Unit 20

Question 1

How can you reduce separation anxiety?

Answer 1

Have parent hold child during assessment
Talk to them appropriately for their age
Create routine similar to home
Bring object from home

Question 2

What are the 3 phases of separation anxiety?

Answer 2

Protest: crying, clinging
Despair: cessation of crying, still avoidant
Detachment: denial, not contentment, resignation

Question 3

What are the reactions of the family?

Answer 3

Parents:
- Helplessness
- Questioning skills of staff
- Accepting the reality of hospitalization
- Dealing with fear
- Coping with uncertainty
- Seeking reassurance
Siblings
- May not understand
- Being cared for by nonrelatives (feeling neglected)
- Not knowing whats is happening due to lack of information
- Perceiving parents treating sick child differently

Question 4

How to minimize/prevent stress of separation?

Answer 4

Encourage parents to stay
Bring object from home
Similar routine

Question 5

How to minimize/prevent loss of control?

Answer 5

Maintain routine
Promote freedom of movement and play

Question 6

How to minimize/prevent fear of bodily injury

Answer 6

Modify procedure techniques for children based on age
Size of bandages?
Explanation effectiveness

Question 7

What is regression?

Answer 7

Developmental delayed - counteract this by providing developmentally appropriate activities.

Question 8

S/S of type 1DM

Answer 8

Excessive thirst and hunger
Unexplained weight loss
Blurred vision
Slow healing cuts/sores
Fatigue
Vaginal yeast infections
Frequent urination

Question 9

Treatment of DKA

Answer 9

Weigh them
Cardiac monitor
O2 as needed
Suction if unconscious
Foley catheter
ABX if febrile

Question 10

What is the IV therapy for DKA?

Answer 10

NS bolus 10-20mL/kg over 1-2hrs; dont exceed 40-50mL/kg in the first 4-5 hrs
Regular insulin IV 0.1 units/kg/hr
Give K+ when lvls are normal or low and pt is voiding
Blood glucose should decrease 50-100mg/dL/hr

Question 11

What is DKA

Answer 11

The body doesn’t have enough glucose for metabolism, so the body breaks down alternative sources of energy; this produces ketones

Question 12

Management of DM1

Answer 12

During illness monitor BS every 2-3hr
Teach children to give insulin injections
Stress the importance of hand-washing
Give 30 min prior to exercise

Question 13

Hypoglycemia s/s

Answer 13

Shaking
Dizziness
Increased HR
Anxiety
Headache
Irritable

Question 14

Hyperglycemia s/s

Answer 14

Dry skin
Frequent urination
Nausea
Sleepiness after eating

Question 15

Interventions for hypoglycemia

Answer 15

Glucose (10-15g or 1 tsp of honey)
Glucagon IM or SQ
Dextrose IVP in hospital