Corso di Laurea in Infermieristica Pediatrica

• Provide students with main concepts in terms of classification, epidemiology, pathogenesis, and treatment of the most frequent chronic diseases of childhood, in particular endocrinological and metabolic diseases.
• Provide students with the ability to work as a team in the management of care for children and adolescents with chronic diseases.
• Provide students with the basic knowledge and skills to establish a helping relationship with the child family.
• Provide students with the knowledge and skills to formulate therapeutic education plans for the child/family-care-givers.

METABOLIC DISEASES: at the end of the module, the students will acquire the ability to recognize the various pathologies, prepare the means to carry out any investigations, interpret the laboratory tests, implement the therapeutic guidelines, and program remote controls.

DIETETICS: at the end of the module, students will learn about the characteristics of breast milk, formula milks, on the metods of weaning, and on the nutrition of the child in the the first year of life, in infancyand adolescence, on the dietary therapy for specific chronic diseases, and aspects of artificial nutrition.

CLINICAL NURSING IN METABOLIC DISEASES: at the end of the module, students will be able to identify the care needs of patients suffering from chronic diseases and their families and to recognize the appropriate nursing interventions related to them. 

REPORT OF AID AND THERAPEUTIC EDUCATION: at the end of the module, the students will be able to do patients intake and provide therapeutic education for the child and family.

Traditional, depending on the rectoral dispositions, lessons can also be held in mixed mode - in presence and/or online (blended courses with rotation presence).

Depending on the rectoral provisions, exams (both written and oral) can also be carried out in mixed mode - in presence and / or online, using the UniTo platforms (Moodle, WebEx, etc.).

1. Written examination

At the end of the course the knowledge acquired by the student on the different contents of the entire syllabus will be evaluated through tests.

For each module a test will be given, consisting of multiple-choice and/or open-ended questions.

The number of questions will vary according to the form, which will be communicated to the students by the teacher before the end of the lessons.

The time established for the duration of the test will be about 1 hour per test for a maximum time of 4 hours for the entire appeal.

The score for each individual answer will vary depending on the complexity and type of application.

2. Oral examination:

For the CLINICAL NURSING IN METABOLIC DISEASE module there is an oral exam to complete the written one.

For all other modules the oral examination is upon request only to complete final vote or to improve a sufficient vote on the written examination. 

• The exam modality above described is the same for all sessions and all dates..
• No partial bonus are allowed.
• No partial exam or single modules can be considered passed out of the whole exam including the 4 modules.
• The insufficient exam should be undertaken in another session with the same modality and all the 4 modules.

ENDOCRINE-METABOLIC DISORDERS IN CHILDHOOD

• Diabetes mellitus (DM): Classification and epidemiology of DM in childhood. Methods of evaluation of insulin secretion and function.  Pathogenesis, clinical features, and treatment of the various types of DM. Prediction and prevention of DM. Prevention and treatment of acute (DKA, hypoglycemic episodes) and chronic complications.
• Obesity: Classification, pathogenesis, clinical features, diagnosis, and treatment of childhood obesity. Prevention of obesity in children. The metabolic syndrome in childhood: diagnosis, treatment, and prevention.
• Thyroid disorders: Physiology of thyroid gland function in newborn, child and adolescent. Classification, pathogenesis, clinical features, diagnosis, and treatment of congenital and acquired hypothyroidism. Prevention, early diagnosis, and follow-up of hypothyroidism. Hyperthyroidism: pathogenesis, clinical features, diagnosis and treatment.
• Short stature: Classification, pathogenesis, clinical features, diagnosis, and treatment of growth disturbances in childhood. Physiopathology of the secretion of GH-GF1 and of the hormones involved in stature growth, from the fetus to the adult.
• Disorders of pubertal growth: Mechanisms involved in pubertal maturation in boys and girls. Neuro-endocrine control of pubertal growth. Precocious puberty.
• The child with metabolic disorders: Classification, clinical characteristics, diagnosis, and treatment of the most frequent hereditary metabolic disorders.

CLINICAL NURSING OF CHRONIC DISORDERS OF CHILDHOOD

• Nursing of the child/adolescent with newly diagnosed diabetes mellitus.
• Nursing of the child/adolescent with Type 1 diabetes mellitus, with acute hypoglycemia or diabetic ketoacidosis.
• Therapeutic education of the child/adolescent with Type 1 diabetes mellitus: self monitoring blood glucose SMBG, insulin injection, use of new devices and pump for continuous subcutaneous insulin infusion, glycemia, blood ketones evaluation, CGM. Physical activity and exercise.
• Therapeutic education of the child/adolescent with diabetes mellitus aimed at prevention of late complications of diabetes (retinopathy, nephropathy, peripheral neuropathy, and diabetic foot).
• Nursing of the child/adolescent with endocrine disorders.
• Nursing of the child/adolescent with metabolic or rare disorders (management of therapy and its correct use, dietary education).

THE MUTUAL HELP RELATIONSHIP AND THE THERAPEUTIC EDUCATION

• Principle of the mutual helping relationship: therapeutic communication (empathy, self-esteem, self well-being).
• Role of the pediatric nurse.
• Child/family-oriented approach.
• Style and methods that facilitate interviews: how to ask and answer questions, to listen, to understand, and help the child/parents; the role of empathetic speech and experience.
• How to facilitate communication and the helping relationship.
• How to start a helping relationship: the relation between nurse/parents/child.
• Discretion and confidentiality of the therapeutic relationship.
• Features of the teaching process.
• To inform, educate, and teach the child and his/her family.
• The therapeutic outcome according to the WHO, and aims of therapeutic education.
• Motivation and learning skills: auto-efficacy, educational counseling, compliance and adherence, evaluation of coping, self-esteem, body imaging, anxiety and phobias, family interrelationships.
• Therapeutic education: definition and differences of education and health promotion; WHO definition.
• Recipients, purposes, and therapeutic effects of therapeutic education.
• Therapeutic education as a person-centered learning process: informing, educating, and instructing the child and family/care-givers.
• The teaching-learning process: analysis of the different aspects; the three domains of learning: cognitive, affective, psycho-motor.
• Pedagogical-systemic approach: from analysis of educational needs to assessment of learning.

NUTRITION AND DIET FOR CHILDREN WITH CHRONIC DISORDERS

Nutrition during the pediatric age

• Breast-feeding: maternal milk.
• Bottle-feeding: formula milk and special formula (diet-formula).
• Weaning: main characteristic of foods.
• Mineral water.
• Feeding in preschool and in school age.
• Feeding in adolescence.

DIETARY THERAPY

• Healthy nutrition guidelines from early chilhood to adolescence. 
• Energy and nutrient needs.
• Breast feeding and infant formula. 
• Division: main characteristics of food.
• Mineral waters.

Dietotherapy in:

• Obesity and dca.
• Vomiting, acute diarrhoea, constipation.
• Infiammatory bowel diseases.
• Food allergies.
• Celiac disease.
• Juvenile diabetes mellitus.
• Cystic fibrosis.
• Chronic renal insufficiency.
• Congenital diseases of metabolism.
• Artificial nutrition.
• The hospital dietician.

METABOLIC DISORDERS

• S. Bernasconi, L. Mughetti, L. Ghizzoni: “Endocrinologia pediatrica” Ed. Mc Graw-Hill
• G.R. Bugio, A. Martini: “Pediatria pratica. Orientamenti diagnostici e terapeutici.”  Ed. C.G. edizioni Medico-Scientifiche Torinio (capitoli consigliati: pp. 233-253; 267-333; 849-857; 1183-1210; 1297-1309; 1335-1354; 1395-1407)

 CLINICAL NURSING OF METABOLIC DISORDERS

• Teaching material provided by the teachers (handouts, reviews of literature, copies of slides used in class)
• Scientific articles indicated from time to time, by the teacher, on the topic

RELATION BETWEEN TREATMENT AND THERAPEUTIC EDUCATION

• Brunner – Suddarth.  Infermieristica medico-chirurgica. Vol. I, IV ed. cap. 4. Milano: Casa Editrice Ambrosiana, 2010
• Craven R., Hirnle C., Jensen S. Principi fondamentali dell’ASSISTENZA

INFERMIERISTICA. Vol. I,  

• V ed.   Milano: Casa Editrice Ambrosiana, 2013
• Saiani L, Brugnolli A. Trattato di Cure Infermieristiche. cap. 4, pp 53-55. Napoli: Sorbona, 2011
• D’Ivernois J.F., Gagnayre R. Educare IL PAZIENTE un approccio pedagogico. II ed. cap.1-2.
• Milano: McGraw-Hill, 2006
• Lacroix A., Assal J.P. EDUCAZIONE TERAPEUTICA DEI PAZIENTI Nuovi approcci alla malattia
• cronica. II ed. Torino: Edizioni Minerva Medica, 2005
• Rossato E., Rigoli A.M., et al. (a cura di) EDUCAZIONE TERAPEUTICA Una risorsa per malati e
• curanti. I ed. Venezia: Marsilio Editori, 2001
• teaching material provided by the teachers (handouts, reviews of literature, copies of slides used in class)

NUTRITION AND DIET FOR CHILDREN WITH CHRONIC DISORDERS

• Teaching material provided by the teacher ( copies of slides used in class)
• larn 2014 (nutrient reference intake levels and energy for the italian population)
• crea healthy eating guidelines 2018. 
• paper of the ministry of health: national guidelines for rehabilitation in disordersof 2017 nutrition 
• italian standards for the treatment of diabetes mellitus 2018, sid (italian diabes society)
• epesn guidelines 2016: guidelines on nutrition care for infant children, and adult with
• cystic fibrosis
• k-doki clinical practice guidelines for chronic kidney disease
• espen clinical nutrition practice guidelines in chronic bowel disease (ibd )2017

The methods of carrying out the teaching activity may vary according to the limitations imposed by the current health crisis. In any case, the remote mode is ensured throughout the academic year.