39308 - Paediatrics and Neonatology

Learning outcomes

By the end of the course, students will have acquired the theoretical knowledge essential for comprehending and effectively performing nursing practices in Pediatric, Neonatal, and Neonatal/Pediatric Intensive Care Units. Additionally, they will be prepared to apply these principles in any healthcare setting involving pediatric or neonatal patients.

Course contents

The topics of the course are divided into two main branches focused on the newborn and the pediatric patient
For each of these, the main physiological and developmental characteristics, physiopathology, and diagnostic-therapeutic framework of the main diseases characterizing newborns and children will be addressed, as well as the medical devices that distinguish pediatric and neonatal patients from adult ones.
The course is aimed to provide theoretical tools for the correct understanding and conduct of nursing practice in Pediatric, Neonatal, and Neonatal/Pediatric Intensive Care Units, as well as any other context characterized by the presence of pediatric or neonatal patients.

This course will cover the following topics:

The topics covered will be:

1. Physiology of the Newborn:

• Definition, characteristics, and classification of the newborn:
  • Gestational age
  • Weight
  • Percentiles and growth
• Physiological neonatal adaptation:
  • Respiratory
  • Cardiovascular
  • Thermal

1.1. Routine Care of the Healthy Term Newborn

• Apgar score
• Nursing care in the delivery room:
  • Prophylaxis (vit K and ocular)
  • Umbilical cord blood gas analysis
• Neonatal physical examination
• Neonatal neurological examination
• Neonatal screenings:
  • Pulse-oximetry
  • Red reflex
  • Otoacoustic emissions
  • Congenital hip dysplasia screening
  • Metabolic screening
  • Nirsevimab

2. Neonatal Pathology: diagnostic-therapeutic framework and necessary measures for nursing management of the following conditions:

2.1. Labor and Delivery Emergencies

• Neonatal resuscitation: guidelines, methods, and measures
• Perinatal asphyxia, hypoxic-ischemic encephalopathy, and neonatal hypothermic treatment

2.2. Neonatal neurology

• Neonatal neurological disorders:
  • Intracranial hemorrhage
  • Seizures
  • Neonatal abstinence syndrome 

2.3. Neonatal respiratory disorders

• Neonatal respiratory disorders:
  • Neonatal respiratory pathophysiology
  • Apnea
  • Respiratory distress
  • Transient tachypnea
  • Hyaline membrane disease
  • Meconium aspiration
  • Pneumothorax
  • Persistent pulmonary hypertension
  • Bronchopulmonary dysplasia
• Neonatal respiratory support devices:
  • Oxygen therapy
  • High flow
  • CPAP
  • Mechanical ventilation

2.4. Neonatal general pathology

• Physiological and pathological weight loss
• Neonatal hyperbilirubinemia
• Neonatal hypoglycemia
• Gastroesophageal reflux
  

2.5. Neonatal cardiology

• Neonatal cardiovascular disorders:
  • Shock
    
    • Physiopathology
    • Identification and classification:
      • Hypovolemic shock
      • Distributive shock
      • Cardiogenic shock
      • Obstructive shock
      • Dissociative shock
• Congenital heart diseases
  

2.6. Neonatal infectious diseases

• Early- and late-onset sepsis

2.7. Preterm newborn

• Physiopathological characteristics of the premature neonate and its development, diseases of prematurity:
  • Necrotizing enterocolitis
  • Retinopathy of prematurity

3. Pediatric Physiology:

• Classification and characteristics of pediatric age
• Medical history collection
• Signs and symptoms
• Physical examination and approach
• Growth and development
  

4. Pediatric Prevention:

• Screening
• Health check-ups
• Vaccines

5. Anxiety and pain in neonatal and pediatric age:

• Physiopathology and development
• Signs and symptoms
• Evaluation
• Treatment
• Pediatric palliative care network

6. General Pediatric Pathology:

• Celiac disease
• Diabetes
• Allergies
• Asthma
  

7. Pediatric Infectious Diseases:

• Fever
  • Kawasaki diseas
  • Febrile seizures
• Exanthems
• Gastroenteritis
• Pharyngotonsillitis
• Croup
• Pneumonia
• Bronchiolitis
• Meningitis
• Encephalitis
• Osteomyelitis
  
• Otitis, Mastoiditis, Cellulitis
• Urinary Tract Infections

8. Pediatric Emergencies and Life Support:

• Pediatric Base Life Support
• Primary patient evaluation in the emergency setting: ABCDE
• Cardiac arrest:
  • Recognition
  • Management
  • Resuscitation
  • Defibrillation and drugs
    
• Respiratory distress/failure:
  • Rescue ventilation
  • Initial management: ABC
  • Secondary management:
    • Upper airway obstruction
    • Lower airway obstruction

Readings/Bibliography

Pediatria Generale e Specialistica - A. Pession, G. Faldella
Nelson, Manuale di Pediatria - 21° Edizione
Cloherty e Stark’s. Manuale di neonatologia - 8° Edizione
Pediatric Advanced Life Support - Manuale per operatori - linee guida 2020

Teaching methods

Lectures

Assessment methods

Oral test

The exam consists of three questions:

1. First question chosen by the candidate: the candidate selects one of the course topics and has a maximum of 5 minutes to present the subject concisely. This format reflects the practice of clinical and conference presentations, training the student to deliver a clear and effective presentation within a set timeframe.
2. Two additional questions: formulated by the examination board on other topics from the program, selected among those covered during the lectures.

Attendance at lectures is of primary importance for the final grade, as the exam aims to assess the candidate’s preparation and autonomous clinical reasoning ability regarding the various subjects addressed during the course, with particular attention to the reasoning demonstrated during the lessons.

Final grading:

• Preparation on a very limited number of topics covered in the course and ability to analyze only with the help of the instructor, overall correct language expression → 18-19
• Preparation on a limited number of topics covered in the course and  ability to autonomously analyze only purely executive issues, correct language expression → 20-24
• Preparation on a wide range of topics covered in the course, ability to make autonomous choices of critical analysis, mastery of specific terminology → 25-29
• Substantially exhaustive preparation on the topics covered in the course, ability to make autonomous choices of critical analysis and connection, full mastery of specific terminology, and ability to argue and reflect → 30-30L

Teaching tools

Slides (projected and commented during frontal lectures)

Office hours

See the website of Enrico Cocchi