[Exam 3] Chapter 33 – Caring for Children in Diverse Settings Flashcards
Hospitalization in Childhood: What reason accounts for the majority of hospitalizations in children younger than 5?
Diseases of respirtory system such as asthma and pneumonia
Hospitalization in Childhood: What reasons account for the majority of hospitalizations in children over 5?
Respiratory system, mental health problems, injuries, and GI Disorders
Hospitalization in Childhood: Adolescents between 15-19 are hospitalized why?
Pregnancy, childbearing, mental health, and injury
Hospitalization in Childhood: What nursing strategies are needed to prepare children and families for experience while minimizing negative efffects
Identifyign needs of children and families through astute assessment of nonverbal and verbal behaviors, and then validating the information with acurate interpretation and providing appropriate responses
Hospitalization in Childhood: When is the critical time to ensure the best outcome for child and family?
During the admission process
Childs Reaction To Hospitalization: The psychological effects of illness and hospitalization on a child can include what?
Anxiety and fear related to the overall process and the potential for bodily injury, physical harm, and pain
Childs Reaction To Hospitalization: Why may separation anxiety occur?
Because they are distressed related to being removed from family and familiar surroundings
Childs Reaction To Hospitalization - Anxiety/Fear: Anxiety often stems from what?
Rapid onset of the illness or injury, particularly when child has limited experiences with disease or illness
Childs Reaction To Hospitalization - Anxiety/Fear: Normal fears of childhood include what?
Fear of separation from parents and family, loss of control, and bodily injury, mutilation or harm
Childs Reaction To Hospitalization - Anxiety/Fear: What would cause children to have this anxiety?
Unfamilar environment, health care procedures, and sutations such as strange words being used and strange equipment
Childs Reaction To Hospitalization - Separation Anxiety: THis typically begins when child has developed what ability?
Object permanence (understanding that things exist even when they are out of sight)
Childs Reaction To Hospitalization - Separation Anxiety: What are the three stages that the infant/child goes through during separation anxiety?
Protest, Despair, and Detachment
Childs Reaction To Hospitalization - Separation Anxiety: What happens during first stage, protest?
Occurs when child is separated from the parents or primary caretaker . May last hours to several days . REacts aggressively by crying , agitation, and rejecting others
Childs Reaction To Hospitalization - Separation Anxiety: What happens if parents don’t return within short time?
Child exhibits second stage, despair
Childs Reaction To Hospitalization - Separation Anxiety: What happens during the second stage, despair?
Child displays hopelessness by withdrawing from others, becoming quiet without crying and exhibiting apathy, depression and lack of interest in food.
Childs Reaction To Hospitalization - Separation Anxiety: What occurs during the final stage, detachment?
Child forms coping mechanisms to protect against further emotional pain. During long-term separation. Shows interest in environment, starts to play again, and forms superficial relationships with nurses. If parents return, child ignores them.
Childs Reaction To Hospitalization - Loss of Control: What does the loss of control cause?
Increases in perception of threat and affects their coping skills. Lose control over routine self-care and usual tasks.
Factors Affecting Child Reaction to Hospital - Developmental Level: What will affect their perception of actual events in hospital?
Childs age, cognitive level, and developmental level
Factors Affecting Child Reaction to Hospital - Developmental Level: How to younger children handle what is happening to them?
Have a more difficult time comprehending what is happening to them.
Factors Affecting Child Reaction to Hospital - Developmental Level Infants: How can they gain sense of trust in the world?
Through rhythmic and reciprocal patterns of ocntact and feeding, resulting in bonding to the primary caregiver.
Factors Affecting Child Reaction to Hospital - Developmental Level Infants: What needs to infants need?
Secure pattern of restful sleep, satisfaction of oral /nutritional need, relaxation of body sytems, and spontaneous response to communication
Factors Affecting Child Reaction to Hospital - Developmental Level Infants: What causes feelings of fear, separation anxiety, and loss of control?
When critical patterns of feeding, contact, comfort, sleeping , elimication, and stimulation are disrupted.
Factors Affecting Child Reaction to Hospital - Developmental Level Infants: What leads to anxiety in the infant?
When the infant does not get their basic needs met by parents when they cry or gesture
Factors Affecting Child Reaction to Hospital - Developmental Level Toddlers: Development of what process is disrupted if hospitalized?
Autonomy
Factors Affecting Child Reaction to Hospital - Developmental Level Toddlers: How do toddlers feel about traumatic events?
They are able to recall them. Simply walking toward the treatmetn room where traumatic procedure previously occured may upset the toddler
Factors Affecting Child Reaction to Hospital - Developmental Level Toddlers: What responses will toddlers have to anxiety taht is produced?
Pleading parents to stay, physically trying to go after the parents, throwing temper tantrums, adn refusing to comply with usual routines.
Factors Affecting Child Reaction to Hospital - Developmental Level Toddlers: Restrictiosn related to mobiltiy and new skill acquisition results in wha?
Loss of control. They may have regression in toilet training and refusing to eat
Factors Affecting Child Reaction to Hospital - Developmental Level Preschoolers: What do they understand about their visit?
They understand that they’re there because they are sick, but they do not understand the cause of their illness.
Factors Affecting Child Reaction to Hospital - Developmental Level Preschoolers: They are egocentric , meaning what?
Believe that some person deed or thought caused their illness, which can lead to guilt and shame.
Factors Affecting Child Reaction to Hospital - Developmental Level School-Age: They are generally hospitalized why?
Because of long-term illnesses or trauma.
Factors Affecting Child Reaction to Hospital - Developmental Level School-Age: General task of their deelopmental stage is what?
To develop confidence through a sense of industry .
Factors Affecting Child Reaction to Hospital - Developmental Level School-Age: Stress of illness or anxiety is related to what?
Diagnostic tests and therapeutic interventions may lead to inward or outward expressions of distress.
Factors Affecting Child Reaction to Hospital - Developmental Level School-Age: After age 11, there is an increased awareness of what?
physiologic, psycholigical, and behavioral causes of illness and injury.
Factors Affecting Child Reaction to Hospital - Developmental Level School-Age: What are they usually concerned about?
disability and death, adn they fear injury and pain. They want to know why procedures are being performed.
Factors Affecting Child Reaction to Hospital - Developmental Level School-Age: Some may regress to do what?
Become needy, demanding their parents attention or playing with special “comfort toys” they used at a younger age
Factors Affecting Child Reaction to Hospital - Developmental Level School-Age: How does hospitilization present loss of control?
by limiting their activites, making them feel helpless and dependent. LEads to loneliness, boredom, isolation and depression.
Factors Affecting Child Reaction to Hospital - Developmental Level Adolescents: What do they fear?
Injury and pain. Concenred about how illess will affect their body image.
Factors Affecting Child Reaction to Hospital - Developmental Level Adolescents: Where does their anxiety come from?
Being separated from friends
Factors Affecting Child Reaction to Hospital - Developmental Level Adolescents: What feels may they display due to loss of control?
Anger, withdrawal, or general lack of cooperation.
Factors Affecting Child Reaction to Hospital - Previous Experiences: What can previous experiences cause?
Can either facilitate preparation or impair it if the experiences were perceived as negative
Factors Affecting Child Reaction to Hospital - Previous Experiences: What to know about this?
If children had previous experiences, how the experience unfolded and their response will determine may of their eactions to hospitalization
Factors Affecting Child Reaction to Hospital - Recent Stress/Changes and Individual Coping: The effects of hospitilization on children are influenced by what?
Nature and severity of the health problems, condition of child, and degree to whcih activites and routines differ from those of everyday life
Factors Affecting Child Reaction to Hospital - Recent Stress/Changes and Individual Coping: Lack of sensory stimulation in hospital environment can lead to what?
Listlessness, indifference, unhappiness, and even appetite changes.
Factors Affecting Child Reaction to Hospital - Recent Stress/Changes and Individual Coping: What can result if child’s motor activity restricted?
Anger and hyperactivity may result
Factors Affecting Child Reaction to Hospital - Recent Stress/Changes and Individual Coping: How to distract child from illness?
Play, recreation, and education opportunities.
Factors Affecting Child Reaction to Hospital - Parents Response to Child In Hospital: What will happen if parents do not children truth or answer their questions?
Can confuse and frighten them and may weaken child’s trust in parents.
Family Reaction to Child in Hospital - Reaction of Parents: What feelings may they experiences?
Denial, anger, depression, and confusion. Parents may deny that the child is ill.
Family Reaction to Child in Hospital - Reaction of Parents: What feeling will they have due to loss of control?
May express anger, especially directed at nursing stuff or another higher power.
Family Reaction to Child in Hospital - Reaction of Parents: Why may depression occur?
Because of exhaustion and the psychological and physical requirements of spending long hours in a hospital caring for a child.
Family Reaction to Child in Hospital - Reaction of Parents: Why may confusion develop?
Because of dealing with an umfamilar environment or the loss of a parental role.
Family Reaction to Child in Hospital - Reaction of Siblings: What feelings may they experience?
Jealously, insecurity, resentment, confusion, and anxiety.
Family Reaction to Child in Hospital - Reaction of Siblings: What may preschoolers feel here?
That they may have caused the illness.
Family Reaction to Child in Hospital - Factors Influencing Family Reactions: What has a significant influence on families response?
Cultural, ethinic, and religious vairations, values, and practices related to illness, general response to stress, and attitudes
Nurse Role in Caring for Child in Hospital: What should nurse consider when establishing strategies to care for children in the hopsital?
Should examine the general effects of hospitalization on children in each developmental stage and should strive to understand botht he reactions of child and family.
Nurse Role in Caring for Child in Hospital: Nursing care for a hospitalized child occured in what four phases?
Introduction, building a trusting relationship, decision-making phase, and providing comfort and reassurance.
Nurse Role in Caring for Child in Hospital: What does the introduction phase involve?
Initial contact with childrena dn their families and establishes foundation for a trusting relationship. Use their favorite toys.
Nurse Role in Caring for Child in Hospital: How can a trusting relationship be built?
By using appropriate language, games, and play such as singing a song during a procedure, preparing the child adequately for procedures and providing explanations and encouragement
Nurse Role in Caring for Child in Hospital: What occurs in the decision-making phase?
Nurse gives some control over to the child by allowing them to participate in making certain decisions.
Nurse Role in Caring for Child in Hospital: What occurs in the comfort and reasurance phase?
Uses techniques such as praising the child and providing opportunities to cuddle with a favorite toy.
Nurse Role in Caring for Child in Hospital - Prep Children and Families for Hospital: What are major causes of stress for hospitalized child and family?
New experiences, unfamilar sights, and sounds, disruption of sleep patterns and pain associated with tx
Nurse Role in Caring for Child in Hospital - Prep Children and Families for Hospital: How to help ease the stress of hospitalization of child, by encouraging what?
To work with a child-life specialist at the hospital who can give the child comprehensive preparation for the hospital
Nurse Role in Caring for Child in Hospital - Prep Children and Families for Hospital: What can good prep do to child?
Reduce childs fears and increase their ability to cope with hospital experiences.
Nurse Role in Caring for Child in Hospital - Prep Children and Families for Hospital: What should preparation include?
Exploring child’s perceptions, reviewing previous experiences, and identifying coping strategies.
Nurse Role in Caring for Child in Hospital - Prep Children and Families for Hospital: What should the goal of prep be?
To decrease fear and anxiety by allowing the child to better understand what is happening.
Nurse Role in Caring for Child in Hospital - Prep Children and Families for Hospital: Useful techniques for prep include what?
Perform nursing care on stuffed animals or dolls
Avoid use of medical terms
Allow child to handle some equipment
Show child the room where they will eb staying
Nurse Role in Caring for Child in Hospital - Prep Children and Families for Hospital: What can a hospital guided tour help with?
They can provide role-playing, where during stops the child can see, touch, and feel equipment that may be used.
Nurse Role in Caring for Child in Hospital - Prep Children and Families for Hospital: American Society of Anesthesiologists have prepared a coloring book titled My Trip to The Hospital, that was desinged to do what?
Alleviate some of the fears that younger children may have related to the hospital experience. DEscribes process from admission through discharge
Nurse Role in Caring for Child in Hospital - Admitting Child To Facility: What does this involve?
Preparing them for admission and introducing the child to the unit where they will be staying
Nurse Role in Caring for Child in Hospital - Admitting Child To Facility and Types of Admissions/Nursing Care: What hospital units may the child be admitted to?
General inpatient unit
ED/ Urgent Care
PICU
Outpatent
Rehab Unit
Nurse Role in Caring for Child in Hospital - Admitting Child To Facility and Types of Admissions/Nursing Care: After introducing yourself to the family and getting the childs name, what should be done?
Orient them to the hospital unit. Explain policies and routines and the personnel who will be involved in the care of child.
Nurse Role in Caring for Child in Hospital - Admitting Child To Facility and Types of Admissions/Nursing Care: What will you obtain during nursing interview?
Information about child’s history, routines, and reason for admission. Obtain VS and perform physical assessment.