Family-Centered Care Chapter 21 Flashcards
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Questions and Answers

A previously 'potty-trained' 30-month-old child has reverted to wearing diapers while hospitalized. The nurse should reassure the parents that this is normal because of which reason?

  • Regression is seen during hospitalization. (correct)
  • The child is experiencing urinary urgency because of hospitalization.
  • The child was too young to be 'potty-trained.'
  • Developmental delays occur because of the hospitalization.
  • Which is the appropriate procedure for obtaining the blood pressure on a child in the playroom?

  • Ask the child to return to his or her room for the blood pressure, then escort the child back to the playroom. (correct)
  • Document that the blood pressure was not obtained because the child was in the playroom.
  • Take the blood pressure in the playroom.
  • Ask the child to come to the exam room to obtain the blood pressure.
  • Which intervention can the nurse implement to promote a sense of control for a 5-year-old child with pneumonia symptoms?

  • None, this is an emergency and the child should not participate in care.
  • Have parents wait in the waiting room.
  • Allow the child to hold the digital thermometer while taking the child's blood pressure. (correct)
  • Ask the child if it is OK to take a temperature in the ear.
  • When speaking with the parents of a child admitted to the intensive care unit, which stressors should the nurses expect to be evident? (Select all that apply)

    <p>Strange smells</p> Signup and view all the answers

    Which are the benefits of therapeutic play for a hospitalized child? (Select all that apply)

    <p>Allows the child to express feelings</p> Signup and view all the answers

    Which discharge interventions should the nurse implement for a child being discharged after inguinal hernia repair? (Select all that apply)

    <p>Discuss dietary restrictions.</p> Signup and view all the answers

    Which creates stressors for children and parents in ICUs? (Select all that apply)

    <p>Sleep deprivation</p> Signup and view all the answers

    Which should the nurse document as complementary or alternative medical practices used by a toddler's parents? (Select all that apply)

    <p>Hypnotherapy for relief of pain</p> Signup and view all the answers

    What represents the major stressor of hospitalization for toddlers and preschoolers?

    <p>Separation anxiety</p> Signup and view all the answers

    What should the nurse interpret when Eric appears to be 'settled in' during his hospitalization?

    <p>He may be experiencing detachment, which is the third stage of separation anxiety.</p> Signup and view all the answers

    When a preschool child is hospitalized without adequate preparation, how may they view the hospitalization?

    <p>Punishment</p> Signup and view all the answers

    Which age group is particularly vulnerable to events that lessen their feeling of control and power?

    <p>School-age children</p> Signup and view all the answers

    The 10-year-old girl saying 'Wait a minute' and 'I'm not ready' indicates what?

    <p>This is normal behavior for a school-age child.</p> Signup and view all the answers

    What is the most common initial reaction of parents to a child's hospitalization?

    <p>Disbelief</p> Signup and view all the answers

    What best describes the siblings' feelings towards the hospitalized child?

    <p>Jealousy and resentment are common reactions to the illness of a sibling.</p> Signup and view all the answers

    What intervention can minimize separation anxiety in toddlers during hospitalization?

    <p>Encourage parents to room in.</p> Signup and view all the answers

    What is an appropriate intervention for a four-year-old upset by hospitalization?

    <p>Let him know it is all right to cry.</p> Signup and view all the answers

    What should the nurse explain to Latasha, age 8, to help her adjust to being admitted to the hospital?

    <p>Explain hospital schedules to her, such as mealtimes.</p> Signup and view all the answers

    What should the nurse do when Samantha, age 5, asks for a Band-Aid after an injection?

    <p>Apply a Band-Aid.</p> Signup and view all the answers

    What should the nurse advise when Kimberly, age 3, is hospitalized and her parents want to buy her new toys?

    <p>Children often need familiar toys from home.</p> Signup and view all the answers

    What is appropriate for a parent experiencing guilt over their child's hospitalization?

    <p>Clarify misconceptions about the illness.</p> Signup and view all the answers

    Which roommate should the nurse assign to a 14-year-old boy being admitted for an appendectomy?

    <p>A 15-year-old boy admitted with a vasoocclusive sickle cell crisis</p> Signup and view all the answers

    What statement about separation anxiety should an adolescent be expected to say?

    <p>I hope my friends don't forget about visiting me.</p> Signup and view all the answers

    How should the nurse conduct a physical exam for a 2-year-old child sitting on a parent's lap?

    <p>Perform the exam while the child is on the parent's lap.</p> Signup and view all the answers

    What intervention should a nurse implement for a school-age child struggling to sleep at night?

    <p>Create a schedule similar to the one the child follows at home.</p> Signup and view all the answers

    Study Notes

    Separation Anxiety in Young Children

    • Major stressor for children from infancy to preschool age is separation anxiety, known as anaclitic depression.
    • Separation from family is a primary concern, causing emotional distress during hospitalization.

    Behavior Signs in Hospitalized Toddlers

    • Detachment in young children may indicate a manifestation of separation anxiety rather than contentment.
    • Encourage parental presence as detachment can lead to misunderstandings of the child’s needs.

    Perceptions of Hospitalization

    • Preschoolers often perceive hospitalization as punishment for misdeeds if not adequately prepared.
    • Preparation is crucial to avoid misconceptions and anxiety in young patients.

    Vulnerability of School-Age Children

    • School-age children experience significant stress due to loss of control, altered family roles, and peer acceptance issues.
    • They may struggle more than younger children with feelings of powerlessness in a hospital environment.

    Control and Decision-Making

    • School-age children may express a desire to maintain control over situations, such as choosing when to have medical interventions.
    • Providing structured choices can help them feel more empowered during procedures.

    Parental Reactions to Child’s Hospitalization

    • Initial parental reactions to a child’s hospitalization often include disbelief, especially with sudden illnesses.
    • Anger and guilt typically follow as common emotional responses, leading to feelings of exhaustion.

    Sibling Reactions

    • Siblings of hospitalized children may express jealousy, resentment, and feelings of being neglected.
    • Their emotional distress reflects a need for acknowledgment of their feelings towards a sibling's illness.

    Minimizing Separation Anxiety in Toddlers

    • Encouraging parents to "room in" during hospitalization can significantly reduce a toddler's separation anxiety.
    • Familiar items from home provide comfort and reassurance for young children.

    Emotional Support for Hospitalized Children

    • Allowing children to express emotions like crying is acceptable and essential in providing emotional support during anxiety-provoking situations.
    • The nurse's presence and acknowledgment of feelings can help ease distress.

    Hospital Orientation for School-Age Children

    • School-age children benefit from explanations about hospital routines to regain a sense of control.
    • Being oriented to their environment can alleviate anxiety about hospitalization.

    Responding to a Child's Needs Post-Injection

    • Providing a Band-Aid immediately after an injection can help address a child's fears and anxieties about injuries.

    Understanding Child Behavior During Hospitalization

    • Familiar items are more comforting than new toys during a hospital stay for young children.
    • Parents should bring favorite objects to help keep the child reassured.

    Parental Guilt Management

    • Clarifying misconceptions about a child's illness can help parents dealing with feelings of guilt regarding hospitalization.

    Room Assignments for Hospitalized Adolescents

    • Considerations for roommate assignment should prioritize age, sex, and the nature of the illness to promote comfort.

    Adolescent Social Concerns

    • Adolescents hospitalized may worry about maintaining peer connections and status, which can affect mental health during recovery.

    Physical Examinations for Young Children

    • Performing examinations while a child is on the parent’s lap can minimize anxiety and enhance comfort.

    Sleep Routines for Hospitalized Children

    • Establishing a consistent schedule that mirrors home routines can improve sleep quality for hospitalized children.

    Regression During Hospitalization

    • Regression, such as reverting to diaper use in toddlers, is a typical response to stress and hospitalization, and should be communicated to parents as temporary.

    Appropriate Environments for Medical Procedures

    • Medical procedures should be conducted in less stressful environments, like private rooms, rather than play areas accustomed to free play.### Emergency Department Intervention
    • Promoting a sense of control in children during emergencies enhances cooperation during procedures.
    • Allowing a child to hold the digital thermometer while taking blood pressure fosters engagement.
    • In emergencies, children should still be given choices, like selecting which ear to measure temperature.
    • Parents’ presence helps mitigate anxiety for the child during medical assessments.

    Intensive Care Unit Admission Stressors

    • Parents of a child admitted to the ICU may face stress due to the unfamiliar environment and equipment.
    • Disruption of normal day-night routines is common in ICU settings due to continuous lighting.
    • Strange smells and inadequate knowledge about the child’s condition contribute significantly to parental stress.
    • Privacy concerns are heightened in intensive care units, adding to family distress.

    Benefits of Therapeutic Play

    • Therapeutic play aids children in expressing their feelings and coping with concerns.
    • Nurses gain valuable insights into children’s emotional states through nondirective play activities.
    • Differentiation between therapeutic play and structured therapy is crucial; the former is broader and less directive.
    • Play therapy provides a safe outlet for anger and emotional distress.

    Discharge Interventions for Surgical Patients

    • Discharge planning must include detailed dietary restrictions, emphasizing clarity in instructions.
    • Providing a pain scale helps families assess and manage post-operative pain at home.
    • Parents should be informed about potential complications following an inguinal hernia repair.
    • Prescriptions are ideally filled prior to the child's discharge for timely pain management.

    ICU Stressors for Families

    • ICUs present physiological and environmental stressors for both children and parents.
    • Equipment noise, such as monitors and alarms, can be overwhelming for families.
    • Unfamiliar odors and sleep deprivation are common issues in the ICU setting.
    • The caring nature of healthcare staff can alleviate some of the stress experienced by families.

    Complementary and Alternative Medicine Practices

    • Alternative practices include non-conventional remedies such as chamomile tea, hypnotherapy, and acupressure.
    • Acetaminophen and cool mist vaporizers are classified as standard medical practices rather than alternatives.
    • Nurses should document any complementary or alternative methods that families employ for symptom management.

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    Description

    Test your knowledge of family-centered care for children during their illness and hospitalization. This quiz focuses on key concepts, stressors, and nursing strategies that are essential for caring for young patients. Ideal for nursing students and professionals seeking to enhance their understanding of pediatric care.

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