ch 38: family centered care & hospitalization Flashcards
EXAM 1 content
when children are stressed in a hospital, what tends to develop with the child to the parents?
separation anxiety
what are the separation anxiety phases?
- protest phase
- despair phase
- detachment phase
Please Don’t Die
what happens in the protest phase?
crying, screaming, & clinging to the parent
what happens in the despair phase?
stops crying, shuts down to prevent stress, & evidence of depression
what happens in the detachment phase?
- denial
- accepts situation, not content
- wants to be alone
how do we avoid separation anxiety?
assigning the same nurses to the same patients
what happens in early childhood when we avoid separation anxiety?
they can withstand many other stressors
in late childhood and adolescence, who do they feel more separated from?
their peers, not their family
- the only exception is the first time in the hospital
when infants feel a loss of control, what should we do?
- trust! they are going through trust vs mistrust
- care for the baby when crying
- console them: pacifier, takling, etc
- consistent caregivers
- having a daily routine
what happens to infants when you let them “cry it out”?
it can slow down their development & develop mistrust
when toddlers feel a loss of control, what should we do?
- given them autonomy: the choice in medications is HOW they want to take their medication, not not taking it
- daily routine & rituals
if toddlers feel a sense of control loss, what would that lead to?
- regression
- negativity
- temper tantrums
what is regression? (in terms of toddlers)
losing skills they recently gained (sleeping through the night, potty training) –> going back to an earlier stage of development
what should we do when a toddler has temper tantrums? what is the most important thing?
safety is the most important thing
- wait it out because they will calm down
- some grow out of it, some don’t
what are needs of preschoolers when they lose control?
- they have egocentric & magical thinking –> let them be involved & have choices
- might view illness/hospitalization as punishment –> let them be more comfy with frequent visit
- they have preoperational thought
what are kids of school age needs if they lose control?
- independence & productivity
- they always want to do something, or else they will be bored
in the school age, what do they usually fear?
- death
- abandonment
- permanent injury
what might adolescents do if they feel they are losing control?
- feeling like they are struggling for independence & freedom (it amplifies in the hospital)
- feel separated from the peer group
- might respond with anger/frustration
- needs information about the illness
if adolescents feel separated from their peer group, what might they do?
pick nurses that are younger to relate
- especially with male patients that pick someone attractive
what are some individual risk factors that increase their risk of going to the hospital?
- difficult temperament: every child is diff & have diff types of consoling
- lack of fit between child & parent: especially with the same sex
- age 6 mo - 5 yo: more likely to get injured
- male gender
- below avg. intelligence
- multiple & continuing stresses
what are some changes in the pediatric population that we can identify?
- more serious & complex problems
- fragility of newborns
- severe injuries
- increased survival w/technology
- more invasive & traumatic procedures
- increase length of hospital stay
- increase of non accidental traumas
with an increase of severe injuries in the pediatric, what do we as nurses have to do now?
CPR on younger
what is the most common cause of severe injuries in children?
1st: gunshots
2nd: motor vehicle accidents
what are the benefits of hospitalization?
- safe haven
- recovery
- competence in coping
- mastery of stress
- new social experience
