Chapter 13: Care of the hospitalized child Flashcards
LEARN DUMBASS
What are common stressors for hospitalized children?
- Separation from parents, primary caretaker, or peers
- Loss of self-control, autonomy, and privacy
- Painful and/or invasive procedures
- Fear of bodily injury and disfigurement
These stressors can significantly impact a child’s emotional and psychological well-being during hospitalization.
How do young children respond to hospitalization and illness?
They respond based on their developmental stage and previous experiences with medical professionals.
Limited understanding of illness can lead to stress and anxiety about hospitalization.
What are key considerations for infants in a hospital setting?
- Encourage normal wake/sleep cycles and feeding times
- Provide family-centered care
- Allow parents to participate in calming the infant
- Address separation anxiety at 6-8 months
Infants are unaware of illness but can sense stress in loved ones.
What major stressors do toddlers and preschoolers face during hospitalization?
- Separation from parents
- Disruption of routine
- May see illness as punishment
- Incorrect cause-and-effect perceptions
Calm explanations and maintaining routines can help mitigate stress.
What developmental understanding do school-age children have regarding illness?
They begin to understand body functions and may experience stress from procedures, leading to possible regression in behavior.
Encouraging participation in care can foster a sense of industry.
What are the concerns of adolescents when hospitalized?
- Understanding complex nature of illness
- Fear of missing out with friends
- Concerns about body image and appearance
- Need for privacy and independence
Involvement in care decisions can empower adolescents.
What are common parental responses to the stressors of hospitalization?
- Disbelief
- Anger
- Guilt
- Fear and anxiety
- Frustration
- Depression
- Confusion
These responses can affect family dynamics and coping strategies.
What strategies can promote coping and normal development for hospitalized children?
- Rooming In
- Child Life Specialist involvement
- Therapeutic play
- Animal-assisted therapy
- Art and music therapy
These strategies aim to reduce anxiety and promote engagement.
What are important discharge considerations for families of hospitalized children?
- Family ability to provide care
- Financial burdens
- Educational needs
- Parent teaching on ongoing care
- Preparing siblings for the transition
Effective planning is crucial for a smooth transition post-hospitalization.
What should be explained to parents before a procedure for an infant?
- Explain the procedure and their role
- Allow parents to comfort the infant
- Do not ask parents to hold the infant down
Quick procedures with soothing techniques can help reduce stress.
How should a toddler be prepared for a medical procedure?
- Explain just before the procedure
- Avoid giving choices when none are available
- Comfort the child after the procedure with a favorite drink or sticker
Providing reassurance and comfort is key for toddlers.
What techniques can be used for school-age children during procedures?
- Clear explanations with visual aids
- Teach stress-reduction techniques
- Offer a choice of reward after the procedure
Engaging children in their care can enhance cooperation.
What are the recommendations for administering IM injections in children?
- Preferred site: vastus lateralis
- No more than 1-2 mL for vastus lateralis
- Z-track method to prevent seepage
- Hourly IV checks due to risk of infiltration
Proper techniques ensure safety and minimize discomfort during injections.
How should otic drops be administered to children under 3 years?
Pull the pinna down.
For children over 3 years, pull the pinna up.
Developmental response to illness (INFANT)
Unaware of illness and its effects, they only see a deviation from their normal life.
*Keep them on a routine
Sense stress and anxiety in loved ones
*Give the parent opportunity to step away. If the parent isn’t stressed, the infant won’t be either.
Encourage participation when able. Allow parents to touch the infant, remain within view and talk to the infant to calm them when possible.
Toddlers/Preschoolers how may they perceive illness?
They may see illness as a punishment
*Calmly explain that the illness is not their fault.
School-age
Foster a sense of industry: encourage participation in care, cont. schoolwork, and art/crafts
*Stressful procedures can lead to regression or behavior changes.
Adolescents
Understands the complex nature of illness and often fears the results of it.
Fear of missing out with friends and peers and encourage participation in playroom, school.
Parental response to stressors of hospitalization
Disbelief, anger, guilt. (sudden illness) Reassure pt. they did the right thing.
Burdens of missed work, additional expenses, caring for siblings (Interact with family to find a solution)
Sibling response
Confusion, guilt, anger, jealousy, and rejection.
Strats to promote coping and normal development
Rooming in: 24/7 parental visitation and parental involvement.
Child life specialist: planned play and collab with child life therapist
Therapeutic play: Dramatic play/ medical play
Therapy: animal-assisted, art, and musical therapy
Discharge considerations
Family ability to provide care: equipment, training (Discharge pt. when fam is edu is ready.
Financial burdens: Can they afford meds?
Preparation of pediatric procedures by age INFANT
*Before procedure: Explain to parents the procedure, the reason for it, and their role. Allow the parents the option to present for procedures. Parents may be able to touch a foot, rub a cheek, and talk soothingly to the infant.
*During the procedure: Immobilize the infant (swaddle/restrain). Perform procedures quickly. Use touch, voice, pacifier, and bottle as distractions.
Parents should provide comfort post-procedure.
Preparation of pediatric procedures by age Toddler
*Before the procedure: Explanation just before the procedure. Explain that the child didn’t do anything wrong; the procedure is simply necessary.
*During the procedure: Perform in tx room, immobilize the child, Avoid choices when none are available. ALLOW THE CHILD TO CRY OR SCREAM, and comfort the child post-procedure, toy from toy chest.
