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Pediatrics > Week 2 Care of children with special needs, Acute , chronic, and Term. Illnessess > Flashcards

Week 2 Care of children with special needs, Acute , chronic, and Term. Illnessess Flashcards

1
Q

What are the three major stressors of hospitalization for pediatric clients?

A
  • Separation
  • Loss of control
  • Bodily injury and pain
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2
Q

Separation anxiety begins around ____ and peaks at ___ but can be present up to age ___ especially when the child is hospitalized

A

6 months
1-3 years
5 years

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3
Q

When a child is hospitalized, some parents are able to get paid family leave. This helps prevent ____ in the pediatric patient.

A

Developmental delays

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4
Q

With school-aged children and older, it is important to allow _____ to visit not just ____

A

Friends and other family members

not just parents.

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5
Q

Hospitalized adolescents require ____support in addition to family support

A

Peer

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6
Q

What are the three stages of separation anxiety?

A
  • Protest
  • Despair
  • Detachment
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7
Q

What occurs during the Protest stage of sep. anxiety

A

The child will cry and cling to the parent

The child will resist any attempts to comfort them

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8
Q

What occurs during the Despair stage of sep. anxiety

A

The child will ignore their parents when they return

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9
Q

What occurs during the detachment stage of sep. anxiety

A

There will be a notable lack of protest when parents leave. The child will be happy, content, and indifferent.

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10
Q

What is a special consideration that a child’s caregivers need to take during the detachment stage of separation anxiety?

A

The child will often attach themselves to their caregivers and can form a stronger bond with them than their parents

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11
Q

Loss of control is based on the _____ of the individual

A

Preception

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12
Q

What control does an infant need?

A

Que’s of when they are hungry or need to be changed or in pain. This communication is their sense of control and is important for them to build trust

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13
Q

What control does a toddler need?

A

They need to be able to make choices and be an individual.

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14
Q

What control does a preschooler need?

A

Similar to a toddler. They need to know they have choices, they can make their own play plans. let them interact with equipment.

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15
Q

What control does a school-aged child need?

A

What friends they play, what activities they do. Individualize things to fit their personality

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16
Q

What control do adolescents need?

A

Control over their appearance, control over peer group visits, control over some health care choices

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17
Q

What is reverse PRN?

A

Children are not going to be able to keep their PRN schedule in their head or anticipate their pain. Sometimes you anticipate the pain for them and give them their PRN meds before the pain starts and assess afterward instead of waiting for a request

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18
Q

When is the NIPS assessment used?

A

in neonatal patients

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19
Q

What is the FLACC tool used for?

A

Pain assessment in non-verbal patients

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20
Q

What does FLACC stand for

A
  • Face
  • Legs
  • Activity
  • Cry
  • Consolability
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21
Q

What is the oucher scale?

A

An infographic showing pain expressions in children of different ethnicities

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22
Q

Why should you always consider culture in pediatric pain assessments?

A

Because some cultures teach their children(especially male children) not to express pain.

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23
Q

Always try to assess a pediatrics pain without ____ present. Because ___

A

Parents

Because the child may be embarrassed or shamed to admit pain in front of parents

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24
Q

What are some non-pharmacological pain relief techniques for children?

A
  • Distraction
  • Playing
  • Sucrose water as an analgesic toot sweet
  • Buzzys
  • Cold packs
25
Q

How does fear influence pain?

A

It magnifies it

26
Q

What are five things that can help prepare a child for procedures?

A
  • Play
  • Read books
  • Ask questions
  • Be honest
  • Allow visits before
27
Q

All pediatric medication orders are based on ____

A

mg/kg/day or dose

28
Q

Weight-based medication doses are usually only used up to _____kg

A

50

29
Q

When applying topical medications to younger children, it is import to consider that

A

they have a large BSA in proportion to adults

30
Q

When a child has an IV we check it every _____

Why?

A

30 minutes

Because they are more likely to infiltrate and are hurt much quicker than adults if this happens

31
Q

When administering IV medications to a pediatric patient, ALWAYS USE A_____

A

pump

32
Q

If no IV pump is available for a pediatric patient you can use a____

A

Volutrol chamber IV system

33
Q

What are some considerations when supporting a patient’s sibling?

A

Consider their developmental level

  • Be honest with them
  • Encourage questions and discussions
  • Encourage visitations
  • Prepare them if their sibling can’t speak or will be asleep/sedated.
  • Encourage the expression of their feelings
34
Q

What is the developmental focus for children with special needs?

A

Emphasize abilities and strengths

Be person focused

35
Q

What does it mean to be person focused?

A

“the child with diabetes”
Not
“The Diabetic child”

36
Q

What are the aspects of family-centered care that are important for children with special needs?

A
  • Collaboration (parents may be experts in condition)
  • The therapeutic relationship
  • Communication
37
Q

What is normalization?

A

The integration of a child with special needs into society?

38
Q

What is an example of normalization?

A

Inclusion therapy, allowing the child with special needs to play and participate with activities that all other children are participating in

39
Q

Children with special needs need managed care. What does this mean

A

It means that they are fully depended on adults for care

40
Q

Discuss the impact of caring for a child with special needs on a family.

A
  • The time of diagnosis means everything

- It can cause major role strain and even cause families to grow distant if the stress and strain are not managed

41
Q

What type of coping is the best for families with children with special needs

A

Use a direct approach, not avoidance.
Use the child’s strengths instead of using white lies and wishful thinking.
Example: Let the child keep score in the game when they can’t physically participate don’t tell them “someday you will be out there on the field”
It doesn’t mean they will never be able to participate but it does teach them to focus strengths and abilities instead of feeling isolated

42
Q

What are the 6 stages of adjustment?

GBORDG

A
  • Guilt and Self-accusation
  • Bitterness and anger
  • Overprotection
  • Rejection
  • Denial
  • Gradual Acceptance
43
Q

What do parents often do during the bitterness and anger phase of adjustment?

A

they stop caring for themselves.

44
Q

During the overprotective phase of adjustment, what is there commonly a lack of?

A

Discipline. The parent doesn’t want the child to feel any other pain or hardships so they eliminate rules

45
Q

What is the ultimate goal of family coping?

A

Acknowledgment and Reintegration

46
Q

What occurs during Acknowledgement and reintegration?

A
  • It is a culmination of the adjustment phase
  • Social reintegration begins
  • Needs of the family change over time
  • Chronic sorrow is present
  • Complete resolution is not possible yet but it’s not seen as impossible
47
Q

What is chronic sorrow and why is it good

A

It is the realization that nothing you can do will change the current condition of the child. It’s good because it shows that the parent is finally accepting the child’s condition.
Sometimes parents Need permission to feel this because they feel wrong thinking this way

48
Q

What are the four aspects of parental support?

A
  • Family
  • Friends
  • Parent- to - parent
  • Parent-professional
49
Q

What is transition care and when does it begin?

A

It is when we begin to help the child understand that they will soon be responsible for managing their own care. We teach them how and this process begins around 12-13 years old depending on the developmental level

50
Q

What are the three most common fears stated by families and children when diagnosed with a terminal illness

A
  • Fear of pain and suffering
  • Fear of dying alone or not being there at the time of death
  • Fear of the actual death
51
Q

Describe the concept of death for a 0-2 year-old

A

There is none but the tension is felt

52
Q

Describe the concept of death for a 2-3 year old

A

The see it as a separation “they will come back

53
Q

Describe the concept of death for a 4-6 year old

A

They see it as temporary. Thoughts cause death, MAgic thinking is present. “ they will wake up I just know it!”
“this is my fault because I was bad”

54
Q

Describe the concept of death for a School aged child.

A

Its exaggerated and universal

55
Q

Describe the concept of death for a 8-10 year old

A

They realize that it is permanent

56
Q

Describe the concept of death for an adolescent

A

It happens to everyone but me

“selective immortality/universality”

57
Q

What are the five traits of the best nurses that grieving families have identified

A
  • non-abandonment
  • Respect for the client
  • Care for the family
  • Facilitation of the family process
  • Followup after the clients death
58
Q

What are some important considerations the nurse needs to know regarding the grieving sibling

A
  • The parents may not be emotionally available
  • They need honesty
  • They need to express their feelings
  • They will ask loaded questions and have behavior changes
  • They may need peer support
  • Notify their school (parents do this)

Pediatrics (20 decks)

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