,Pediatric FOURTH
EDITION
Primary Care
Practice Guidelines for Nurses
Edited by
Beth Richardson, PhD, RN, CPNP, FAANP
Pediatric Nurse Practitioner
HealthNet, Inc.
Associate Professor Emeritus
School of Nursing
Indiana University
Indianapolis, Indiana
,World Headquarters
Jones & Bartlett Learning
5 Wall Street
Burlington, MA 01803
978-443-5000
www.jblearning.com
Jones & Bartlett Learning books and products are available through most bookstores and online booksellers. To contact Jones &
Bartlett Learning directly, call 800-832-0034, fax 978-443-8000, or visit our website, www.jblearning.com.
Substantial discounts on bulk quantities of Jones & Bartlett Learning publications are available to corporations, professional
associations, and other qualified organizations. For details and specific discount information, contact the special sales
department at Jones & Bartlett Learning via the above contact information or send an email to .
Copyright © 2020 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or
mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission
from the copyright owner.
The content, statements, views, and opinions herein are the sole expression of the respective authors and not that of Jones & Bartlett
Learning, LLC. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer,
or otherwise does not constitute or imply its endorsement or recommendation by Jones & Bartlett Learning, LLC and such refer-
ence shall not be used for advertising or product endorsement purposes. All trademarks displayed are the trademarks of the par-
ties noted herein. Pediatric Primary Care: Practice Guidelines for Nurses, Fourth Edition is an independent publication and has not
been authorized, sponsored, or otherwise approved by the owners of the trademarks or service marks referenced in this product.
There may be images in this book that feature models; these models do not necessarily endorse, represent, or participate in
the activities represented in the images. Any screenshots in this product are for educational and instructive purposes only.
Any individuals and scenarios featured in the case studies throughout this product may be real or fictitious, but are used for
instructional purposes only.
The authors, editor, and publisher have made every effort to provide accurate information. However, they are not responsible
for errors, omissions, or for any outcomes related to the use of the contents of this book and take no responsibility for the use of
the products and procedures described. Treatments and side effects described in this book may not be applicable to all people;
likewise, some people may require a dose or experience a side effect that is not described herein. Drugs and medical devices are
discussed that may have limited availability controlled by the Food and Drug Administration (FDA) for use only in a research
study or clinical trial. Research, clinical practice, and government regulations often change the accepted standard in this field.
When consideration is being given to use of any drug in the clinical setting, the health care provider or reader is responsible for
determining FDA status of the drug, reading the package insert, and reviewing prescribing information for the most up-to-date
recommendations on dose, precautions, and contraindications, and determining the appropriate usage for the product. This is
especially important in the case of drugs that are new or seldom used.
Production Credits
VP, Product Management: David D. Cella boy middle right), © Images by Tang Ming Tung/Moment/
Director of Product Management: Amanda Martin Getty Images (young girl bottom left), © Jamie Grill/Getty
Product Manager: Rebecca Stephenson Images (adult woman top right), © JGI/Tom Grill/Blend Images/
Product Assistant: Anna-Maria Forger Getty Images (boy studying top right), © Sutiporn Somnam/
Production Editor: Vanessa Richards Moment/Getty Images (young girl top left), © Hero Images/
Senior Marketing Manager: Jennifer Scherzay Getty Images (nurse bottom left), © Weekend Images Inc./
Product Fulfillment Manager: Wendy Kilborn E+/Getty Images (young girl bottom middle), © gawrav/E+/
Composition: S4Carlisle Publishing Services Getty Images (adult woman middle left), © Steve Debenport/
Cover Design: Kristin E. Parker E+/Getty Images (nurse holding a girl’s cast), © Hero Images/
Rights & Media Specialist: John Rusk Getty Images (mother and daughter bottom right), © peeterv/
Media Development Editor: Troy Liston DigitalVision/Getty Images (young boy bottom right)
Cover Image (Title Page, Part Opener, Chapter Opener): Printing and Binding: Bang Printing
© Adriana Varela Photograph/Moment/Getty Images (young Cover Printing: Bang Printing
boy top left), © Marvin Fox/Moment/Getty Images (young
Library of Congress Cataloging-in-Publication Data
Names: Richardson, Beth, 1944- editor.
Title: Pediatric primary care: practice guidelines for nurses/edited by
Beth Richardson.
Other titles: Pediatric primary care (Richardson)
Description: Fourth edition. | Burlington, Massachusetts: Jones & Bartlett
Learning, [2020] | Includes bibliographical references and index.
Identifiers: LCCN 2018008098 | ISBN 9781284149425 (spiral)
Subjects: | MESH: Pediatric Nursing--methods | Primary Care Nursing | Nurse
Practitioners | Infant | Child
Classification: LCC RJ245 | NLM WY 159 | DDC 618.92/00231--dc23
LC record available at https://lccn.loc.gov/2018008098
6048
Printed in the United States of America
22 21 20 19 18 10 9 8 7 6 5 4 3 2 1
, Contents
Preface xvii
Acknowledgments xix
Contributors xxi
S E C T I O N O N E
Child Health Care 1
C H A P T E R 1
Obtaining an Initial History 3
Beth Richardson
Introduction 3
Initial Information 3
Reason for Current Visit 3
Past History 3
Review of Systems 5
Family History 6
Disease History 7
Social History 7
Development 8
Bibliography 8
C H A P T E R 2
Obtaining an Interval History 9
Donna Hallas
The Interval History 9
Interval History for Athletic Child or Adolescent 14
Focused History 14
Applying Data Obtained in Interval History to Clinical Practice 17
When to Refer 17
Bibliography 17
iii
EDITION
Primary Care
Practice Guidelines for Nurses
Edited by
Beth Richardson, PhD, RN, CPNP, FAANP
Pediatric Nurse Practitioner
HealthNet, Inc.
Associate Professor Emeritus
School of Nursing
Indiana University
Indianapolis, Indiana
,World Headquarters
Jones & Bartlett Learning
5 Wall Street
Burlington, MA 01803
978-443-5000
www.jblearning.com
Jones & Bartlett Learning books and products are available through most bookstores and online booksellers. To contact Jones &
Bartlett Learning directly, call 800-832-0034, fax 978-443-8000, or visit our website, www.jblearning.com.
Substantial discounts on bulk quantities of Jones & Bartlett Learning publications are available to corporations, professional
associations, and other qualified organizations. For details and specific discount information, contact the special sales
department at Jones & Bartlett Learning via the above contact information or send an email to .
Copyright © 2020 by Jones & Bartlett Learning, LLC, an Ascend Learning Company
All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or
mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission
from the copyright owner.
The content, statements, views, and opinions herein are the sole expression of the respective authors and not that of Jones & Bartlett
Learning, LLC. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer,
or otherwise does not constitute or imply its endorsement or recommendation by Jones & Bartlett Learning, LLC and such refer-
ence shall not be used for advertising or product endorsement purposes. All trademarks displayed are the trademarks of the par-
ties noted herein. Pediatric Primary Care: Practice Guidelines for Nurses, Fourth Edition is an independent publication and has not
been authorized, sponsored, or otherwise approved by the owners of the trademarks or service marks referenced in this product.
There may be images in this book that feature models; these models do not necessarily endorse, represent, or participate in
the activities represented in the images. Any screenshots in this product are for educational and instructive purposes only.
Any individuals and scenarios featured in the case studies throughout this product may be real or fictitious, but are used for
instructional purposes only.
The authors, editor, and publisher have made every effort to provide accurate information. However, they are not responsible
for errors, omissions, or for any outcomes related to the use of the contents of this book and take no responsibility for the use of
the products and procedures described. Treatments and side effects described in this book may not be applicable to all people;
likewise, some people may require a dose or experience a side effect that is not described herein. Drugs and medical devices are
discussed that may have limited availability controlled by the Food and Drug Administration (FDA) for use only in a research
study or clinical trial. Research, clinical practice, and government regulations often change the accepted standard in this field.
When consideration is being given to use of any drug in the clinical setting, the health care provider or reader is responsible for
determining FDA status of the drug, reading the package insert, and reviewing prescribing information for the most up-to-date
recommendations on dose, precautions, and contraindications, and determining the appropriate usage for the product. This is
especially important in the case of drugs that are new or seldom used.
Production Credits
VP, Product Management: David D. Cella boy middle right), © Images by Tang Ming Tung/Moment/
Director of Product Management: Amanda Martin Getty Images (young girl bottom left), © Jamie Grill/Getty
Product Manager: Rebecca Stephenson Images (adult woman top right), © JGI/Tom Grill/Blend Images/
Product Assistant: Anna-Maria Forger Getty Images (boy studying top right), © Sutiporn Somnam/
Production Editor: Vanessa Richards Moment/Getty Images (young girl top left), © Hero Images/
Senior Marketing Manager: Jennifer Scherzay Getty Images (nurse bottom left), © Weekend Images Inc./
Product Fulfillment Manager: Wendy Kilborn E+/Getty Images (young girl bottom middle), © gawrav/E+/
Composition: S4Carlisle Publishing Services Getty Images (adult woman middle left), © Steve Debenport/
Cover Design: Kristin E. Parker E+/Getty Images (nurse holding a girl’s cast), © Hero Images/
Rights & Media Specialist: John Rusk Getty Images (mother and daughter bottom right), © peeterv/
Media Development Editor: Troy Liston DigitalVision/Getty Images (young boy bottom right)
Cover Image (Title Page, Part Opener, Chapter Opener): Printing and Binding: Bang Printing
© Adriana Varela Photograph/Moment/Getty Images (young Cover Printing: Bang Printing
boy top left), © Marvin Fox/Moment/Getty Images (young
Library of Congress Cataloging-in-Publication Data
Names: Richardson, Beth, 1944- editor.
Title: Pediatric primary care: practice guidelines for nurses/edited by
Beth Richardson.
Other titles: Pediatric primary care (Richardson)
Description: Fourth edition. | Burlington, Massachusetts: Jones & Bartlett
Learning, [2020] | Includes bibliographical references and index.
Identifiers: LCCN 2018008098 | ISBN 9781284149425 (spiral)
Subjects: | MESH: Pediatric Nursing--methods | Primary Care Nursing | Nurse
Practitioners | Infant | Child
Classification: LCC RJ245 | NLM WY 159 | DDC 618.92/00231--dc23
LC record available at https://lccn.loc.gov/2018008098
6048
Printed in the United States of America
22 21 20 19 18 10 9 8 7 6 5 4 3 2 1
, Contents
Preface xvii
Acknowledgments xix
Contributors xxi
S E C T I O N O N E
Child Health Care 1
C H A P T E R 1
Obtaining an Initial History 3
Beth Richardson
Introduction 3
Initial Information 3
Reason for Current Visit 3
Past History 3
Review of Systems 5
Family History 6
Disease History 7
Social History 7
Development 8
Bibliography 8
C H A P T E R 2
Obtaining an Interval History 9
Donna Hallas
The Interval History 9
Interval History for Athletic Child or Adolescent 14
Focused History 14
Applying Data Obtained in Interval History to Clinical Practice 17
When to Refer 17
Bibliography 17
iii
