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Care of the Child With a Health Disorder . 415 Chapter 16 Nursing Care of the Child With an Infectious or Communicable Disorder.. 417 Infectious Process, 418 xxii CONTENTS Variations in Pediatric Anatomy and Physiology, 420 Common Medical Treatments, 420 Sepsis, 433 Bacterial Infections, 435 Scarlet Fever, 435 Cat Scratch Disease, 436 Diphtheria, 437 Pertussis, 437 Tetanus, 438 Viral Infections, 438 Viral Exanthems, 439 Mumps, 439 Poliomyelitis, 439 Rabies, 445 Vector-Borne Infections, 446 Lyme Disease, 446 Rocky Mountain Spotted Fever, 449 Parasitic and Helminthic Infections, 451 Sexually Transmitted Infections, 451 Chapter 17 Nursing Care of the Child With a Neurologic Disorder 466 Variations in Pediatric Anatomy and Physiology, 467 Common Medical Treatments, 467 Seizure Disorders, 467 Epilepsy, 475 Febrile Seizures, 489 Neonatal Seizures, 489 Structural Defects, 490 Neural Tube Defects, 490 Microcephaly, 492 Arnold-Chiari Malformation, 492 Hydrocephalus, 492 Intracranial Arteriovenous Malformation (AVM), 496 Craniosynostosis, 496 Positional Plagiocephaly, 498 Infectious Disorders, 499 Bacterial Meningitis, 499 Aseptic Meningitis, 501 Encephalitis, 502 Reye’s Syndrome, 503 Botulism, 503 Rabies, 504 Trauma, 504 Head Trauma, 504 Nonaccidental Head Trauma, 508 Birth Trauma, 510 Near Drowning, 510 Blood Flow Disruption, 511 Cerebral Vascular Disorders (Stroke), 512 Periventricular/Intraventricular Hemorrhage (PVH/IVH), 512 Chronic Disorders, 513 Headaches, 513 Breath Holding, 514 Chapter 18 Nursing Care of the Child With a Disorder of the Eyes or Ears Variations in Pediatric Anatomy and Physiology, 518 Common Medical Treatments, 518 Infectious and Inflammatory Disorders of the Eyes, 525 Conjunctivitis, 525 Nasolacrimal Duct Obstruction, 527 Eyelid Disorders, 527 Periorbital Cellulitis, 528 Eye Injuries, 529 Visual Disorders, 531 Refractive Errors, 532 Astigmatism, 532 Strabismus, 533 Amblyopia, 534 Nystagmus, 534 Infantile Glaucoma, 534 Congenital Cataract, 535 Retinopathy of Prematurity, 535 Visual Impairment, 536 Otitis Media, 538 Acute Otitis Media, 538 Otitis Media With Effusion, It has been predicted that our greatest advances in the next decade will not come from technology but from our deeper understanding of what it means to be human, spiritual beings (Naisbitt, 2000). In the 21st century, significant demographic, economic, social and environmental changes will influence families and affect children’s health. Children’s health care must have a broader approach than simply a focus on detection and management of disease. Complex health conditions that plague children today require greater skills and understanding on the part of the nurse. The concept of holistically caring for humankind—as mental, emotional, and spiritual beings—has gained popularity in health care (Sessanna, 2003). Complementary modalities are becoming increasingly popular, and consumers and healthcare providers are including holistic therapies in their everyday care for both self and patient. Holistic care can expand the experiences of both the child and family and change the way that nurses experience practice. In this era of increasingly sophisticated healthcare technology and technical demands, nurses need to preserve efforts to provide humanistic, compassionate and holistic care (Driessnack, 2004). I have been a pediatric nurse for more than 35 years and an advanced practice nurse for 27 of those years. From the holistic nursing: Every Nurse’s Specialty © iStockphoto.com/Dra Schwartz fall 2009 Beginnings 21 beginning of my practice, I have embraced a caring/healing philosophy of care. Self-care has been at the center of my practice. Children and families have received holistic care in my practice and have provided me with some of my greatest education about the human condition. To have a holistic approach to health care is to hold a worldview that emphasizes healing as always possible, no matter what the individual situation (Frisch, 2001). Through a healing process, patients draw on their inner strength with a goal to reach something that is intangible. Peace can be realized by even very young children through some of life’s greatest trials (Driessnack, 2004). One of the greatest challenges for holistic nurses, particularly in pediatrics, is being able to focus on healing within a healthcare system that embraces a reductionistic view of health care. Nurses can meet these challenges by expanding their caring approaches informed by research, education and practice (praxis). To create a caring environment and engender an atmosphere of respect and compassion, nurses need to understand what caring is, how to be caring, and the impact of caring and non-caring on others (Hunt, 1999). Praxis is a synthesis of thoughtful reflection, caring and action within a theory and research-driven practice. So how do I integrate my holistic philosophy into a healthcare setting that is financially driven to provide medical care from a reductionistic approach? I start each day with meditation and prayer. I also depend on my intuition and sensing to guide me through each patient encounter. Before entering a patient room, I spend a few moments centering, opening the flow of energy focused on being present in the moment. Each child in my practice is treated as a unique individual with a historicity to be
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