	788	(1)
Follow-up and Referral	789	(1)
Pressure-Equalizing Tubes	789	(1)
Specific Ear Problems in Children	790	(18)
Otitis Externa	790	(2)
Foreign Body in the Ear Canal	792	(1)
Acute Otitis Media	792	(6)
Otitis Media With Effusion	798	(4)
Cholesteatoma	802	(1)
Mastoiditis	802	(1)
Sensorineural and Conductive Hearing Loss	803	(5)
Cardiovascular Disorders	808	(50)
Jan Freitas-Nichols
Introduction	808	(1)
Standards of Care	808	(1)
Anatomy and Physiology	809	(3)
Fetal Circulation	809	(1)
Neonatal Circulation	809	(2)
Normal Cardiac Structure and Function	811	(1)
Conduction System	812	(1)
Heart Sounds	812	(1)
Pathophysiology	812	(1)
Assessment of the Cardiovascular System	813	(7)
History	813	(1)
Physical Examination	813	(6)
Common Diagnostic Studies	819	(1)
Management Strategies	820	(5)
Referral	820	(1)
Family Support	821	(2)
Primary Health Care for Children With Cardiovascular Diseases	823	(1)
Prevention of Bacterial Endocarditis	823	(2)
Primary Prevention	825	(1)
Congenital Heart Diseases	825	(15)
Congestive Heart Failure	825	(1)
Acyanotic Congenital Heart Disease (Left-To-Right Shunts)	826	(1)
Atrial Septal Defect	827	(2)
Ventricular Septal Defect	829	(2)
Patent Ductus Arteriosus	831	(3)
Cyanotic Congenital Heart Disease (Right-To-Left Shunts)	834	(1)
Transposition of the Great Arteries (TGA)	834	(1)
Tetralogy of Fallot	835	(1)
Tricuspid Atresia	836	(1)
Obstructive Cardiac Lesions	837	(3)
Acquired Heart Disease	840	(13)
Chest Pain	840	(2)
Hypertension	842	(4)
Kawasaki Disease	846	(2)
Rheumatic Fever	848	(1)
Bacterial Endocarditis	849	(1)
Myocarditis	850	(2)
Pericarditis	852	(1)
Cardiac Arrhythmias	853	(5)
Respiratory Disorders	858	(34)
Mark H. Goodman
Margaret A. Brady
Introduction	858	(1)
Anatomy and Physiology	858	(1)
Upper Respiratory Tract	858	(1)
Lower Respiratory Tract	859	(1)
Pathophysiology Involved in Lower Airway Disease	859	(1)
Defense Systems	860	(1)
Assessment of the Respiratory System	861	(3)
History	861	(1)
Physical Examination	862	(1)
Diagnostic Procedures	863	(1)
Basic Respiratory Management Strategies	864	(1)
General Measures	864	(1)
Medications	864	(1)
Patient and Parent Education	865	(1)
Indications for Tonsillectomy and Adenoidectomy	865	(1)
Upper Respiratory Tract Disorders	865	(10)
Nasopharyngitis (The Common Cold or Upper Respiratory Tract Infection) and Tonsillopharyngitis	865	(3)
Acute Purulent Rhinitis	868	(1)
Sinusitis	869	(2)
Diphtheria	871	(1)
Pertussis	872	(1)
Recurrent Epistaxis	873	(1)
Nasal Foreign Body	874	(1)
Extrathoracic Airway Disorders	875	(4)
Laryngotracheobronchitis---Infectious Croup	875	(2)
Acute Spasmodic Croup	877	(1)
Epiglottitis	877	(1)
Bacterial Tracheitis	878	(1)
Intrathoracic Airway Disorders	879	(13)
Foreign Body Aspiration	879	(1)
Bronchitis	880	(1)
Bronchoiolitis	881	(2)
Pneumonia	883	(5)
Tuberculosis	888	(1)
Cystic Fibrosis	888	(1)
Syncope	889	(1)
Pectus Excavatum	890	(2)
Gastrointestinal Disorders	892	(45)
Ann M. Petersen-Smith
Introduction	892	(1)
Anatomy and Physiology	892	(1)
Pathopysiology	893	(1)
Assessment	893	(1)
History	893	(1)
Pysical Examination	893	(1)
Common diagnostic studies	894	(1)
Management Strategies	894	(1)
Medications	894	(1)
Nutrition	895	(1)
Activity	895	(1)
Conseling and Education	895	(1)
Upper Gastrointestinal tract Disorders	895	(8)
Dysphagia	895	(1)
Vomiting and Dehydration	896	(4)
Gastroesophageal Reflux	900	(1)
Peptic Ulcer Disease	901	(2)
Lower Gastrointestinal Tract Disorders	903	(18)
Infantile Colic	903	(7)
Acute Abdominal Pain	910	(1)
Appendicitis	911	(2)
Intussusception	913	(1)
Recurrent Abdominal Pain	914	(4)
Malabsorption Syndromes	918	(1)
Foreign Bodiesin the Gastrointestinal Tract	919	(1)
Anal Fissure	920	(1)
Inflammatory Bowel Diseases	921	(2)
Crohn Disease	921	(1)
Ulcerative Colitis	922	(1)
Failure to Thrivew (Organic)	923	(3)
Lower Gastrointestinal Tract Infections	926	(11)
Acute Diarrhea	926	(5)
Chronic Diarrhea	931	(1)
Intestinal Parasites	932	(5)
Dental and Oral Diseases	937	(37)
Charles Poland II
Jeffrey A. Dean
Introduction	937	(1)
Standards of Care	938	(1)
Anatomy and Physiology	938	(1)
Pathopysiology and Defense Mechanisms	939	(9)
Disruptuion in Formation, eruptiuon, or Shedding of Teeth	939	(1)
Dental Caries	940	(3)
Malocclusions	943	(2)
Gingivitis and Periodontal Disease	945	(1)
Trauma	946	(2)
Assessment	948	(1)
History	948	(1)
Physical Examination	948	(1)
Management and Preventive Dental Strategies	949	(12)
Establishing the Dental Home	949	(3)
Oral health Counseling and Risk Assessment	952	(2)
Controlling the Caries Epidemic	954	(2)
Preventing and Treating Maloclusion	956	(4)
Preventing Trauma to the Teeth and Mouth	960	(1)
Discouraging the Use of Tobacco	960	(1)
Prevention of Bacterial Endocarditis	960	(1)
Specific Dental and Oral Problems	961	(13)
Infants	961	(2)
Toddlers	963	(3)
Preschool and School-Age Children	966	(2)
Adolescent	968	(6)
Genitourinary Disorders	974	(48)
Nancy Barber Starr
Introduction	974	(1)
Standards of Care	974	(1)
Anatomy and Physiology	974	(1)
Pathopysiology and Defense Mechanisms	975	(1)
Pathopysiology	975	(1)
Defense Mechanisms	975	(1)
Assessment of the Genitourinary System	975	(4)
History	975	(1)
Physical Examination	975	(1)
Diagnostic Studies	976	(3)
Management Strategies	979	(1)
Education and Counseling	979	(1)
Medication, Diet, and Activity	980	(1)
Referral	980	(1)
Upper Genitourinary Tract Disorders	980	(16)
Renal Tubular Acidosis	980	(2)
Wilms Tumor	982	(1)
Hematuria	983	(5)
Proteinuria	988	(2)
Nephritis or Glomerulonephritis	990	(3)
Nephrotic Syndrome	993	(3)
Lower Genitourinary Tract Disorders	996	(11)
Urinary Tract Infection	996	(7)
Board ofVesicoureteral Reflux	1003	(4)
Common Genitourinary Conditions In males	1007	(15)
Hypospadias	1007	(1)
Undescended Tests---Cryptorchidism	1008	(2)
Hydrocele	1010	(1)
Spermatocele	1011	(1)
Varicocele	1012	(1)
Inguinal Hernia	1013	(1)
Testicular Masses	1014	(1)
Phimosis and Paraphimosis	1014	(2)
Scortal Trauma	1016	(1)
Testicular Torsion	1016	(1)
Epididymitis	1017	(2)
Urethiritis	1019	(3)
Gynecological Conditions	1022	(37)
Nancy Barber Starr
Introduction	1022	(1)
Standards of Care	1022	(1)
Anatomy and Physiology	1023	(1)
Pathopysiology and Defense Mechanisms	1023	(2)
Pathophysiology	1023	(2)
Defense Mechanisms	1025	(1)
Assessment of the Gynecologial System	1025	(3)
History	1025	(1)
Physical Examination	1025	(1)
Diagnostic Studies	1026	(2)
Management Strategies	1028	(1)
Anticipatory Guidance	1028	(1)
Counseling and Education	1028	(1)
Medications	1028	(1)
Specific Gynecological Problems of Children and Adolescents	1028	(31)
Labial Adhesions	1028	(1)
Menstrual Cycle Disorders	1029	(1)
Mittleschmerz	1029	(3)
Dysmenorrhea	1032	(1)
Endometriosis	1033	(2)
Dysfnctional Uterine Bleeding	1035	(2)
Amenorrhea	1037	(4)
Vulvovaginitis and Vaginal Discharge	1041	(6)
Sexually Transmitted Diseases	1047	(12)
Dermatological Diseases	1059	(75)
Nancy Barber Starr
Introduction	1059	(1)
Skin Development	1059	(1)
Anatomy and Physiology	1059	(2)
Dermatological Considerations in Children with Dark Skin or from Diverse Cultural or Ethnbic Groups	1061	(1)
Cutaneous Reaction Patterns	1061	(1)
Normal Variations and Common Problems	1061	(1)
Cultural or Ethnic Practices	1062	(1)
Pathopysiology and Defense Mechanisms	1062	(1)
Assessment of the SDkin and Subcutaneous Tissue	1062	(3)
History	1062	(1)
Physical Examination	1063	(1)
Diagnostic Studies	1063	(2)
Management Strategies	1065	(5)
Hydration and Lubrication	1065	(2)
Medications	1067	(3)
Counseling and Anticipatory Guidance	1070	(1)
Bacterial Infections of the Skin and Subcutaneous Tissue	1070	(5)
Impetigo	1070	(2)
Cellulitis	1072	(2)
Folliculitis and Furuncle	1074	(1)
Fungal Infections of the Skin	1075	(8)
Candidiasis	1075	(2)
Tinea Capitis	1077	(1)
Tinea Corporis	1077	(3)
Tinea Cruris	1080	(1)
Tinea Pedis	1081	(1)
Tinea Versicolor	1082	(1)
Viral Infections of the Skin	1083	(6)
Herpes Simplex	1083	(2)
Herpes Zoster	1085	(1)
Molluscum Contagiosum	1086	(2)
Warts	1088	(1)
Infestrations of the Skin	1089	(7)
Pediculosis	1089	(5)
Scabies	1094	(2)
Allergic and Inflammatory Reactions of the Skin	1096	(14)
Acne	1096	(4)
Atopic Dermatitis	1100	(1)
Contact Dermatitis	1100	(1)
Diaper Dermatitis	1101	(3)
Seborrhea	1104	(1)
Sunburn	1105	(2)
Drug Eruptions	1107	(3)
Vascular Reactions of the Skin	1110	(4)
Urticaria	1110	(2)
Erythema Multiforme	1112	(2)
Papulosquamous Eruptions of the Skin	1114	(3)
Pityriasis Rosea	1114	(1)
Psoriasis	1115	(2)
Congenital lesions of the Skin	1117	(4)
Vascular and Pigmented nevi	1117	(3)
Vitiligo and Hypopigmentation	1120	(1)
Hair and Nail Disorders	1121	(6)
Tinea Capitis	1121	(2)
Traumatic Alopecia	1123	(1)
Alopecia Areata	1124	(1)
Onychomycosis	1125	(2)
Paroncyhia	1127	(1)
Body Art	1127	(7)
Tattoos and Body Piercing	1127	(7)
Musculoskeletal Disorders	1134	(38)
Catherine E. Burns
Margaret A. Brady
Introduction	1134	(1)
Anatomy and Physiology	1134	(1)
Pathopysiology and Defense Mechanisms	1135	(3)
Pathophysiology	1135	(1)
Defense Mechanisms	1136	(2)
Assessment of the Orthopedic System	1138	(2)
History	138	(1000)
Physical Examination	1138	(2)
Special Examinations	1140	(2)
Hip Examinations	1140	(2)
Back Examination	1142	(1)
Diagnostic Studies	1142	(1)
Management Strategies	1143	(2)
Counseling	143	(1001)
Exercise	1144	(1)
Anticpatory Guidance: Musculoskeletal Development	1144	(1)
Shoes	1144	(1)
Care of Children in Casts	1144	(1)
Splints and Braces	1144	(1)
Genetics Counseling	1144	(1)
Physical Therapy	1144	(1)
Specific Orthopedic Problems of Children	1145	(20)
Brachial Plexus Injuries	1145	(1)
Clavicle Fracture	1146	(1)
Rib Probles---Costochondritis	1146	(1)
back Problems	1147	(3)
Hip Problems	1150	(8)
Knee Prolems	1158	(4)
Foot Problems	1162	(3)
Other Common Musculoskeletal System Findings Needing Attention	1165	(7)
Toe-Walking	1165	(1)
Growing Pains or Leg Aches of Childhood	1166	(1)
Limps	1166	(1)
Overuse Syndromes of Childhood and Adolescence	1167	(1)
Muscle Diseases	1167	(5)
Perinatal Conditions	1172	(58)
Deborab K. Parks
Diane F. Montgomery
Robert J. Yetman
Introduction	1172	(1)
Standards of Care	1172	(1)
Anatomy and Physiology	1173	(1)
Intrauterine-to-Extrauterine Transition	1173	(1)
Pathopysiology	1174	(1)
High-Risk Pregnancy	1174	(1)
Acquired Health problems	1174	(1)
Genetic Problems	1174	(1)
Pernatal Compolications and Injuries	1174	(1)
Assessment of the Neonate	1174	(11)
History	1174	(2)
Physical Examinations	1176	(2)
Diagnostic Studies	1178	(7)
Management Strategies	1185	(3)
Initial Care	1185	(1)
Establishing Feeding	1185	(1)
Anticipaytory Guidance Prior to Discharge	1185	(2)
Early Discharge and Follow-up	1187	(1)
Premature Infants and Newborns with Special Needs	1188	(1)
Common Neonatal Conditions	1188	(37)
Skin Conditions	1188	(4)
Head, Face, and Eye Conditions	1192	(2)
Cardiac Conditions	1194	(1)
Respiratory Conditions	1194	(1)
Gastrointestinal and Abdominal Conditions	1194	(8)
Renal Conditions	1202	(3)
Endocrine conditions	1205	(1)
Methopedic Conditions	1205	(2)
Orthopedic Conditions	1207	(1)
Central Nervous System Conditions	1207	(2)
Hematological Conditions	1209	(7)
Infections f the Newborn	1216	(5)
Sexually Transmitted diseases	1221	(3)
Drug-Exposed Infants	1224	(1)
Sudden Infant Death Syndrome	1225	(5)
Common Injuries	1230	(30)
Margaret A. Brady
Introduction	1230	(1)
Common Pediatric Injuries	1231	(29)
Trauma to the Skin and Soft Tissues	1231	(14)
Bites	1245	(7)
Head Injuries	1252	(2)
Heat and Cold Injuries	1254	(6)
Gentic Disorders	1260	(23)
Catherine E. Burns
Introduction	1260	(1)
Review of Genetics	1260	(1)
Assessment	1261	(6)
Risk Factors	1261	(1)
History	1262	(1)
Physical Examination	1262	(3)
Developmental Assessment	1265	(1)
Laboratory Studies	1265	(2)
Genetic Disorders	1267	(8)
Chromosomal Disorders	1267	(4)
Single-Gene Defects	1271	(3)
Multifactorial Problems	1274	(1)
Nontraditional Inheritance Patterns	1274	(1)
Teratogens	1275	(1)
Genetics and Cancer	1275	(1)
Management	1275	(8)
Penatal Screening	1275	(1)
Newborn Geneticvs Screening	1276	(1)
Genetic Disorder Diagnosis	1277	(1)
Genetics Counseling	1277	(1)
Primary healoth Care of Children With Genetic Disorders	1278	(5)
Environmental health Issues	1283	(27)
Ardys M. Dunn
Catherine E. Burns
Introduction	1283	(4)
Implications for Nurse Practitioners	1287	(1)
Relationship between Environmental Factors and Human Health	1287	(4)
Epidemiological Model: Risk Assessment	1287	(1)
Toxicological Principles	1288	(1)
Assessment	1289	(1)
Management of Environmental Conditions	1289	(2)
Prevention and Patient Education	1291	(1)
Common Environmental Agents and Adverse Effects	1291	(15)
General pediatric Poisoning	1291	(2)
Lead Poisoning	1293	(4)
Mercury	1297	(1)
Air Pollution: Indoor and Outdoor	1298	(3)
Airborne Contaminants	1301	(2)
Pesticides	1303	(2)
Polychlorinated Biphenyls	1305	(1)
Getting Information about Toxicants	1306	(2)
Reporting Requirements	1308	(2)
Complementary Medicine	1310	(43)
Catherine Blosser
Introduction	1310	(5)
History of complementary Medical Practices	1315	(1)
Scientific Observation and Complementary Medicine	1316	(1)
The Use of Complementary Practices in the United States	1317	(1)
The Attraction of Complementary Medical Practices	1318	(1)
The Role of Nurse Practitioners	1318	(1)
Talking with Patients	1319	(1)
Safety and Regulatory Issues	1319	(2)
Using Complementary Therapies with Children	1321	(2)
The Role of Allergies as Viewed by Complementary Medicine Practitioners	1322	(1)
Specific Complementary Treatments for Children and Adolescents	1323	(30)
APPENDIX A Medications	1353	(56)
Mealnie A. Canady
APPENDIX B Growth Grids	1409	(18)
Ardys M. Dunn
APPENDIX C Normal Laboratory Values	1427	(10)
Steven Godstein
Catherine E. Burns
APPENDIX D Healthy People 2010 Objectives: Draft for Public Comment	1437	(10)
Child and Adolescent Focused Objectives	1437	(1)
Healthy People 2010 Goals	1437	(1)
Healthy People 2010 Objectives	1437	(10)
Physical Activity and Fitness	1437	(1)
Nutrition	1438	(1)
Tobacco Use	1438	(1)
Education and Community-Based Programs	1439	(1)
Environmental health	1439	(1)
Food Safety	1440	(1)
Injury/Violence Prevention	1440	(1)
Oral Health	1440	(1)
Access to Quality Health Services	1441	(1)
Family Planning	1441	(1)
Maternal, Infant, and Child Care	1442	(1)
Arthritis, Osteoporosis, and Chronic Back Conditions	1443	(1)
Cancer	1443	(1)
Human Immunodeficiency Virus Infection	1443	(1)
Immuniation and Infectious Diseases	1443	(1)
Mental health and Mental Disorders	1444	(1)
Respiratory Diseases	1444	(1)
Sexually Transmitted Diseases	1445	(1)
Substance Abuse	1445	(2)
Index	1447