Nursing evolution Pediatrics
Clinical was online simulation scenarios using swift-river
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Get Help Now!Nursing Evolution
Due No Due Date Points 10 Submitting a text entry box or a file upload
NURS_307 – Nursing Evolution Rubric
Start Assignment
Each student is required to complete and turn in the evolution of the course prior to sitting for the final exam. This is a portfolio requirement that
must be completed at the end of each course. You will not be allowed to sit for the final without having completed the evolution for this course.
Total Points: 10
Criteria Ratings Pts
3.3 pts
3.4 pts
3.3 pts
Reflects on current
theory and clinical
class with concepts
and theories using
the Program
Learning Outcomes
and BSN Essentials
listed in the syllabus
3.3 pts
Meets Expectations
- Reflects on current theory class and
clinical and how courses support each
other (transfer of knowledge to apply to
clinical)- Focused to Current Term. 2.
Synthesizes theories and concepts from
liberal education to build an understanding
of the human experience. 3. Uses skills of
inquiry and analysis to address practice
issues 4. Applies knowledge of social and
cultural factors in the care of populations
encountered in this course.
2.51 pts
Approaches Expectations
- Limited reflection on current theory class
and clinical and how courses support each
other (transfer of knowledge to apply to
clinical)- Focused to Current Term. 2. Limited
synthesis of theories and concepts from
liberal education to build an understanding of
the human experience 3. Use limited skills of
inquiry and analysis to address practice
issues 4. Applies limited knowledge of social
and cultural factors in the care of populations
encountered in this course.
1.65 pts
Does Not Meet Expectations
1.No reflection on current theory class
and clinical and how courses support
each other 2. Does not synthesize
theories and concepts from liberal
education to build an understanding of
the human experience 3. Does not
use skills of inquiry and analysis to
address practice issues 4. Does not
apply knowledge of social and cultural
factors in the care of populations
encountered in this course.
Develops an
effective
communication
style for interacting
with current
patients, families,
and the
interdisciplinary
health team when
providing holistic,
patient centered
nursing care to
populations
encountered in this
course.
3.4 pts
Meets Expectations
- Reflects on providing holistic patient care to populations
encountered in this course. 2. Describes inter-collaborative
involvement (i.e. Interprofessional rounds; consultations and
interaction with PT/OT; Respiratory Therapy, Pharmacist
consultation—describe their role/ contribution.)
2.58 pts
Approaches Expectations
- A limited reflection on
providing holistic patient care to
populations encountered in this
course. 2. Describes limited
inter-collaborative involvement
1.7 pts
Does Not Meet Expectations
- No reflection on providing
holistic patient care to
populations encountered in this
course. 2. Does not describes
inter-collaborative involvement
Models leadership
when providing
safe, quality nursing
care; coordinating
the healthcare
team; and when
tasked with
oversight and
accountability for
care delivery.
3.3 pts
Meets Expectations
- Describe an event that demonstrates: •
application of leadership concepts, skills
and decision making in the provision of
high quality nursing care, • healthcare
team coordination • the oversight and
accountability for care delivery 2. Describe
an event that demonstrates leadership,
appropriate teambuilding and collaborative
strategies to effectively implement patient
safety and quality improvement initiatives
within the context of the interprofessional
team
2.51 pts
Approaches Expectations
- Describes limited leadership
concepts, skills and decision making in
the provision of high quality nursing
care, healthcare team coordination and
the oversight and accountability for care
delivery 2. Limited description of an
event that demonstrates leadership,
appropriate teambuilding and
collaborative strategies to effectively
implement patient safety and quality
improvement initiatives within the
context of the interprofessional team
1.65 pts
Does Not Meet Expectations
- Gives no examples of leadership
concepts, skills and decision making in the
provision of high quality nursing care,
healthcare team coordination and the
oversight and accountability for care
delivery in a variety of settings 2. Does not
describe an event that demonstrates
leadership, appropriate teambuilding and
collaborative strategies to effectively
implement patient safety and quality
improvement initiatives within the context
of the interprofessional team
xxvii
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Brief Contents
1 Nurse’s Role in Care of the Child: Hospital,
Community, and Home 1
2 Family-Centered Care and Cultural Considerations 17
3 Genetic and Genomic Influences 45
4 Growth and Development 66
5 Pediatric Assessment 98
6 Introduction to Health Promotion and
Maintenance 144
7 Health Promotion and Maintenance for the Newborn
and Infant 154
8 Health Promotion and Maintenance for the Toddler
and Preschooler 166
9 Health Promotion and Maintenance for the
School-Age Child and Adolescent 182
10 Nursing Considerations for the Child in the
Community 207
11 Nursing Considerations for the Hospitalized
Child 222
12 The Child With a Chronic Condition 246
13 The Child With a Life-Threatening Condition
and End-of-Life Care 260
14 Infant, Child, and Adolescent Nutrition 281
15 Pain Assessment and Management in Children 310
16 Immunizations and Communicable Diseases 333
17 Social and Environmental Influences on the Child 367
18 Alterations in Fluid, Electrolyte, and Acid–Base
Balance 404
19 Alterations in Eye, Ear, Nose, and Throat
Function 440
20 Alterations in Respiratory Function 474
21 Alterations in Cardiovascular Function 518
22 Alterations in Immune Function 563
23 Alterations in Hematologic Function 589
24 The Child With Cancer 610
25 Alterations in Gastrointestinal Function 655
26 Alterations in Genitourinary Function 701
27 Alterations in Neurologic Function 739
28 Alterations in Mental Health and Cognitive
Function 790
29 Alterations in Musculoskeletal Function 821
30 Alterations in Endocrine Function 861
31 Alterations in Skin Integrity 900
Appendix A Physical Growth Charts 942
Appendix B Blood Pressure Tables 952
Appendix C Dietary Reference Intakes 954
Appendix D Selected Pediatric Laboratory Values 956
Appendix E Diagnostic Tests and Procedures 959
Appendix F Body Surface Area Nomogram 964
Appendix G Conversions and Equivalents 965
Glossary 966
Index 978
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Principles of Pediatric
Nursing
Caring for Children
Seventh Edition
Jane W. Ball, RN, CPNP, DrPH
Consultant, Trauma System Development, Gaithersburg, Maryland
Ruth C. Bindler, RNC, PhD
Professor Emeritus, Washington State University College of Nursing, Spokane, Washington
Kay J. Cowen, RN-BC, MSN, CNE
Clinical Professor, University of North Carolina at Greensboro School of Nursing, Greensboro, North Carolina
Michele R. Shaw, RN, PhD
Associate Professor, Washington State University College of Nursing, Spokane, Washington
330 Hudson Street, NY NY 10013
$��B%$//����B��B6(B)0�LQGG���� �������������������DP
ISBN-13: 978-0-13-425701-3
ISBN-10: 0-13-425701-4
Publisher: Julie Levin Alexander
Editorial Coordinator: Sarah Henrich
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Cover Credit: A Day In May, painting used
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Printer/Binder: Courier Kendalville
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Notice: Care has been taken to confirm the accuracy of information presented in this book. The authors, edi-
tors, and the publisher, however, cannot accept any responsibility for errors or omissions or for consequences
from application of the information in this book and make no warranty, express or implied, with respect to its
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The authors and publisher have exerted every effort to ensure that drug selections and dosages set forth in this
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Many of the designations by manufacturers and seller to distinguish their products are claimed as trademarks.
Where those designations appear in this book, and the publisher was aware of a trademark claim, the designa-
tions have been printed in initial caps or all caps.
A note about nursing diagnoses: Nursing diagnoses in this text are taken from Nursing Diagnoses—Definitions
and Classification 2015–2017. Copyright © 2014, 1994–2012 by NANDA International. Used by arrangement with
John Wiley & Sons Limited. 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 this work.
Library of Congress Cataloging-in-Publication Data
Names: Ball, Jane (Jane W.), author. | Bindler, Ruth McGillis, author. |
Cowen, Kay J., author. | Shaw, Michele R., author.
Title: Principles of pediatric nursing: caring for children / Jane W. Ball,
Ruth C. Bindler, Kay J. Cowen, Michele R. Shaw.
Description: Seventh edition. | Hoboken, NJ : Pearson Education, [2017] |
Includes bibliographical references and index.
Identifiers: LCCN 2016035091| ISBN 9780134257013 | ISBN 0134257014
Subjects: | MESH: Pediatric Nursing | Nursing Assessment–methods | Child |
Infant
Classification: LCC RJ245 | NLM WY 159 | DDC 618.92/00231—dc23 LC
record available at https://lccn.loc.gov/2016035091
2014017177
10 9 8 7 6 5 4 3 2 1
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iii
We dedicate this book to:
š� Our families who are ever supportive and understanding about our passion for children
and writing,
š� Our mentors, colleagues, and students who inspire us to apply our knowledge and
challenge our thinking,
š� The children, adolescents, and families with whom we work and who foster our
philosophy of pediatric nursing.
Dedication
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About the Authors
JANE W. BALL graduated from the
Johns Hopkins Hospital School of
Nursing and subsequently received a
BS from the Johns Hopkins University.
She began her nursing career work-
ing in the pediatric surgical inpatient,
emergency department, and outpa-
tient clinic of the Johns Hopkins Medi-
cal Center, first as a staff nurse and
then as a pediatric nurse practitioner.
After recognizing a need to focus on the health of children, she
returned to school and obtained both a master ’s degree of pub-
lic health and a doctorate of public health degree from the Johns
Hopkins University Bloomberg School of Public Health with a
focus on maternal and child health. After graduation, Dr. Ball
became the chief of child health services for the Commonwealth
of Pennsylvania Department of Health. In this capacity she
oversaw the state-funded well-child clinics and explored ways
to improve education for the state’s community health nurses.
After relocating to Texas, she joined the faculty at the Univer-
sity of Texas at Arlington School of Nursing to teach community
pediatrics to registered nurses returning to school for a BSN.
During this time Dr. Ball became involved in writing her first
textbook, Mosby’s Guide to Physical Examination, which is cur-
rently in its eighth edition. After relocating to the Washington,
DC, area, she worked at Children’s National Medical Center on
a number of federally funded projects. The first project in 1986,
teaching instructors of emergency medical technicians from all
states about the special care children need during an emergency,
revealed the shortcomings of the emergency medical services
system for children. This exposure was a career-changing event.
A textbook titled Pediatric Emergencies: A Manual for Prehospital
Providers was subsequently developed. A second project led to
the development of a pediatric emergency education program
for nurses in emergency departments to promote improved care
for children. Both of these programs served as a foundation for
other pediatric emergency education developed and sponsored
by national organizations. For 15 years Dr. Ball managed the
federally funded Emergency Medical Services for Children’s
National Resource Center. As executive director, she provided
and directed the provision of consultation and resource devel-
opment for state health agencies, health professionals, families,
and advocates about successful methods to improve the health-
care system so that children get optimal emergency care in all
healthcare settings. After leaving that position, she continues
to be engaged in many projects with a focus on the emergency
care system. She is a consultant to the American College of Sur-
geons Committee on Trauma, supporting state trauma system
development. She recently completed a federally funded project
to study whether the implementation of a statewide pediatric
emergency department recognition program improved pediat-
ric emergency care. In 2010, Dr. Ball received the Distinguished
Alumna Award from the Johns Hopkins University.
RUTH C. MCGILLIS BINDLER re-
ceived her BSN from Cornell Uni-
versity—New York Hospital School
of Nursing. She worked in oncology
nursing at Memorial-Sloan Ketter-
ing Cancer Center in New York, and
then as a public health nurse in Dane
County, Wisconsin. Thus began her
commitment to work with children as
she visited children and their families
at home and served as a school nurse. Due to this interest in
child healthcare needs, she earned her MS in child development
from the University of Wisconsin. A move to Washington State
was accompanied by a new job as a faculty member at the Inter-
collegiate Center for Nursing Education in Spokane. Dr. Bindler
was fortunate to be involved for over 38 years in the growth
of this nursing education consortium, which is a combination
of public and private universities and colleges and is now the
Washington State University (WSU) College of Nursing. She
obtained a PhD in human nutrition at WSU, where she taught
theory and clinical courses in child health nursing, cultural di-
versity and health, graduate research, pharmacology, and as-
sessment, and served as lead faculty for child health nursing. Dr.
Bindler was the first director of the PhD in Nursing program at
WSU and most recently served as Associate Dean for Graduate
Programs, which include Master of Nursing, Post-Masters cer-
tificates, PhD, and Doctor of Nursing Practice (DNP) programs.
She recently retired and serves the college and profession as a
professor emeritus, continuing work with graduate students
and research. Her first professional book, Pediatric Medications,
was published in 1981, and she has continued to publish articles
and books in the areas of pediatric medications and pediatric
health. Research foci have been childhood obesity, type 2 dia-
betes, metabolic syndrome, and cardiometabolic risk factors in
children. Ethnic diversity and interprofessional collaboration
have been additional themes in her work. Dr. Bindler believes
that her role as a faculty member and administrator enabled
her to learn continually, foster the development of students in
nursing, lead and mentor junior faculty into the teaching role,
and participate fully in the profession of nursing. In addition
to teaching, research, publication, and leadership, she enhances
her life by professional and community service and by activities
with her family.
v
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vi About the Authors
KAY J. COWEN received her BSN from
East Carolina University in Greenville,
North Carolina, and began her career
as a staff nurse on the pediatric unit
of North Carolina Baptist Hospital in
Winston-Salem. She developed a spe-
cial interest in the psychosocial needs
of hospitalized children and preparing
them for hospitalization. This led to
the focus of her master ’s thesis at the
University of North Carolina at Greensboro (UNCG), where she
received a master of science in nursing education degree with a
focus in maternal child nursing.
Mrs. Cowen began her teaching career in 1984 at UNCG,
where she continues today as clinical professor in the Parent
Child Department. Her primary responsibilities include coor-
dinating the pediatric nursing course, teaching classroom con-
tent, and supervising a clinical group of students. Mrs. Cowen
shared her passion for the psychosocial care of children and the
needs of their families through her first experience as an au-
thor in the chapter “Hospital Care for Children” in Jackson and
Saunders’ Child Health Nursing: A Comprehensive Approach to the
Care of Children and Their Families published in 1993.
In the classroom, Mrs. Cowen realized that students learn
through a variety of teaching strategies and became especially
interested in the strategy of gaming. She led a research study to
evaluate the effectiveness of gaming in the classroom and sub-
sequently continues to incorporate gaming in her teaching. In
the clinical setting, Mrs. Cowen teaches her students the skills
needed to care for patients and the importance of family-cen-
tered care, focusing not only on the physical needs of the child
but also on the psychosocial needs of the child and family. Dur-
ing her teaching career, Mrs. Cowen has continued to work part
time as a staff nurse, first on the pediatric unit of Moses Cone
Hospital in Greensboro and then at Brenner Children’s Hospital
in Winston-Salem. In 2006, she became the part-time pediatric
nurse educator in Brenner ’s Family Resource Center. Through
Mrs. Cowen’s expertise, she is able to extend her love of teach-
ing to children and families, and through her role as an author,
she is able to extend her dedication to pediatric nursing and
nursing education.
MICHELE R. SHAW received her BSN
from Pacific Lutheran University in
Tacoma, Washington. She began her
career as a nurse at a long-term care
facility and then as a home healthcare
nurse in Spokane, Washington. While
making home visits, she became in-
terested in the nursing care needs of
children and families. She realized
the importance of educating the fam-
ily about their child’s condition and to include family members
while planning and carrying out the nursing care plan. This in-
terest in family nursing led her into the area of maternal-child
nursing, where she served as a postpartum nurse for nearly 18
years. Her experience with providing nursing care to families in
various settings has highlighted her belief in the need of a fam-
ily-centered approach in order to provide optimal nursing care.
Dr. Shaw began her teaching career as a teaching assistant in
2001 at the Washington State University (WSU) College of Nurs-
ing, where she continues today as an associate professor. It was
during those early years as a teaching assistant that she began
to realize her passion for educating nursing students. This in-
terest led to her completing a master ’s degree in nursing with
an emphasis on education at WSU. Knowing that she wanted
to continue working in nursing academia, Dr. Shaw went on to
receive her PhD in nursing from the University of Arizona in
Tucson. She has taught theory, seminar, and clinical courses in
maternal-child nursing, family health, evidence-based practice,
ethical decision making, physical assessment, and professional
practice. Dr. Shaw recently assisted in the development of the
Bachelor of Science-to-PhD in Nursing program at WSU. This
fast-track program will enable students with an earned bach-
elor’s degree to complete a PhD in nursing in four years.
Dr. Shaw enjoys working with undergraduate and gradu-
ate students and encourages active participation in research.
Her research interests include children with asthma and their
families, childbearing women and their families, and substance
use among youth and childbearing women. She is particularly
interested in children’s and families’ unique perspectives, and
thus much of her research uses qualitative approaches. She con-
tinues to publish articles in the areas of pediatric asthma and
substance use among childbearing women. Dr. Shaw believes
her active role in nursing academia and research allows her
to stay current in various pedagogical approaches to enhance
nursing students’ learning experiences, as well as continuous
learning about evidence-based interventions to provide nursing
care to children and families.
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vii
Thank You!
We are forever grateful to nurse geneticist Linda D. Ward, PhD, APRN, the author of this
book’s genetics chapter, Chapter 3, “Genetic and Genomic Influences.” We appreciate her
expertise in genetic and genomic science, her superb writing skills, and her willingness
to contribute such an essential chapter to our text. We are also thankful to Brenda Senger,
RN, PhD, for contributing the content on mitochondrial diseases in Chapter 30.
We are grateful to all the nurses, both clinicians and educators, who reviewed the
manuscript of this text. Their insights, suggestions, and eye for detail helped us prepare a
more relevant, useful, and current book, reflective of the present time and of the essential
components of learning in the field of child health nursing.
Mary Armstrong, MSN, RN,
CCRN, CPN
Carson Newman University
Jefferson City, Tennessee
Elizabeth Bettini, APRN,
MSN, PCNS-BC, CHPPN
Division of Anesthesiology &
Pain Medicine
Children’s National Medical
Center
Washington, D.C.
Melissa Black, PhDc, MSN,
FNP, RN
NCLEX Review Nurse
Kaplan
Greenville, South Carolina
Ann M. Bowling, PhD, RN,
CPNP-PC, CNE
Assistant Professor
Wright State University
Dayton, Ohio
Michele I. Bracken, PhD,
WHNP-BC
Associate Professor
Clinical Coordinator Ma-
ternal/Newborn/Women’s
Health
Salisbury University
Salisbury, Maryland
Robin Caldwell, RNC-OB
Instructor
Catawba Valley Community
College
Hickory, North Carolina
Karan Dublin, MEd, RN
Professor
Tyler Junior College
Tyler, Texas
Barbara S. Edwards, RN,
CPN
Staff Nurse
Brenner Children’s Hospital
Winston-Salem, North
Carolina
Linda B. Esposito, MSN, RN,
CCRN
Nurse Practice Specialist
Brenner Children’s Hospital
Wake Forest Baptist Medical
Center
Winston-Salem, North
Carolina
Julie Fitzgerald, PhD, RN,
CNE
Assistant Professor
Ramapo College of New
Jersey
Mahwah, New Jersey
Niki Fogg, MS, RN, CPN
Assistant Clinical Professor
Texas Woman’s University
Dallas, Texas
Vivienne Friday, EdD, RN
Nurse Educator
Bridgeport Hospital School of
Nursing
Bridgeport, Connecticut
Deborah Henry, MSN, RN
Nursing Faculty
Blue Ridge Community
College
Flat Rock, North Carolina
Indra Hershorin, PhD, RN,
CNE
Assistant Professor
Barry University
Miami Shores, Florida
Karen L. Hessler, PhD, FNP-C
Assistant Professor
University of Northern
Colorado
Greeley, Colorado
Catherine Hrycyk, MScN, RN
Faculty, Pediatric Nursing and
Pharmacology
De Anza College
Cupertino, California
Gina Idol, RN, BSN, CPN
Wake Forest Baptist Health
Brenner Children’s Hospital
Winston-Salem, North
Carolina
Laura Kubin, PhD, RN, CPN,
CHES
Assistant Professor
Texas Woman’s University
Dallas, Texas
Meredith Lahl, MSN, PCNS-
BC, PPCNP-BC, CPON
Senior Director of Advanced
Practice Nursing
Cleveland Clinic
Cleveland, Ohio
Robyn Leo, MS, RN
Associate Professor and
Chairperson for Nursing
Worcester State University
Worcester, Massachusetts
Angela P. Lukomski, RN,
DNP, CPNP
Associate Professor
Eastern Michigan University
Ypsilanti, Michigan
Patricia Novak, RN, BSN, MSN
Faculty
Gateway Community College
Phoenix, Arizona
Gloanna J. Peek, PhD, RN,
CPNP
Clinical Associate Professor
PNP Specialty Option
Coordinator
The University of Arizona
Tucson, Arizona
Susan Perkins, MSN, RN
Senior Instructor
Washington State University
Spokane, Washington
Linda Sue Pippin, MSN,
RN-BC
Adjunct Faculty
Newberry College
Newberry, South Carolina
Theresa Puckett, RN, CNE
Instructor
Stark State College
North Canton, Ohio
Colleen Quinn, RN, MSN,
EdD
Professor
Broward College
Davie, Florida
JoAnne Silbert-Flagg, DNP,
PNP, IBCLC
Assistant Professor
Johns Hopkins University
Baltimore, Maryland
Jennifer S. Simmons, MSN,
RN, CPNP-AC/PC, CPON
Pediatric Oncology Nurse
Practitioner
Brenner Children’s Hospital
Wake Forest Baptist Medical
Center
Winston-Salem, North
Carolina
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viii Thank You!
Anita Smith, CPNP
Nurse Practitioner
Department of Pediatric
Hematology
Wake Forest Health Sciences
Winston-Salem, North
Carolina
Charla Smith, MSN, RN,
CPN, CNE
Associate Professor
Jackson State Community
College
Jackson, Tennessee
Nancy M. Smith, DNP,
CRNP, FNP-BC
Assistant Professor
Salisbury University
Salisbury, Maryland
Maureen P. Tippen, RN, C,
MS
Clinical Assistant Professor
University of Michigan
Flint, Michigan
Teresa Tyson, RN, PhD
Assistant Professor
Winston-Salem State
University
Winston-Salem, North
Carolina
Diane K. Van Os, MS, RN
Professor
Westminster College
Salt Lake City, Utah
Amber Welborn, RN, MSN
Lecturer
University of North Carolina
Greensboro, North Carolina
Cecilia Wilson, PhD, RN,
CPN
Associate Clinical Professor
Texas Woman’s University
Dallas, Texas
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ix
Preface
Health care and healthcare delivery systems are chang-ing dramatically. The Affordable Care Act, a focus on interprofessional collaboration, an emphasis on
patient safety, and evidence-based practice will contribute to
ongoing challenges and evolution in health care in the com-
ing years. Pediatric nurses must respond to and integrate
these changes into their practice. In addition, pediatric nursing
presents its own unique challenges for practitioners of health
care. Student nurses must learn what helps them to provide
safe, effective, and excellent care today, while integrating new
knowledge and skills needed as nursing practice continues to
develop and respond to healthcare needs. Students must learn
how to think and apply information as new knowledge be-
comes available. “As the student uses knowledge in situations
of practice, new understanding is gained as well as knowing
how, when, and why it is relevant in particular situations. . . .
We call this teaching for a sense of salience.”*
Faculty are responsible for selecting patient care assign-
ments that assist the student in applying knowledge in the
clinical setting, as well as utilizing various pedagogies to assist
the student in focusing on the patient experience. We have in-
tegrated concepts from the Carnegie Report that foster clinical
expertise by offering a variety of critical thinking and
clinical reasoning questions, patient care scenarios, and re-
search and evidence-based practice features. Information tech-
nology plays a major role in both health care and teaching, and
therefore features in this text encourage the student to use and
analyze content available through information technology.
Preparation for Nursing
Excellence
The goal of this seventh edition of Principles of Pediatric Nurs-
ing is to provide core pediatric nursing knowledge that pre-
pares students for excellence in nursing and to offer the tools of
scholarship and critical thinking needed to apply this learning
in the future. Students must learn to question, evaluate the re-
search evidence available, apply pertinent information in clini-
cal settings, and constantly adapt to growing knowledge and
an evolving healthcare system.
This text reflects a multitude of approaches to learning that
can be helpful to all students. We acknowledge that many stu-
dents learn pediatric nursing in a very short time period. There-
fore, the approaches in this text are designed to assist students
to assess the child’s needs, take into account population-based
practice, and make care decisions based on the standards of pe-
diatric nursing practice.
Realities of Pediatric Nursing
Pediatric nursing occurs in many acute care and community
healthcare settings, such as hospitals, homes, schools, and
health centers. Procedures may be performed in short-stay
units, and long-term care is often provided at home for children
with complex health conditions. Families are often the provid-
ers of care as well as the case managers for these children. Tech-
nologic advances are resulting in earlier diagnoses and new
therapies; these technologic approaches are integrated when-
ever pertinent throughout the text.
Pediatric nursing care is provided within the context of a
rapidly changing society. An examination of the major morbidi-
ties and mortalities of childhood guided the revision of material
and topics throughout the text. Specific chapters focus on the
family, health promotion across the life span, pediatric nutri-
tion, and care for children with chronic conditions. Chapter 2
addresses cultural influences on health care and provides guid-
ance for students caring for children in our growing intercul-
tural society. Chapter 3, on genetics and genomics, is intended
to help students recognize the impact of such knowledge …
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