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Nursing 3 Exam 2
Care of hospitalized child
| Question | Answer |
|---|---|
| Impact of hospitalization on family | They may feel anxious or fearful because of severity of illness and having to watch child suffer pain |
| Impact of hospitalization on family | Disrupts usual routines;changes in who is at home with siblings & who is working |
| Methods to promote adaptation to hospitalization | Child life programs, rooming in, therapeutic play, therapeutic recreation |
| Therapeutic Play | "play is the work of childhood", often collabortive effort between neurses, child life therapists & parents |
| Therapeutic recreation | used w/adolescents, focus on contact w/peers, parties, games, movies, etc. |
| Types of Play | Therapeutic & Dramatic |
| What is children's understanding of health and illness based upon? | Cognitive ability at diff develpmental stages, previous experiences, younger children usually experience separation anxiety |
| 3 phases of seperation anxiety? | Protest, Despair, Denial or detachment |
| protest | crying, clinging, acting aggressively |
| despair | sadness, withdrawal from environment |
| denial or detachment | detaching feelings from parents, lack of protest when parents leave, formation of relationships w/others, child internalizes the stressor and seems outwardly happy |
| Infants | by 6 months-realize they are seperate beings |
| Infants | Can id primary caregivers, may feel anxious w/strangers(seperation anxiety) |
| Infants | if left alone, hospitalization can be more traumatic-encourage parents to stay |
| Infants | Can sense parents anxiety |
| Toddlers and Preschoolers | Begin to understand illnes but not its cause |
| Toddlers and Preschoolers | Has Magical thinking; "bad behavior, animal, etc made me sick" |
| Toddlers and Preschoolers | Knows names and locations of some body parts-usually those that can be seen |
| Toddlers and Preschoolers | Seperation from parents is MAJOR STRESSOR |
| Toddlers and Preschoolers | Fear bodily mutilation: demonstrates on dolls first, band-aids |
| School-Age | More realistic understanding of illness, Like models |
| School-Age | They like modes, drawings as part of explanation |
| School-Age | Understands more about body parts- heart,lungs, bones |
| School-Age | Have less fear of seperation, as they know parent will return |
| School-Age | Fears: Pain,stitches,disfigurement |
| Adolescents | Have good understanding of illnes and body |
| Adolescents | A major stressor for them is worrying about body image, establishing self-identity-allow choices and control when possible |
| Adolescents | stressors of hospitalization-seperation from peers,home, and school |
| What can nurses do? | tailor care to family's needs and preferences |
| What can nurses do? | honest and open communication |
| What can nurses do? | View parent as the expert about the child |
| What can nurses do? | Respect cultural practices |
| Preparation of Hospitalization | Tours fo hospital unit or surgical area |
| Preparation of Hospitalization | allow childrent to touch equipment and try on attire to lessen anxiety |
| Preparation of Hospitalization | use photos or videos that show medical settings and procedures |
| Emergency Dept | Need honest, accurate info, repeat info frequently...family presence during resuscitations, invasive procedures |
| What to do if child is in isolation? | Encourage family to visit-discuss use of gowns,gloves and masks explain rationale. |
| Therapeutic play | helps assess knowledge of illness or injury, child draws body, child makes up a story |
| Dramatic Play | acts out experience of healthcare |
| Toddlers Therapeutic play | helps them release tension, playing peek-a-boo, hide-n-seek, read books and stories, dolls, building blocks, safe hospital equipment(stethoscopes, syringes w/out needles) |
| Preschoolers Therapeutic play | outline of body, playing w/safe hosp equip, crayons & coloring, puppets, play dough, pet therapy, child may regress w/hospitalization |
| School age Therapeutic Play | Regression common, outlines of body, dolls, use developmentally appropriate terms for body parts, games books computer, crafts, play should promote a sense of achievement |
| Adolescent Recreation | Therapeautic recreation, focus on peers, telephone contact, examples:pizza parties, video games, movie night |
| Nursing interventions | Based around childs understanding of health and illness, assess family for strengths & challenges, collaborate w/child life, encourage rooming in, therapeutic play |
| Nursing interventions | meet educational needs of school-age children, prep for procedures, consider parent the expert about the child |
| Safety considerations | Use of side rails, carrying infants not recommended, wall sockets should be covered, security devices in place, doors closed, positioning of infants to sleep, alarms, variations in medication admin |
| Child life specialist | works with childrent being treated for cancer. special dolls are used to familiarize children with the proceduresthat they will undergo. |
Created by:
jbittner
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