NRNP – 6541 Primary Care of Adolescents & Children

Week 1: Overview of Growth and Development and Genetic Conditions

How many times have you wished you had a crystal ball? How often have you thought, If only I had known…in relation to personal and professional decisions? We all wish we always had the best information and advice available for charting the best path forward.
Sometimes we have the information we need—and sometimes we are that crystal ball for others. Specifically, as a nurse practitioner engaged in pediatric care, you have a significant role in setting young people on a healthy path through life. Certainly, a crystal ball is not among your professional tools. (And how much easier would your work be if it were?) Rather, your knowledge of factors for optimal growth and development, and guidance for families in establishing habits that help children thrive, can support longer, happier, and more productive lives for your pediatric patients.
Understanding what impacts growth and development in positive or adverse ways enables you to both treat specific conditions and promote wellness. Here, too, knowledge is key. Not only in terms of information such as a family’s genetic history, but in working closely with families to learn their ideas of what matters for children’s growth and development. Appreciating and respecting cultural perspectives is vital in creating a foundation of trust for encouraging healthful choices and decisions for children and, as they age into adolescence, by them as well.
This week you will begin with an overview of human growth and development that continues with more depth in the weeks that follow. Through the Week 1 text readings and other Learning Resources, you will also examine fundamentals of pediatric care and analyze the challenges and opportunities this course provides in meeting your career goals. No crystal ball required—just thoughtful consideration of the path you aim to follow in advanced nursing as a Family Nurse Practitioner.
Learning Objectives
Students will:

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Analyze strengths and challenges related to advanced nursing in pediatric care
Analyze career goals and objectives in pediatrics

Learning Resources

Required Readings (click to expand/reduce)

Required Media (click to expand/reduce)

Discussion: Getting Started with Pediatrics

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Primary care of children from newborns to those on the cusp of adulthood requires considerable knowledge, as well as the finesse to manage parents and families of all types, and the changing needs, attitudes, and independence of young people as they grow and mature. Considering that this week—in fact, this entire first module—is focused on growth and development, it is fitting for you to reflect on your current and anticipated

growth and development in advanced nursing, and specifically, in pediatric care. When you made your decision to pursue training as a Family Nurse Practitioner, how did pediatrics factor in your thinking? Is the opportunity to work with children and adolescents a strong motivator, or does it rank for you as more of a concern?
As you get started with this course, take time to reflect on your present capacity as you prepare to immerse yourself in the requirements of pediatric care as a nurse practitioner. How can you benefit most from this course, and how can it further you along the professional path you have chosen or in achieving your career goals?
This Discussion can be a catalyst for self-assessment and offer valuable insights from your colleagues. It is also an opportunity to get to know them and to introduce yourself, in anticipation of further interaction as you engage in the course i-Human Assignments.
To prepare:

Review this week’s Learning Resources, and particularly Chapters 5, 6, 8, and 14 of the Burns’ Pediatric Primary Care text.
Consider the roles and responsibilities of a nurse practitioner providing pediatric primary care. Work to define the strengths you bring to the position of Family Nurse Practitioner and the challenges you face.
Reflect on this course and what you expect to learn and do, such as by reviewing the course description, outcomes, and course introduction. Consider how the next 11 weeks can help build your strengths and address your challenges.
Also consider your career goals and objectives and how this course can support and/or further them. Be detailed in your thinking.

By Day 3 of Week 1
Post a brief introduction of yourself that includes an explanation of your strengths and challenges as they apply to pediatrics and the role of a Family Nurse Practitioner. Also explain your career goals and objectives, and how your work in this course can help to accomplish those goals and objectives as a Family Nurse Practitioner. Use your research to support your explanations by providing credible and scholarly sources.
Read a selection of your colleagues’ responses.
By Day 6 of Week 1
Respond to at least two of your colleagues’ posts on two different days by offering suggestions or resources to help your colleagues in addressing their professional strengths, challenges, or career goals and objectives. Use your research to support your suggestions. Provide at least 3 credible and current scholarly sources.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information
Grading Criteria
To access your rubric:
Week 1 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 1
To Participate in this Discussion:
Week 1 Discussion

Assignment: i-Human Case Studies

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In the weeks ahead, you will be required to complete assignments addressing specific health conditions through a virtual patient encounter using the i-Human simulation software. You will have a total of six i-Human Case Study Assignments throughout the course, which you will complete in the i-Human Patients platform.

In preparation for your first assignment, ensure that you are able to login to the software. Refer to the Student Manual in the Learning Resources for this week for support in navigating i-Human.
In addition, you are highly encouraged to explore the practice case, available in the Week 1 Learning Resources. No grade will be assigned for this practice case, but it must be completed in Week 1 to receive feedback.
No Assignment submission required for this week. 

Assignment 2

Practicum Manual Acknowledgment
The Practicum Manual describes the structure and timing of the classroom-based and practicum experiences and the policies students must follow to be successful in the nurse practitioner (NP) specialties.

Field Experience: MSN Nurse Practitioner Practicum Manual

Click here and follow the instructions to confirm you have downloaded and read the entire MSN Nurse Practitioner Practicum Manual and will abide by the requirements described in order to successfully complete this program.

What’s Coming Up in Week 2?

Practicum – Upcoming Deadline
In the Nurse Practitioner programs of study (FNP, AGACNP, AGPCNP, and PMHNP) you are required to take several practicum courses. If you plan on taking a practicum course within the next two terms, you will need to submit your application via Meditrek .
For information on the practicum application process and deadlines, please visit the Field Experience: College of Nursing: Application Process – Graduate web page.
Please take the time to review the Appropriate Preceptors and Field Sites for your courses.
Please take the time to review the practicum manuals, FAQs, Webinars and any required forms on the Field Experience: College of Nursing: Student Resources and Manuals web page.

Field Experience: College of Nursing Quick Answers

Field Experience: MSN Nurse Practitioner Practicum Manual
Student Practicum Resources: NP Student Orientation

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Next week, you will continue your focus on growth and development with a detailed exploration of the first years of life. In considering primary care of infants, toddlers, and preschoolers, you will explore issues that can affect young children’s growth and development.

i-Human Case Study

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In Week 2, you will complete your first i-Human Case Study Assignment on evaluation and management of growth and development issues. Be sure you have your i-Human login and password, and contact your Instructor if you are missing this information.

To go to the next week:
Week 2

 
 
 

Week 2: Infants, Toddlers, and Preschoolers

When we think of human growth and development, perhaps no age comes to mind more vividly than the youngest children. Tracking the extraordinary changes that occur with often amazing speed from birth to the advent of formal schooling around age 5 is exciting, awe-inspiring, and frequently, anxiety producing for families. The spectrum of where children may fall in growth and development is particularly wide in these years. And recognizing when extra attention is needed or a condition is present to be addressed can be made more complicated by family interpretations or expectations, and the limited capacity of infants, toddlers, and preschoolers to convey what they are, or are not, experiencing.
Primary care of infants, toddlers, and preschoolers requires both detective and diplomatic skills on the part of nurse practitioners. Assessing very young children involves employing knowledge of child development and developmental milestones with what you can observe and interpreting red flags that may signal developmental issues. As to diplomacy, families can hold beliefs, notably resistance to vaccines and immunization protocols, which impact young children’s health and well-being. Working with families to understand and address their ideas, preferences, and possible misconceptions is vital for developing a solid care team of key adults and you.
This week you will prepare for your youngest patients with Learning Resources on topics related to care and development of infants, toddlers, and preschoolers, as well as recognizing and responding to developmental concerns. Through your first i-Human Case Study Assignment this week, you will assess, evaluate, diagnose, treat, and manage patients with potential growth and development issues. Keep in mind that considering the unique needs of the family is an essential element of this and every pediatric visit in the course, and your future practice.
Learning Objectives
Students will:

Assess growth and development in pediatric patients
Evaluate health conditions of pediatric patients
Formulate differential diagnoses for pediatric patients
Analyze socio-cultural needs of pediatric patients and families
Formulate evidence-based treatment and management plans
Recommend evidence-based care strategies and wellness education for pediatric patients and families

Learning Resources

Required Readings (click to expand/reduce)

Required Media (click to expand/reduce)

Assignment: i-Human Case Study: Evaluation and Management of Growth and Development Issues

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Imagine this is your first day or perhaps your 500th day as a Family Nurse Practitioner. You enter the examination room where a young child—infant, toddler, preschooler—and one or more family members, who may be a parent, grandparent, or other caregiver, are waiting for you. Imagine the child and family are new patients, and this is your first time meeting them.

That introduction sets the stage for this Assignment. You will use the i-Human technology to meet and treat your avatar pediatric patient. Pay particular attention to the socio-cultural details that are provided for the featured family. Consider what would be important for you to know and to ask in order not only to assess, evaluate, and diagnose a young child, but also to develop evidence-based treatment and management plans and recommend specific activities and routines to promote health and wellness.
To prepare:

Review the Learning Resources. Consider how to apply understanding of developmental milestones and socio-cultural family needs in assessing, diagnosing, and treating pediatric patients.
Access i-Human Patients from this week’s Learning Resources and review the i-Human Case Study. Based on the provided patient information, think about the health history you would need to collect from the patient.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.
Identify 3–5 possible conditions that may be considered in a differential diagnosis for the patient.
Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
Develop a treatment plan for the patient that includes health promotion and patient education strategies for patients and families.

Assignment:
As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the i-Human Graduate Programs Help link within the i-Human platform.
By Day 7 of Week 2
Complete your Assignment in i-Human.
Grading Criteria
To access your rubric:
Week 2 Assignment Rubric

What’s Coming Up in Week 3?

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Next week, you will focus on growth and development of school-age children and adolescents up to age 21, when young people transition to adult care. Although you will not have an i-Human Case Study Assignment next week addressing this specific age group, looking ahead to other modules in the course, you will have i-Human Assignments that feature patients ages 5 and older. Careful attention to key aspects of growth and development for school-age children and adolescents will support your work in future weeks.

Knowledge Check

Next week, you will take the Module 1 Knowledge Check. This formative assessment will include questions pertaining to content from Weeks 1–3. Plan your time accordingly to allow adequate time to read and review all Module 1 Learning Resources to prepare for the Knowledge Check, which must be completed by Day 7.

To go to the next week:
Week 3

Week 3: School-Age Children and Adolescents

Consider the range of pediatric patients you may see in an average day as a Family Nurse Practitioner. Some may be the little ones you examined previously. Some may be young school-age children whose stages of growth and development are closer to preschoolers and not yet transitioning to middle childhood. Yet as your patients increase in chronological age, growth and development take more conspicuous turns. It is no coincidence that teachers of young children and teachers of young adolescents have many parallel experiences. Both early childhood and young adolescence are significant periods of physical, cognitive, social, and emotional development.
Although aspects of pediatric care for school-age and adolescent patients can be easier—most, at least theoretically, are able to answer questions—the need for both detective and diplomatic skills continues. Physical changes in children can trigger all kinds and degrees of emotional response. Concerns about body image are central in this time, and “early bloomers” and “late bloomers” can struggle as they compare themselves to some concept of “normal.” Blooming sexuality can raise issues of confidentiality, such as when teens and parents are in conflict over sexual activity or identification. Your role requires understanding rights on all sides and negotiating help, when you can.
This week, the Learning Resources are selected to help you prepare for both the mundane and dramatic aspects of monitoring growth and development, and resulting care needs, of school-age children and adolescents. There is no assignment pertaining to this age group, in order to allow sufficient time to review for your Module 1 Knowledge Check. However, keep in mind that as you move on to the next modules on specific conditions, your foundational knowledge of growth and development in children and teens will aid in assessing and evaluating your i-Human pediatric patients, and of course, your very human ones ahead.
Learning Objective
Students will:

Identify key terms, principles, and concepts related to growth and development of infants, toddlers, preschoolers, school-age children, and adolescents, and primary care of pediatric patients

Learning Resources

Required Readings (click to expand/reduce)

Required Media (click to expand/reduce)

Knowledge Check: Module 1: Evaluation and Management of Growth and Development Issues

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Throughout the course you will have 4 Knowledge Check assessments, one in each module. These exercises are situated to provide you with formative practice, help you gauge your understanding of each module, and prepare for the Midterm in Week 6 and the Final Exam in Week 11. Looking ahead, each Knowledge Check also helps to ready you for the exam that will count most, for your Family Nurse Practitioner certification.

This week, be sure to allot plenty of time for reviewing key concepts and information from Weeks 1–3. A list of topics is included to help you focus your preparation. You will have 20 questions to answer.
To prepare:

Review Weeks 1–3 Learning Resources, using the topic list, below, as a guide.
Module 1 Knowledge Check topics will include the following:

Developmental milestones of infants, toddlers, preschoolers, school-age children, and adolescents
Developmental issues and red flags
Genetic conditions
Preventative care and wellness
Vaccines and immunizations
Age/stage-appropriate healthy nutrition/elimination, physical activity, sleep and rest
Age/stage-appropriate healthy sexual development and sexuality
Socio-cultural considerations in treating/working with patients and families
Evidence-based strategies for patient/family health promotion and education

Knowledge Check
You are required to answer 20 questions, randomly selected. You will have 1 attempt for each question. Each question is worth 1 point.
By Day 7 of Week 3
Complete and submit your Knowledge Check.
Submission Information
Submit Your Knowledge Check by Day 7
To submit your Knowledge Check:
Week 3 Knowledge Check

What’s Coming Up in Module 2?

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Next week you will move on to Module 2 and the introduction of specific health conditions to address in children and adolescents.

i-Human Case Study

In Week 4, you will complete a i-Human Case Study Assignment on Eye, Ear, Nose, and Throat conditions. As needed, consult the i-Human Manual to answer questions or in other ways strengthen your preparation for the week ahead.

Photo Credit: Getty Images/iStockphoto

To go to the next module:
Module 2

Module 2: EENT, Respiratory and Cardiovascular, and Dermatological Conditions

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Think of all the common sayings that use parts of the body to convey strong emotions, even though, taken literally, they make little sense. For example, “I’m all ears!”, meaning you’re very eager to hear what somebody has to say. But everyone has only two ears and when those two ears are working properly, in most situations, two is enough. Imagine how loud and chaotic the world would sound to be listening with 10 ears, or 20!
Or we talk, and often with great drama, about eyes being like windows that let us look inside another person and know that person deeply. But eyes are designed to see out, and not for others to see in.
Lungs and heart are also favorites. When we’re very enthusiastic or very mad, we “yell at the top of our lungs!” Not at the bottom of the lungs, always the top. If “you wear your heart on your sleeve,” you’re letting everyone know how you feel. And overall, we speak of the heart as where emotions are found, as though love and courage, anger, sadness and fear, are all crammed inside that pumping muscle.
Here’s one more example: when something “gets under our skin,” we’re truly upset! How that saying evolved is certainly a mystery. Because, well, there is something under our skin: muscle, bone, blood and a whole amazing set of organs and array of systems that make up the human body.
The point here is not how nonsensical language can be, but how connected we are emotionally to our bodies and, in particular, to certain parts. As a nurse practitioner you will have varying opportunities to explore eyes, ears, heart, lungs, skin—and conditions that can go wrong with each in children and adolescents. It’s good to remember how special those parts are, not just in function but in feeling too.
What’s Happening This Module?
Module 2: EENT, Respiratory and Cardiovascular, and Dermatological Conditions is a 3-week module. In each week of the module, you will focus on specific structures or systems of the body and consider conditions that children and adolescents may present. Specifically, in Week 4, your attention is eye, ear, nose, and throat (EENT) conditions and includes an i-Human Case Study Assignment to complete. In Week 5, you move on to the respiratory and cardiovascular systems, with the third i-Human Case Study Assignment. In Week 6, your focus is dermatological conditions, with Learning Resources on skin issues and ailments in childhood and adolescence. There is no i-Human Assignment in Week 6, to allow ample time to prepare for two key assessments: The Module 2 Knowledge Check and the Midterm Exam.

 

What do I have to do?
When do I have to do it?

Review your Learning Resources
Days 1–7, Weeks 4, 5, 6
 

Week 4 i-Human Case Study: Evaluation and Management of EENT Conditions
 
By Day 7 of Week 4
Complete and submit your i-Human Case Study Assignment

Week 5 i-Human Case Study: Evaluation and Management of Respiratory and Cardiovascular Conditions
By Day 7 of Week 5
Complete and submit your i-Human Case Study Assignment

Week 6 Module 2 Knowledge Check
 
By Day 5 of Week 6
Complete and submit your Module 2 Knowledge Check

Week 6 Midterm Exam
 
By Day 7 of Week 6
Complete and submit your Midterm Exam

 

Go to Weekly Content
Week 4
Week 5
Week 6
 

Week 4: Evaluation and Management of EENT Conditions

It is the first thing you observe as you meet a young patient—the child’s face: eyes, ears, nose, mouth. So, as this course on primary care shifts from a focus on a child’s whole-body growth and development to specific body structures and systems, it is natural to start with those defining features.
Close observation is among your most important tools in caring for children and adolescents. Eyes, ears, nose, and throat (EENT) exams are all part of a well-child visit. Your knowledge of what is normal and what is not will support you in identifying conditions and disorders that can impact children’s sight and hearing, their normal breathing, and restful sleep.
Assessing and evaluating EENT conditions may require your detective skills of observing, listening, and careful questioning. Or, in cases of injury to eyes, an object in a child’s ear or nose, or an obvious throat issue, the problem and your needed response may be immediately clear. The Learning Resources this week provide knowledge and recommendations for preparing for pediatric patients with a range of possible EENT conditions and emergencies, and for making diagnoses and determining treatments.
Keep in mind the importance of your relationship with parents and guardians. The more you understand about a family and the greater the cooperative bond you form, the more effective the management strategies you can provide.
This week you will further your preparation in all of these aspects of pediatric care as you complete your i-Human Case Study in evaluating and managing EENT conditions.
Learning Objectives
Students will:

Assess pediatric patients for eye, ear, nose, and throat conditions
Evaluate health conditions of pediatric patients
Formulate differential diagnoses for eye, ear, nose, and throat conditions in pediatric patients
Analyze socio-cultural needs of pediatric patients and families
Formulate evidence-based treatment and management plans for eye, ear, nose, and throat conditions in pediatric patients
Recommend evidence-based strategies for educating patients and families on treatment and management of eye, ear, nose, and throat conditions

Learning Resources

Required Readings (click to expand/reduce)

Required Media (click to expand/reduce)

Assignment: i-Human Case Study: Evaluation and Management of EENT Conditions

Photo Credit: Getty Images

Welcome to another i-Human Case Study. Take a moment to imagine a child and family you might meet. Based on the Learning Resources for this week, consider eye, ear, nose, and throat (EENT) conditions you may identify frequently as a Family Nurse Practitioner and those that may be more unusual. Also consider what aspects of the exam process might be more challenging for you—assessing, evaluating, providing multiple diagnoses, treatments, or offering the patient and family management advice. Work to be mindful of how to take best advantage of the simulated i-Human exam to prepare for pediatric patients with EENT conditions.

To prepare: 

Review this week’s Learning Resources and consider how to apply knowledge of EENT conditions and understanding of socio-cultural family needs in assessing, diagnosing, and treating pediatric patients.
Access i-Human Patients from this week’s Learning Resources and review the i-Human Case Study. Based on the provided patient information, think about the health history you would need to collect from the patient.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.
Identify 3–5 possible conditions that may be considered in a differential diagnosis for the patient.
Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
Develop a treatment plan for the patient that includes health promotion and patient education strategies for patients with EENT conditions and their families.

Assignment: 
As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the i-Human Graduate Programs Help link within the i-Human platform.
By Day 7 of Week 4
Complete your Assignment in i-Human.
Grading Criteria
To access your rubric:
Week 4 Assignment Rubric

What’s Coming Up in Week 5?

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Next week, you will address respiratory and cardiovascular health of children and adolescents and conditions related to these critical human systems. As a Family Nurse Practitioner, you may be the first to diagnose a child’s respiratory or cardiovascular condition or be part of an ongoing effort to treat and manage one. Needless to say, the Week 5 content is among the most significant for the well-being of pediatric patients.

To go to the next week:
Week 5

Week 5: Evaluation and Management of Respiratory and Cardiovascular Conditions

Respiratory disorders are a natural next focus from EENT, given the nostrils and epiglottis are part of the upper respiratory tract. And a stuffy or runny nose, and a scratchy or sore throat are among the symptoms of familiar upper respiratory conditions like the common cold.
Lower respiratory tract disorders such as pediatric asthma may also be common, particularly if you practice in an inner-city urban center (Asthma and Allergy Foundation of America, 2019). Helping families manage a child’s asthma and other respiratory conditions with environmental triggers, such as secondhand smoke, can involve astute diplomacy in recommending ways to provide healthier air at home.
As you anticipate what to expect in assessing cardiovascular conditions in children, consider that “most…are due to congenital heart disease (CHD), which affects nearly 1% of all live births—or about 40,000 babies per year” (Burns, 2017, p. 756). Whether you will care for a child with CHD, or be the first to recognize a child’s condition, your work requires “a high index of suspicion regarding any signs or symptoms of cardiovascular disease in young children” (Burns, 2017, p. 756).
While CHD may cause most pediatric heart ailments, cardiovascular disease can be acquired when children and adolescents develop hypertension. For many young people under stress or getting too little physical exercise and carrying too much body weight, high blood pressure is a dangerous outcome. In turn, understanding family history and habits is vital for managing the condition and helping the child or adolescent, and perhaps the entire family, to adopt different approaches, priorities, and routines.
This week, will be a “quiet” week in which you will take the time to review the Learning Resources and prepare for your Midterm Exam in Week 6. No Assignment submissions will be required for this week however, it will be important for you to continue to work through the topics for this week. The Learning Resources will prepare for your pivotal role as a primary care provider in evaluating and managing pediatric respiratory and cardiovascular conditions.
Reference
Asthma and Allergy Foundation of America. (2019). Asthma capitals 2019. https://www.aafa.org/asthma-capitals/
Learning Objectives
Students will:

Assess pediatric patients for respiratory and cardiovascular conditions (A)
Evaluate health conditions of pediatric patients (A)
Formulate differential diagnoses for pediatric respiratory conditions (A)
Formulate differential diagnoses for pediatric cardiovascular conditions (A)
Analyze socio-cultural needs of pediatric patients and families (A)
Formulate evidence-based treatment and management plans for pediatric patients with respiratory conditions (A)
Formulate evidence-based treatment and management plans for pediatric patients with cardiovascular conditions (A)
Recommend evidence-based strategies for educating patients and families on treatment and management of respiratory conditions (A)
Recommend evidence-based strategies for educating patients and families on treatment and management of cardiovascular conditions (A)

 

Learning Resources

Required Readings (click to expand/reduce)

Required Media (click to expand/reduce)

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