Caring in Diverse Settings Flashcards
Reasons for Hospitalization younger than 5
Respiratory diseases
Reasons for Hospitalization for Older Children
Respiratory diseases
mental health
injuries
gastrointestinal disorders
Reasons for Hospitalization for Adolescents
pregnancy
childbearing
mental health
injury
Psychological Effects of Hospitalization
- anxiety and fear
- potential for injury, pain
- separation from home, family
- regression
Normal Fears
- separation anxiety
- loss of control
- bodily injury
- harm
- unfamiliar environment
3 Stages of Separation Anxiety
- Protest
- Despair
- Detachment
Protest Stage
displays crying, agitation, rejection of others, anger, inconsolable, grief
Despair Stage
withdrawn and quiet without crying; displays apathy, depression, lack of interest, sadness
Detachment Stage
uses coping mechanisms, displays resignation but not content, developmental delays
Loss of Control means
- change of routine
- unable to do simple tasks
- confined to bed
- decisions
Factors influencing Family Reactions
- parenting style
- family-child relationship
- coping skills
- cultural variations
- attitudes about the care of sick child
Behavior/Methods for Coping
- ignore or negate problems
- stoicism, passive acceptance
- anger, withdrawal, rejection
- intellectualizing
Methods to Promote Coping
- breathing techniques
- distractions
- imagery
- music
- child teaching
4 Phases of Nursing Care
- Intro
- Building trust
- Decision-making phase
- Providing comfort/reassurance
Types of Admissions
- general inpatient unit
- emergency and urgent care department
- pediatric intensive care unit
- outpatient or special procedures unit
- rehab unit or hospital
How can we teach parents to prepare the child for the hospital?
- read stories
- talk about it/ BE HONEST
- let child ask questions
- bring items from home
- include siblings
Steps of Admission Process
- establish trust
- introduce self
- talk about what will happen
- communicate at age appropriate levels
- orient to hospital unit
- perform interview
Hospital Restraint Policy
- reason for restraint
- assessment parameters identifying the need
- use of at least 1 alternative method
- use least restrictive type
- need written order within 1 hour of application
- face-to-face evaluation
Nursing Responsibilities for Restraints
- make sure it fits
- check 15 mins after initial placement
- then check q 1 hour
- check temp, pulse, cap refill
- remove q 2 hours
- positive reinforcement
Discharge Instructions
- follow up appointments
- when to contact doctor
- diet
- activity level allowed
- medications
- additional treatment required at home
- when can they return to school
- referral info
Role of Community-Based Nurse
- disease prevention
- education and communication
- discharge planning and case management
- advocacy
- physical care
Goal of Home Health Care
promoting, restoring, and maintain the health of the child
School Nursing
- health screens
- assess growth and development
- first aid
- care for acute and chronic illness
- train staff
- education
- liaison b/t school and doctor
Role of Nurse in Home Care
- direct providers of care
- educator
- advocate
- case manager
LEARN
Listen Explain Acknowledge Recommend Negotiate and Agree
Disadvantage of Home Health Care
- can be intrusion of privacy
- overwhelming
- financial issues can burden family
