Unit 2: Legal, Ethical, & Health Care Systems

What are the top causes of neonatal mortality (birth–28 days)?

Congenital malformations (#1), low birth weight, prematurity, and maternal/birth complications.

What are the top causes of infant mortality (28 days–1 year)?

Congenital malformations, low birth weight, sudden infant death syndrome (SIDS, #3), and unintentional injuries (#5).

What are the top 5 causes of injury-related death in infants?

Suffocation, homicide, motor vehicle accidents, undetermined suffocation, and drowning.

Define child morbidity.

Any illness or injury that limits activity, requires medical attention or hospitalization, or results in a chronic condition.

What program provides health insurance for uninsured children up to 19 years old?

CHIP (Children’s Health Insurance Program), which serves families who earn too much for Medicaid but can’t afford private insurance.

What is the purpose of Medicaid in pediatric care?

Public insurance based on family income that provides coverage for low-income children.

What is the main difference between public and private insurance for children?

Public programs (Medicaid, CHIP) are income-based; private insurance is employer-provided or self-paid.

What is the Nurse Practice Act?

A law regulated by each state that defines the legal roles, responsibilities, and scope of practice for nurses.

What are Standards of Clinical Practice?

Professional guidelines (from ANA, SPN, NAPNAP) that define standards for nursing care and performance using the nursing process.

What is informed consent?

A formal, signed and witnessed authorization for an invasive procedure or research participation after full explanation and understanding of the procedure.

Who is legally responsible for obtaining informed consent?

The physician or healthcare provider performing the procedure.

When can a minor legally provide informed consent?

If they are legally emancipated, married, pregnant, or seeking treatment for birth control, mental health, or substance abuse.

Which parent can provide consent if parents are divorced?

Only the parent with legal authority/custody may provide consent for treatment.

When do parents lose the right to make healthcare decisions for a child?

When refusal of care would deny lifesaving treatment or create a conflict of interest between parent and child.

Define confidentiality in pediatric care.

The ethical and legal responsibility to protect private patient information from being shared without consent.

What are exceptions to confidentiality in pediatric nursing?

Adolescent with reportable disease (TB, HIV, STI), suspected child abuse, or suicide/homicide risk.

What law governs patient privacy and confidentiality in healthcare?

HIPAA — Health Insurance Portability and Accountability Act.

What is the Patient Self-Determination Act?

A law that requires patients to be informed about their rights to make healthcare decisions and advance directives.

What are examples of advance directives?

A living will and durable power of attorney for healthcare decisions.

When are advance directives especially important in pediatrics?

For adolescents with life-threatening or terminal conditions.

What does DNR stand for, and what does AND mean?

DNR = Do Not Resuscitate; AND = Allow Natural Death (comfort-focused care, often used for hospice or terminal illness).

What are common ethical issues in pediatric nursing?

Saving newborns with severe impairments, genetic testing, and organ transplantation.

What is family-centered care?

A philosophy that emphasizes collaboration with families as partners in care, respecting their values, culture, and preferences.

What is the nurse’s role in patient advocacy?

To support and empower families to make informed choices and access needed resources.

What is the purpose of case management in pediatrics?

To coordinate multidisciplinary care, ensure safe and cost-effective services, and facilitate transitions (e.g., hospital to home).

What is discharge planning, and when should it begin?

A collaborative process to prepare for safe home care, starting at admission.

What are clinical practice guidelines (clinical pathways)?

Evidence-based, standardized plans that outline the sequence and timing of interventions for specific conditions to achieve expected outcomes.

What are the key legal responsibilities of nurses under the Nurse Practice Act?

To practice within their defined scope, maintain competency, and uphold professional and ethical standards.

Why is documentation so important in pediatric nursing?

It provides legal evidence of care, communication among providers, and protection in case of legal review.