caring for child with chronic illness and at end of life Flashcards
what are the 4 trends of care?
1) developmental : focus on Childs development level rather than chronological age or diagnosis. the Childs abilities and strengths are emphasized rather than disabilities. basically attention is directed towards normalizing experiences, adapting the environment and promoting coping skills
2) family-centred care : the child’s physical, emotional health is influenced by how well their family functions.
3) normalization: efforts that family members make to create a normal family life despite illness like pursuing hobbies, going to school etc..
4) shared decision making : Shared decision making among the child, family, and health care team can result from open, honest, culturally sensitive communication and the establishment of a therapeutic rela- tionship between the family and health care providers.
what are the 3 Coping with ongoing stress and periodic crises examples?
1) Concurrent stresses within the family: The ability to deal with the overwhelming stress of a lifelong disability or illness is challenged further when additional stresses are present.
2) Coping mechanisms : 2 types can be chosen. Avoidance behaviours or approach behaviours
3) Parental empowerment : rocess of recognizing, promot- ing, and enhancing competence. For parents of children with chronic conditions, empowerment may occur gradually as strength and capabilities are drawn on to master the child’s care, manage family life, and plan for the future
what are the 4 phases of phases of adjustment and emotional reactions?
1) shock and detail
2) anger
3) adjustment - guilt and anger
4) reintegration and acknowledgment
what is situational crisis?
basically establishing a support system for a family so they don’t get succumbed by their conditions
what are the 2 maladaptive pattern?
1) feels different and withdraws
2) is irritable, moody and acts out
what are developmental tasks for infancy?
trust vs mistrust
for toddlers?
autonomy
prescool?
initiative vs purpose
schoolage?
sense of accomplishment
adolescent?
personal vs sexual/intimacy
what are the 5 patterns of coping?
1) Develop competence and optimism—They accentuate the positive aspects of the situation and concentrate more on what they
have or can do than on what is missing or on what they cannot do; are as independent as possible
2) Feel different and withdraw—They see themselves as being different from other children because of the chronic health condition;
view being different as negative; see self as less worthy than others; focus on things they cannot do and sometimes over-restrict
activities needlessly
3) Are irritable and moody, act out—They use proactive and self-initiated coping behaviours, although usually counterproductive in
that the behaviours are not ego enhancing or socially responsible and do not result in desired outcomes; act out irritably, which may
or may not be associated with the condition’s symptoms
4) Adhere to treatment—They take necessary medications, treatments; adhere to activity restrictions; also use behaviours that
indicate developing independence (e.g., assume responsibility for taking medication)
5) Seek support—They talk with adults, children, physicians, and nurses; develop plans to handle issues as they occur; use
downward comparison (i.e., realize that others have it worse)
what are the 3 central concepts to family centred home care?
1) home as familiar - the environment where one is most comfortable
2) home as centre - the location of rewarding everyday experiences
3) home as protector - privacy, safety, identity
what are the 3 fears the child and parent have?
1) fear of pain and suffering
2) fear of dying alone or parents fear of not being present when the child dies
3) fear of actual death
list 5 signs of approaching death
how can nurses support families at a time of death?
