hospitalization, illness, and play

Question 1

Separation anxiety during hospitalization manifests in three behavioral responses:

Answer 1

• Protest: screaming, clinging to parents, verbal and physical aggression toward strangers
• Despair: withdrawal from others, depression, decreased communication, developmental regression
• Detachment: interacting with strangers, forming new relationships, happy appearance

Question 2

level of understanding infants

Answer 2

• Inability to describe illness and follow directions

- Lack of understanding of the need of therapeutic procedures

Question 3

impact of hospitlization infants

Answer 3

• Experiences stranger anxiety between 6 to 18 months of age
• Displays physical behaviors as expressions of discomfort due to inability to verbalize
• Can experience sleep deprivation due to strange noises, monitoring devices, and procedures
• Can experience anxiety due to the unfamiliar environment and fear of the unknown

Question 4

level of understanding toddlers

Answer 4

• Limited ability to describe illness
• Poorly developed sense of body image and boundaries
• Limited understanding of the need for therapeutic procedures
• Limited ability to follow directions

Question 5

impact of hospitalization toddlers

Answer 5

• Experiences separation anxiety
• Can exhibit an intense reaction to any type of procedure due to the intrusion of boundaries
• Behavior can regress

Question 6

level of understanding prescoolers

Answer 6

• Limited understanding of the cause of illness but knows what illness feels like
• Limited ability to describe manifestations
• Fears related to magical thinking
• Ability to understand cause and effect inhibited by concrete thinking

Question 7

impact of hospitalization preschoolers

Answer 7

• Can experience separation anxiety
• Can harbor fears of bodily harm
• Might believe illness and hospitalization are a punishment

Question 8

level of understanding adolescents

Answer 8

• Increasing ability to understand cause and effect

- Perceptions of illness severity are based on the degree of body image changes

Question 9

impact of hospitalization adolescents

Answer 9

• Develops body image disturbance
• Attempts to maintain composure but is embarrassed about losing control
• Experiences feelings of isolation from peers
• Worries about outcome and impact on school/activities
• Might not adhere to treatments/medication regimen due to peer influence

Question 10

family responses to pain

Answer 10

• Fear and guilt regarding not bringing the child in for care earlier
• Frustration due to the perceived inability to care for the child
• Altered family roles
• Worry regarding finances if work is missed
• Worry regarding care of other children within the household
  Fear related to lack of knowledge regarding illness or treatments
• Siblings experiencing loneliness, jealousy, guilt, fear, or anger
• Caregiver role strain, related to the impact of hospitalization on family processes

Question 11

nursing interventions for hospitalization

Answer 11

• Teach the child and family what to expect during hospitalization.
• Encourage family members to stay with the child during the hospital experience to reduce the stress.
• Maintain routine as much as possible.
• Encourage independence and choices.
• Explain treatments, procedures, and cares to the child.
• Provide developmentally appropriate activities.

Question 12

interventions for infants

Answer 12

• Place infants whose parents are not in attendance close to nurses’ stations so that their needs can be quickly met.
• Provide consistency in assigning caregivers.

Question 13

toddlers nursing interventions

Answer 13

• Encourage parents to provide routine care for the child, such as changing diapers and feeding.
• Encourage the child’s autonomy by offering appropriate choices.
• Provide consistency in assigning caregivers.

Question 14

interventions preschoolers

Answer 14

• Explain procedures using simple, clear language.
• Avoid medical jargon and terms that can be misinterpreted.
• Encourage independence by letting the child provide self-care.
  Encourage the child to express feelings.
• Validate the child’s fears and concerns.
• Provide toys that allow for emotional expression
• Provide consistency in assigning caregivers.
• Give choices when possible, such as, “Do you want your medicine in a cup or a spoon?”
• Allow younger children to handle equipment if it is safe.

Question 15

school age children nursing interventions

Answer 15

• • Provide factual information.
• Encourage the child to express feelings.
• Try to maintain a normal routine for long hospitalizations, including time for school work.
• Encourage contact with peer group.

Question 16

interventions adolescents

Answer 16

• Provide factual information.
• Include the adolescent in the planning of care to relieve feelings of powerlessness and lack of control.
• Encourage contact with peer group.

Question 17

play

Answer 17

• Allows children to express feelings and fears.
• Facilitates mastery of developmental stages and assists in the development of problem solving abilities.
• Allows children to learn socially acceptable behaviors.
• Activities should be specific to each child’s stage of development.
• Can be used to teach children.
• A means of protection from everyday stressors.

Question 18

social character of play

Answer 18

• Onlooker: the child observing others
• Solitary: the child playing alone
• Parallel: children playing independently but among other children, which is characteristic of toddlers
• Associative: children playing together without organization, which is characteristic of preschoolers
• Cooperative play: organized playing in groups, which is characteristic of school-age children

Question 19

functions of play

Answer 19

Play helps in the development of various types of skills.

Intellectual
Sensorimotor
Social
Self-awareness
Creativity
Therapeutic  and  moral values

Question 20

play infants

3 months
3-6 months
6-9 months
9-12 months

Answer 20

Infants

• Birth to 3 months: colorful moving mobiles, music hostility, and sadness sound boxes
• 3 to 6 months: noise-making objects, soft toys
• 6 to 9 months: teething toys, social interaction
• 9 to 12 months: large blocks, toys that pop apart, push-and-pull toys

Question 21

toddlers play

Answer 21

• Cloth books, puzzles with large pieces
• Large crayons and paper
• Push-and-pull toys, balls
• Tricycles
• Educational television
• Videos for children

Question 22

play related to age preschool

Answer 22

• Imitative and imaginative play - Drawing, painting, riding a tricycle, swimming, jumping, running
• Educational television and videos

Question 23

play related to age school age children

Answer 23

• Games that can be played alone or with another person
• Team sports
• Musical instruments, Arts and crafts

Question 24

play related to age adolscents

Answer 24

• Team sports
• School activities, Peer interactions
• Reading, listening to music
• Peer interactions

Question 25

therapeutic play

Answer 25

• Makes use of dolls and/or stuffed animals
• Encourages the acting out of feelings of fear, anger
• Enables the child to learn coping strategies in a safe
• Assists in gaining cooperation for medical treatment

Question 26

nursing interventions for play

Answer 26

• Select toys that are safe for the child.
• Consider isolation precautions and the child’s illness in relation to toy selection.
• Select activities that enhance development.
• Observe the child’s play for clues to the child’s fears or anxieties.
• Encourage parents to bring one favorite toy from home.
  before it is performed.
• Provide play opportunities that meet the child’s level of activity tolerance
• Allow the child to go to the play room if able.
• Encourage the adolescent’s peers to visit.
• Involve a child life specialist in planning activities.