The hospitalized child Flashcards

1
Q

Why do children get stressed in the hospital?

A
  1. Stress represents a change from the usual state of health & routine
  2. Children have a limited number of coping mechanisms to resolve stressors
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2
Q

Infants understanding of health and illness

A

Separation anxiety
- protest (cry)
- despair (sad, lonely)
- detachment/denial (sad or withdrawn even with parent present)

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3
Q

Toddler and preschooler in hospital

A

all about routine

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4
Q

Adolescent in hospital

A

care about privacy

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5
Q

Stressor for all children

A

Separation
Loss of control, autonomy and privacy
Being subjected to painful and invasive procedures
Fear of bodily injury and disfigurement

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6
Q

Infant stressors

A

o separation anxiety**
o stranger anxiety
o painful, invasive procedures
o immobilization
o sleep deprivation

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7
Q

Toddler stressors

A

o separation anxiety**
o loss of self-control
o immobilization
o painful, invasive procedures
o bodily injury or mutilation
o fear of the dark

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8
Q

Pre-schooler stressors

A

o separation anxiety** and fear of abandonment
o loss of self-control
o bodily injury or mutilation
o painful, invasive procedures
o fear of the dark, ghosts & monsters

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9
Q

School aged child stressors

A

o loss of control
o loss of privacy & control over bodily functions
o bodily injury
o painful, invasive procedures
o fear of death

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10
Q

Adolescent stressors

A

o loss of control**
o fear of altered body image, disfigurement, disability, & death
o separation from peer group

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11
Q

Newborn and infant response to pain

A

Crying, facial appearance, generalized body response
No relationship b/n cause & response

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12
Q

Older infant response to pain

A

Crying; localized body response; expression of pain or anger; physical struggle

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13
Q

Young child response to pain

A

Crying & screaming; verbal expressions; thrashing; lack of cooperation; begging; anticipates pain

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14
Q

School aged child response to pain

A

Similar to young child; time-wasting behaviours; muscular rigidity

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15
Q

Adolescent response to pain

A

Less vocal; less physical resistance; more verbal; increased muscle tension & body control

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16
Q

Non-pharmacological strategies for pain

A
  • General strategies
  • Distraction
  • Relaxation
  • Guided Imagery
  • Positive self-talk
  • Thought-stopping
  • Behavioural contracting
17
Q

FLACC

A

Face
Legs
Activity
Cry
Consolability

18
Q

Two step strategy of pharm management of pain

A

Nonopioids (e.g. acetaminophen &NSAIDS) for mild pain
Strong opioid (morphine) for moderate to severe pain

19
Q

Coping mechanisms for pain

A
  • Regression
  • Denial
  • Repression (forgetting)
  • Postponement
  • Bargaining
20
Q

Strategies to promote coping

A

Child Life programs
Rooming in
Therapeutic Play (Toddler, pre-schooler, school-age)
Therapeutic Recreation

21
Q

Family assessment

A
  • Family roles
  • Knowledge
  • Support system
  • Siblings
22
Q

Reactions to life threatening illness or injury

A
  1. Shock and disbelief
  2. Anger and guilt
    - May feel responsible for cause
    - May feel guilty for not noticing onset of illness
  3. Deprivation and loss
  4. Anticipatory waiting
  5. Readjustment or mourning
23
Q

Nursing management

A
  • Provide information and build trust
  • Promote parental involvement
  • Provide for physical and emotional needs
  • Facilitate positive staff-parent relationships and communication
  • Maintain or strengthen family support systems
24
Q

Factors increasing siblings reactions

A
  • Younger and experiencing many changes
  • Cared for outside the home by non-relatives
  • Little information about ill sibling
  • Perceived parents to be treating them differently than before siblings hospitalization