NUR6150: Advanced Practice in Primary Care: Pediatrics
NUR6150: Advanced Practice in Primary Care: Pediatrics
Course Description
This course prepares advanced practice registered nurses (APRNs) to deliver comprehensive, evidence-based primary care to infants, children, adolescents, and their families. Emphasis is placed on health promotion, disease prevention, acute and chronic illness management, developmental surveillance, and family-centered care across diverse populations. Students will develop advanced clinical decision-making skills, cultural competence, and interprofessional collaboration abilities necessary for independent and collaborative pediatric primary care practice. The course integrates pathophysiology, pharmacology, and evidence-based guidelines from organizations such as the American Academy of Pediatrics (AAP), Bright Futures, and the National Association of Pediatric Nurse Practitioners (NAPNAP).
Credit Hours: 3 (Didactic)
Prerequisites: Graduate standing in Nursing, Advanced Pathophysiology, Advanced Pharmacology, Advanced Health Assessment.
Course Learning Objectives
Upon completion, students will be able to:
Perform comprehensive age-appropriate health assessments and developmental screenings.
Formulate differential diagnoses and evidence-based management plans for common pediatric conditions.
Apply principles of health promotion and anticipatory guidance across developmental stages.
Integrate pharmacologic and non-pharmacologic interventions while considering pediatric-specific safety and efficacy.
Address behavioral, mental health, and social determinants of health in pediatric populations.
Demonstrate ethical, legal, and culturally responsive care in primary pediatric settings.
Detailed Weekly Schedule
Week 1: Foundations of Pediatric Primary Care & Well-Child Visits
Weekly Notes:
Introduction to the role of the Pediatric Nurse Practitioner (PNP). Overview of pediatric primary care models, family-centered care, and Bright Futures guidelines. Emphasis on developmental milestones (0–18 years), growth charts (WHO/CDC), and the medical home concept.
Discussion Questions:
How does family-centered care differ from traditional patient-centered care in pediatrics? Provide examples.
Discuss the impact of social determinants of health on well-child visit adherence.
Assignment:
Complete a self-assessment of pediatric developmental milestones (submit table/chart).
Initial discussion post + 2 peer responses.
Week 2: Growth, Development & Nutrition Across the Lifespan
Weekly Notes:
Detailed review of physical, cognitive, language, and psychosocial development (Erikson, Piaget, etc.). Nutritional needs from infancy through adolescence, including breastfeeding, formula, solids, and adolescent eating disorders. Failure to thrive and obesity evaluation.
Discussion Questions:
Compare growth patterns in preterm vs. term infants and implications for monitoring.
How would you counsel a family on introducing solid foods while addressing cultural dietary preferences?
Assignment:
Develop a 1-page anticipatory guidance handout for parents of a 6-month-old (nutrition + development).
Week 3: Immunizations & Health Promotion
Weekly Notes:
CDC/AAP immunization schedules, catch-up protocols, vaccine hesitancy, contraindications, and adverse event reporting (VAERS). Health promotion topics: injury prevention, dental health, screen time, and safe sleep.
Discussion Questions:
How would you address vaccine hesitancy in a family citing religious or safety concerns?
Evaluate the evidence for or against routine well-child visits in healthy adolescents.
Assignment:
Create an immunization education script/role-play for a hesitant parent (submit recording or written script).
Week 4: Acute Care I – Respiratory & Infectious Diseases
Weekly Notes:
Common conditions: URI, otitis media, pharyngitis, bronchiolitis, pneumonia, croup, asthma exacerbations. Diagnostic approaches, antimicrobial stewardship, and red flags.
Discussion Questions:
Differentiate bacterial vs. viral causes of pharyngitis and justify treatment decisions.
Discuss disparities in asthma prevalence and outcomes among pediatric populations.
Assignment:
Case study: Develop a SOAP note and management plan for a 4-year-old with wheezing.
Week 5: Acute Care II – Gastrointestinal & Dermatologic Conditions
Weekly Notes:
Gastroenteritis, constipation, GERD, appendicitis, atopic dermatitis, impetigo, diaper dermatitis, and common viral exanthems. When to refer.
Discussion Questions:
How do cultural practices influence the presentation and management of pediatric skin conditions?
Debate the use of probiotics in acute gastroenteritis.
Assignment:
Comprehensive SOAP note for a toddler with vomiting and rash.
Week 6: Midterm Exam & Behavioral/Mental Health Screening
Weekly Notes:
Screening tools (ASQ, M-CHAT, PHQ-9 modified for teens, CRAFFT). ADHD, anxiety, depression, autism spectrum, and behavioral concerns. Trauma-informed care.
Discussion Questions:
How should a PNP approach a positive ADHD screening in a school-aged child?
Discuss the impact of social media on adolescent mental health.
Assignment:
Midterm Exam (multiple choice + short answer).
Develop a behavioral health screening protocol for your future practice.
Week 7: Chronic Conditions I – Asthma, Allergies & Atopic Disease
Weekly Notes:
Stepwise asthma management (NHLBI guidelines), allergic rhinitis, food allergies, anaphylaxis action plans, and eczema management. Environmental control and education.
Discussion Questions:
Compare controller vs. rescue medications in pediatric asthma.
How do environmental justice issues affect asthma outcomes?
Assignment:
Asthma action plan creation + patient/family education materials.
Week 8: Chronic Conditions II – Endocrine & Hematologic Disorders
Weekly Notes:
Type 1 & Type 2 diabetes, thyroid disorders, growth hormone deficiency, sickle cell disease, iron deficiency anemia, and lead poisoning screening.
Discussion Questions:
Discuss transition planning for adolescents with Type 1 diabetes moving to adult care.
Evaluate universal vs. targeted lead screening recommendations.
Assignment:
Case study analysis: 12-year-old with new-onset diabetes (management plan including school accommodations).
Week 9: Adolescent Health & Reproductive Care
Weekly Notes:
Confidentiality (minor consent laws), sexual health, contraception, STI screening/treatment, menstrual disorders, sports physicals, and substance use.
Discussion Questions:
How do state laws on minor consent affect your practice in providing reproductive care?
Address the rising rates of adolescent depression and suicide.
Assignment:
Write a policy brief on one adolescent health issue (e.g., HPV vaccination or vaping).
Week 10: Musculoskeletal & Sports Medicine
Weekly Notes:
Common orthopedic issues: scoliosis, developmental dysplasia of the hip, Osgood-Schlatter, fractures, overuse injuries. Pre-participation physical evaluation.
Discussion Questions:
When should a limping child be referred to orthopedics?
Discuss female athlete triad and relative energy deficiency in sport (RED-S).
Assignment:
Pre-participation sports physical template development.
Week 11: Neurologic & Developmental Disorders
Weekly Notes:
Seizure disorders, headaches, concussions, cerebral palsy, intellectual disability, and learning disorders. Neurodevelopmental surveillance.
Discussion Questions:
Compare first-line treatments for pediatric epilepsy syndromes.
How can PNPs support families of children with neurodevelopmental disabilities?
Assignment:
Seizure action plan + educational resources.
Week 12: Pediatric Pharmacology & Prescribing Safety
Weekly Notes:
Pediatric-specific pharmacokinetics/pharmacodynamics, weight-based dosing, off-label use, antibiotic stewardship, and pain management. Black box warnings and monitoring.
Discussion Questions:
Discuss challenges of medication adherence in adolescents.
Evaluate the risks vs. benefits of stimulant medications for ADHD.
Assignment:
Prescribe for 3 sample cases with rationale and monitoring plan (including calculations).
Week 13: Emergencies, Abuse & Neglect
Weekly Notes:
Recognition of child abuse/neglect, reporting laws, injury patterns, sexual abuse, and common pediatric emergencies (dehydration, status asthmaticus, sepsis).
Discussion Questions:
How does implicit bias affect recognition of child maltreatment?
Outline steps for managing a suspected non-accidental injury in clinic.
Assignment:
Mandatory reporting simulation and reflection paper.
Week 14: Cultural Competence, Diversity & Global Health Perspectives
Weekly Notes:
Care of immigrant/refugee children, LGBTQ+ youth, health equity, and global pediatric issues (malnutrition, vaccine-preventable diseases).
Discussion Questions:
How can PNPs provide culturally humble care to diverse pediatric populations?
Discuss the impact of climate change on child health.
Assignment:
Cultural case study analysis.
Week 15: Professional Role, Transition to Practice & Final Exam
Weekly Notes:
Scope of practice, billing/coding, malpractice considerations, leadership, quality improvement, and certification preparation (PNCB/PCNB).
Discussion Questions:
What are the biggest challenges facing new PNPs in primary care?
How will you maintain evidence-based practice throughout your career?
Assignment:
Final Exam.
Capstone Project: Comprehensive Well-Child Visit Plan for a specific age group (including anticipatory guidance, screening, and follow-up).
Required Texts/Resources (Suggested):
Burns et al., Pediatric Primary Care (latest edition)
Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents
CDC Immunization Schedules & AAP Red Book
Additional journal articles and guidelines provided weekly.
Grading:
Discussions: 20%
Weekly Assignments/Case Studies: 30%
Midterm & Final Exam: 30%
Capstone Project: 20%
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