Mosby's Pocket Guide to Pediatric Assessment PDF
Preview Mosby's Pocket Guide to Pediatric Assessment
Mosby’s POCKET GUIDE TO Pediatric Assessment Joyce K. Engel, RN, MEd, PhD Dean of Students Medicine Hat College Medicine Hat, Alberta, Canada Fifth Edition with 100 illustrations 11830 Westline Industrial Drive St. Louis, Missouri 63146 MOSBY’S POCKET GUIDE TO PEDIATRIC ISBN-13: 978-0-323-04412-7 ASSESSMENT, FIFTH EDITION ISBN-10: 0-323-04412-3 Copyright ©2006 by Mosby, Inc., an affiliate of Elsevier, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, record- ing, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’s Health Sciences Rights Department in Philadelphia, PA, USA: phone: (+1) 215 239 3804, fax: (+1) 215 239 3805, e-mail: [email protected]. You may also complete your request on-line via the Elsevier homepage (http://www.elsevier.com), by selecting ‘Customer Support’and then ‘Obtaining Permissions.’ Notice Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manu- facturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience and knowl- edge of the patient, to make diagnoses, to determine dosages and the best treat- ment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Author assumes any liability for any injury and/or damage to persons or property arising out or related to any use of the material contained in this book. The Publisher Previous editions copyrighted 2002, 1997, 1993, 1989 ISBN-13: 978-0-323-04412-7 ISBN-10: 0-323-04412-3 Acquisitions Editor: Catherine Jackson Managing Editor: Michele D. Hayden Publishing Services Manager:John Rogers Senior Project Manager: Cheryl A. Abbott Senior Design Manager: Bill Drone Printed in the United States of America Last digit is the print number: 9 8 7 6 5 4 3 2 1 Reviewers Sherry D. Ferki, RN, MSN Adjunct Faculty Old Dominion University School of Nursing; Adjunct Faculty College of the Albemarle Portsmouth, Virginia Mary Ann McClellan, ARNP, CPNP, MN, CFLE Assistant Professor University of Oklahoma College of Nursing Oklahoma City, Oklahoma The author would also like to acknowledge consultants and reviewers who participated in previous editions of this book: Barbara W. Berg, RN, PNP, MN Head Nurse Rose Children’s Center at Rose Medical Center Denver, Colorado Dena K. Cuyjet, RN, MS, CPNP Pediatric Nurse Practitioner Newborn Discharge Coordinator Kaiser Permanente San Francisco San Francisco, California Terry Fugate, RN, BSN Formerly Adjunct and Associate Faculty Texas Tech University, Health Sciences Center Lubbock, Texas iii iv Reviewers Sarah G. Fuller, RN, CPNP, PhD Associate Professor College of Nursing, University of South Carolina Columbia, South Carolina Sandra L. Gardner, RN, MS, PNP Director Professional Outreach Consultation Aurora, Colorado Marilyn B. Hartsell, RN, MSN Coordinator Tri-Regional Education and Networking Development System University of Delaware Newark, Delaware Karen Halvorson, RN, MN Chief Patient Care Officer Highline Medical Center Seattle, Washington Christina Bergh Jackson, RN, CPNP, MSN Pediatric Nurse Practitioner Pennsylvania School of the Deaf Philadelphia, Pennsylvania; Instructor Eastern College St. Davids, Pennsylvania Carol A. Kilmon, RN, MSN, PhD, CPNP Assistant Professor The University of Texas Medical Branch Galveston, Texas Reviewers v Catherine F. Noonan, RN, MS, CPNP Nurse Practitioner Children’s Hospital; Assistant Professor Nurse Education Department, Bunker Hill Community College Boston, Massachusetts Mary Ann Norton, RNC, PhD, CPNP Associate Professor North Michigan University Marquette, Michigan Margaret C. Slota, RN, MN Pediatrics Consultant Pittsburgh, Pennsylvania Janet F. Sullivan, RN,C, PhD Clinical Associate Professor Parent Child Health Nursing State of New York Health Sciences Center Stony Brook, New York This page intentionally left blank Preface As in previous editions, the goal of Mosby’s Pocket Guide to Pediatric Assessment is to present the complexities of assessing the health of children within a portable, usable, accessible, and practical format. The emphasis of the pocket guide on children 1 month to late adolescence assumes the influences of families, culture, genetics, and of the prenatal and neonatal periods. Organization and Approach This edition continues to set about the physical assessment of chil- dren through a systematic, body systems approach. This approach is replicated in the family assessment model, which strongly reflects its foundations in systems. The presentation of approaches to the home environment, culture, communication, development, abuse, and psychosocial and mental health places assessment of the child within a broader and holistic framework related to the health of children and families. Sections on assessment methodologies and findings are usually preceded by discussion of developmental vari- ations that assist in rooting the process of assessment within the context of the child. Clinical alerts draw the attention of beginning and advanced nurses to significant findings and/or deviations from normal that might commonly be found in pediatric clients. Nursing diagnoses complete the assessment. The New Edition Since the fourth edition was written, we have been confronted with global concern about diseases such as SARS and avian flu. These infectious diseases, along with West Nile virus, while perhaps less devastating among children than adults, reflect the global chal- lenges that infections present for the young. Infections, suicide, and unintentional injuries represent leading causes of death among children and adolescents. In recognition of this, the fifth edition provides up-to-date information and assessments associated with vii viii Preface the new viral infections and with athletic and head injuries. It also offers a new chapter on assessment of mental health in children and adolescents, as well as incorporation of mental health findings throughout the text, including those associated with eating disorders. Nearly every chapter includes revised or new content. Expanded assessment material on the common childhood symptoms of fever, vomiting, and diarrhea has been incorporated into charts, similar to those included in earlier editions on cough, headaches, and abdom- inal pain, with the goal of providing nurses with information that is quickly available in these areas that often crop up in everyday practice with children. Continued Journeys The expansion of knowledge and the causes of illness are reminders that health is dynamic and complex, just as are families and children. It is my hope that Mosby’s Pocket Guide to Pediatric Assessment will provide a concise, practical guide to assist in making sound decisions that will in turn help families and children toward making sense of their experience and toward positive coping. Joyce Engel Contents UNIT I HEALTH HISTORY 1 Beginning the Assessment, 3 Guidelines for Communicating with Children, 3 Communicating with Infants, 4 Communicating with Toddlers, 5 Communicating with Preschool-Age Children, 6 Communicating with School-Age Children, 6 Communicating with Adolescents, 7 Communicating with Parents, 7 Communicating with Parents and Children from Diverse Cultures, 8 Establishing a Setting for the Health History, 9 2 Dimensions of a History, 32 Guidelines for Interviewing Parents and Children, 32 Information for Comprehensive History, 34 3 Family Assessment, 44 Rationale, 44 General Concepts Related to Assessment, 44 Stages in Family Development, 46 Tasks and Characteristics of Stepfamilies, 47 Guidelines for Communicating with Families, 47 Assessment of the Family, 48 Related Nursing Diagnoses, 56 4 Home Visits and Assessments, 58 Making Home Visits, 58 Making the Initial Visit, 59 Assessment of the Home Environment, 59 Related Nursing Diagnoses, 61 ix
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