[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.
Nurse Role in Caring for Child in Hospital - Admitting Child To Facility To General Inpatient Unit Stays: Who i this for?
Stays re shorter and involve moer acute conditions, resulting in little time for admission precautions.
Nurse Role in Caring for Child in Hospital - Admitting Child To Facility To General Inpatient Unit Stays: How long is the stay here?
May be a special 23-hour observation so child is in setting for less than 24 hours.
Nurse Role in Caring for Child in Hospital - Admitting Child To Facility To General Inpatient Unit Stays: What should be done when child admitted to general unit?
Take extra time to orient and explain the routines and procedure to child and family. Emphaize that parents can stay and that child should be roomed close to nurses station
Nurse Role in Caring for Child in Hospital - Admitting Child To Facility To ED/Urgent Care: Major cause for admission here?
Is for injuries from accidents.
Nurse Role in Caring for Child in Hospital - Admitting Child To Facility To ED/Urgent Care: What is important to due since its fast paced and family may be hesistant to ask questions?
Keep the family and child well inforomed. Help family identify their concerns and their suport system. Prepare them for what they will experience.
Nurse Role in Caring for Child in Hospital - Admitting Child To Facility To PICU: What does this specialize in?
Caring for children in crisis.
Nurse Role in Caring for Child in Hospital - Admitting Child To Facility To Isolation Room: THese are used for what?
Situations involving the risk for infection.
Nurse Role in Caring for Child in Hospital - Admitting Child To Facility To Isolation Room: What will children experience here?
Sensory deprivation due to limited contact with others and the use of personal protective equipemtn such as gloves, masks, and gowns
Nurse Role in Caring for Child in Hospital - Admitting Child To Facility To Isolation Room: What should you do for child when they are in isolation?
Introduce yourself before entering the room and allow child to view your face before applying a mask.
Nurse Role in Caring for Child in Hospital - Admitting Child To Facility To Rehab Units: Who would be admitted here?
HElps children regain abilities lost due to neurologic injuries or serious burns. Resembles home environment, with special services to help children relearn activites of daily living.
Nurse Role in Caring for Child in Hospital - Addressing Effects of Hospital Developmentally: When addressing the fears, separation anxiety, loss of control, nurse should consider what?
child’s age and cognitive or developmental level . Internvetions based on how child experiences these stressors at that age
Nurse Role in Caring for Child in Hospital - Addressing Effects of Hospital Developmentally for Newborn: How to decrease fear?
Avoid separation from primary caregiver if possible, which promotes healthy attachment.
Nurse Role in Caring for Child in Hospital - Addressing Effects of Hospital Developmentally for Newborn: What to do if parents can be by baby?
Look for volunteers to provide consistent comfort for the baby
Nurse Role in Caring for Child in Hospital - Addressing Effects of Hospital Developmentally for Newborn: Maintaining infants home routine is related to what?
Sleep and feedings to help decrease feedings of loss of control.
Nurse Role in Caring for Child in Hospital - Addressing Effects of Hospital Developmentally for Newborn: Be alert for signs of discomfort other than crying, including what?
Furrowed brow or tense body posture.
Nurse Role in Caring for Child in Hospital - Addressing Effects of Hospital Developmentally for Toddelrs: Key nursing concerns include
separation anxiety, growth and development, and autonomy.
Nurse Role in Caring for Child in Hospital - Addressing Effects of Hospital Developmentally for Toddelrs: How to decrease amount of fear?
Establishing a trusitng relationship through nonthreatening play.
Nurse Role in Caring for Child in Hospital - Addressing Effects of Hospital Developmentally for Toddelrs: How to maintian home routine?
Related to meals and sleep or a nap provides sstructure and may decrease feelings of loss of control
Nurse Role in Caring for Child in Hospital - Addressing Effects of Hospital Developmentally for Preschoolers: Nursing care focuses on what?
Special needs, fears, and fantasies.
Nurse Role in Caring for Child in Hospital - Addressing Effects of Hospital Developmentally for Preschoolers: Allow them to make simple decisions such as?
Which color bandage to use or whether to take medicine from a cup or a syringe to help give them some sense of control.
Nurse Role in Caring for Child in Hospital - Addressing Effects of Hospital Developmentally for School-Age: How should information be provided?
Honestly using concrete, meaningful words to teh school-age child to minimize fear of the unknown
Nurse Role in Caring for Child in Hospital - Addressing Effects of Hospital Developmentally for School-Age: Nursing considerations when caring for these children include
Ensuring safety and promoting growth and development
Nurse Role in Caring for Child in Hospital - Preparing Family For Surgery: Good preparation provides what?
Reassurance and comfort to the child and allows them to know what will happen and what is expected of them
Nurse Role in Caring for Child in Hospital - Preparing Family For Surgery: Preoperative care for child occurs how?
Preparation and teaching must be geared to the child’s age and developmental level
Nurse Role in Caring for Child in Hospital - Preparing Family For Surgery: What do preoperative preparation programs allow for children?
Allows for children and families to experience a trial run in a supprotive environment to help reduce anxiety
Nurse Role in Caring for Child in Hospital - Preparing Family For Surgery: How to help children understand what is going to happen to them?
Use items such as stuffed animals or dolls and also allow them to role-play various experiences with the dolls.
Nurse Role in Caring for Child in Hospital - Preparing Family For Surgery: What are Shadow Buddies?
Custom-made dolls that have same illness or surgery as child. They may have an ostomy, scar, or a catheter.
Nurse Role in Caring for Child in Hospital - Preparing Family For Surgery: When do you alert infant or toddlers about surgery
As close to the day of surgery as possible to prevent undue anxiety
Nurse Role in Caring for Child in Hospital - Preparing Family For Surgery: When should you tell preschoolers or school-age children about surgery?
Preschool: 1-2 days before
School-Age : 3-5 days before
Nurse Role in Caring for Child in Hospital - Preparing Family For Surgery: When do you tell adolescents about surgery?
7-10 days beforehand
Nurse Role in Caring for Child in Hospital - Maintaining Safety: What to know about identifcation band?
Ensure it is in place at all times. If removed, make sure another is attached to another extremity.
Nurse Role in Caring for Child in Hospital - Maintaining Safety: Monitor children closely to avoid what?
Accidents such as child pushing wrong knob, picking up a piece of equipment or supplies left in room
Nurse Role in Caring for Child in Hospital - Maintaining Safety - Use of Restraints: Hospitals are required to have a policy in place that specifies what?
REason for restraint
Client assessment parameters
Use of least restrictive type of restraint
Need for a written order
Need for face-to-face eval within 1 hour of application of restraint
Nurse Role in Caring for Child in Hospital - Maintaining Safety - Use of Restraints: What can restraints promote?
Physical distress in a child and be stressful for the parents as well. Children can view it as a punishment.
Nurse Role in Caring for Child in Hospital - Maintaining Safety - Use of Restraints: What is Atraumatic Care?
Therapeutic hugging should be used for procedures and treatmetns such as IV lien isnertion and when child needs to reamin still
Nurse Role in Caring for Child in Hospital - Maintaining Safety - Use of Restraints: What restraint would be appropriate if should has an intravenous catheter in antecubital space?
Use an elbow restraint or arm board
Nurse Role in Caring for Child in Hospital - Maintaining Safety - Use of Restraints: When selecting a restraint, nurse must choose what
least reastive type and aply it for the shortest time necessary
Nurse Role in Caring for Child in Hospital - Maintaining Safety - Use of Restraints: What should you do before applying restraint?
Explain the reason for the restraint to the child and the parents.
Nurse Role in Caring for Child in Hospital - Maintaining Safety - Use of Restraints: Purpose of soft limb restraint?
Wrist or ankle restraint to prevent range of motion of extremiteis
Nurse Role in Caring for Child in Hospital - Maintaining Safety - Use of Restraints: When would elbow restraint be used?
Prevents child from flexing and reaching face, head, IV, adn other tubes
Nurse Role in Caring for Child in Hospital - Maintaining Safety - Use of Restraints: When would mummy restraint be used??
Body restraint using a sheet/blanket folded into aquare to secure the whole body of the child
Nurse Role in Caring for Child in Hospital - Maintaining Safety - Use of Restraints: When would a jack restraint be used?
Jacket worn by child with ties attached to childs back adn to side of bed. Used to keep children flat in bed such as after surgery or safe in chair
Nurse Role in Caring for Child in Hospital - Maintaining Safety - Use of Restraints: What safety checks must nurse make?
Tie into bed or crib frame
Use a clove-hitch type of knot
Check restraints 15 mins after initial placement
Remove restraint every 2 hours for ROM
Nurse Role in Caring for Child in Hospital - Maintaining Safety - Transport Of Child: What factors need to be considered before transport?
Safety issues, the age and developmental level of child, child’s physical condition, and destination
Nurse Role in Caring for Child in Hospital - Maintaining Safety - Transport Of Child: Various methods of transport include what?
Carrying the infant and using strollers, wagons, or rolling beds
Nurse Role in Caring for Child in Hospital - Providing Basic Care: Basic care involves what?
Hygiene, including bathing, hair care, oral care, and nutritional care
Nurse Role in Caring for Child in Hospital - Providing Basic Care - General Hygiene: When my injury to childs skin occur?
When sierting IV line, removing a dressing, positioning a child in bed, changign diaper, and removing electrode patches
Nurse Role in Caring for Child in Hospital - Providing Basic Care - Bathing: What should you do before bathing and performing other hygiene measures?
Assess family’s preferences and hoem practices for the child, such as time of day, rituals, special equipment, and allergies to products
Nurse Role in Caring for Child in Hospital - Providing Basic Care - Hair Care: How often should shampooing be done for younger children?
Shampooing once or twice a week
Nurse Role in Caring for Child in Hospital - Providing Basic Care - Hair Care: Hair care for African American?
Using a broad-toothed comb
Nurse Role in Caring for Child in Hospital - Providing Basic Care - Oral Hygiene: : How to clean infants mouth?
Wipe the infants gums with a wet cloth after feeding.
Nurse Role in Caring for Child in Hospital - Providing Basic Care - Oral Hygiene: : What will you do for someone who is immunosuppresed?
Soft toothbrush and moistened gauze sponges to prevent bleeding
Nurse Role in Caring for Child in Hospital - Providing Basic Care - Nutritional Care: What may refusal to eat be realted to?
Feelings of separation, or may be their attempt at controlling the siutation
Nurse Role in Caring for Child in Hospital - Providing Play, Activities: What should you call playrom for older school-age children?
Call it an activity room or social room. Promotes maturity
Nurse Role in Caring for Child in Hospital - Providing Play, Activities: How can you keep playroom and bed a “safe” place?
Perform invasive procedures such as penipunctures in the treatroom room. Never perform them in these same palces
Nurse Role in Caring for Child in Hospital - Providing Play, Activities - Unstructured Play: Unstructured play allows children to do what?
Control events, ideas, and relationships. Encourage parents to bring toys from hom e
Nurse Role in Caring for Child in Hospital - Providing Play, Activities - Unstructured Play: What do infants and toddlers enjoy playing with?
Manipulating locks and playing with stacking toys
Nurse Role in Caring for Child in Hospital - Providing Play, Activities - Unstructured Play: What do preschoolers enjoy playing with?
Coloring, dollhouses, or playing with plastic building blocks like LEgos
Nurse Role in Caring for Child in Hospital - Providing Play, Activities - Unstructured Play: What do school-age children and adolescents enjoy playing with?
Playing video gmes, putting together a puzzle, or building a model
Nurse Role in Caring for Child in Hospital - Providing Play, Activities - Play for Nursing Care: Use play as appropriate while providing what
routine nursing care of the child
Nurse Role in Caring for Child in Hospital - Providing Play, Activities - therapeutic Play: What is this?
Nondirected and focuses on helping the child cope with feelings and fears. HElp the child deal with physical and psychological challenges of illness and hospitaliztion
Nurse Role in Caring for Child in Hospital - Providing Play, Activities - therapeutic Play: Who coordinates these activites?
The CLS
Nurse Role in Caring for Child in Hospital - Providing Play, Activities - therapeutic Play: What goals are included here?
Maintaining normal living patterns, minimizing psychological trauma, and promoting optimal deelopment of child
Nurse Role in Caring for Child in Hospital - Providing Play, Activities - therapeutic Play: What is supervised “needle play”?
Assists those who undergo frequent blood work. Doll can receive injection as child works out their nger and anxiety
Nurse Role in Caring for Child in Hospital - Promoting Schoolwork: Connection to child’s school helps with what?
Maintian normalcy for the child and minimizes the disruption of everyday life
Nurse Role in Caring for Child in Hospital - Adressing Family Needs: Encourage families to have what in place before, during, and after hospitalization?
Support systems
Nurse Role in Caring for Child in Hospital - Addressing Family Needs - Parents: Why is it important to help families work through their feelings?
Anxiety levels of parent greatly affects anxiety level of the child
Nurse Role in Caring for Child in Hospital - Addressing Family Needs - Parents: What contributes to parents feelings of anxiety?
Visiting restrictions, unexpected changes in health, lack of information in health condition, and changes in their routine and roles.
Nurse Role in Caring for Child in Hospital - Providing Child/Family Teaching: The overall goals here?
Minimize families stress, educate about treatment, and ensure that family can provide appropriate care upon discharge
Nurse Role in Caring for Child in Hospital - Providing Child/Family Teaching: What can preadmission programs do?
Introduce the child and family to the setting.
Nurse Role in Caring for Child in Hospital - Preparaing Fam/Child for Discharge: When does discharge planning begin?
Upon admission.
Nurse Role in Caring for Child in Hospital - Preparaing Fam/Child for Discharge: Discharge instructions generally include what?
Follow-up appointment
Guideliens on when to contact physician
Diet
Activity level allowed
Medication information
Community Care In Childhood: Nurses practicing in the community promote what?
Thehealth of individuals, families, groups, and promote an environment that supports health
Community-Based Nursing Settings - Outpatient/Ambulatory Care: Who is this provided to?
THose who do not require care in acute setting
Community-Based Nursing Settings - Outpatient/Ambulatory Care: Why are outpatient units used?
To keep hostpital stays short and decrease the cost of hospitalization
Community-Based Nursing Settings - Outpatient/Ambulatory Care: Example of someone getting surgery here?
Arrive in morning, undergo surgery, and then go home in the evening.
Community-Based Nursing Settings - Outpatient/Ambulatory Care: Examples of surgeries performed?
Tympanostomy tube placement, hernia repair, tonsillectomy, blood transfusions, and chemotherapy
Community-Based Nursing Settings - Outpatient/Ambulatory Care: Advantages of this environment?
Minimal separation from family, minimal disruption of family pattern, decreased risk of infection, and decreased cost.
Community-Based Nursing Settings - Outpatient/Ambulatory Care: Disadvantages of this??
Does not have equipment for overnight stays. If emergency occurs, go to hospital.
Community-Based Nursing Settings - Outpatient/Ambulatory Care: Role of nurse here?
Admission and assessment, preoperativev teaching and preparation, client assessment/support, postoperative monitoring, case management, and teaching
Community-Based Nursing Settings - Outpatient/Ambulatory Care: What can parents do to make child more comfortable?
Encourage parent to bring one of the child’s favorite toys, blankets, or games
Community-Based Nursing Settings - Physicians Office/Urgent Care: What children use this?
For well care, episodic ill care, acute care and care of chronic conditions
Community-Based Nursing Settings - Physicians Office/Urgent Care: For well care and illness or injury, children are seen where?
By their primary physician
Community-Based Nursing Settings - Physicians Office/Urgent Care: Roles role in these settings?
Preparing clients, collecting pertinent health information, performing assessments, assisting with diagnostic testing, changing wound dressings and maintaining medical records.
Community-Based Nursing Settings - Physicians Office/Urgent Care: Essential component of primary care practice is what?
Telephone triage. Parents often call for advice in order to treat their children at home.
Community-Based Nursing Settings - Physicians Office/Urgent Care: What does the triage nurse need to determine?
Whether child requires emergency care, office visit, or home management
Community-Based Nursing Settings - Medically Fragile Day Care Centers: What is a medically fragile child?
Child with medical complexity, and is a child with “substantial health care needs, one or more chronic conditions, functional limitations and health care use”
Community-Based Nursing Settings - Medically Fragile Day Care Centers: Why were these developed?
To meet the needs of the children . They accept children who have complicated medical needs.
Community-Based Nursing Settings - Medically Fragile Day Care Centers: Examples of kids admitted here??
Those with multiple congenital anomalies, children who are ventilator dependent, those with respiratory conditions, and those with cancer
Community-Based Nursing Settings - Medically Fragile Day Care Centers: What medical professionals present here?
Nurses, PT, OT, ST, and CLS
Community-Based Nursing Settings - Medically Fragile Day Care Centers: What does nursing care include?
Direct care such as administering meds and changing dressings, identifying potential medical emergencies, and determining need for changes in care
Community-Based Nursing Settings - Schools: How do nurses promote healthy school environment?
By supporting healthy food services and promoting proper physical education and sports policies and practices
Community-Based Nursing Settings - Schools: Examples of activites that school nurse does?
Conduct health screenings
Assess growth and development
Provide emergency first aid
Train staff on CPr
Education on health promotion
Community-Based Nursing Settings - Schools: Nurses develop a Individualized Health Plan, which is what?
Formalizes the plan of support for a student with complex health care needs. Written aggreement developed as part of interdisciplinary collab of school staff along with the student
Community-Based Nursing Settings - Schools: What does the Individualized Health Plan (IHP) describe?
The students needs and how the school plans to meet these needs.
Community-Based Nursing Settings - Schools: Examples of students who may need an IHP?
Asthma, serious allergies, type 1 diabetes, physical disabilites, and ADHD
Community-Based Nursing Settings - Schools: What does a IHP need to include?
Directions for care while the child is at school and must also take into account circumstances that may affect the student’s health care needs
Community-Based Nursing Settings - Other Community Settings: Primary focus on nurses in variety of different settings within community?
Promoting health, preventing disease and injury and ensuring a safe environment
Community-Based Nursing Settings - Other Community Settings: What do nurses do in child care centers?
Help address infection control issues and assess a safe environment
Community-Based Nursing Settings - Home Health Care: Examples of children that benefit from this?
Osteomyelitis requiring intravenous antibiotics or chronic health care issues
Community-Based Nursing Settings - Home Health Care: Periodic visitng nurse care is used when?
The child needs intermitent interventions such as intravenous antibiotic administration, follow-up with child, and periodic monitoring
Community-Based Nursing Settings - Home Health Care: Goals of nursing care here includes what
promoting, restoring, and maintaining the health of the child
Community-Based Nursing Settings - Home Health Care: Home care focuses on what?
Minimizing the effects of the illness or disability, along with providing the cchild or family with the means to care for the illness or disability at home
Community-Based Nursing Settings - Home Health Care w/ Family-Centered Home Care: What does this focus on?
Increasing support for the emotional and developmental needs of the child. Encourages families to care for their children at home while professionals provide support
The nurse is preparing a 5-year-old boy for surgery on his lower leg. His mother is helping him into the hospital gown and the boy fights removal of his underwear. What is the most appropriate nursing action?
Allow the mother to remove the underwear. Tell the boy he is acting childishly. Notify the OR that the underwear is on. Allow the boy to keep his underwear on.
Allow the boy to keep his underwear on
A 6-month-old infant requires restraint to prevent removal of his nasogastric tube. What is the priority nursing intervention?
Tie the restraint loosely to prevent skin breakdown. Leave the baby unrestrained when directly observed. Position the restrained infant prone to prevent aspiration. Place the infant in a room near the nurses’ station.
Leave the baby unrestrained when directly observed
A 10-year-old child on a regular diet refuses to eat the food on her meal tray. She requests chicken nuggets, French fries, and ice cream. What is the best nursing action?
Ask that the child’s desired foods be sent up from the kitchen. Negotiate with the child to eat at least part of the food on the tray. Remove a privilege. Offer the child cereal and milk from stock on the nursing unit.
Ask that the child’s desired foods be sent up from the ktichen
A child is to undergo a tympanostomy tube placement in a freestanding outpatient surgery center. What is the major disadvantage associated with this location?
Increased risk for infection Increased health care costs Need to be transferred if overnight stay is required Increased disruption of family functioning
Need to be transferred if overnight stay is required
