Immigrant visas issued to orphans entering the United States (a proxy measure for international adoptions) totaled 13,620 in 1997, more than double the amount in 1992. As international adoption numbers rise, pediatric nurses encounter more adopted children and adoptive families. Among the many adoption-related issues confronting pediatric health care providers, the one most frequently voiced is: "Should we do or look for anything differently in adopted children? And, if so, what?" To address this issue, a three-fold approach is suggested: (a) recognize the physical conditions and medical problems prevalent in the international countries with high adoption rates; (b) identify the unique adoption-related tasks encountered by children according to their current developmental stage; and (c) determine recommendations for providers, parents, and children to successfully address or cope with these adoption-related tasks and conditions.