PEDIATRIC NURSING

Practical Nursing – Pediatrics 2024-2025

PEDIATRIC NURSING

TABLE OF CONTENTS

Course Description
Course Objectives
Course Requirements
Grading Criteria Theory
Grading Criteria Clinical
References
Chapter Titles
Unit Objectives
Exam Schedule
ATI Resources
Pediatric Drug List
Clinical Facility Sites
Skills Checklist
Pre-Conference Form
Nursing Assessment Guide
(detailed) Pediatric Nursing
Assessment Form Memorandum of
Understanding
 Practical Nursing – Pediatrics 2024-2025

PEDIATRIC NURSING

90 Hours

COURSE DESCRIPTION

Pediatric Nursing is a three-week course taught during the second level of the program. This
course focuses on provision of safe, effective nursing care to the pediatric patient and provides
supportive education to families. Emphasis is placed on the promotion and maintenance of
wellness through utilization of preventive education, community resources and management of
disease entities.

The clinical component provides the student with the opportunity to apply pediatric theory and
practice through planned activities in wellness-based centers, acute care settings and special
education centers.

COURSE OBJECTIVES

▪ Utilize the nursing process along with critical thinking skills in the care of the pediatric patient
and family.
▪ Identify childhood and adolescent illness/diseases and analyze the effect on the pediatric
patient.
▪ Participate as an active member of the health care team in providing nursing care services
and promoting wellness through health teaching in acute care, home, school, and
community settings.
▪ Understand dosage and proper protocol for safe administration of pediatric medications and
 intravenous therapy.
▪ Examine the role of prenatal care, growth and development, and anticipatory guidance
on maturational and common health problems of the pediatric patient.
▪ Identify risk factors that interfere with pediatric patient/family psychosocial integrity and
promote use of behavioral management.

Practical Nursing – Pediatrics 2024-2025

COURSE REQUIREMENTS

The goal of the clinical rotation is to provide the student with a supervised learning experience in
which knowledge from classroom learning and independent learning can be applied directly in the
care of clients using the nursing process. Clinical performance is evaluated throughout the rotation
with a written evaluation at the end of the clinical assignment. The clinical instructor assesses
students’ strengths and weaknesses in the clinical setting. The clinical grade will be recorded as
pass / fail. To pass the clinical portion, the student must successfully complete the stated
objectives located in the clinical evaluation tool. Failure to pass the clinical component will result in
a failure of both theory and clinical components. Specific requirements for successful completion
of this portion of the course include:

▪ Students must achieve an overall exam grade average of 75% or better (inclusive of unit
Exams, homework and final exam) before participation is calculated into the grade.
Note: Participation to be calculated into the overall final grade contingent upon exam
average of 75% or better.
▪ Students will be required to complete all assigned Capstone material on ATI during each
rotation as part of their 10% ATI/homework grade.
▪ Maintain a passing grade in the clinical rotation with successful clinical performance on a
Pediatric unit or related setting.
▪ Student must maintain a passing grade in the clinical rotation and a passing grade of 75%
in theory in order to be successful in the course.
▪ Demonstrate competency in pharmacology related to weekly performance, objectives, and
final examination.
▪ Actively participate in-group discussions relating clinical experiences to theoretical learning. ▪
 Students must comply with submission of all personal health data information in order to
participate in clinical. It is the student’s professional responsibility to keep all records updated
in the Health Sciences Office. This includes but is not limited to, updated health assessment
form, TB testing, blood titers, vaccinations, etc.
▪ Adherence to attendance policy.
▪ Preparation for clinical is expected of all students. Review of material for rotation areas the
night before is required. A student is marked unprepared when there is evidence of a lack
of adequate verbalization of knowledge, plan of care or inability to safely care for the
assigned client.
▪ Compliance with the uniform dress code is required for all clinical experiences. Uniforms are
to be neat and clean and comply with the dress code as set forth in the Student Handbook. ▪
Additional simulation lab practice with high fidelity mannequins in Pediatric clinical scenario at
a proficient level according to Sim rubric completed.

Student must maintain a passing grade in BOTH theory and clinical components to
be successful in the course.

Practical Nursing – Pediatrics 2024-2025

GRADING CRITERIA – THEORY

The goal of classroom learning related to theoretical knowledge is to assist the student to develop
an understanding of the information presented. Ultimately, this knowledge base provides the basis
of logical applications of the nursing process in the clinical care of pediatric patients. Specific
requirements for successful completion of this portion of the course include:

▪ Satisfactory participation and attendance in class

▪ Minimum of 75% average in theory
Two Unit Tests and One PN Nursing Care of Children Assignment 65% Final
Exam 20% ATI Assignments/Homework 10% Classroom Participation (after
75% average is maintained) 5%

GRADING CRITERIA – CLINICAL/LAB

The goal of the clinical rotation is to provide the student with a supervised learning experience in
which knowledge from classroom learning and independent learning can be applied directly in the
care of clients using the nursing process. Clinical performance is evaluated throughout the rotation
with a written evaluation at the end of the clinical assignment. The clinical instructor assesses
students’ strengths and weaknesses in the clinical setting. The clinical grade will be recorded as
pass / fail. To pass the clinical portion, the student must successfully complete the stated
objectives located in the clinical evaluation tool. Failure to pass either the theory or clinical
component will result in a failure of the course. Specific requirements for successful
completion of this portion of the course include:

▪ Minimum of 90% clinical attendance: attendance is mandatory for the clinical rotation. ▪
Preparation for clinical is expected of all students. Review of material for rotation areas the
night before is required. A student is marked unprepared when there is evidence of a lack
of adequate verbalization of knowledge, plan of care, or inability to safely care for the
assigned client.
▪ Compliance with the uniform dress code is required for all clinical experiences
unless otherwise directed by the instructor. Uniforms are to be neat and clean and
comply with the dress code as set forth in the Student Handbook.
▪ Additional simulation lab practice with high fidelity mannequins in Pediatric clinical scenario at
a proficient level according to Sim rubric completed.

Student must maintain a passing grade in BOTH theory and clinical components to
be successful in the course.

Practical Nursing – Pediatrics 2024-2025

REFERENCES

1. Assessment Technologies Institute®, ATI Engage Pediatric

2. Linnard-Palmer, L., & Coats, G. H. (2021a). Safe maternity and pediatric nursing
care. F.A. Davis.
3. Assessment Technologies Institute®, LLC (ATI) Content Mastery Series®
Nursing Care of Children PN Edition, Version 11th Edition

4. Dosage Calculation, Preparation & Administration, 9th Ed.

Susan Buchholz. Philadelphia, PA: Wolters Kluwer 2020
 Practical Nursing – Pediatrics 2024-2025

Table of content:

ATI Engage Pediatric Nursing

Unit 1: Overview of Pediatric Nursing

• Pediatric Nursing Today
• Genetics and Genomics in Pediatric Nursing
• Health Assessment of Pediatric Clients

Unit 3: Specific Considerations in the Pediatric

Population • Communicable Diseases and
Immunizations
• Pediatric Client in the Hospital Setting
 • Disabilities and Chronic Illness
• Terminal Illness and End of Life

Unit 4: Health Alterations in the Pediatric

Population • Sensory Nervous System
• Cognitive System
• Respiratory System
• Cardiovascular System
• Gastrointestinal System
• Endocrine System
• Immune System
• Genitourinary System
• Neuromuscular and Musculoskeletal System
• Neurological System
• Hematological System
• Integumentary System

ATI Dosage Calculation and Safe Medication Administration

4.0 • Dosage by Weight
• Pediatric Medication
• Safe Medication Administration

Practical Nursing – Pediatrics 2024-2025

Engage Pediatric Unit Modules

UNIT 1: Overview of Pediatric Nursing

At the completion of the Pediatric rotation, the student will be able to:
▪ Discuss the specialty of pediatric nursing.
▪ Examine the role of the pediatric nurse.
▪ Explore family and social factors affecting the pediatric population. ▪
Examine current trends and issues in pediatric nursing.
▪ Examine chromosomal anomalies in the pediatric population.
 ▪ Explore etiological risk factors, diagnosis, and differential clinical presentation of
select chromosomal anomalies.
▪ Explore etiological risk factors, diagnosis, and differential clinical presentation of
monogenetic disorders.
▪ Explore etiological risk factors, diagnosis, and differential clinical presentation of
inheritance patterns and gene expression.
▪ Explore etiological risk factors, diagnosis, and differential clinical presentation of
select inborn errors of metabolism.
▪ Explore the role of the nurse in caring for pediatric clients affected by genetic
conditions and their support systems (family, parents, caregivers).
▪ Apply the nursing process using clinical judgment functions while providing care to
pediatric clients.
▪ Explore the art of communicating with pediatric clients and their support systems
(family, parents, caregivers).
▪ Discuss the process used to perform a nutritional assessment of pediatric clients. ▪
Apply the variations in technique used in physical assessment of pediatric clients. ▪
Apply the variations in technique used in pain assessment of pediatric clients. ▪ Apply
the nursing process using clinical judgment functions while providing care to pediatric
clients.

UNIT 3: Specific Considerations in the Pediatric Population

At the completion of the Pediatric rotation, the student will be able to:
▪ Discuss the role of the nurse in infection control in the pediatric population. ▪
Discuss etiology, pathophysiology, prevention, care, and treatment of childhood
communicable disease.
▪ Examine immunotherapy concepts, provision of atraumatic care related to
immunizations, and administration of vaccines across the lifespan.
▪ Discuss etiology, pathophysiology, prevention, care, and treatment of parasitic
infestations and infections.
▪ Apply the nursing process using clinical judgment functions while providing care to
pediatric clients who have a communicable or transmissible disease. ▪ Explore the
emotional and social responses to hospitalization of pediatric clients and their support
systems (family, parents, caregivers) across the lifespan. ▪ Explore the role of the
nurse in meeting emotional and social needs of pediatric

Practical Nursing – Pediatrics 2024-2025

clients and their support systems (family, parents, caregivers) in a hospital setting.
▪ Discuss the role of the nurse in completing admission assessment and
interventions.
▪ Discuss the role of the nurse in caring for pediatric clients in a hospital setting. ▪
Apply the nursing process using clinical judgment functions while providing care to
pediatric clients in a hospital setting
▪ Explore trends in care for pediatric clients who have chronic illnesses. ▪ Explore
the effects of chronic illness on pediatric clients and their social support systems
(family, parents, caregivers).
▪ Explore trends in care for pediatric clients who have disabilities.
▪ Explore the effects of pediatric disabilities on clients and their social support
systems (family, parents, caregivers).
▪ Apply the nursing process using clinical judgment functions while providing care to
 pediatric clients who have a chronic illness or disability.
▪ Examine the epidemiology, statistics, and conditions leading to death of pediatric
clients who have a terminal illness.
▪ Explore the role of the nurse in providing social and emotional care to pediatric
clients who have a terminal illness and at the end of life, their support systems
(family, parents, caregivers), the care team, and the nurse.
▪ Explore the role of the nurse in providing palliative and hospice care to pediatric
clients who have a terminal illness.
▪ Explore the role of the nurse in providing care to pediatric clients who are dying. ▪
Explore specific considerations for pediatric clients who are dying or deceased. ▪
Apply the nursing process using clinical judgment functions while providing care to
pediatric clients who have a terminal illness or are dying.

UNIT 4: Health Alterations in the Pediatric Population

At the completion of the Pediatric rotation, the student will be able to:
▪ Examine the anatomy, physiology, pathophysiology, and screening of pediatric
clients experiencing alterations in sensory perception.
▪ Explore etiology, epidemiology, risk factors, clinical presentation, diagnosis, and
treatment of alterations in sensory perception in pediatric clients.
▪ Describe the effect of alterations in sensory perception on pediatric clients’ overall
health.
▪ Explore the role of the nurse when caring for pediatric clients experiencing
alterations in sensory perception.
▪ Apply the nursing process using clinical judgment functions while providing care to
pediatric clients experiencing alterations in sensory perception.
▪ Examine the anatomy, physiology, pathophysiology, and screening of pediatric
clients experiencing alterations in cognitive function.
▪ Explore etiology, epidemiology, risk factors, clinical presentation, diagnosis, and
treatment of alterations in cognitive function in pediatric clients.
▪ Describe the effects of alterations in cognitive function on pediatric clients’ overall
health.
▪ Explore the role of the nurse when caring for pediatric clients experiencing
alterations in cognitive function.
▪ Apply the nursing process using clinical judgment functions while providing care to
pediatric clients experiencing alterations in cognitive function.

Practical Nursing – Pediatrics 2024-2025

▪ Examine the anatomy, physiology, pathophysiology, and screening of pediatric

clients experiencing alterations in respiratory function.
▪ Explore etiology, epidemiology, risk factors, clinical presentation, diagnosis, and
treatment of alterations in respiratory function in pediatric clients.
▪ Describe the effect of alterations in respiratory function on pediatric clients’ overall
health.
▪ Explore the role of the nurse when caring for pediatric clients experiencing
alterations in respiratory function.
▪ Apply the nursing process using clinical judgment functions while providing care to
pediatric clients experiencing alterations in respiratory function.
▪ Examine the anatomy, physiology, pathophysiology, and screening of pediatric
clients experiencing an alteration in cardiovascular function and perfusion. ▪ Explore
etiology, epidemiology, risk factors, clinical presentation, diagnosis, and treatment of
alterations in cardiovascular function and perfusion of pediatric clients. ▪ Describe the
effect of alterations in cardiovascular function and perfusion on pediatric clients’
overall health.
▪ Explore the role of the nurse when caring for pediatric clients experiencing
alterations in cardiovascular function and perfusion.
▪ Apply the nursing process using clinical judgment functions while providing care to
pediatric clients experiencing alterations in cardiovascular function and perfusion. ▪
Examine the anatomy, physiology, pathophysiology, and screening of pediatric clients
who have alterations in digestive function.
▪ Explore etiology, epidemiology, risk factors, clinical presentation, diagnosis, and
treatment of alterations of digestive function in pediatric clients.
▪ Describe the effects of alterations in digestive function on pediatric clients’ overall
health.
▪ Explore the role of the nurse when caring for pediatric clients experiencing
alterations in digestive function.
▪ Apply the nursing process using clinical judgment functions while providing care to
pediatric clients experiencing alterations in digestive function.
▪ Examine the anatomy, physiology, pathophysiology, and screening of the pediatric
client who has alterations in endocrine function.
▪ Explore etiology, epidemiology, risk factors, clinical presentation, diagnosis, and
treatment of alterations in endocrine function of pediatric clients.
▪ Describe the effect of alterations in endocrine function on pediatric clients’ overall
health.
▪ Explore the role of the nurse when caring for pediatric clients experiencing
alterations in endocrine function.
▪ Apply the nursing process using clinical judgment functions while providing care to
pediatric clients experiencing alterations in endocrine function.
▪ Examine the anatomy, physiology, pathophysiology, and screening of pediatric
clients experiencing alterations in immune function.

Practical Nursing – Pediatrics 2024-2025

▪ Explore etiology, epidemiology, risk factors, clinical presentation, diagnosis, and

treatment of alterations in immune function in pediatric clients.
▪ Describe the effect of alterations in immune function on pediatric clients’ overall
health.
▪ Explore the role of the nurse when caring for pediatric clients experiencing
alterations in immune function.
▪ Apply the nursing process using clinical judgment functions while providing care to
pediatric clients experiencing alterations in immune function.
▪ Examine the anatomy, physiology, pathophysiology, and screening of pediatric
 clients experiencing alterations in genitourinary function.
▪ Explore etiology, epidemiology, risk factors, clinical presentation, diagnosis, and
treatment of alterations in genitourinary function in pediatric clients. ▪ Describe the
effect of alterations in genitourinary function on pediatric clients’ overall health.
▪ Explore the role of the nurse when caring for pediatric clients experiencing
alterations in genitourinary function.
▪ Apply the nursing process using clinical judgment functions while providing care to
pediatric clients experiencing alterations in genitourinary function.
▪ Examine the anatomy, physiology, pathophysiology, and screening of pediatric
clients experiencing alterations in musculoskeletal function.
▪ Examine the anatomy, physiology, pathophysiology, and screening of pediatric
clients experiencing alterations in neuromuscular function.
▪ Explore etiology, epidemiology, risk factors, clinical presentation, diagnosis, and
treatment of alterations of neuromuscular function in pediatric clients. ▪ Describe the
effect of alterations in neuromuscular function on pediatric clients’ overall health.
▪ Explore the role of the nurse when caring for pediatric clients experiencing
alterations in neuromuscular function.
▪ Apply the nursing process using clinical judgment functions while providing care to
pediatric clients experiencing alterations in neuromuscular function. ▪ Examine the
anatomy, physiology, pathophysiology, and screening of pediatric clients experiencing
alterations in neurological function.
▪ Explore etiology, epidemiology, risk factors, clinical presentation, diagnosis, and
treatment of alterations in neurological function in pediatric clients. ▪ Describe the
effect of alterations in neurologic function on pediatric clients’ overall health.
▪ Explore the role of the nurse when caring for pediatric clients experiencing
alterations in neurologic function.
▪ Apply the nursing process using clinical judgment functions while providing care to
pediatric clients experiencing alterations in neurological function.
▪ Examine the anatomy, physiology, pathophysiology, and screening of pediatric
clients experiencing alterations in hematological function.
▪ Explore etiology, epidemiology, risk factors, clinical presentation, diagnosis, and
treatment of alterations in hematological function in pediatric clients. ▪ Describe the
effect of alterations in hematologic function on pediatric clients’ overall health.
▪ Explore the role of the nurse when caring for pediatric clients experiencing
alterations in hematologic function.
▪ Apply the nursing process using clinical judgment functions while providing care to

Practical Nursing – Pediatrics 2024-2025

pediatric clients experiencing alterations in hematological function. ▪ Examine

the anatomy, physiology, pathophysiology, and screening of pediatric clients
experiencing alterations in integumentary function.
▪ Explore etiology, epidemiology, risk factors, clinical presentation, diagnosis, and
treatment of alterations in integumentary function in pediatric clients. ▪ Describe the
effect of alterations in integumentary function on pediatric clients’ overall health.
▪ Explore the role of the nurse when caring for pediatric clients experiencing
alterations in integumentary function.
▪ Apply the nursing process using clinical judgment functions while providing care to
pediatric clients experiencing alterations in integumentary function.
 Practical Nursing – Pediatrics 2024-2025

EXAM SCHEDULE
EXAM 1:
Unit 1: Overview of Pediatric Nursing
Pediatric Nursing Today
Genetics and Genomics in pediatric Nursing
Health Assessment of pediatric clients
Unit 3: Specific Considerations in the Pediatric Population
Communicable Diseases and Immunizations
Pediatric Clients in the Hospital setting
Respiratory System
Cardiovascular System
Integumentary System
Pediatric math: Dosage Calculations and Safe Medication Administration
** Additional information: Textbook: Linnard-Palmer, L., & Coats, G. H. (2021a). Safe
maternity and pediatric nursing care. F.A. Davis.
EXAM 2:
Unit 4: Health Alterations in the Pediatric Population
Sensory Nervous System
Gastrointestinal System
Endocrine System
Immune System
Genitourinary System
Neuromuscular and Musculoskeletal System
Neurological System
Hematological System
Pediatric math: Dosage Calculations and Safe Medication Administration
** Additional information: Textbook: Linnard-Palmer, L., & Coats, G. H. (2021a). Safe
maternity and pediatric nursing care. F.A. Davis.
EXAM 3:
▪ Pediatric Project

FINAL:
CUMULATIVE
Unit 3: Specific Considerations in the Pediatric Population
Disabilities and Chronic Illness
Terminal Illness and End of Life
Unit 4: Health Alterations in the Pediatric Population
Cognitive System
Pediatric math: Dosage Calculations and Safe Medication
Administration **Cumulative information from previous exams.
** Additional information: Textbook: Linnard-Palmer, L., & Coats, G. H. (2021a). Safe
maternity and pediatric nursing care. F.A. Davis.

Practical Nursing – Pediatrics 2024-2025

ATI RESOURCES

VIDEO CASE STUDIES PN 3.0

 ▪ Gas Exchange/Oxygenation: Cystic Fibrosis Part 1
▪ Gas Exchange/Oxygenation: Cystic Fibrosis Part 2
▪ Gas Exchange/Oxygenation: Identify Health Concerns/Client at Risk for Developing Cystic
Fibrosis
▪ Gas Exchange/Oxygenation: Pediatric Asthma
▪ Health Promotion/Wellness/Disease Prevention: Scoliosis Screening

DOSAGE CALCULATION AND SAFE MEDICATION ADMINISTRATION

4.0 ▪ Dosage by Weight
▪ Pediatric Medication
▪ Safe Medication Administration

CAPSTONE
▪ Virtual assignments: Content Modules and Assessments given by ATI

Practical Nursing – Pediatrics 2024-2025

PEDIATRIC DRUG LIST:

Amoxicillin Adrenalin Glucagon Aspirin Aminophylline

Imferon Lanoxin Dilantin Keflex Mycostatin Solumedrol

Concerta Epinephrine Vermox Adderall Ritalin

Pancreatase

Practical Nursing – Pediatrics 2024-2025

CLINICAL FACILITY SITES

Premm Learning Center

Westhampton Beach Learning
Center Jefferson Academic Center
Brookside MultiCare Nursing
Center Sayville Academic Center
Good Samaritan Hospital
CHS St. Charles Hospital
CHS

Practical Nursing – Pediatrics 2024-2025

SKILLS CHECKLIST

1. Admission and discharge

2. Bathing infant and child
3. Crib making
4. Diapering and dressing infant
5. Weighing infant and child
6. Feeding infant and child
7. Isolation technique
8. Medication administration – oral, rectal, and parental
9. Restraints – papoose
10. Mist tent
11. Vital Signs – Taking apical pulse
12. Safety – Demonstration of equipment
13. Traction – Check of weights and alignments
14. Collection of Specimens – urine, stool, sputum, nose and throat culture
15. Monitor IV therapy
16. Intake and output of child, weighing diapers
17. Monitor pulse oximetry
18. Nasal / oral suctioning
19. Oxygen administration
20. Specimen collection

Practical Nursing – Pediatrics 2024-2025

EASTERN SUFFOLK SCHOOL OF PRACTICAL NURSING

PRE-CONFERENCE FORM

Name: Rotation: _____________

 Week of:

PRE-CONFERENCE FORM

Patient’s Initials: Date:

Diagnosis and brief definition: Priority Nursing Diagnosis:

Prioritize Specific Care / Treatment: Patient / Resident Goal: (Patient will…)

Medication Pertinent to Diagnosis:

I.V. Solution Drip Rate: Reason For: 1 Lab & Reason:

List result: Normal & Abnormal

Patient’s Initials: Date:

Diagnosis and brief definition: Priority Nursing Diagnosis:

Prioritize Specific Care / Treatment: Patient / Resident Goal: (Patient will…)

Medication Pertinent to Diagnosis:

I.V. Solution Drip Rate:Reason For: 1 Lab & reason:

List result: Normal & Abnormal

Protected Health Information (PHI) is to be used for stated purposes only. This information must be “de-identified” according to HIPAA requirements (i.e. demographics cannot be
used). When this information is no longer required for academic purposes, dispose of properly by shredding.

_________________________________
Instructor Signature

Practical Nursing – Pediatrics 2024-2025

 EASTERN SUFFOLK SCHOOL OF PRACTICAL NURSING
Nursing Assessment Guide

ADMISSION DATE: Admission to hospital DIAGNOSIS: Current

CLIENT’S INITIALS: Initials only
ALLERGIES: Write in RED ADMISSION: Reason for this admission PATIENT HISTORY:
past illnesses
VITAL SIGNS:
Temp: oral, rectal, axillary.
Pulse: Apical--regular/irregular, strong/bounding
Resp: Pay attention to the depth of respiration by watching chest movements (shallow, deep,
retractions, labored, uneven)
Blood pressure: position the patient’s upper arm at the level of the heart. Note right or left arm.
Pulse Ox: Location, Room Air or Oxygen Therapy and type. Pain: Quality and location

Neurological Assessment
LOC: A change in the level of consciousness is the earliest and most sensitive indicator that the
patient’s neurological status has changed.
- Is the patient alert and following commands?
- Is the patient lethargic or drowsy? Delayed response to external stimulus? (ie: verbal,
tactile, etc.)
- Is the patient stuporous and requiring vigorous stimulation for a response? - Is
the patient comatose and not responding to verbal or tactile stimuli?
ORIENTATION:
- Is the patient oriented to person, place and time or is the patient disoriented to any of the
previous mentioned? (Be specific as to which, if disoriented)
MENTAL STATUS:
- Is the patient's thought process clear, cohesive (organized/connected), coherent (logical/lucid)?
- Are there smooth and logical transitions between ideas?
- Are there disordered thought patterns?
- Is the patient confused?
SENSORY:
- Include assessment of all senses including pupillary response.
MOTOR:
- Is the patient able to move all extremities freely?
- Is there paresis, paralysis, weakness? If so, specify the area.

Respiratory Assessment
LUNG SOUNDS:
- Crackles / Rales: cellophane crumpling
- Wheezes: high pitched musical sounds
- Rhonchi: Course rattling sounds/snoring
- Pleural Friction Rub: grinding noise
 Practical Nursing – Pediatrics 2024-2025

Classify each according to its location, pitch and intensity. If no abnormalities are noted, the
assessment would read: “lung sounds clear bilaterally to auscultation, upper and lower lobes,” Listen to
upper and lower lobes bilaterally.
- Assess the patient's process of breathing and rate and depth of respiration. -
Assess the 02 in use and check the flow meter for correct rate.
- Assess the patient for a cough – described as dry, productive or non-productive.
Also, describe the expectorant by consistency, color and amount.
SPUTUM:
- Best sample is in early morning.
- Describe: purulent, bloody, serous, frothy, amount, odor, thick, copious?
OXYGEN THERAPY:
- Nasal or mask, amount of liters/minute, humidified and %: Check MD order for appropriate
information.
INCENTIVE SPIROMETER:
- A device used to promote full inhalation and oxygenation of the lungs. Used particularly
after surgery. Document # times/hour used or encouraged.
INHALATION THERAPY:
- Check orders if the patient is receiving any inhalers or treatments via Respiratory
Department. Humidifiers? Aerosol Therapy?
TRACH CARE:
- If the patient has a trach, is it patent / intact? + air exchange?
- What kind of trach is it? (Ex: #8 Shiley) If so, did you provide care? Describe.
CHEST TUBE:
- Does the patient have a chest tube? Is it intact? Where is it located? Connected to
suction?
- Describe color and amount of drainage.
Cardiovascular Assessment
PULSES (extremities):
- Assess arterial pulses bilaterally with your index and middle finger. You should check the
carotid, brachial, radial, popliteal, and dorsalis pedis pulse. They should be graded as absent, weak,
normal, full, bounding, thready or irregular-comparing left side to right. CAPILLARY REFILL:
- Assess the nail beds on the fingers/toes bilaterally. Press down. Refill time should be less
than 3 seconds.
EDEMA: Check for any fluid retention of the extremities: place the thumb over the tibia or foot
for five seconds and record one of the following:
0 - no edema
1+- barely discernable pitting
2+- deeper pitting/less than 5mm accompanied by a normal leg contour
3+- deep depression 5-10mm accompanied by foot and leg swelling
4+- an even deeper depression (more than 1cm) accompanied by severe leg and foot swelling
CYANOSIS: Occurs when oxygenation to the skin is poor. The most reliable place to check is the
circumoral mucous membranes of the mouth. Paleness indicates poor blood flow to larger organs.
Document accordingly: present or none noted and location if any noted. Report cyanosis to your
instructor immediately.

GI Assessment
Correct order of assessment of the abdomen:
INSPECTION:
- Begin with the mouth and end with the rectum.
- Check mouth for masses, swelling, bleeding or any abnormality of the mouth. -
Check the shape of the abdomen: flat, rounded, convex, concave or distended.

Practical Nursing – Pediatrics 2024-2025

- Check umbilicus for any abnormalities.

- Check the skin for any breakdowns, scars, varicosities, striae or rashes.

BOWEL SOUNDS: Lightly place the stethoscope in the right lower quadrant/slightly below the right of
the umbilicus.

AUSCULTATE: In a clockwise fashion in each of the 4 quadrants, spending at least 2 minutes in each
area, note the character and the quality of the bowel sounds and describe as absent, present,
hypoactive, hyperactive.
- Normal bowel sounds – high-pitched gurgling noises occurring 5 or more times per minute.
- Hypoactive bowel sounds indicate hypo-mobility; possibly a paralytic ileus – you must listen
3-5 minutes to verify that you definitely hear hypoactive or absent bowel sounds. -
Hyperactive bowel sounds indicate hypermobility or a mechanical obstruction. These sounds
are frequent, loud, rushing and high-pitched (called borborygmi).

****It is important to assess bowel sounds with an s/p abdominal surgical patient because it may take up
to 12 to 36 hours for bowel sounds to return.

PALPATION:
- Use the pads of your fingers and push down approximately 2 inches using a small
circular motion. Check one quadrant before moving on to the next one. You are
assessing for masses and/or pain.
Note: If the pain increases with the palpation, or when you let go quickly – this is called rebound
tenderness and is seen with an appendicitis.
- The abdomen should be soft and non-tender. Abdominal palpation includes light and
deep touch.
- Does it feel firm, rigid, distended, soft, tender or flat? If the abdomen feels rigid, do not
palpate it. The patient could have peritoneal inflammation, and palpation can cause pain and
rupture an inflamed organ. NOTIFY INSTRUCTOR SHOULD YOU ASSESS THIS.

BM/FLATUS: Document accordingly.

- Did the patient have a BM? Document the amount/color/odor/frequency/consistency. -
Is the patient passing gas? Intestinal gas is called flatus.
- Gray or clay colored stool may indicate that bile is missing as in gallbladder disease. -
Dark black or tarry: may indicate presence of digested blood/iron supplementation. -
Melena: bright red blood may indicate rectal bleeding.
- Yellow-green stool: may indicate microorganisms, suggesting an infection.

EMESIS:
- Describe color, consistency, amount, and frequency. Is it projectile in nature?

TUBES/DRAINS:
-Indicate the name of each. Ex: Nasogastric Tube, Jackson Pratt, Hemovac. Is it attached
to a suction device? Describe the drainage by indicating the color, odor, consistency.
-Gastric suction: yes/no (if yes, what type-NGT, Salem Sump, etc.)
 Practical Nursing – Pediatrics 2024-2025

OSTOMY:
Many surgeries of the intestinal tract require an artificial opening into the bowel. An incision
is made into the abdomen and a loop of the intestine is brought through the incision and opened to
allow for drainage. The opening is called a stoma or ostomy.

- Does your patient have a stoma?

- What color is it? A healthy stoma is beefy red. Is it edematous/retracted? Does it bleed
occasionally? Is there any noted irritation at the peristomal area? Describe output.

DIET:
- According to MD order-DOCUMENT INTAKE. Note appetite: How much was eaten?
(Use percentage ex: 25% = poor, 50% = fair, 100% = good)
- Is fluid intake adequate? Is the diet tolerated?

GU Assessment
PALPATION:
- Palpate the lower abdomen, about 3 finger breaths above the symphysis pubis to check for
a full bladder. Is the patient distended?

URINARY OUTPUT:
- Inspect urine’s color, consistency, clarity, amount or presence of sediment. - When was the
last time this patient voided? Be alert to any discomfort when voiding ex: burning, pressure?
- Output: document the output that you calculated during your care of the patient. Is the
amount consistent with intake/IV?
The color of the urine varies with the patient's hydration. Freshly voided urine is yellow or amber. over
hydration results in colorless urine. Dehydration results in concentrated urine dark amber or orange
brown. Does the urine have abnormal characteristics? Check appropriate labs: U/A, C&S, BUN, Cr. Is
there an odor?

Integumentary Assessment
APPEARANCE:
- Assess how the skin appears and feels to you. Is it cool, dry or clammy?
- Note the color of the skin: Red-erythema, Gray-blue-cyanosis, Pallor-loss of color, Gray
ashen, jaundice-yellow color.
- As you touch the patient to check an IV or to do a BP, you can assess skin warmth,
temperature, dryness and turgor.
Skin Integrity: Describe as intact vs. not intact. This includes a surgical incision, a decubitus ulcer,
lesion or any open area.

Mobility Assessment
- Activity - as ordered in the chart by the MD. Ex: OOB, BRP, BR.
- Weight bearing status: This is the determination how much weight the MD wants the
patient to utilize on an affected extremity when standing. An example would be non- weight bearing
left lower extremity/or full weight bearing. (can use both legs to stand). Assistive devices: Does the
patient use a walker, crutches or wheelchair?
 - ROM: All of your patients should receive ROM while in your care, unless contraindicated by
the MD.
- Note type of ROM: active or passive. Note how well the patient tolerated activity.

Practical Nursing – Pediatrics 2024-2025

Psychosocial Assessment
EMOTIONAL STATUS:
Does patient appear anxious, sad, pleasant, angry, irritable, apathetic, preoccupied or
prefers isolation and un-involvement?

COMMUNICATION:
Does patient communicate clearly and relevantly, loudly, have difficulty processing,
difficulty making needs known, minimally verbal, avoids answering questions, hyper verbal,
has " flight of ideas" (going from one topic to another), or is there a language barrier?

IV Solution
- Note solution ordered.
- Note any additives. Ex: KCL or multivitamins.
- Note rate in ml/hr. as ordered by MD. You must always check that the IV is infusing at the
rate that it was ordered.

Calculation: You must calculate the drops per minute the IV would be running.

Use your formula:

Volume x Calibration
---------------------------- = drops per minute
Time in minutes

- Check the LIB: What is left in the bag when you leave? If the patient is on a pump, it will be the
total volume left to be infused.
- Check the site: Where is the access point? (Ex: left or right arm). How does it appear? (Reddened,
swollen, painful, or intact and infusing well without any noted complications) Check for S/S of
infiltration, phlebitis or infection. Document date inserted and size of catheter. - Piggyback: note
solution ordered. (ex. Penicillin, Ancef, Zofran, etc.)

All of these assessments are to be addressed. If the situation does

not apply to your patient, then document none noted or not
applicable. A nurse’s note should always follow. This assessment
is a guide for your note. Remember, if it is not documented, it was
not done. In addition, every problem addressed requires an
intervention!
 Practical Nursing – Pediatrics 2024-2025

Eastern Suffolk School of Practical Nursing

Pediatric Nursing Assessment Form

Student Name: ___________________________________ Date: ________________________ Patient Initials:

__________ Admission Date: __________ Admitted via: _________

Birth Date: ________ Information obtained from: __________ Relationship to Child: _________________

Child's Legal Guardian: ________________________ Child's Nickname:

____________________________

Vital Signs temp- apical pulse- radial pulse- resp. BP- Height- Weight- Head Circ.-

Current Chief Complaint/Diagnosis: Symptoms and Duration Child's/Caregivers'

Understanding of Condition:

Previous Illness/Injuries/Diagnosis: illness, symptoms, Injuries or surgery:

and duration

History of anesthesia complications?

 Allergies and Reactions: Immunizations Dates: Exposure to Infectious
DPT (DT)- Diseases:
date:(varicella
rubeola etc.)

oral polio

Hepatitis B

Hib (type)-

MMR (measles, mumps, rubella)

TB skin test result:

Varicella

Pneuomococcal

INCLUDE REQUIRED IMMUNIZATION SCHEDULE IN ADDITION TO THE IMMUNIZATIONS YOUR PATIENT RECEIVED

Practical Nursing – Pediatrics 2024-2025

Special interests, toys, games,

hobbies__________________________________________________ Security Object:
________________________ Was it brought to hospital? _____________________ Bowel/Bladder
Habits:
Toilet Training (if applicable): Started? Yes ____ No ____
Terms used for BM: ____________ Urination: _______________________
Frequency of BM: ________ color_________
consistency_____________________ Toilet Training Completed? _____ Yes
______No _____
Does child have problem with diarrhea or constipation? __________________
Diapers: Day: _____ Yes ______ No
Night: ___ Yes____ No ______
Does child have urinary frequency, burning, and discomfort? _____
If yes please
explain__________________________________________________ Sleep/Rest:
Bedtime: _______ Wakeup: ______ Nap: ______ When: _______
Activity:
Does infant roll over? ___________
Does child stand/walk? __________
Does child dress self? __________
Does child go up/down stairs? ______
Does child talk in formed sentences? _____

Eating Habits:
Feeds self? Yes ______ No ______
Food and Beverage Likes?
___________________________________________________ Usual appetite?
____________________________________________________________ Special bottle?
Yes ______ No __________
Appetite now? ________________________
Owns a pacifier? Yes ____ No ______
Time of last food or drink? ___________
Does Child drink alcoholic beverages? _ ____

Other behavior habits of the child:

Thumb sucking? _____
Nail biting? _____
Headbanging? _______
Rituals (explain) _____________
Disposition (describe) ________________

Items Brought to the Hospital?

Glasses? Yes ______ No ______
Contacts? Yes ______ No ______
Hearing Aids? Yes ______ No ______
Dentures? Yes ______ No ______
Braces? Yes ______ No ______

Practical Nursing – Pediatrics 2024-2025

BODY SYSTEM NURSING ASSESSMENT NURSING DIAGNOSIS INTERVENTION

Neurological:
LOC
Orientation
Mental Status
Sensory/Neuro Checks
Motor
Pain (0/10)

Skin Assessment:
jaundice_____
cyanosis_____
pallor/redness
rashes/abrasions
cool___warm____
clammy___dry____
appearance______
Resp.Assessment:
Lung Sounds
Retractions
Cough/Sputum
O2 Therapy
Inhalation Therapy
Incentive Spirometer
Trach Care
Chest Tube

C/V Assessment:
Capillary Refill
Edema
Cyanosis
Heart Murmurs

Gastrointestinal:
Bowel sounds
Palpation
BM/Flatus
Tubes
Drains
Ostomy
Diet/Appetite

Genitourinary:
Urine/Description
Foley/SBD
Other
I/O

Mobility/Activity:
Wt. Bearing status
Assistive Devices
ROM

IV Therapy:
Solution/Rate
IVPB’S
Calculations Mg/Kg
LIB
IV gauge #/Site/Date

Psychosocial:
Emotional Status
Communication

Practical Nursing – Pediatrics 2024-2025

EASTERN SUFFOLK SCHOOL OF PRACTICAL NURSING

HEALTH SCIENCES
MEMORANDUM OF UNDERSTANDING
 for Course Outlines

Student Name: ____________________________________________

I have received the course outline for _______________________________ and I understand
it is my responsibility to read and refer to the contents.
▪ I have been given the opportunity to ask questions, and my questions have been
satisfactorily answered.
▪ I agree to abide by the standards and expectation as stated in the syllabus. These
include the nursing program’s ethical standards, as further indicated in the Practical
Nursing Handbook.
▪ I will adhere to the following requirements for classwork completion: º I will hand in all
my assignments on time, and understand late assignments will result in a grade of
zero.
º To successfully complete course requirements, all assigned work must be
submitted to achieve a final course grade.
º This course has components of both clinical course experience and theory
learning. The attendance for both of these will impact my daily grade and impact my
final grade for the course.
º Acceptable performance in classroom theory is comprised of these
components:
▪ Passing grade 75% or greater from combined homework and exams.
▪ ATI assignments/Homework counts for 10% of theory grade.
▪ I must produce assigned project(s) with a passing grade of greater than 75%
this is an unit test grade.
▪ Student must achieve an overall grade average of 75% or better (inclusive of
unit exams, homework and final exam) before participation is calculated into
the grade.
º Acceptable performance in clinical is comprised of these components: ▪ I
must attend 90% of the required clock hours for clinical. Any hours missed from
clinical are subject to make up in either Sims or clinical setting.
▪ I must produce the clinically assigned project(s) with a passing grade of greater
than 75%
▪ For successful completion of the course, I need to have a current physical
exam with proof of required blood work, titers and immunizations. Failure to
have these components will prevent inclusion in the clinical experience and
result in failure of and termination from the program.
Failure to achieve a passing grade in either theory or clinical will result in
termination from the program.

Student Signature Date

Practical Nursing – Pediatrics 2024-2025