Advanced

Pediatric Nursing

Study Guide

PED402 (2019)
Bachelor of Science in Nursing and Midwifery

Department of Nursing & Midwifery

Faculty of Nursing and Public Health
Thimphu: Bhutan

January  2015,  Nursing  and  Midwifery  Department,  FoNPH   Page  1  

 
This publication was prepared, produced and published in 2015 by:

Department of Nursing and Midwifery

Faculty of Nursing of Public Health
University of Medical Sciences of Bhutan
Thimphu: Bhutan
PO Box: 298
Phone: Office: 02-321210
Web site: www.fnph.edu.bt

All rights reserved

This publication is copyright.

Apart from any fair dealing for the purpose of private study, research, criticism or review as
permitted under the Copyright Act, no part may be reproduced by any process or placed in
computer memory without written permission.
All inquiries should be made to the publisher.

Module contact person:

1. Deki Pem, Lecturer, 77111234
2. Passang Lhamo Sherpa, Sr. Lecturer, 17738156

First Revised in 2019

January  2015,  Nursing  and  Midwifery  Department,  FoNPH   Page  2  

 
Table  of  Contents  
Introduction  .........................................................................................................................................  4  
Description/Rationale  ...........................................................................................................................  4  
Learning  outcomes  ................................................................................................................................  4  
Teaching  Methods  .................................................................................................................................  4  
Assessment:  ...........................................................................................................................................  5  
Records and Documentation:  ................................................................................................................  5  
Late  Submission  .....................................................................................................................................  5  
Search  Engines  .......................................................................................................................................  5  
Assignment topics to choose  ................................................................................................................  6  
Appendix 1: Record of visits  .................................................................................................................  7  
Appendix 2: Learning guide for Pediatric Nursing Process  ..............................................................  10  
Appendix  3:  Pediatric  Nursing  Process  Marking  Guide  .......................................................................  12  
Appendix  4:  Presentation  marking  Guide  ...........................................................................................  13  
Appendix  5:  Assignment  marking  guide  .............................................................................................  14  
Appendix  10:    Assignment  Submission  Form  ......................................................................................  15  
Appendix  11:    Application  for  Extension  .............................................................................................  16  
 

January  2015,  Nursing  and  Midwifery  Department,  FoNPH   Page  3  

 
Introduction

Advanced Paediatric Nursing enhance knowledge and skills to provide comprehensive care to
children on medical and surgical conditions, critical ill children, intensive care, and children
with behavioural and social problems. It also provides knowledge on legal and ethical issues
whereby students can provide ethical and a safe care to children. This module is self-directed
learning module, which enables the students to move ahead to put effort to explore the
informatics environment, engage in group learning settings, interact with patients, and share
information.

Description/Rationale
The student will learn with self-directed method, review evidence based practice and provide
care with best practice, present the work to their peer in the classes and to the supervisors. This
will provide an opportunity for the students to enhance knowledge and skills to provide best
practice services to children with diverse problems and diseases.
Learning outcomes
• Provide comprehensive care to children with medical and surgical conditions.
• Provide intensive care to neonate and children.
• Manage the child with behavioral, mental and social problems.
• Identify the social and welfare services for challenged children.
• Provide nursing care with critically ill children and other problems.
• Provide an ethically safe care to sick newborn and children with special needs in respect to
the belief, religion and cultural diversity.
• Demonstrate competency in caring for a child at end of life care and psychosocial care for
family.

Teaching Methods
The students will:
Unit I: Choose the patient in any ward; Pediatric Ward, PICU and NICU. After a selection of
the patient, student will inform the supervisor to verify the case for case study and care plan.
Unit II: Student will choose the topic of their choice within the broad topics in the curriculum
not limited to it to enhance the knowledge and to apply during clinical placement in various
units of neonatal and pediatric care. You can correlate with the patient if you have come across
any; within your family member, neighborhood, in the hospital, etc.

January  2015,  Nursing  and  Midwifery  Department,  FoNPH   Page  4  

 
Assessment:
1. Consultation and verification of the case after the clinical observation posting: within a
week of clinical posting
2. Submission of case study (Nursing Process), (30%): a week after the selection of patient
3. Presentation (20 %): 6th – 8th April 2019
4. Class Test (20%): 21st April 2019
5. Assignment (30%) 1000 words: 30th April 2019

Records and Documentation:

The students must keep all entries confidential. Keep all information in a secure safe place.
Late Submission
An assignment submitted after the due date without an extension will incur a penalty of 5% per
working day of the total possible mark for the piece of assessment in question. Example: if the
assessment is worth 50 marks a penalty of 2.5 marks will apply for each working day late up to
3 days (a working day is defined as Mon – Fri 9.00 – 4.pm).

Assignments will not be accepted after 3 working days beyond the due date unless an
extension has been granted.

Marking guide and assignment submission form must be attached with assignment on
submission.

Failure to submit an assessment within 3 working days of the assignment due date, without
obtaining an extension, will result in a fail grade.
Obtain an extension before a week of due date.

Search Engines
Medline, Cinahl, pubmed and a number of other databases are accessible through the Hinari
and Proquest. Also don’t forget to access the library resources at your clinical site.

January  2015,  Nursing  and  Midwifery  Department,  FoNPH   Page  5  

 
Assignment topics to choose
A student can select any topic within or beyond this broad area.
1. Child development
2. Developmental care
3. Common behavioral disorders
4. Common psychiatric problems
5. Mentally, physically and socially challenged children
The case study should include any of the following topic/s.
1. Care before, during and after surgery
2. Pediatric Intensive Care Unit
3. Care of a baby on ventilator
4. Neonatal Intensive Care Unit
5. Care of a baby in incubator/radiant warmer
6. Preterm baby
7. Low birth weight baby
8. Congenital disorders
9. Severe newborn problems: congenital or acquired.
10. Palliative care
11. Phototherapy
12. Severe malnutrition

January  2015,  Nursing  and  Midwifery  Department,  FoNPH   Page  6  

 
Appendix 1: Record of visits
Records of Visits
1. Pediatric Ward
Day Date Hours Name of the staff Signature

January  2015,  Nursing  and  Midwifery  Department,  FoNPH   Page  7  

 
 2. Pediatric Intensive Care Unit

Day Date Hours Name of the staff Signature

January  2015,  Nursing  and  Midwifery  Department,  FoNPH   Page  8  

 
 3. Neonatal Intensive Care Unit
Day Date Hours Name of the staff Signature

January  2015,  Nursing  and  Midwifery  Department,  FoNPH   Page  9  

 
 Appendix 2: Learning guide for Pediatric Nursing Process
 

Learning guide for Pediatric Nursing Process

1 Greet the patient’s caregiver (parents, relatives) and explain what you are going to do.
Explain that you will be asking questions that are related to the child’s health and that you
might need to do a physical examination of the child
2 Soci-economic status of the parents should be used to relate the child’s health status and
disease process, for example the types of house and the number of people living in the
house may offer some information about direct or indirect cause of the disease/problems
3 Medical history
Chief complaints; List 1-2 main complaints in patient’s own words (if the patient cannot
talk write in the parents/ attendant own words, with duration and chronological order (the
order in which they developed).
History of present illness: relevant details of each chief complaint
• Begin by stating when the patient was last well
• Describe each symptom in chronological order with duration, whether getting
better or worse, precipitating and relieving factors, and associated symptoms
• Obtain history from relatives or friends as necessary
• Then detail other questions, which seem relevant
• Functional inquiry (by system) for other symptoms, e.g. chest pain, appetite, etc.
• Brief summary in notes.
History of past illness; Ask the caregiver if the child has any past history of illness/injury
and treatment. (Write in chronological order). Any history of allergy, hereditary disease,
or contagious diseases? This is to help you develop a relationship with the present illness
and allow provide appropriate health education towards the end. Mention only if it is
significant
Family history; Ask the caregiver if there is a history of any familial illness. Mention
only if it is significant.
Birth history: Get a history of antenatal (antenatal attendance, maternal health) , natal
(events at birth) , postnatal (events after delivery for both mother and infant), and neonatal
history
Immunization history; All history of immunization (BCG, Polio, DPT, measles and
others )
Feeding history; feeding at birth, exclusive breast feeding, history of formula feeding if
any, time and type of complementary food, current food habit.

Treatment history – history of any previous treatment revived

4 Physical examination: get permission from the caregiver and the patient to examine the
patient. Warm your hand by rubbing gently, do all procedure without distressing the
patient (vitals may be taken first followed by other procedure. Keep the anthropometry
measurement towards the end of physical examination to reduce stress to the patient). OFC
is measured only on clients less than 2 years old. Use WHO card to determine Z score. If
the child has any congenital anomaly such as down syndrome mention the classical signs
in the physical examination such as low set ears, short fingers, etc..
5 Systemic examination: Handle patient gently (observation is more important than
physical touch for the children), be polite, distract the child’s attention with dangling toys

January  2015,  Nursing  and  Midwifery  Department,  FoNPH   Page  10  

 
 while listening to breath sound, HR,
i) Respiratory system:
a. inspection - Chest : deformity , Rate and rhythm of respiration, signs of respiratory
distress
b. palpation - Movement of the chest
c. auscultation - Character of Breath sounds: ( vesicular and bronchial ) Added
sounds(Crepitation , rhonchi)
ii) Cardiovascular system
a. inspection – Precordial bulge
b. palpation – Apex beat, position and character, thrill
c. Auscultation –
iii) Gastrointestinal system
a. inspection - Shape /distension of abdomen, Scars, striae, veins, hernia and umbilicus
(everted, hernia )
b. Palpation - Palpate: liver and spleen, other masses, guarding, rebound tenderness
c. percussion - shifting dullness, fluid thrill as indicated
iv) Urinary system –
a. Palpation - palpate both kidneys in lumbar region, palpate suprapubic region
v) Nervous system - associate with developmental milestone
Medical diagnosis :- define the disease and give a brief etiology / causative factor
Patho-physiology:
Write a brief anatomy and physiology of the anatomical structure involve and describe the
patho-physiology of the disease relating to the impairment of physiology during the disease.
Mention the complications of the diseases
Investigation:
Mention the investigation done and their findings interpret the abnormal finding and relate with
the disease.
Management :
Includes medical, surgical, nutritional and physiotherapy
Explain the reason for prescribing the treatment, for drug therapy (medication) follow the
pattern of drug book
Nursing – mention the nursing care provided in a short paragraph or bullet so that it will assist
you in developing a good nursing process
Nursing diagnosis:
For nursing diagnosis and writing nursing care plan follow the format below (identify nursing
diagnosis on daily basis and provide nursing care accordingly, maintain this in your written
document in chronological order).
Nursing Objectives Nursing Patient outcome
diagnosis intervention

Conclusion:
Conclusion should have the patient outcome with regard to the nursing care you provide.
Reference: for referencing use APA style
 
 

January  2015,  Nursing  and  Midwifery  Department,  FoNPH   Page  11  

 
Appendix 3: Pediatric Nursing Process Marking Guide

Student ID no: _________________________ Category: ___________________________

Ward/unit: ________________________ Period of placement: _________________________
1. Patient Identification Mar Marks
ks obtained
• Name • Permanent address 2
• Age/Sex • Ward/bed no
• C/o • Hospital registration no
• Local address • Date of selection
• Date of admission
2. Socioeconomic status of parent/s 4

• Sanitation, housing • No. of children/ numbers of people living

in the house
• Level of education of parents • Occupation/Income of parents
3. Medical history 24
• Chief complaints for present illness
• History of present illness: (Relevant details of each chief complaint)
• History of past illness and treatment (birth history in case of neonate)
• Family history;
• Birth history (birth order)
• Immunization history
• Feeding history
• Developmental history
4. General examination of the child 10
• Head, scalp, face, eyes, ears (any discharges), OFC (35 cm at birth), neck
vein, lymph nodes
• Body weight
• Height/length
• Calculate z score for WH, HA and WA (using WHO growth chart)
• MUAC
• Skin condition (Pallor, Jaundice, Cyanosis , Signs of dehydration)
• Vital signs:- Heart rate, respiratory rate, body temperature (mention the site),
pulse rate
5. Systemic examination: Perform one relevant systemic examination following 5
the given guideline
6. Medical diagnosis 2
7. Pathophysiology 2
8. Investigation done 5
9. Management
• Management (medical, surgical, nutritional (breastfeeding / complementary 12
feeding), physiotherapy, daily nursing care)
• Nursing management: Nursing diagnosis and nursing care plan 20
10. Comparative Study: compare the findings in the patient and in the book (clinical 4
symptoms, etiology, patho-physiology, treatment modalities).
11. Conclusion: include patient outcome with regard to the nursing care provided. 5
12. Reference 5
Total marks 100

January  2015,  Nursing  and  Midwifery  Department,  FoNPH   Page  12  

 
Signature of the supervisor: __________________________ Date: ______________________

Appendix  4:  Presentation  marking  Guide  

 

Faculty of Nursing and Public Health

Presentation Marking Guide

Presenter/s’ name: __________________________ Program: _______________________

Topic: _____________________________________ Date/time: ______________________

Sl. no Category/points Grading

5 4 3 2 1
1 Content

2 Presentation

3 Visual aids

4 Comprehension

5 Creativity

6 Research/References/Bibliography

7 Preparedness

Any additional comments for further improvement:

   

January  2015,  Nursing  and  Midwifery  Department,  FoNPH   Page  13  

 
 Appendix  5:  Assignment  marking  guide  
 

Assignment Marking Guide

Sl. Parameters Poor Fair Good Very Excellent
no Good
1 2 3 4 5
Organization and Structure of Assignment
1 Introduction:
States the learning goals to be addresses
Offers a brief background/rationale
2 Body of text:
Logical development and appropriate structure
3 Conclusion: offers summary of findings
Research
4 Evidence of wide reading on the topic
5 Presentation of reference list (end text citation)
6 Correctly acknowledge sources in-text (in-text
citation)
Analysis and interpretation of the resource material
7 Demonstrates understanding of source material
8 Uses research findings to support argument and
ideas.
9 Clarity of interpretation and analysis
10 Present own ideas
Presentation of writing
11 Grammar, appropriate use of expression, correct
spelling, sentence structure., free of errors
Comments:
Marking guide included: Yes/No

Signature of Examiner: _______________________ Date: __________________

January  2015,  Nursing  and  Midwifery  Department,  FoNPH   Page  14  

 
  

Appendix  10:    Assignment  Submission  Form  

Bachelor of Science in Nursing and Midwifery

Assignment Submission Form

Student name: __________________________________________________

Module Code no. and name: _______________________________________

To be submitted to: ______________________________________________

Date due: ______________________________________________________

Statement of Authorship
Honesty and integrity are the core values of Nursing and Midwifery services as well as in
academic culture Therefore, I pledge that the attached material is my original work and have
not received any assistance. No other person’s work has been used without due
acknowledgement.

Student ID no: _________________________________________________

Signature: ____________________________________________________

Date of submission: ____________________________________________

Words: _______________________________________________________

January  2015,  Nursing  and  Midwifery  Department,  FoNPH   Page  15  

 
Appendix  11:    Application  for  Extension    

Bachelor of Science in Nursing and Midwifery

Application for Extension

Name: ………………………………………………………………………………………….

Student ID. no: ……………………………………………………………………………...

Date of Application: …………………………………………………………………….

Module Code and Name: ……………………………………………………………….

Lecturer: ……………………………………………………………………………………

Assessment Due Date: …………………………………………………………………..

Reason for Extension required: …………………………………………………...

…………………………………………………………………………………………………..

Extension until: ………………………………………………………………………….

Extension Granted: Due Date now: …………………………………………...........

Extension not granted: Reason: ……………………………………………………

…………………………………………………………………………………………………..

Lecturer Signature: …………………………………………………………………....

Date: …………………………………………………………………………………………...

January  2015,  Nursing  and  Midwifery  Department,  FoNPH   Page  16