Contents
Contributors vii
Preface ix
Part I Clinical Issues in
Paediatrics 1
1. A developmental approach to the
history and physical examination in
paediatrics 3
2. Anatomical and physiological
differences in paediatrics 8
3. Care of the adolescent 12
4. General principles in the
assessment and management of
the ill child 15
5. Pharmacology in paediatrics 1 8
6. Internet resources for the nurse
practitioner 22
7. Paediatric telephone advice and
management for the nurse
practitioner 27
8. Transcultural nursing care 31
Part II Common Paediatric
Problems 35
9. Dermatological problems 37
9.1 'My child has a rash' 37
9.2 Acne 42
9.3 Atopic eczema 47
9.4 Birthmarks 50
9.5 Burns 55
9.6 Cellulitis 59
9.7 Food allergy 61
9.8 Fungal skin infections 64
9.9 Impetigo 70
9.10 Infantile seborrhoeic
dermatitis (ISD) or infantile
eczema (including cradle
cap) 73
9.11 Nappy rash 75
9.1 2 Pediculosis humanus capitus
(head lice) 77
9.13 Psoriasis 79
9.14 Scabies 83
9.15 Viral skin infections (warts
and molluscua
contagiosum) 85
10. Problems related to the head,
eyes, ears, nose, throat or
mouth 88
10.1 Congenital blocked
nasolacrimal duct 88
10.2 Eye trauma 90
10.3 The'red eye' 95
10.4 Common oral lesions
100
10.5 Common oral trauma
105
10.6 Acute otitis media 109
10.7 Amblyopia and strabismus
112
11. Respiratory and cardiovascular
problems 1 16
11.1 Asthma and wheezing
116
1 1.2 Bronchiolitis 121
11.3 Pneumonia 124
1 1.4 Stridor and croup
(laryngotracheobronchitis)
127
11.5 Syncope 130
11.6 Chest pain 133
12. Gastrointestinal and endocrine
problems 137
12.1 Acute abdominal pain
137
12.2 Childhood constipation
and encopresis 141
Contents
12.3 Acute gastroenteritis
(vomiting and diarrhoea)
144
12.4 Jaundice 148
12.5 Threadworms 153
12.6 Diabetes mellitus 154
12.7 Delayed sexual
development (delayed
puberty) 158
12.8 Premature sexual
development (precocious
puberty) 162
12.9 Short stature 164
12.10 Ingestions and poisonings
168
13. Musculoskeletal problems,
neurological problems and
trauma 172
13.1 Limp and hip pain 172
13.2 Lacerations 175
1 3.3 Pain assessment and
management 177
13.4 Febrile seizures 183
13.5 Head injury 185
14. Genitourinary problems and
sexual health 1 89
14.1 Urinary tract infection
189
14.2 Enuresis 192
14.3 Vulvovaginitis in the
prepubescent child 195
14.4 Adolescent contraception
198
14.5 Sexually transmitted
infections 202
14.6 Painful male genitalia
207
15. Infectious diseases and
haematology 21 3
15.1 Acute fever (<7 days
duration) 213
15.2 Glandular fever (Epstein-
Barr infection) 217
Contributors
Editor
Katie Barnes MSc MPH BSc(Hons) CPNP
Katie Barnes is a Certified Paediatric
Nurse Practitioner (CPNP) who emigrated
from America in 1997. Originally from
Cape Cod, she received her undergraduate
nurse training in Boston at Northeastern
University in 1986 and subsequently
moved to New York City where she
completed a Master of Science degree in
Paediatric Primary Care at Columbia
University in 1989. After achieving her
National Board Certification as a PNP,
she was named as a Fellow in the National
Association of Paediatric Nurse
Practitioners and began working with
disenfranchised children on mobile
medical units in the New York homeless
and foster care systems. Katie followed
this with a PNP position in paediatric
haematology at Columbia-Presbyterian
Medical Centre until she travelled to the
jungles of Guatemala to work with Mayan
children in rural villages. She returned
from Central America to conduct a
community-based, randomised controlled
trial for the New York City Department
of Health and Columbia University
School of Public Health where she also
completed a Master of Public Health in
1996. Upon arriving in England, she
worked as a lecturer in child health and a
paediatric nurse practitioner (PNP) until
she moved to Liverpool in 2002 (where
she continues her practice and consulting
work). During her 6 years in England,
Katie has been very fortunate to
collaborate in the education, training
and policy development of advanced
paediatric nursing practice; she lectures,
consults and presents widely on a variety
of educational, clinical and advanced
practice policy issues.
Medical Consultant
Peter Wilson MBCKB, MRCPCH
Peter received his medical degree in
1993 from the University of Cape Town,
South Africa. After working in primary
care paediatrics for 2 years he arrived in
the UK where he has worked in
paediatrics ever since. He became
a member of the Royal College of
Paediatrics and Child Health in 1997
and is currently in his final year as
a Specialist Registrar in paediatric and
cardiac intensive care at Great Ormond
Street Hospital. His special interests are
sepsis and the critically ill child.
Pharmacy Consultant
Sara HigginSOn BPharm, MRPharmS
Sara qualified as a pharmacist from
Bradford University in 1992 and
subsequently accepted a post at Ipswich
Hospital in Suffolk. In 1994 she received
her London Diploma in Pharmacy
Practice from the London School of
Pharmacy. Sara chose to pursue paediatric
and neonatal pharmacy in 1997.
Contributors
Andrea G Abbott DBO(T) BSc(Hons) SRO
Clinical Tutor/Orthoptist,
Maidstone Ophthalmic Hospital,
Maidstone
10.7 Amplyopia and strabismus
Dolsie Allen MSc RN CFNP
Former Senior Lecturer,
Nurse Practitioner Programme,
Saint Martin's College, Lancaster
14.3 Vulvo-vaginitis in the
prepubescent girls
14.5 Sexually transmitted infections
Gilly Andrews RGN ENBAOS ENBSIOS
Clinical Nurse Specialist in
Family Planning,
King's College Hospital
NHS Trust, London
14.4 Adolescent contraception
Katie Barnes MSc MPH BSc(Hons) CPNP
Consultant, National Nursing
Leadership Programme, Manchester;
Certified Paediatric Nurse Practitioner,
Old Swan NHS Walk-in Centre,
Liverpool; Visiting Lecturer,
Paediatric Nurse Practitioner
Programme, City University,
Saint Bartholomew School of Nursing
and Midwifery, London;
Guest Lecturer, Paediatric Nurse
Practitioner Programme, Saint Martin's
College, Lancaster
1. A developmental approach to the
history and physical
2. Anatomical and physiological
differences in paediatrics
3. Care of the adolescent
4. General principles in the assessment
and management of the ill child
5. Pharmacology in paediatrics
12.1 Acute abdominal pain
15.1 Acute fever
Kelly A Barnes DMD
Certificate of Advanced Graduate Study
in Endodontics, Boston University School
of Dental Medicine, Boston, USA.
Private Practice, Endodontic Associates
of Lexington, USA
10.4 Common oral lesions
10.5 Common oral trauma
Breidge Boyle MSc BSc RGN RSCN
Advanced Nurse Practitioner
(Neonatal), Great Ormond Street
Hospital, London
Appendix 2 Age-appropriate B/P and
vital signs
Gill Brook CBE RSCN RGN
Clinial Nurse Specialist, Liver Disease,
Birmingham Children's Hospital NHS
Trust, Birmingham
12.4 Jaundice
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