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TomasW.BarkleyJr.PhDACNP-BCFAANPProfessorDirectorofNursePractitionerProgramsCaliforniaStateUniversityLosAngelesSchoolofNursingandPresidentBarkleyAssociatesLosAngelesCAforPediatricNursePractitioners2ndEditionBarkleysReviewGuide BarkleyAssociatesInc.P.O.Box69901WestHollywoodCA90069BARKLEYSREVIEWGUIDEFORPEDIATRICNURSEPRACTITIONERS2ndEDITIONCopyright2015byBarkleyAssociatesInc.Allrightsreserved.NopartofthispublicationmaybereproducedortransmittedinanyformorbyanymeanselectronicormechanicalincludingphotocopyrecordingoranyinformationstorageandretrievalsystemwithoutpermissioninwritingfromBarkleyAssociatesInc.PermissionmaybesoughtdirectlyfromBarkleyAssociatesbythefollowingphone1.866.938.5557or1.323.656.1606fax1.323.656.1620e-mailContact_Usnpcourses.com.NoticeKnowledgeandbestpracticesaresubjecttochangeasnewresearchandfurtherexperienceexpandknowledge.Changesinpracticetreatmentanddrugtherapymaybewarrantedorappropriate.Itisrecommendedthatreadersverifythemostup-to-dateinformationregardingproceduresfeaturedorcheckthemanufacturersofadministeredproductssoastoverifytherecommendeddoseformulamethodsofadministrationandcontradindications.Itisthedutyofpractitionersrelyingontheirexperienceandknowledgeofthepatientscircumstancestodeterminedosagesandthebesttreatmentforeachpatientwhiletakingallsafetyprecautions.TothefullestextendofthelawneitherthePublishernortheEditorContributorsorReviewersassumeanyliabilityforanyinjuryandordamagetopersonsorpropertyarisingoutoforrelatedtoanyuseofthecontentinthisbook.ThePublisherInternationalStandardBookNumber978-0-986402111PrintedintheUnitedStatesofAmerica iiiThomasW.BarkleyJr.PhDACNP-BCFAANPisPresidentofBarkleyAssociatesInc.dedicatedtoprovidingthenationsbestnursepractitionercertifcationreviewclinicalupdateandcontinuingeducationcourses.HeisalsoaProfessorofNursingandDirectorofNursePractitionerProgramsatCaliforniaStateUniversityLosAngeles.Sincethemid-1990sDr.Barkleyhasbeenactivelyteachingdevelopingandimplementingnursepractitionercontinuingeducationofferingsbothnationallyandinternationally.Dr.BarkleysclinicalbackgroundandpracticeareincriticalandacutecarenursingwhereheholdsnationalcertifcationasanacutecarenursepractitionerfromtheAmericanNursesCredentialingCenter.HereceivedaBachelorofSciencedegreeinNursingfromtheUniversityofAlabamaamastersdegreeinCriticalCareNursingfromtheUniversityofVirginiaandholdsaDoctorofPhilosophydegreeinNursingwithaspecialtyinnursingeducationandnursingeducationadministrationfromtheUniversityofAlabamaatBirmingham.InadditiontohisclassroomandpracticeresponsibilitiesDr.BarkleyistheprimaryeditoroftheAmericanJournalofNursingBook-of-the-Yearaward-winningtextPracticeGuidelinesforAcuteCareNursePractitionersandPracticeConsiderationsfortheAdult-GerontologicalAcuteCareNursePractitioner.HehasalsopublishednumerousrefereedarticlesrelatedtoacutecarenursingpracticenursingeducationandmulticulturalHIVAIDSprevention.ABOUTTHEEDITOR ivUsingexpertisegleanedfromhisyearsofexperienceDr.Barkleyhasassistedthousandsofnursepractitionerswithsuccessfulpassingoftheirinitialnationalcerticationexams.Additionallyhiscompanyoffersthemostextensivenumberofdifferentcerticationreviewclinicalupdatecoursesinthecountryservingnursepractitionersinthefollowingspecialtiespediatricsfamilyadultacutecareadult-gerontologyprimarycareadult-gerontologyacutecarepsychiatricmentalhealthandwomenshealth. vErinBaylorDNPRNPNP-CONPAssistantProfessorClinicalNursingUniversityofRochesterSchoolofNursingRochesterNYMaryAnnBestPhDRNCPNPPMHSPediatricAdolescentBehavioralHealthUniversityofTexasMedicalBranchGalvestonTXNicoleL.BoucherPHDRNCPNPClinicalAssistantProfessorDepartmentofHealthBehaviorandBiologicalSciencesUniversityofMichiganSchoolofNursingAnnArborMIDeborahBuschDNPCPNPCLCAssistantProfessorPediatricNursePractitionerUniversityofMarylandSchoolofNursingPediatricNursePractitionerProgramBaltimoreMDREVIEWERS viValerieGrifnDNPPPCNP-BCFNP-BCRNAssistantClinicalProfessorSIUESchoolofNursingEdwardsvilleILVanessaKalisDNPPNP-ACACNP-BCCNSRNAssistantProfessorProgramDirectorPediatricAcuteCareNursePractitionerandAdult-GerontologicAcuteCareNursePractitionerProgramsBrandmanUniversityIrvineCASusanKennelPhDARNPFAANPAssistantProfessorDirectorofthePediatricPrimaryConcentrationUniversityofSouthernFloridaCollegeofNursingTampaFLPamelaL.KingPhDFNPPNPFAANPMSNProgramDirectorSchoolofNursingSpaldingUniversityLouisvilleKYDonnaJ.MarvicsinPhDPPCNP-BCCDEClinicalAssistantProfessorUniversityofMichiganSchoolofNursingAnnArborMIDonnaG.NativioPhDCRNPFAANFAANPAssociateProfessorViceChairforAdministrationDirectoroftheDoctorofNursingPracticeDNPProgramUniversityofPittsburghPittsburghPA viiAnnOSullivanPhDFAANCRNPProfessorUniversityofPennsylvaniaSchoolofNursingSchoolofMedicinePhiladelphiaPAMollyK.RothmeyerDNPFNP-BCCPNP-ACAssistantProfessorUniversityofAlaskaAnchorageAlaskaDebraP.ShockeyDNPAPRN-BCCPNPAssistantProfessorVirginiaCommonwealthUniversitySchoolofNursingRichmondVALeighSmallPhDRNCPNP-PCFNAPFAANPFAANAssociateProfessorandChairFamilyandCommunityHealthNursingDepartmentVirginiaCommonwealthUniversitySchoolofNursingRichmondVAJoettaD.WallaceMSNCPONFNP-CNursePractitionerPediatricsCoordinatorPediatricPalliativeCareProgramMillerChildrensHospitalLongBeachCaliforniaAssociateClinicalProfessorDepartmentofPediatricsUniversityofSouthernCaliforniaLosAngelesCalifornia KathleenP.WilsonPhDPNP-BCFNP-BCCPNPNursePractitionerPrivatePracticePediatricsandInternalMedicineTallahasseeFloridaContributingFacultyGraduateProgramWaldenUniversitySchoolofNursing ixBarkleysReviewGuideforPediatricNursePractitioners2ndEditionisdesignedasastreamlinedreferencetextforbothpediatricandfamilynursepractitionersworkingwithchildrenofallages.Theobjectiveofthisworkwastollavoidinthemarketplacebyofferingacomprehensivebookwhileprovidingtimelyandessentialinformationneededforprudentdecision-makinginpediatricclinicalpractice.UtilizingnationalpediatricexpertsalongwithnationalcerticationexaminationcontentblueprintoutlinesfromtheAmericanNursesCredentialingCenterANCCandthePediatricNursingCerticationBoardPNCBthetextoffersacomprehensivelookatthemostcommonpediatricdiagnosesandpracticeconsiderations.Whetherpreparingforaninitialnationalcerticationexamorneedinganall-inclusiveevidence-basedupdateofthelatestpediatricpracticeguidelinesandtrendsthebookisideal.DesignedinadetailedyeteasytoreadquicktondoutlineformatBarkleysReviewGuideforPediatricNursePractitioners2ndEditionisdividedintothreesections.SectionIPediatricHealthConsiderationsexplorescommonfundamentalprinciplesorganizedbydevelopmentalagegroupincludingimmunizationrecommendations.Uniquetootherbooksthissectionendswithchaptersaddressinggeneticevaluationsandpediatricdisasterplanning.PREFACE xSectionIIPediatricIssuesandDisordersusesbothanageappropriateandsystems-specicapproachtoaddresspediatricconditionsanddisordersfrequentlyencounteredinclinicalpractice.Over300pagesofthemostcommonpediatricpatientpresentationsareincludedhighlightedbycausesincidencedatasignssymptomslaboratorydiagnosticconsiderationsandthemostup-to-datemanagementandtreatmentstrategies.FinallyextensivelydetailedunlikeanyotherpediatricreviewtextthebookendswithSectionIIIPracticeIssuesTrendsandHealthPolicy.Inthissectionnationalimplicationsaffectingnursepractitionerpracticeareexamined.Valuabletopicsforthepractitionerincludescopeofpracticereimbursementregulatoryandaccreditingguidelinesnavigatingthehealthcaresystemonbehalfofthepatienthealthcarepolicynancingbillingandcodingregulatoryandaccreditingguidelinesfederalandstateregulationsexaminingandutilizingevidenceinpracticeandethicalprinciples.Withselectpracticequestionsincludedattheendofeverychapterthisbookwasinspiredbyourvaluedformerstudentsandcustomerstoprovideanadditionalpivotalresourcesotheymaycontinuetheirsuccessfulcareers.Wetrustthatyouwillndthetextcomprehensivelyusefulinyourpracticeaswell. xiSectionOneHealthConsiderationsChapter1PrenatalNewbornHealthScreening3TheNewbornAssessmentHistory3TheNewbornAssessmentPhysicalExamination6TheNewbornAssessmentSelectedScreeningTests14ConsiderationsforNewbornScreening14Chapter2GrowthandDevelopment20ThePhysicalDomain20TheCognitiveDomain24CognitiveandPsychosocialDomain24MajorTheoriesofGrowthandDevelopment25GrowthandDevelopmentLandmarks28GrowthandDevelopmentMilestones30MilestonesbyAge31Chapter3InfantHealthConsiderations35ChildHealthSupervision35TheInterview37ThePhysicalExaminationNecessaryElements37DevelopmentalMonitoring39StageAppropriateScreenings41AnticipatoryGuidance41TABLEOFCONTENTS xiiChapter4ToddlerandPreschoolHealthConsiderations46Defnition46PeriodicityGuidelines46SpecifcToolsofChildHealthScreening48DevelopmentalMonitoring51StageAppropriateScreenings53AnticipatoryGuidance54DevelopmentalDiscussionGuidance55Chapter5SchoolAgeHealthConsiderations59Defnition59Focus59WellChildChecksWCC59AnticipatoryGuidance62DevelopmentalDiscussionGuidance63Chapter6AdolescentHealthConsiderations68Defnition68Focus68WellChildChecksWCC69DevelopmentalMonitoring72AnticipatoryGuidance73Chapter7ImmunizationRecommendations77Catch-upPearls85CommonAdverseResponses86ReportableEventsFollowingVaccination88Chapter8GeneticEvaluations91GeneticAdvancements91GeneticDisorders93OtherSyndromesofNote96 xiiiChapter9DisasterPlanningConsiderations101AnatomicDifferences101PhysiologicalDifferences103ImmunologicDifferences104DevelopmentalDifferences104PsychologicalDifferences104SectionTwoIssuesandDisordersChapter10InfantHealthIssuesandDisorders111DisordersThatMayBePresentatBirth111SuddenInfantDeathSyndromeSIDS111FailuretoThriveFTT112FeveroftheVeryYoungInfant113Chapter11ToddlerandPreschoolIssuesandDisorders120Stuttering120AutismSpectrumDisorder121OtherPervasiveDisorders124Chapter12SchoolAgeandAdolescentIssuesandDisorders128Obesity128ChildAbuseandNeglect129AttentionDefcitHyperactivityDisorderADHD131EatingDisorders136Chapter13CardiovascularIssuesandDisorders141BloodFlowThroughtheHeart141CongenitalHeartDiseasesDefects142CommonGeneticSyndromesandAssociatedCardiacDefects146InnocentMurmurs148 xivHypertension149RheumaticFeverHeartDisease151KawasakiDisease152HeartFailure153Chapter14GastrointestinalIssuesandDisorders157Gastroenteritis157GastroesophagealRefuxDiseaseGERD161PyloricStenosis163Intussusception163Appendicitis164Malabsorption165Hepatitis166Chapter15DermatologicalandCommunicableIssuesandDisorders171EvaluationofSkinDisorders171Acne175FungalInfections177VaricellaZosterVirusChickenpox179MolluscumContagiosum180AtopicDermatitisEczema182AllergicContactDermatitis183IrritantDiaperDermatitis184Psoriasis184PityriasisRosea186Impetigo187Scabies188LymeDisease189Measles191CoxsackieVirusHand-Foot-And-Mouth-Disease193RockyMountainSpottedFever195Warts195SubungalHematoma195 xvChapter16EyeEarNoseandThroatIssuesandDisorders198HordeolumStye198Chalazion199Conjunctivitis199Cataracts201Retinoblastoma201Strabismus202OtitisExternaSwimmersear202AcuteOtitisMediaAOM203SerousOtitisMediaOtisMediawithEffusionOME205HearingLoss205CommonCold206PharyngitisTonsillitis207Epiglottitis209Croup209InfectiousMononucleosis210SinusitisRhinosinusitis211Chapter17RespiratoryIssuesandDisorders215PulmonaryFunctionsTests215Bronchiolitis216Asthma217Pneumonia222CysticFibrosis223Chapter18InfammatoryMusculoskeletalIssuesandDisorders227Osgood-SchlatterDiseases227ToxicSynovitis227Legg-Calve-PerthesDiseaseLCPD228SlippedCapitalFemoralEphiphysisSCFE230GenuVarumBowleg231GenuValgumKnock-Knee231 xviScoliosis232DevelopmentalDysplasiaoftheHipDDH233MuscularDystrophy234AnkleSprain235Chapter19NeurologicalIssuesandDisorders239CranialNerves239Headache240FirstorWorstHeadaches241MigraineHeadachesVascularHeadaches243SeizureDisorder246FebrileSeizures252NeurofbromatosisVonrecklinghausenDisease253TicDisorders254Chapter20HematologicalIssuesandDisorders260RedBloodCellRBCIndices260Anemias261MicrocyticAnemias261LeadPoisoning267Glucose-6-PhosphateDehydrogenaseDefciencyG6PD268Leukemias269Chapter21EndocrineIssuesandDisorders273DiabetesMellitus273Hyperthyroidism278Hypothyroidism280ShortStature282Chapter22GenitourinaryandGynecologicalIssuesandDisorders287Enuresis287UrinaryTractInfection289GlomerulonephritisGN291 xviiHypospadias292CryptorchidismUndescendedTestes293TesticularTorsion293Dysmenorrhea294Sexually-TransmittedDiseasesandInfections295SectionThreePracticeIssuesTrendsandHealthPolicyChapter23PracticeIssuesTrendsandHealthPolicy307TheNursePractitionerPatientRelationship307PrivacyandConfdentiality308HealthCareDelivery312ProfessionalResponsibility319EthicalPrinciples324HistoryoftheNursePractitionerRole325Evidence-basedPracticeandResearchMethods326LegalTerms329CulturalCompetence331References337Index357 ComprehensivetexttailoredtotheneedsofPediatricNursePractitionersEvidence-baseddiscussionsformorethan400ofthemostcommonconditionsandtreatmentsinpediatricpracticeSelectfocusedpracticequestionsaftereverychapterExtensivesectiononIssuesTrendsandHealthPolicySupplementalchartsandfiguresforeasy-to-accessinformation978098640211190000ISBN978-0-9864021-1-1TextOverviewwww.NPcourses.com