Nursing Of The Hospitalized Child

Question 0

The ultimate objective in care of children.

Answer 0

Family centered care

Question 1

Children are ____________, not ________ _______.

Answer 1

Individuals; small adults

Question 2

What are the two factors that influence care even greater than the disease process.

Answer 2

Chronological and developmental age

Question 3

Gross motor first three months

Answer 3

Recliner- sleeps up to 20 hours per day

Question 4

3-6 months gross motor

Answer 4

Gains control to sit

Question 5

6-9 months gross motor

Answer 5

Bouncer or crawler
Fine motor:
Pincher grasp

Question 6

9-12 months gross motor

Answer 6

Crawler or cruiser

Question 7

Infancy period

Answer 7

1st day to walking

Question 8

Infant- what causes them stress?

Answer 8

As early as 6 months, infants are acutely aware of the absence of their parents and are fearful of strangers; infants can sense the anxiety of their parents; infants are usually used to a routine, hospitalization can disrupt that and cause stress

Question 9

Infant development promotion:

Trust vs Mistrust

Answer 9

Place child in position so they can see their hands and face (infant seat); talk about everything in the room; touch, swaddle, speak softly to soothe; smile and put face in field of vision; simulate home routine when possible; assign same nurse; keep frightening objects out of view; pay attention to light and sound stimulation; hold for feedings- and allow from non-nutritive sucking; toys, mobiles, rattles, picture books, blocks

Question 10

Infant- working with parents

Answer 10

Allow parents to be present during procedures and comfort after; teach parents procedures they are capable of doing; model appropriate interactions & caregiving; praise proper parent interactions; encourage parent to stimulate infant (talk, trips out of room, noises); if celebrities or costumed figures come explain that to infants over 8 mo. This may cause anxiety; arrange for care of other family at home

Question 11

Preparing infants for procedures

Answer 11

Keep mom and calm, get them to help; sensory soothing methods; cuddles and hugs; safe restraints if needed; have security objects from home

Question 12

Early childhood- Toddler

Answer 12

Begins when child attains locomotion; marked physical and personality development; rapid language development

Question 13

Toddler greatest fear

Answer 13

Loss of bodily control

Question 14

PRAISE- Toddlers

Answer 14

P- parallel play- they like other children but not cooperate or play together
R- rituals, routines, regression- May regress to deal with stress- expected; routine crucial
A- autonomy vs shame and doubt; accident prone
I- involve parents
S- separation anxiety- in full swing- tolerate hospital the worst
E- Explore- love to get into stuff

Question 15

Toddler- Disease perception

Answer 15

“I am sick because I don’t have a band-aid.” Perception is external and unrelated

Question 16

Toddler- development phase

Answer 16

Autonomy vs. shame and doubt

Question 17

Toddler- development promotion

Answer 17

Praise appropriate behavior (swallowing medicine); provide avenues for mobility (even moving in bed); provide outlets for aggression (pegs and hammer); ensure access to finger foods (important for fine motor); allow for reasonable exploration; offer choices when possible; difficulty with change (keep home routine as much as possible); develop rituals and put in care plan; model rituals after home routine; have child repeat names of things and talk through steps in patient care

Question 18

Toddlers- preparing for procedures

Answer 18

Egocentric- don’t care about other kids w/ illness; inform about procedure the day of-no concept of time; In description only include what they will see, hear, smell, feel; praise what they do well; “mommy and daddy will be waiting”

Question 19

Early childhood- preschooler

Answer 19

3-5 years; socialization with other children is vital; work to gain self control- trying to delay impulses; begin to develop a self-concept- able to scar for life

Question 20

Preschoolers-MAGIC

Answer 20

Magical Thinkers
M- fear mutilation- biggest fear
A- associative play
G- Guilt vs Initiative - love to ask questions- need to be answered and not ignored 
I- Imaginary playmate