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Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
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Classroom Response System Lecture Note Presentation
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #1
A mother asks the pediatric nurse about what she should begin to feed her 6-monthold infant. The correct response is:
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #1 Choices
1. Egg whites are the least allergenic food to be introduced into the babys diet. 2. Rice cereal is the first solid introduced that is least allergenic of the cereals. 3. Formula is the only source of nutrition given for the first year. 4. Fruits and vegetables are good sources of iron.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Question #1 Answer
1. Egg whites are the least allergenic food to be introduced into the babys diet. 2. Rice cereal is the first solid introduced that is least allergenic of the cereals. 3. Formula is the only source of nutrition given for the first year. 4. Fruits and vegetables are good sources of iron.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Question #1 Rationale
Introduction of solid food is recommended at age 4 to 6 months, when the gastrointestinal system has matured sufficiently to handle complex nutrients. The suck reflex and tongue-thrust reflex diminish at 4 months of age. Rice cereal is the first solid food because it is a rich source of iron and rarely induces allergic reactions.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Question #1 Rationale
Fruits and vegetables, good sources of vitamins and fiber, are introduced after cereal, one at a time to determine allergic reactions. Egg whites are highly allergenic.
Application level
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #2
A 1-year-old male child is scheduled for a routine exam at the pediatric clinic. The childs birth weight was 8 lbs. 2 oz. The child now weighs 18 pounds, 4 oz. The nurse knows that this weight is:
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #2 Choices
1. 2. 3. 4. Below the expected weight. Appropriate for the childs age. Above the expected weight. Individualized and thus unpredictable.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #2 Answer
1. 2. 3. 4. Below the expected weight. Appropriate for the childs age. Above the expected weight. Individualized and thus unpredictable.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #2 Rationale
The first year of life is one of rapid growth. The birth weight usually doubles by 5 months and triples by the end of the first year. The other choices are incorrect.
Analysis level
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #3
A school nurse prepares a lecture on puberty for 5th- and 6th-grade girls. She asks the group, What is the first sign of puberty? A student correctly replies:
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #3 Choices
The appearance of breast buds. An increase in energy and appetite. The occurrence of the first menarche. Appearance of body odor.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #3 Answer
The appearance of breast buds. An increase in energy and appetite. The occurrence of the first menarche. Appearance of body odor.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #3 Rationale
Puberty is a process that brings about the development of secondary sex characteristics, which begin, with the appearance of breast buds at 9 to 11 years followed by the growth of pubic hair. Menarche follows approximately 1 year later. Body odor may result later because of an increase in secretions from the apocrine glands.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Question #4
A 4-year-old scores two failures on the Denver II. Which of the following statements is most accurate?
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #4 Choices
1. The child is not as intelligent as expected for age and should be referred to a learning specialist. 2. The child has a speech problem and should be referred to a speech therapist. 3. The child is at risk for school problems and should be retested. 4. The failures are to be expected in preschoolers who may not be cooperative with testing.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Question #4 Answer
1. The child is not as intelligent as expected for age and should be referred to a learning specialist. 2. The child has a speech problem and should be referred to a speech therapist. 3. The child is at risk for school problems and should be retested. 4. The failures are to be expected in preschoolers who may not be cooperative with testing.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Question #4 Rationale
The Denver II is a screening test, not a diagnostic test; therefore children who score a failure should be retested. The child is considered at-risk until other diagnostic indicators can determine a specific problem.
Analysis level
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #5
Whenever the parents of a 10-month-old leave their hospitalized child for short periods, he begins to cry and scream. The nurse explains that this behavior demonstrates that the child:
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #5 Choices
Needs to remain with his parents at all times. Is experiencing separation anxiety. Is experiencing discomfort. Is extremely spoiled.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #5 Answer
Needs to remain with his parents at all times. Is experiencing separation anxiety. Is experiencing discomfort. Is extremely spoiled.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #5 Rationale
Infants and toddlers between the ages of 6 months and 30 months experience separation anxiety. There are three stages of separation anxiety. The child who demonstrates crying and rejecting anyone other than the parent is in protest, the first stage of separation anxiety. This behavior does not exhibit spoiling or any indication of discomfort. The second is despair.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Question #5 Rationale
The child expresses hopelessness, appears quiet, and is withdrawn. The third stage is detachment. The child becomes interested in the environment, especially the caregivers. If the parents return, the child ignores them.
Analysis level
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #6
A teenager refuses to wear the clothes his mother bought for him. He states he wants to look like the other kids at school and wear clothes like they wear. The nurse explains this behavior is an example of teenage rebellion related to internal conflicts of:
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #6 Choices
Autonomy vs. shame and doubt. Trust vs. mistrust. Identity vs. role confusion. Initiative vs. inferiority.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #6 Answer
Autonomy vs. shame and doubt. Trust vs. mistrust. Identity vs. role confusion. Initiative vs. inferiority.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #6 Rationale
Eriksons theory of psychosocial development states that the child is faced with conflicts that need to be resolved. Erikson identifies stages of personality development. Identity vs. role confusion (12 to 19 years) is a period when adolescents search for answers regarding their future.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #6 Rationale
During this time, the child rejects the identity presented by his parents and attempts to create his own identity. Identity is often based on peers. Positive outcomes result in optimism and confidence. Negative outcomes result in sense of purposelessness or deviance.
Application level
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Question #7
The nurse conducts Denver II screenings at a community center for infants and young children. The nurse explains that the purpose of these screenings is to:
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #7 Choices
1. Reverse degenerative processes that have occurred. 2. Recognize early infection in order to prevent spread to individuals in close contact with the child. 3. Recognize a disorder early so strategies can be developed to promote optimum development. 4. Measure intelligence and readiness for school.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Question #7 Answer
1. Reverse degenerative processes that have occurred. 2. Recognize early infection in order to prevent spread to individuals in close contact with the child. 3. Recognize a disorder early so strategies can be developed to promote optimum development. 4. Measure intelligence and readiness for school.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Question #7 Rationale
The Denver II is a developmental screening test. The primary reason for doing developmental screenings to find children who might be at risk and refer them for further assessment so that possible delays can be identified and appropriate early intervention initiated. The Denver II is not a measure of intelligence. It has nothing to do with infection control nor is it an intervention to correct degenerative processes.
Application level
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Question #8
A mother of a 4-year-old tells the nurse that her son is a picky eater. The nurse should inform the mother that she should:
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #8 Choices
1. Increase the amount of carbohydrates in the daily menu plan. 2. Administer vitamins twice a day to her child. 3. Be more concerned with the quantity of food than the quality of food. 4. Recognize this is common for preschoolers as their caloric requirements have decreased slightly.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Question #8 Answer
1. Increase the amount of carbohydrates in the daily menu plan. 2. Administer vitamins twice a day to her child. 3. Be more concerned with the quantity of food than the quality of food. 4. Recognize this is common for preschoolers as their caloric requirements have decreased slightly.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Question #8 Rationale
The preschooler will be influenced by others eating habits and demonstrate their likes and dislikes for food preferences. The caloric requirement decreases slightly, to 90 kcal/kg/day. Quality, not quantity, is important. It is not necessary to give vitamins after infancy unless the child is at nutritional risk.
Application level
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Question #9
A father brings his 5-year-old to the doctors office for a well-child visit. The father is embarrassed by his childs behavior during the visit. The father states that every time the child comes for an immunization she begins to cry and scream. An appropriate response to this father is:
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #9 Choices
1. All children have a major fear of needles; preschoolers often believe pain is a punishment. 2. Your child most likely had a traumatic experience at an early age. 3. Next time the mother should accompany the child for an immunization. 4. It is best to ignore this type of behavior as the child is seeking attention.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Question #9 Answer
1. All children have a major fear of needles; preschoolers often believe pain is a punishment. 2. Your child most likely had a traumatic experience at an early age. 3. Next time the mother should accompany the child for an immunization. 4. It is best to ignore this type of behavior as the child is seeking attention.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Question #9 Rationale
Preschoolers relate pain to an injury; they fear injections and do not believe an injection takes away pain. This is a normal response to cry and scream, kick and protest. Any supportive caretaker should accompany the child. This behavior does not necessarily indicate the child has experienced a previous traumatic injection.
Analysis level
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Question #10
A mother of a 15-month-old brings her son to the clinic. While doing a nursing assessment, the mother makes the following comments. Which comment merits further investigation by the nurse?
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #11
The mother of a 12-month-old infant who is hospitalized is upset that she must leave her baby to go home for a short time. What should the nurse suggest to this concerned parent?
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #12
An inexperienced mother is playing with her 8-month-old in the playroom. The nurse has taught the mother about toys that are developmentally appropriate for the child. The nurse will know the teaching has been successful when the mother selects:
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Question #13
The nurse is discussing STDs with a 17year-old student. To correctly plan the teaching lesson, the nurse utilizes Piagets theory to determine the adolescents cognitive abilities. The educational plan should be based on the:
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Learning Outcomes
1. 2. 3. 4. Describe Major Developmental Theories Plan Theory-Based Interventions Explain Contemporary Approaches Recognize Major Developmental Milestones 5. Synthesize Approaches in Planning Assessments of Growth and Development
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Erikson
Developmental tasks
Piaget
Cognitive stages
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Bandura
Social learning theory
John Watson
Behaviorism
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Erikson
Task achievement promotes psychosocial health
Piaget
Cognitive skills guide client, teaching content and method
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Bandura
Parent and nurse as role models
Watson
Reward desirable behaviors
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Contemporary Approaches
Ecologic
Nature plus nurture
Temperament
Personality characteristics
Resiliency
Nature plus nurture plus adaptive skills
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Temperament Theory
Adjust care relative to childs temperament
Resiliency Theory
Identify risks; plan interventions based on child/family skills
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Influences on Development
Genetic Inheritance Prenatal Influences Environmental Influences Family Culture
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Developmental Milestones
Physical Growth and Development Cognitive Development Psychosocial Development
Play Personality and temperament Communication
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Assessment Planning
Newborn
Cue to infants alertness Observe attachment behavior
Infant
Fine/gross motor skills Receptive communication more than expressive communication Personality characteristics
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Play
Occurs at All Stages Affects Physical, Cognitive, Psychosocial Development Nursing Role: Facilitate Play
Necessary in health and illness Can be part of teaching or therapy
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Promoting Development
Newborn
Multisensory stimulation
Infant
Multisensory stimulation Hearing spoken language Fine/gross motor activities
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Preschooler
Dramatic play, puppets Reading together Associative play
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Adolescent
Sports, school activities Games, reading, music
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Summary
Nurses use Theories to Assess, Plan, and Implement Care Nursing Role: Promote Growth and Development
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Resources
Child Trends www.childtrends.org This group conducts research, gathers data on indicators of childrens health, analyzes trends, and provides a wealth of articles and publications on their website.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Resources (contd)
The Annie E. Casey Foundation www.aecf.org A national organization serving and advocating for vulnerable children and families. The national Kids Count, a database of state-by-state indicators of child health and welfare, can be found at this site.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Resources (contd)
Morbidity and Mortality Weekly Report http://www.cdc.gov/mmwr/ Provides current information and recommendations on issues such as food safety and vaccinations. National Center for Health Statistics http://www.cdc.gov/nchs/ This site provides a wealth of information about health, health status, and use of the health care system.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Resources (contd)
The Brazelton Institute www.brazeltoninstitute.com Promotes the healthy development of young children and their families through education and research.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Resources (contd)
American Academy of Pediatrics www.aap.org This professional site offers news, fact sheets, research, and policy guidelines. The You and Your Family section provides information to families, some of which is available in Spanish.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Resources (contd)
Zero to Three www.zerotothree.org Supported by the National Center for Infants, Toddlers, and Families, this site provides information for consumers and professionals about children ages zero to three.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Resources (contd)
U. S. Food and Drug Administration www.fda.gov The FDAs site provides a wealth of information for both consumers and professionals on topics such as food safety, new drug approvals, cosmetics, and tobacco use.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Resources (contd)
Bright Futures http://www.brightfutures.org/ A national health initiative whose website offers downloadable information on prenatal care, health care for children of all ages, guidelines for physical examinations, and related information.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Resources (contd)
Childrens Safety Network http://www.childrenssafetynetwork.org/ A national resource center for the prevention of childrens injuries and violence which provides a clearinghouse of useful information for childhood injury prevention professionals.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Resources (contd)
Emergency Medical Services for Children http://www.childrensnational.org/EMSC/ A national initiative that works to prevent child disability and/or death due to injury. Research and family teaching and other educational materials can be found here.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Resources (contd)
Office of Minority Health http://minorityhealth.hhs.gov/ Here youll find publications and data related to ethnic disparities in health care delivery and the offices work to eliminate them.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Resources (contd)
Safety Belt Safe USA http://www.carseat.org/ This organization promotes child passenger safety. Find out here how to select a car seat and which car seats have been recalled. Free publications in English and Spanish available for download.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Resources (contd)
National Highway Transportation Safety Administration http://www.nhtsa.gov Information on all aspects of transportation safety, some tailored for health care professionals.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen
Resources (contd)
The National Safe Kids Campaign http://www.safekids.org/ A nonprofit agency dedicated to eliminating preventable injuries in children. Information on state laws, common hazards, etc. OutProud http://www.scarleteen.com The National Coalition for Gay, Lesbian, Bisexual, and Transgender Youth, this site offers resources for youth and educators.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen Copyright 2012 by Pearson Education, Inc. All rights reserved.
Resources (contd)
PFLAG http://community.pflag.org/Page.aspx?pid= 194&srcid=-2 Parents, Families, and Friends of Lesbians and Gays Promotes the health and well-being of lesbians, gays, bisexual, and transgendered persons through advocacy and education.
Principles of Pediatric Nursing, Fifth Edition Jane Ball Ruth Bindler Kay Cowen