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Caring for a hospitalized child
CSM Nursing Caring for a hospitalized child
54
Nursing
Undergraduate 3
02/24/2016

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Cards

Term
What is a child's understanding of health and illness primarily based on?
Definition
1. Cognitive ability at different developmental stages
2. Previous experience with healthcare professionals
Term
At what age does a child realize they are separate beings?
Definition
6 months; infant
Term
What may a child feel if they are not with their parents?
Definition
1. Anxious with strangers
2. Separation anxiety
Term
At what developmental stage does a child identify primary caregivers vs strangers?
Definition
Infant
Term
At what developmental stage can a child sense a parent's anxiety?
Definition
Infant
Term
What should a nurse tell a parent who is about to leave their infant alone in a hospital?
Definition
Encourage the parents to stay because staying in a hospital alone may be traumatic
Term
What are developmental issues for a hospitalized infant?
Definition
1. Separation anxiety
2. Stranger anxiety
3. Painful, invasive procedures
4. Immobilization
5. Sleep deprivation
6. Sensory overload
Term
What are some responses infants make to illness?
Definition
1. Sleep-wake cycle disrupted
2. Feeding routines disrupted
3. Displays excessive irritability
Term
How do toddlers and preschoolers perceive illness?
Definition
They understand illness but not its cause
Term
What type of thinking do toddlers and preschoolers have?
Definition
Magical thinking
Term
What do toddlers and preschoolers know about their body?
Definition
They know some names and locations of body parts, usually only parts they can see
Term
What is a major stressor for toddlers and preschoolers that are hospitalized?
Definition
Separation from parents
Term
What do toddlers and preschoolers fear when hospitalized?
Definition
Bodily mutilation
Term
What are two ways to deter fear of bodily mutilation in toddlers and preschoolers?
Definition
1. Demonstrate procedure on a doll
2. Give the child band aids
Term
What are developmental issues for toddlers?
Definition
1. Separation anxiety
2. Loss of self-control
3. Immobilization
4. Painful, invasive procedures
5. Fear of the dark
Term
How may a toddler respond to illness?
Definition
1. Frightened if forced to lie supine
2. Associates pain with punishment
3. Wonders why parents don't come to the rescue
Term
What are preschooler developmental issues?
Definition
1. Separation anxiety- fear of abandonment
2. Loss of self control
3. Bodily injury or mutilation
4. Painful, invasive procedures
5. Fear of ghosts, monsters and the dark - rich fantasy world
Term
How may a preschooler respond to illness?
Definition
1. Difficulty in separating reality from fantasy
2. Fears ghosts, monsters
3. fear body parts will leak out when skin is not intact- use bandaids
4. Fears tubes are permanent
5. Demonstrates withdrawl, aggression, regression
Term
What developmental level begins to have a more realistic understanding of illness?
Definition
School age
Term
What does a school age child understand about the body?
Definition
They start to understand parts such as the heart, lungs, and bones
Term
How do school age children feel about separation from their parents?
Definition
They know their parents will return
Term
What are fears of a school age child?
Definition
Pain, stitches, disfigurment
Term
What are developmental issues for school age children?
Definition
1. Loss of control
2. Loss of privacy & control over bodily functions
3. Bodily injury
4. Painful, invasive procedures
5. Fear of death
Term
What are 2 responses common from school age children?
Definition
1. Increased sensitivity to environment
2. Detailed hx of events
Term
At what developmental level does a child have a good understanding of illness and body?
Definition
Adolescent
Term
What may an adolescent worry about themselves?
Definition
Body image
Term
What is a good way to help promote establishing self identity for an adolescent patient?
Definition
Allow choices and control when possible
Term
What are major stressors in a hospital for an adolescent patient?
Definition
Separation from peers, home and school
Term
What are developmental issues for an adolescent?
Definition
1. Loss of control
2. Fear of altered body image, disfigurement, disability, or death
3. Separation from peer group
4. Loss of privacy and identity
Term
What are some expected adolescent responses to hospitalization?
Definition
1. Denial
2. Regression
3. Withdrawl
4. Intellectualization
5. Projection
6. Displacement
Term
How does hospitalization effect a family?
Definition
1. Disrupts usual routines
2. There may be increased fear and anxiety
Term
What are two examples of disruptions in usual routines that effect a family with a hospitalized child?
Definition
1. Changes in who is at home with siblings
2. Changes in who is working
Term
What are two things that may cause anxiety or fear for a family with hospitalized child?
Definition
1. Severity of illness
2. Watching the child suffer from pain
Term
What are several considerations a nurse should make when assessing the family of a hospitalized child?
Definition
1. The financial resources including the cost of travel and taking time off work
2. Access to healthcare
3. Availability of community services
4. Cultural considerations
Term
What should a nurse look for when assessing family communication for a hospitalized child?
Definition
1. Family dynamics (disciplining children)
2. Quality of communication
3. Methods of handling problems
4. Sources of strength
Term
What should a nurse look for when assessing family support for a hospitalized child?
Definition
1. Prior methods of coping and whether they were effective
2. Support groups
3. Referral to outside agencies
Term
What are some effects on siblings for a hospitalized child?
Definition
1. Less attention from parents
2. May fantasize about illness or injury
3. Guilt, insecurity, anxiety, jealousy
4. Behavioral or school problems
Term
What are some methods to promote adaptation for a hospitalized child?
Definition
1. Child life programs
2. Rooming in
3. Therapeutic play
4. Therapeutic recreation
Term
What are 4 aspects of child life programs?
Definition
1. Age-appropriate play
2. Preparation for procedures
3. Focus on emotional needs of a child
4. Support family in providing child's care
Term
What are 3 considerations for rooming in?
Definition
1. Parent stays in the child's room and helps provide care
2. Accommodations vary (cots, day beds, etc.)
3. Collaboration between nurse and parent is important
Term
What is the "work of childhood?"
Definition
Play
Term
What are the purposes of play for a hospitalized child?
Definition
1. Facilitates normal development
2. Helps the child learn about healthcare, express anxieties & work through feelings
3. Achieve control
Term
What does therapeutic play do for a child?
Definition
Helps assess knowledge of illness & injury
Term
What type of play is used when a child draws a body?
Definition
Therapeutic play
Term
What type of play is used when a child makes up a story?
Definition
Therapeutic play
Term
What type of play is used when a child uses dramatic play?
Definition
Therapeutic play
Term
Why is therapeutic play for toddlers important & what are examples of therapeutic play for toddlers?
Definition
Helps release tension
1. Playing peek-a-boo, hide n seek
2. Read books & stories
3. Dolls
4. Building blocks
5. Safe hospital equipment (stethoscope, syringes without needles)
Term
What are examples of therapeutic play for preschoolers?
Definition
1. Outline of the body
2. Playing with safe hospital equipment
3. Crayons & coloring
4. Puppets, play dough
5. Pet therapy
Term
Why is therapeutic play for school-age children important and what are examples?
Definition
Child may regress with hospitalization
1. Collecting objects
2. Games, books, schoolwork, crafts, computers
Term
What are important things to remember about adolescents needs?
Definition
1. Therapeutic recreation
2. Focus on peers
3. Telephone contact
Term
What are examples of play for adolescents?
Definition
1. Pizza parties
2. Video games
3. Movie
Term
What can a nurse do to assist Children and Families of a hospitalized child?
Definition
1. Tailor family's need & preferences (primary care nurse)
2. Honest & open communication (allow parents to vent and give breaks)
3. View parent as expert about child
4. Respect cultural practices
Term
What is play therapy?
Definition
Performed with psychologist
Term
Nursing interventions
Definition
1. Base interventions around child's pain
2. Assess family for strengths & challenges
3. Collaborate with child life
4. Encourage rooming in
5. Therapeutic play
6. Meet educational needs of school-age kids
7. Preparation for procedures
8. Consider parent the expert about the child
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