NUR331 Exam 2 Flashcards
How can we promote infant development?
Trust vs Mistrust
- place a child to where they can see their hands
- talk about things in the room
- touch, swaddle, talk to them
- smile, put your face in their field of vision
- try to simulate home routine
- try to assign the same nurse
- keep frightening objects away from their view
- pay attention to light and sound stimulation
- hold them for feedings*
- provide toys
How to prepare infants for procedures?
- keep mom and dad calm
- sensory and soothing strategies
- cuddles, hugs
- safe restraints
- out of view for procedure
- security objects from home
Fears for Toddlers
fears loss of body control
loss of routine
separation
How do we promote toddler development?
- follow/develop rituals
- security objects
- praise
- provide mobility and outlets for aggression
- make sure they have access to finger foods
- allow for exploring
- offer guided choices
- talk through all patient care
How to prepare toddlers for procedures
- kiss
- egocentric
- include what they will see/smell/feel
- praise
- “mommy and daddy will be here waiting”
Fears of Preschoolers
- mutilation
- abandonment
What causes stress in infants?
absence of parent
unfamiliar persons
anxiety their parents face
loss of needs being met (food and sleep)
What to expect from a hospitalized preschooler
- may become overly aggressive or withdrawn
- may bring an imaginary playmate
- may refuse to take meds or cooperate
- like to take ownership of things in the environment
- have little understanding of time
- may regress on toilet training
- enjoy silly humor
How do we promote preschooler development?
- use specific language and look directly at them
- be aware of distracting noises in room
- make silly mistakes and let them catch you
- speak using socially acceptable words
- make sure they have their transitional object
- encourage to promote cooperation
- let them throw and catch objects
- use routines
- read out loud
How to prepare a preschooler for a procedure
- simple explanations with diagram or doll
- play with stethoscope, doll
- vocalize that it is not for punishment
- medical play
Fears of school age children
loss of control
What to expect of school-age children
- like to take risks (IV pumps)
- like adults to be involved when making decisions
- enjoy contact with others their age
- want alone time
- want rules
How do we promote school age development?
- encourage continuation of school work
- give realistic and truthful explanations
- allow quiet and private time
- use a lot of language
- involve them in making things
- promote collection of things
- make a game out of normal routine
How do we prepare school age children for procedures?
- use simple medical terminology
- use diagrams and pictures
- explain the “why”
- explain equipment
- allow the child to play with the equipment
- allow time for questions
- suggest ways to develop control
- allow them to be responsible
What are the fears of an adolescent?
altered body image, loss of control, and separation from peers
Things to understand about a hospitalized adolescent
- they may not like becoming dependent and depersonalized
- they enjoy being personally related to
- understand psychological pain and physical pain
- stage - identity vs role confusion
- may be dating/engaged
How can nurses promote adolescent development?
- teach them at a realistic level
- involve them with different staff members - discuss concerns about the future
- ask them how much they would like their parents to be involved
- have high expectations for appropriate behavior and spell them out
- help them maintain their identity
How to prepare adolescents for procedures
- explain it to them - they are capable of abstract thought and reasoning
- understand they will have fears about their appearance
- they are more concerned about the present time rather than the future
- allow independence
- peer relationships are very important
- suggest ways that they can maintain control
How may parents react to their child becoming hospitalized?
initial disbelief, anger, guilt, fear, frustration, depression
How can nurses work effectively with hospitalized children’s parents?
- encourage visitation and staying the night with the patient
- allow parents to be present during procedures
- acknowledge their importance
- provide them info
- offer support and peer groups
- provide respite
- discuss arrangements for the care of other family at home
- model appropriate parenting
What do children who are vulnerable when hospitalized look like?
- have a difficult temperament
- have a lack of connection with their parents
- between 6 months and 4 years typically
- typically male
- have multiple stressors
- rural home
- passive
What are the stages of separation anxiety?
protest, despair, and detachment
Strategies to decrease the effects of separation anxiety
- have a primary nurse
- maintain a thorough history
- maintain parental contact
- teach parents to be honest about where they’re going
- make their surroundings more familiar
- soften medical equipement
What will a child look like when returning home from the hospital?
- most will adapt fairly quickly
- infants-preschoolers may adapt slower
- children may reject caregiver when going home
- they may regress in their development (potty training)
- consider the pain that they will experience