1. The School-Age Child With a Major Illness
Chapter 23

2. Neurologic Disorders: Seizures
Convulsive disorders
Common in children; result from a variety of causes
Partial seizures
Simple partial
Complex partial seizures–psychomotor seizures

3. Generalized Seizures Tonic–clonic (formerly grand mal)
Absence (formerly petit mal)
Atonic or akinetic (formerly “drop attacks”)
Myoclonic
Infantile spasms

4. 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. Diagnostics Related to Seizures
EEG
Skull radiography
CT or MRI
Brain scan
Physical and neurologic assessments

6. Treatment of Seizures Main goal is complete control of seizures
Anticonvulsant therapy
Surgical intervention
Ketogenic diets

7. 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. Respiratory Disorders: Allergic Rhinitis
Hay fever
Clinical manifestations
Treatment and nursing care

9. Respiratory Disorders: Asthma
Clinical manifestations
Diagnosis
Pharmacologic treatment (bronchodilators, corticosteroids, leukotriene inhibitors, mast cell stabilizers)
Chest physiotherapy

10. Nursing Process: Asthma
Assessment
Nursing diagnoses
Outcome identification and planning

11. Nursing Process: Asthma (cont.)
Implementation
Monitor respiratory function and fluid intake
Promoting energy conservation
Reducing child and parent anxiety
Family teaching
Evaluation

12. 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. Clinical Manifestations of Rheumatic Fever
Carditis
Polyarthritis
Chorea

14. Rheumatic Fever
Diagnosis
Treatment
Prevention

15. Nursing Process: Rheumatic Fever
Assessment
Nursing diagnoses
Outcome identification/planning

16. 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. Major and Minor Manifestations of Rheumatic Fever

18. Gastrointestinal Disorders and Nursing Process
Appendicitis
Intestinal parasites
Enterobiasis (pinworm infection)
Roundworms
Hookworms
Giardiasis

19. 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. Type 1 Diabetes Mellitus
Pathogenesis
Clinical manifestations
Diabetic ketoacidosis
Diagnosis

21. Treatment of Type 1 Diabetes in Children
Insulin therapy
Insulin reaction
Insulin regimen
Insulin administration methods

22. Nursing Process: Type 1 Diabetes Mellitus
Assessment
Nursing diagnoses
Outcome identification and planning
Implementation
Evaluation

23. Type 2 Diabetes Mellitus
Clinical manifestations
Diagnosis
Treatment
Nursing care

24. Genitourinary Disorders and Nursing Process
Enuresis
Encopresis

25. Musculoskeletal Disorders and Nursing Process
Fractures
Cast
Compartment syndrome
Traction (skin, skeletal)
External fixation devices
Crutches

26. Musculoskeletal Disorders and Nursing Process (cont.)
Osteomyelitis
Muscular dystrophy
Legg-Calvé-Perthes disease (coxa plana)
Osteosarcoma
Ewing’s sarcoma

27. Musculoskeletal Disorders and Nursing Process (cont.)
Juvenile rheumatoid arthritis
Scoliosis

28. Integumentary Disorders and Nursing Process
Fungal infections
Tinea capitus (ringworm of the scalp)
Tinea corporis (ringworm of the body)
Tinea pedis
Tinea cruris

29. Integumentary Disorders and Nursing Process (cont.)
Parasitic infections
Pediculosis
Scabies
Allergic disorders
Skin allergies
Plant allergies

30. Integumentary Disorders and Nursing Process (cont.)
Bites
Spider
Tick
Snake

31. Psychosocial Disorders and Nursing Process
Attention deficit hyperactivity disorder
School phobia