Nursing Of The Hospitalized Child Flashcards
The ultimate objective in care of children.
Family centered care
Children are ____________, not ________ _______.
Individuals; small adults
What are the two factors that influence care even greater than the disease process.
Chronological and developmental age
Gross motor first three months
Recliner- sleeps up to 20 hours per day
3-6 months gross motor
Gains control to sit
6-9 months gross motor
Bouncer or crawler
Fine motor:
Pincher grasp
9-12 months gross motor
Crawler or cruiser
Infancy period
1st day to walking
Infant- what causes them stress?
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
Infant development promotion:
Trust vs Mistrust
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
Infant- working with parents
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
Preparing infants for procedures
Keep mom and calm, get them to help; sensory soothing methods; cuddles and hugs; safe restraints if needed; have security objects from home
Early childhood- Toddler
Begins when child attains locomotion; marked physical and personality development; rapid language development
Toddler greatest fear
Loss of bodily control
PRAISE- Toddlers
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
Toddler- Disease perception
“I am sick because I don’t have a band-aid.” Perception is external and unrelated
Toddler- development phase
Autonomy vs. shame and doubt
Toddler- development promotion
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
Toddlers- preparing for procedures
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”
Early childhood- preschooler
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
Preschoolers-MAGIC
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
