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Review the nursing diagnoses for Families of Children with Traumatic Injuries Interrupted family process; spiritual distress; fatigue; hopelessness; parental coping:compromised; anticipatory grieving
Outline the Emergency Room Nursing care to be provided to a child who has suffered injuries after being hit by a car while riding his bike. Frequent physiologic assessment, pain & sedation management, nutritional support, medication administration, management of multiple IV lines & pumps, maintenance of ventilator & hemodynamic monitoring equipment, and wound care.
What Nursing Diagnoses might apply to the child listed above? Risk for sensory overload; Risk for sensory deprivation; Risk for posttraumatic stress; Impaired verbal communication; Spiritual distress; Disturbed sleep pattern; Deficient diversional activity; Anticipatory grieving; Anxiety; Powerlessness; Acute pain
How would a Nurse properly prepare parents to view their child in PICU after she sustained horrific injuries in a car accident in which the parents were not traveling? Prior to entering the room parents are informed about what they will see; explain that tubes & monitors are present & how the child will look & react. Focus on positive aspects of child’s condition.
What nursing diagnoses might apply to a teen who is intubated? Impaired verbal communication; Powerlessness
List the most significant stressors to a teen who is hospitalized with a significant infectious disease. Loss of control, fear of changes in body image, separation from peers;
How would the Nurse help the teen to effectively deal with these stressors? Provide opportunities for choices, encourage participation in self-care, incorporate rituals from home, encourage exchange of messages with friends, allow for privacy & modesty, offer education & explanations that focus on concerns over body image
How would a Nurse most effectively calm a child in the PICU? Promote a sense of security (parental presence at bedside is one of the best ways to decrease anxiety); provide psychosocial care (touch, verbal interchanges); prepare child for procedures; facilitate use of play; promote a sense of control
How would the Nurse help the parents and the child who codes in front of them? Parents are informed about what is being done for the child and the role of each person present;Parents are positioned so they can see child’s face and hold their hand. Encourage them to tell the child how much they are loved
How would a Nurse allay the guilt of parents who cannot remain with a child in the hospital? Encourage them to call the unit at any time to check on their child.
What Nursing action would be most beneficial to allay the fears of a child in PICU after a motor vehicle accident? Promote a sense of security (parental presence at bedside is one of the best ways to decrease anxiety); provide psychosocial care (touch, verbal interchanges, building trusting relationship); consistency of staff
Shock & disbelief initially intensified by physical appearance of their child. Begin in first few moments after hearing the “news” and can last for days.
Anger & guilt – may be directed toward themselves or each other, other individuals, the child, or not at anyone specifically. They may feel responsible for causing the illness or injury. They may feel guilty about not noticing onset of an illness
Deprivation & loss difficulty & ambivalence parents feel in releasing part of their responsibility as the child’s primary caretakers to strangers can threaten their self-esteem & self-control
Anticipatory waiting characterized as “life suspended in time”. Anxiety & sense of powerlessness may increase.
Readjustment & mourning readjustment is experienced as child recovers, improves steadily, and prepares for transfer & discharge. Parents mourn when child remains seriously ill or unresponsive, when outcomes remain uncertain, or when long-term care is needed.
grief an individual’s feelings & behaviors in response to death & loss – painful, individualized & exhausting.
How can Nurses best help children in PICU cope with being on a ventilator? Provide other means of communication (word/finger board), prepare child for procedures, allow choices.
When and to which patients is palliative care provided? Palliative care is a multidisciplinary care strategy designed to relieve physical, social, emotional, and spiritual suffering in children & their families by managing symptoms & monitoring all aspects of suffering during the course of child’s illness.
How can Nurses best help siblings of a child in PICU react favorable to their brother? . Before the visit talk to the sibling what to expect. During the visit demonstrate how to talk to & touch the ill child & encourage the sibling to do the same.Encourage visitation or contact by sending pictures, drawings, cards, messages, phone calls
What Nursing care is provided to children in the end-stages of a terminal illness? Assess the child’s physiologic status (keep airway clear, bathing & keeping skin dry & intact, repositioning frequently) & comfort level (pain-free), assist the child in peaceful death, assist child & family with coping strategies, facilitate grief
How can Nurses best support the parents of an infant who died? Identify family’s wishes for postmortem care before performing any care. Wrap the baby in the blanket & offer the mother & other family members opportunity to hold the baby. Offer to take pictures of the baby & family together.