Child's Experience of Hospitalization

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Questions and Answers

What are the three stages of separation anxiety experienced by children?

Fear, Denial, Anguish

Anger, Sorrow, Acceptance

Confusion, Acceptance, Anger

Protest, Despair, Denial or Detachment (correct)

Which of the following settings is NOT typically considered a health care delivery setting?

Pediatric research center

Daycare facility (correct)

Acute care hospital

Outpatient surgery center

Which factor does NOT influence a child's reaction to hospitalization?

Number of siblings (correct)

Support of family and medical personnel

Age

Previous hospitalizations

What type of care setting is focused on long-term patient recovery?

Extended or long-term care facility Signup and view all the answers

Which of the following is a common stressor for hospitalized children?

Fear of body intrusion Signup and view all the answers

How can nurses lessen the stress of hospitalization for children's parents?

Allow parents to stay in the child's room Signup and view all the answers

What psychosocial milestone can positively influence a preschool child's adjustment to hospitalization?

Increased independence Signup and view all the answers

What does regression in a child typically refer to?

The loss of functioning to a past successful behavior Signup and view all the answers

Which age group shows the most pronounced separation anxiety during hospitalization?

Toddlers Signup and view all the answers

Which of the following is NOT a nonpharmacologic technique for managing pain in children?

Medication administration Signup and view all the answers

What is a common reason children might refrain from reporting pain?

They fear receiving an injection Signup and view all the answers

How can regression in children be minimized?

Through accurate assessment and supportive care planning Signup and view all the answers

What factor significantly influences drug dosage in pediatric pain management?

The child's weight and metabolism differences Signup and view all the answers

Which statement regarding inadequate pain relief is correct?

It leads patients to concentrate on their pain levels Signup and view all the answers

What is the purpose of conscious sedation?

To impair consciousness while maintaining reflexes Signup and view all the answers

When assessing pain in infants, which method is most appropriate?

Behavior scales Signup and view all the answers

Under what conditions is a 1:1 nurse–patient ratio maintained?

Until there is adequate hydration Signup and view all the answers

Why should family members not be used as language interpreters in health care settings?

Information can be lost in translation Signup and view all the answers

How does cultural sensitivity impact anxiety among patients?

It decreases anxiety Signup and view all the answers

What aspect is essential for improving effective communication in a culturally diverse setting?

Being familiar with culturally acceptable behaviors Signup and view all the answers

What might parents use to express their feelings and stresses during their child's hospitalization?

Ventilation through anger or crying Signup and view all the answers

How should a pediatric nurse prepare for the emotional needs of parents?

Trying to be as matter-of-fact as possible Signup and view all the answers

What is a key reason for developing an understanding of patients' early childhood experiences?

To understand behaviors and attitudes towards hospitalization Signup and view all the answers

What can result from poor communication between healthcare providers and patients' families?

Unnecessary fear Signup and view all the answers

What is a major goal when caring for a hospitalized preschool child?

To promote sensorimotor activities Signup and view all the answers

Which strength of adolescents should a nurse utilize in nursing care plans?

Desire for independence in decision-making Signup and view all the answers

Why is it not advisable to place an adolescent patient with a senile patient as a roommate?

Adolescents benefit more from being around their peers Signup and view all the answers

When does discharge planning ideally begin for pediatric patients?

At the time of admission Signup and view all the answers

Which behavior should parents expect after their child’s hospitalization?

Clinging or regression in behavior Signup and view all the answers

What is crucial for establishing trust with a hospitalized child?

Being truthful and transparent Signup and view all the answers

What aspect of confidentiality must nurses recognize when caring for adolescent patients?

Confidentiality should be defined at initial meetings Signup and view all the answers

Which action should nurses take to support a child's adjustment to hospitalization?

Incorporate interactive play whenever possible Signup and view all the answers

Study Notes

Chapter 21: The Child's Experience of Hospitalization

The chapter focuses on the child's experience during hospitalization.
Key objectives include defining key terms, identifying various healthcare settings, describing stages of separation anxiety, strategies to lessen parental stress, understanding psychosocial milestones impacting adjustment to hospitalization, managing pain, and discharge planning.
Healthcare delivery settings include acute care hospitals, extended care facilities, urgent care centers, outpatient clinics, pediatric research centers, outpatient surgery centers, and home healthcare.
Types of children requiring preparation for treatment or procedures include infants, toddlers and preschoolers, school-aged children, and adolescents.
Separation anxiety is a common response to hospitalization, occurring in infants 6 months and older with the most pronounced symptoms in toddlers. This response progresses through protest, despair, and denial/detachment stages.

Lesson 21.1 Objectives

Define key words related to child hospitalization.
Identify health care settings.
Describe the three phases of separation anxiety in children.
Discuss two parental stress reduction methods in hospitalization.
Discuss how preschool developmental milestones affect hospitalization adjustment.

Health Care Delivery Settings

Acute care hospital
Extended care facility
Urgent care center
Outpatient clinic
Pediatric research center
Outpatient surgery center
Home healthcare

Preparing the Child for a Treatment or Procedure

Infants
Toddlers and preschoolers
School-aged children
Adolescents

Separation Anxiety

Occurs in infants 6 months and older.
More pronounced in toddlers.
Three stages: protest, despair, denial/detachment

The Child's Reaction to Hospitalization

Factors influencing reaction: age, amount of preparation given, security of home life, previous hospitalizations, support of family and medical personnel, child's emotional health.
Stressors: separation, pain, fear of body intrusions

Fear

Intrusive procedures are fear-provoking.
Disrupts the child's trust level.
Threatens self-esteem and self-control.
May require activity restrictions.

Regression

Loss of achieved functioning to earlier developmental stages.
Minimized by accurate nursing assessments and care planning to support growth.
Praise motivates appropriate behavior after stress is removed.

Lesson 21.2 Objectives

Discuss pain management in infants and children.
Discuss the importance of language interpreters in healthcare.
Identify problems facing siblings of hospitalized children.
Interpret clinical pathways for hospitalized children.

Pain

Children may refrain from reporting pain due to fear of injections.
Infants assessed using behavior scales.
Toddlers' crying may stem from anxiety/fear, not solely pain.
All pain factors must be considered.

Managing Pain

Non-pharmacological techniques: drawing, distraction, imagery, relaxation, cognitive strategies, backrubs/hand massage.

Response to Drugs

Drug elimination may be prolonged due to immature liver enzyme systems.
Dosages influenced by weight and differences in absorption, metabolism, and clearance.

Drugs Used for Pain Relief

Adequate pain relief allows patients to focus on their surroundings.
Inadequate pain relief may focus the child solely on pain.
More effective pain relief at lower doses given around the clock (preventive pain control).

Conscious Sedation

IV drugs impair consciousness while maintaining airway reflexes and physical/verbal responsiveness.
1:1 nurse-patient ratio until stable vital signs, appropriate motor/verbal skills, adequate hydration, and pre-sedation level of responsiveness/orientation are reached.

Language Interpreters

Improves communication between parents and healthcare team members.
Family members should not be used.
Healthcare settings legally required to provide language interpreters at no charge.

Cultural Response

Cultural sensitivity decreases anxiety.
Effective utilization & compliance enhanced when nurse's approach is compatible with cultural needs & beliefs.
Nonverbal cues & body language important in intercultural communication.

Intercultural Communication and Responses to Hospitalization

Consideration of personal space for various cultures is necessary.
Understanding of acceptable smiling, eye contact, and touch within different cultural contexts.
Nurses must take time to familiarize themselves with culturally acceptable behaviors.

The Parents' Reactions to the Child's Hospitalization

Parents may express feelings though anger, crying, or body language.
Parents' behaviors affected by early childhood experiences.
Understanding parent's issues critical for successful care of pediatric patients.
Poor communication can cause unnecessary fear.

The Nurse's Role in Hospital Admission

Must be prepared to meet emotional needs of the child and parents.
Parents should provide matter-of-fact approach to the experience.
Avoid excessive detail about procedures to minimize anxiety.

Lesson 21.3 Objectives

Contrast problems of preschool and school-age children with hospitalization.
Identify strengths of adolescents that nurses should consider in developing care plans.
Recognize discharge planning steps for infants, children, and adolescents.

Meeting the Needs of the Hospitalized Child

Hospitalization can be frustrating.
May miss continuous parental affection.
Daily routines disrupted.
Assisting parent-child attachment and promoting sensory activities is critical.
Liberal visitation & caregiver consistency are important.

Adjustment to Illness

Adolescents can understand disease implications and participate in care decisions.
Nurses encouraging participation promote adolescent confidence.

Roommate Selection

Adolescents usually benefit from single or shared rooms.
Avoid placing senile or infant patients with adolescents.
Room location is important.

Confidentiality and Legality

Define clear confidentiality parameters during initial meetings.
Emancipated minors no longer under parental authority.
Understanding of state laws regarding confidentiality critical when dealing with adolescents.

Discharge Planning

Starts at admission.
Provide written instructions for home treatments.
Prepare parents for potential behavioral issues after discharge.

Guidance for Parents

Anticipate clinging and regression behaviors.
Support child's participation in family life.
Focus on the child, not the illness.
Be kind, firm, and consistent with bad behaviors.
Build trust through truthfulness.
Allow time for play.

Legal and Ethical Considerations

Discharge charting should include who accompanied the child, time of discharge, condition, method of transport, vital signs, weight, medications, and instructions to parents.

Home Care

Acute or chronic conditions treated are often cared for at home.
Family support by community health care agencies needed in such cases.
Respite care available for primary caregivers.

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Description

Explore the nuances of a child's hospitalization experience in Chapter 21. This chapter covers key terms, healthcare settings, stages of separation anxiety, and strategies to support both children and parents for a smoother experience. Gain insights into managing pain and discharge planning insights tailored for various age groups.

Child's Experience of Hospitalization - Chapter 21

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