TLO 2.11 Psychological Well Being Flashcards
Children’s response to illness?
Fear of unknown Separation anxiety Fear of pain/mutilation Loss of control Anger Guilt Regression
Infant and toddler response to illness?
Separation anxiety
Fear of injury and pain
Loss of control
Preschooler response to illness?
Separation anxiety
Fear or injury and pain
Loss of control
Guilt and shame
School age children response to illness?
Separation
Fear of injury and pain
Loss of control
Adolescents response to illness?
Separation
Fear of injury and pain
Loss of control
Developmental approaches to the hospitalized child
NEONATE?
Anticipate needs and full fill in timely manner Sucking/oral stimulation Swaddling Provide stimulation to each sense Watch for overstimulation Comfort before/after painful procedures Model appropriate behaviors with family Provide consistent caregivers Collaborate with parents Involve parents in care Encourage parents to room in
Developmental approaches to the hospitalized child
YOUNGER INFANT AND OLDER INFANT?
Younger infant: same care as neonate
Older infant:
painful procedure= swaddle and provide nonnutritive sucking
expect regression and educate parents
consistent caregivers (limit number of caregivers)
infants security item
encourage parents to be present during procedures
Developmental approaches to the hospitalized child
TODDLER?
Expect regression
Follow home routines
Involve parents in care
Provide for rooming
Allow for mobility when safe
Use all methods of pain control for painful procedure
Anticipate temper tantrums when child is frustrated
-maintain a safe environment during tantrum
Encourage independence
Provide support when needed
Positive firm attitude
Developmental approaches to the hospitalized child
PRESCHOOLER?
Provide safe way to let out aggression Communication Expect egocentric behavior Safe, secure environment Consistency Collaborate with parents: coping, home routines Provide play and interaction with other children Accept regression and educate parents Encourage independence
Developmental approaches to the hospitalized child
SCHOOL AGE CHILD?
Explain limits and enforce
Involve in care
Explanations
Accept regression, encourage independence
Privacy
Assist with social adjustment
Educational needs, bring in HW, study time
Developmental approaches to the hospitalized child
ADOLESCENT?
Privacy Maintain normalcy Communication/explanations Activities with other adolescents Social adjustment Educational needs, bring in HW, study time
Children’s understanding and reactions to death
What should the nurse do?
Be honest, accurate information in clear simple language
Will be over a gradual process of time
Take into consideration of development level
Kubler-Ross stages of grief and dying?
Denial Anger Bargaining Depression Acceptance
Child’s concept of death
INFANTS AND TODDLERS
View death as a separation from caregiver/parent
Loss of comfort measures
Sense parent’s grief
Allow a much time as possible with primary caregiver
Child’s concept of death
PRESCHOOL AGED
Temporary situation
Guilt and shame
Are they “bad?”
Nurse’s role
Child’s concept of death
SCHOOL AGED
Irreversible event?
Fears
May wonder what the did to cause them to die so young
Make sure someone is with the child at all times
Parents should not avoid talking about death
School age are able to recognize death for what it is
Child’s concept of death
ADOLESCENTS
Understands death is irreversible and inevitable
See themselves as invincible
Isolation
Peers reaction
Child response to their own death- general
Children are not afraid of death, but of abandonment
Children are very sensitive to other’s reaction to dying
Children depend on their parents
They need their parents to give them “permission” to die
Important that they know “loved ones” will remember them
Parent response to their child’s death- general
At first parents may want to do everything to cure the disease
Eventually face the fact
Child’s pain/suffering often push parents towards decision of care vs cure
Will need to talk about the experience of illness leading to death to help process it
When child finally dies, may initially feel relief because their child is not longer suffering
Later, parents will feel intense sadness and grief
Sibling response to death of their sibling
Sibling grief must be acknowledge
May feel responsible for patient getting sick/dying
Important to acknowledge that siblings grief is just as important as parents grief
Sibling will usually need to help to work through grief
