Ch 15

Question 1

Nursing care for hosp child-anxiety

Answer 1

Minimize separation anxiety, loss of control, and pain r/t procedures

Question 2

Infant understanding of illness-3

Answer 2

1. By 6 mo awareness of separate self
2. Unaware of effects of illness
3. Stranger anxiety

Question 3

Toddler and preschooler understanding of illness -3

Answer 3

1. Don’t understand cause
2. May view as form of punishment/ magical
3. Mistaken associations

Question 4

Adolescent understanding of illness

Answer 4

Concerned w appearance and perceive illness/injury in terms of effect on body image

Question 5

Infant hospitalization stress-2

Answer 5

1. Separation/stranger anxiety, pain, immobility, sleep deprivation
2. Tx- parent present, adhere to home routine, pain control, quiet environment

Question 6

Toddler hosp stress-2

Answer 6

1. Separation anxiety, loss of self-control, immobile, pain, body injury/mutilation, fear of dark
2. Tx- parent present/holds, allow choices, explain procedures, night light

Question 7

Stages of separation anxiety -3

Answer 7

1. Protest- scream, cry, clings to parent, may resist comfort from other adults
2. Despair- sad, quiet, withdrawn, compliant, cry when parents return
3. Denial/detachment- no protest when parent leaves, seems happy/content, interest in surroundings, close relationships not established

Question 8

Illness/hospitalization effects and responses-3

Answer 8

1. Separation-withdrawal, abandonment, regression
2. Fear of unknown- procedures/pain-> sleep disruption, anxiety
3. LOSS of control (mobility, autonomy, privacy)- aggression, regression, displacement

Question 9

Preparation for surgery-preop-4

Answer 9

Teach purpose, sensations
Allow transition objects
Parent there for anesthesia induction

Question 10

Preparation for surgery-post op

Answer 10

Have child demonstrate post-op procedures

RN-assess dressing/drains q 1hr, IV site q2hr, bowel sounds q 4hr, lungs q 2hr reposition q 2 hr

Question 11

NPO/liquids and anesthesia -4

Answer 11

Clear liquids- 2 hr, breast milk-4 hrs, formula 6hr, milk/light meal 6 hr

Question 12

Therapeutic play-4

Answer 12

• presents an opportunity to deal w fears, concerns, and stressors of health experiences
  1. Learn about health care
  2. Express anxieties
  3. Work through feelings
  4. Achieve sense of mastery/control over situation

Question 13

Dramatic play

Answer 13

Medical situations are reenacted by child to help cope w painful treatments and intrusive procedures

Question 14

Teaching plan-4

Answer 14

1. Goals and expectations
2. Intervention needed
3. Time for evaluation of expected outcomes
4. Teaching methods and types of materials to use