PrepUs for Pediatrics Chapter 29

He sits quietly and is uninterested in playing and eating.

The nurse is caring for an 8-year-old boy hospitalized for a bone marrow transplant. His parents are in and out of his room throughout the day. Which behaviors of the child would alert the nurse that he is in the second stage of separation anxiety?

Ask the parents what the doctor has told them to ensure their understanding. Provide written information about visiting hours. Prepare the family for what the child will look like when they first visit.

The nurse is preparing a family to visit their child, who has been admitted to the pediatric intensive care unit (PICU) following a motor vehicle accident. What actions by the nurse would reduce the family's anxiety? Select all that apply.

Pretend to perform the procedure on her doll. Teach her the steps of the procedure. Introduce her to the health care personnel.

The nurse is preparing a hospitalized 7-year-old girl for a lumbar puncture. Which actions would help reduce her stress related to the procedure? Select all that apply.

Go slowly with the acquaintance process.

A nurse is admitting a 7-year-old child to the pediatric unit of the hospital. While the nurse is showing the child and parents the room and explaining where things are, the child becomes upset and frightened. What is the best action by the nurse?

In a treatment room

A school-aged child needs to have an IV started. Where would be the best place for the nurse to perform this procedure?

Use of a highly structured format

After teaching a group of students about therapeutic play, the instructor determines that additional teaching is needed when the students identify what as a characteristic of therapeutic play?

"We cannot give you anything to eat or drink before your procedure because we do not want you to get an upset stomach."

A 10-year-old is scheduled for an appendectomy in 6 hours. The child is placed on NPO status and wants to know why he cannot have anything to eat or drink. What is the best explanation by the nurse?

A mobile using gauze and tongue blades

A 5-month-old is hospitalized for dehydration. What can the nurse make with items found on the unit for an activity to distract the child?

Encourage the family to participate in the child-life program.

A 5-year-old child is scheduled for hospitalization in 2 weeks. Which is the best intervention to help ease the stress of hospitalization in this child?

supporting the parent in his or her presence and caregiving

The nurse caring for a 6-month-old infant can best reduce the stress of hospitalization by:

Provide age-appropriate toys and games.

The nurse is caring for a 10-year-old girl who is in an isolation room. Which intervention would be a priority intervention for this child?

Explain to the boy that he must keep his leg very still.

The nurse is caring for a 7-year-old boy who needs his left leg immobilized. What is the priority nursing intervention?

Despair

The nurse is caring for a child who has been hospitalized for 6 days and whose caregivers are unable to stay with the child. The child cried most of the day for the first 3 days but now is quiet and withdrawn. This behavior in the child is an example of which stage of separation?

Boxes to put toys in and/or take out toys Stacking blocks or small boxes to stack Nursery rhymes or sing-along songs on tape

The nurse is caring for a hospitalized toddler who is prescribed bedrest. Which item(s) would the nurse recognize as appropriate for the toddler? Select all that apply.

Knees flexed Facial grimacing Rigid body posture

The nurse suspects that an infant is experiencing pain postoperatively. What behaviors would validate this suspicion? Select all that apply.

Read a story while in the room. Play a game while in the room. Spend extra time to talk while in the room.

A 6-year-old with leukemia is placed on reverse isolation. What nursing actions could prevent depression and loneliness in this client? Select all that apply.

Let the children lie in the beds, use the call lights and practice being a patient. Provide a room for the class with hospital gowns, masks and equipment used on children. Tour the hospital, including the playrooms on the pediatric floors.

A preschool teacher calls the hospital and wants to introduce the concept of a hospital to her preschool class in case they ever get sick and need to be admitted. What resources could the child life specialist provide for this group to aid in their learning? Select all that apply.

Explain all procedures using medical terminology.

A preschooler is admitted to the pediatric floor for dehydration and is frightened. Which nursing intervention would be least effective in alleviating the child's anxiety?

Have the child's classmates send cards to the child. Have parents bring the child's electronic game system. Draw a smile on the nurse's mask before entering the room.

A school-aged child is in isolation at the hospital and her family members ask what they can do to help the child feel less lonely. What would the nurse suggest to this family? Select all that apply.

Determine how much the child knows and is capable of understanding.

The nurse is caring for a preoperative pediatric client. What would it be best for the nurse to do with this client?

The nurse uses pain assessment tools.

The nurse is caring for a preschool aged child following abdominal surgery. Of the following nursing actions, which is the highest priority?

"Let's see who can blow these cotton balls off the table first."

The nurse is caring for a preschooler who requires postsurgical breathing exercises. Which approach will best elicit the child's cooperation?

When the children are capable of understanding basic functions of community resources

The public health nurse is choosing to focus community education for parents of young children about awareness of the hospital. When is the best time to educate the children about the hospital?

Remove one restraint at a time on a regular basis to check for skin irritation.

The toddler needs elbow restraints to keep his hands away from a facial wound. What will the nurse do to best ensure their safe use?

Ask the family members health history questions while the child is being initially treated. Place an identification bracelet on the child, explaining that this will help the hospital staff know who he or she is at all times. Remain calm, explaining procedures to both the family and the client in a caring manner.

What can a nurse do during an emergency admission to alleviate some of the child's and family's fears/anxieties over the situation? Select all that apply.

Protest

When a child is hospitalized and must be away from the caregiver, the child goes through stages of response to the separation. The child who cries and refuses to let the nurse or anyone else provide comfort and is continually looking out the door to see if the caregiver is returning is in which stage of separation?

Having the parent stay with the child

Which intervention is most important in assuring a child's cooperation and reducing his or her fear during an emergency room visit?

Children this age often show regressive behaviors and have nightmares following hospitalization due to fear of another separation.

A mother of a recently discharged preschooler calls the pediatric floor that provided care to her child a week ago. She reports that the child is having elimination accidents, temper tantrums and is waking up at night with nightmares. How should the nurse respond to the mother's concerns?

Gown, gloves and mask

The nurse approaches a client room and notes a sign stating the client is in droplet isolation. Which precautions would be appropriate for this client?

"Your insides are healed and the cut you see on the outside is not what it looks like inside."

The pediatric nurse is caring for a child who is recovering after abdominal surgery several days ago. After the child's sutures are removed, the child asks the nurse, "Will my insides fall out now?" How should the nurse respond?

Sleepy mother holding sleeping child at the child's bedside

The pediatric nurse is caring for a group of children. Which clinical situation will the nurse identify as being a safety concern?

An adolescent who has a broken arm

The pediatric nurse would use standard precautions in caring for which client on her floor?

Encourage family members to spend time with the child and help them with maintaining precautions. Make sure the child understands the isolation precautions are not a punishment. Arrange to spend extra time in the room when performing treatments and procedures.

A nurse is caring for a child on transmission-based precautions. What interventions can the nurse provide to prevent the child from feeling socially isolated? Select all that apply.

Airborne precautions Droplet precautions Contact precautions

Health care providers follow transmission-based precautions when caring for children with documented pathogens or children suspected of having highly transmissible pathogens. Which of the following are included in transmission-based precautions?

Protest

On the first postoperative day, a 4-year-old chld who was hospitalized for an emergency appendectomy has begun to cry relentlessly, will not let the nurse touch him or her, and keeps asking for the parent. The pediatric nurse is aware that this client is in which stage of separation?

"Are you wondering about anything related to your tonsillectomy?"

The nurse is admitting a 14-year-old girl for a tonsillectomy and is preparing her for the procedure. Which of the following is the best statement or question?

Enlist the aid of a child-life specialist.

The nurse is caring for a 10-year-old boy who is in traction. The boy has a nursing diagnosis of deficient diversional activity related to confinement in bed that is evidenced by verbalization of boredom and lack of participation in play, reading, and schoolwork. What would be the best intervention?

therapeutic play.

The nurse is caring for a 10-year-old child admitted for a surgical procedure to be done the next day. The nurse takes the child to a special area in the playroom and lets the child "start" an IV on a stuffed bear. This is an example of:

Unlicensed assistive personnel

The nurse is caring for several families in the home care setting. What additional team member will the nurse have available to assist in the home setting?

most pain

A nurse asks a 5-year-old to use a color scale during a pain assessment. The nurse gives the child crayons and the child picks a red crayon to indicate the pain level. This indicates that the child is experiencing which level of pain?

Keep the crib side rails up at all times.

Caregivers of a hospitalized toddler are being given safety instructions upon admission to the pediatric floor. Which action by the caregiver would be most important to the toddler's safety?

Maintain a schedule of activities the child enjoys Encourage the child to plan the timing of meals and snacks, as appropriate

The nurse is planning care for a child who is admitted to the hospital requiring isolation due to the risk of organism transmission. The nurse determines the child's diagnosis is powerlessness related to separation. Which action(s) will the nurse implement in response to the child's nursing diagnosis? Select all that apply.

Place the infant in a room close to the nurses' station.

The nurse is preparing a postsurgical care plan for an infant girl located on a general hospital unit that only occasionally admits children. To ensure the infant's safety, what should the nurse include in the plan?

Allow the child to put on surgical attire and "operate" on a doll to teach what will be happening.

Which approach by the nurse best demonstrates the correct way to prepare a Hispanic child for a planned hospital admission?

Prepare the child for hospitalization by explaining what to expect and showing him or her around the hospital.

A 6-year-old child will be hospitalized for a surgical procedure. How can the nurse best ease the stress of hospitalization for this child?

That not having food or drink before surgery will prevent an upset stomach

A 5-year-old scheduled for surgery in the morning wakes at 2 am and asks the nurse for something to eat and drink. What should the nurse tell this client?