ch 36 (slide 16): special considerations for promoting normal development p 982

Question 1

congenital anomaly, what should you as a nurse do?

Answer 1

• clarify role w physician when revealing information to enable immediate parent support
• explain to parents in simple words what the defect is
• be aware of nonverbal communication, facial expressions
• present infant as something precious
• emphasize well formed aspects of infant’s body
• allow time & opportunity for parents to express their initial response
• encourage parents to ask questions & provide honest and straight forward answers

Question 2

cognitive impairment, what should you as a nurse do?

Answer 2

often easy for parents to miss clues to its presence unless associated with physical problems
- plan situations to help parents become aware of problem
- encourage parents to discuss their observations of child, without diagnostic opinions
- focus on what the child can do & appropriate interventions to promote progress to involve parents in child’s care with gaining awareness

Question 3

physical disability, what should you as a nurse do?

Answer 3

• helping child & parents over the period of shock & grief and toward the phase of acceptance & reintegration
• institute early rehabilitation
• avoid implying that parents or child was responsible for injury but allow to discuss feelings of blame
• encourage expression of feelings

Question 4

chronic illness, what should you as a nurse do?

Answer 4

• realize true impact may take months or years: conflict between parents & child, if inherited parents may blame themselves or child may blame the parents
• help each family member gain an appreciation of the others’ concern
• discuss hereditary aspect of condition w parents at time of diagnosis to lessen guity & accusatory feelings
• encourage child to express feelings by using 3rd person technique

Question 5

multiple disabilities, what should you as a nurse do?

Answer 5

• child or parent may need more time for shock phase & may be able to attend to only one diagnosis before hearing more info ab the other disorders
• acknowledge parents’ understanding & acceptance of all diagnoses
• appreciate the devastating consequences of more than one disability for a child

Question 6

terminal illness, what should you as a nurse do?

Answer 6

• parents need lots of support to deal w their own feelings & guidance in how to tell the child the diagnosis
• approach subject of disclosure in a positive way
• help parents understand the disadvantages of not telling the child
• guide parents to see the potential problems involved in fostering a conspiracy
• offer parents guidelines for how & what to tell the child ab the disease or the possibility of death (explain based on child’s cognitive ability)
• assure parents that telling a child the name of the illness & the reason for treatments instills hope, provides support from others, & serves as a foundation for explaining & understanding subsequent events
• acknowledge that being honest is not always easy bc the truth may prompt the child to ask other distressing questions, but difficult questions must be answered (am i going to die?)