1. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins The School-Age Child With a Major Illness Chapter 23

2. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Neurologic Disorders: Seizures Convulsive disorders Common in children; result from a variety of causes Partial seizures –Simple partial –Complex partial seizures–psychomotor seizures

3. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Generalized Seizures Tonic–clonic (formerly grand mal) Absence (formerly petit mal) Atonic or akinetic (formerly “drop attacks”) Myoclonic Infantile spasms

4. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Status Epilepticus A seizure lasting longer than 30 minutes, or a series of seizures in which the child does not return to his or her previously normal level of consciousness Medical emergency

5. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Diagnostics Related to Seizures EEG Skull radiography CT or MRI Brain scan Physical and neurologic assessments

6. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Treatment of Seizures Main goal is complete control of seizures Anticonvulsant therapy Surgical intervention Ketogenic diets

7. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Care: Seizure Precautions Prevention of injury through use of padded side rails Oxygen and suction at bedside Side rails in raised position Bed in low position During a seizure, place client on side, loosen tight clothing, and document observations prior to, during, and after seizure

8. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Respiratory Disorders: Allergic Rhinitis Hay fever –Clinical manifestations –Treatment and nursing care

9. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Respiratory Disorders: Asthma Clinical manifestations Diagnosis Pharmacologic treatment (bronchodilators, corticosteroids, leukotriene inhibitors, mast cell stabilizers) Chest physiotherapy

10. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Asthma Assessment Nursing diagnoses Outcome identification and planning

11. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Asthma (cont.) Implementation –Monitor respiratory function and fluid intake –Promoting energy conservation –Reducing child and parent anxiety –Family teaching Evaluation

12. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Cardiovascular Disorders: Rheumatic Fever Primary threat to the cardiovascular system during the school-age years as a complication of rheumatic fever An autoimmune reaction to group A beta-hemolytic streptococcal infection

13. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Clinical Manifestations of Rheumatic Fever Carditis Polyarthritis Chorea

14. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Rheumatic Fever Diagnosis Treatment Prevention

15. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Rheumatic Fever Assessment Nursing diagnoses Outcome identification/planning

16. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Rheumatic Fever (cont.) Implementation –Comfort measures and reduction of pain –Diversional activities and sensory stimulation –Energy conservation –Prevention of injury –Compliance with drug therapy –Family teaching Evaluation

17. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Major and Minor Manifestations of Rheumatic Fever

18. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Gastrointestinal Disorders and Nursing Process Appendicitis Intestinal parasites –Enterobiasis (pinworm infection) –Roundworms –Hookworms –Giardiasis

19. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Endocrine Disorders and Nursing Process Type 1 diabetes mellitus: formerly insulin- dependent diabetes mellitus [IDDM] Type 2 diabetes mellitus: formerly non-insulin– dependent diabetes mellitus

20. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Type 1 Diabetes Mellitus Pathogenesis Clinical manifestations –Diabetic ketoacidosis Diagnosis

21. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Treatment of Type 1 Diabetes in Children Insulin therapy –Insulin reaction –Insulin regimen –Insulin administration methods

22. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Type 1 Diabetes Mellitus Assessment Nursing diagnoses Outcome identification and planning Implementation Evaluation

23. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Type 2 Diabetes Mellitus Clinical manifestations Diagnosis Treatment Nursing care

24. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Genitourinary Disorders and Nursing Process Enuresis Encopresis

25. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Musculoskeletal Disorders and Nursing Process Fractures –Cast –Compartment syndrome –Traction (skin, skeletal) –External fixation devices –Crutches

26. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Musculoskeletal Disorders and Nursing Process (cont.) Osteomyelitis Muscular dystrophy Legg-Calvé-Perthes disease (coxa plana) Osteosarcoma Ewing’s sarcoma

27. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Musculoskeletal Disorders and Nursing Process (cont.) Juvenile rheumatoid arthritis Scoliosis

28. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Integumentary Disorders and Nursing Process Fungal infections –Tinea capitus (ringworm of the scalp) –Tinea corporis (ringworm of the body) –Tinea pedis –Tinea cruris

29. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Integumentary Disorders and Nursing Process (cont.) Parasitic infections –Pediculosis –Scabies Allergic disorders –Skin allergies –Plant allergies

30. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Integumentary Disorders and Nursing Process (cont.) Bites –Spider –Tick –Snake

31. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Psychosocial Disorders and Nursing Process Attention deficit hyperactivity disorder School phobia