Chapter 29: Care of the Hospitalized Child

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?

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

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.

*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.

When working on a pediatric unit, the nurse will perform which action(s) to minimize client fear and anxiety? Select all that apply.

*Explain procedures to the child beforehand in age-appropriate terms. *Include the child's family when providing education. *Remain calm and empathetic with caring for the child. *Encourage the child to inform the nurse of fears. *Allow the child to bring a security blanket from home.

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.

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

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.

*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. *let the children lie in the beds, use the call lights and practice being a patient.

A 2-year-old child is admitted to the hospital for dehydration. This is the first time the child has been in the hospital, and the caregiver has not arrived but is en route. The child is crying and appears afraid. Which intervention by the nurse is appropriate for this child?

Hold and rock the child until the caregiver arrives.

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?

Keep the crib side rails up at all times.

A school-aged child is scheduled for tonsillectomy in a local outpatient surgery center. Which statement by the mother indicates that further education is needed?

"He will need to spend the night here after the surgery is done."

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

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

A 6-year-old child diagnosed with pneumonia is admitted to the hospital for treatment. The child states to the nurse, "I think I am here because I am going to die. This is where my grandmother and uncle both died." Which response by the nurse is most appropriate?

"People come here for many reasons. We will give you the best care we can."

The nurse is working with a group of caregivers of children in a community setting. The topic of hospitalization and the effects of hospitalization on the child are being discussed. Which statement made by the caregivers supports the most effective way for children to be educated about hospitals?

"We are going to take our child to an open house at the hospital so she can see the pediatric unit."

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?

*airborne precautions *droplet precautions *contact precautions

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.

*boxes to put toys in and/or take out toys *stacking blocks or small boxes *nursery rhymes or sing-along songs on tape

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

*knees flexed *facial grimacing *rigid body posture

The nurse is planning play activities for a toddler admitted to the hospital. What play activity(ies) would the nurse include in the plan of care? Select all that apply.

*stacking different-colored blocks *pulling a toy train in the room or hallway *putting together a large-piece puzzle

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

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

A hospitalized 5-year-old child tells the nurse, "I am lonely and bored, and it's not fair I cannot see other people more." The child is on transmission-based precautions. Which action by the nurse is appropriate?

Arrange the daily care schedule to spend extra time in the child's room.

A child's caregiver tells the nurse, "I plan to room-in with my child." Which action will the nurse take?

Ask if the caregiver would like to help the nurse with bathing the child and with the next dressing change.

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?

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

A school-aged child is hospitalized and is in contact isolation and must remain in his room. Which activity could the nurse use to entertain the client to reduce his sense of loneliness?

Play "I Spy" with items in his room.

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?

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

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

Provide age-appropriate toys and games.

An adolescent is scheduled for outpatient arthroscopic surgery on his knee next week. As part of preparing him for the procedure, which action would be most appropriate?

Providing detailed explanations of the procedure at least a week in advance of the procedure.

A 7-year-old child is upset because the family has to wear personal protective equipment (PPE) while in their room. When the family enters, the child cries and requests the PPE be removed. Which action by the nurse is appropriate?

Reinforce teaching to the child of why the PPE is required.

A child is admitted to the hospital for an extended time period following a new diagnosis. The family appears stressed and anxious about what to expect while the child is hospitalized. They express concerns about how to ensure the child will be able to cope and continue to develop while in the hospital and not at home or school. The family asks lots of questions but remains anxious and concerned. Which intervention by the nurse is best?

Request the child life specialist to come and visit with the client and family.

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

Sleepy mother holding her sleeping child at the child's bedside

A 3-year-old who has just been admitted with pneumonia needs to have an intravenous (IV) line inserted for antibiotic therapy. What is the best nursing action?

Take the patient to the treatment room to have the IV inserted.

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

The nurse uses pain assessment too

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

an adolescent who has a broken arm

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

having the parent stay with the child

The nurse is caring for a client placed on droplet precautions. Which teaching is priority for the nurse to reinforce for the caregivers?

how to use and apply personal protective equipment

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

in a treatment room

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?

most pain

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?

protest

The nurse is caring for an 8-year-old girl who requires numerous venipunctures and injections daily. The nurse understands that the child is exhibiting signs of sensory overload and enlists the assistance of the child-life specialist. What should the therapeutic play involve to best deal with the child's stressors?

sewing puppets with needles

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?

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

The nurse is preparing to start an intravenous (IV) line on a stable pediatric client in the hospital. Which location is most appropriate for the nurse to use for this procedure?

the pediatric treatment room

What is the best technique for preventing the spread of infection in hospitalized clients?

washing hands between each client

The public health nurse is educating parents of young children about awareness of the hospital. When is the best time to educate the children about the hospital?

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

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?

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

While the nurse is admitting a 5-year-old client, the caregiver asks, "What can I do to make my child feel secure? This is our first hospitalization." Which nursing response is best?

"You staying with your child will provide the most security."

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.

*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.

When caring for pediatric clients, which intervention(s) will the nurse incorporate to promote safety? Select all that apply.

*Cover electrical outlets in the room. *Inspect toys brought from home for loose pieces. *Keep crib sides up when the child is playing in the crib.

A child has been admitted to the pediatric intensive care unit (PICU). The parents are extremely anxious. What action(s) can the nurse take to help the parents understand their child's care and reduce their anxiety? Select all that apply.

*Describe what the child will look like before parents visit. *Explain all technical terms in ways parents can understand. *Provide support services, such as a chaplain, to help the family cope. *Allow for visitation at any time.

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?

Explain all procedures using medical terminology.

When preparing to apply a restraint to a child, what would be most important for the nurse to do?

Explain that safety, not punishment, is the reason for the restraint.

The LPN enters a 3-year-old client's room and states it is time to go to the treatment room for their daily intramuscular ceftriaxone injection. The parent responds, "It has been a long day. Can we just do it in here?" Which action by the nurse is appropriate?

Explain why it is necessary to take the client to the treatment room.

The nurse is caring for a hospitalized adolescent. What intervention can the nurse use to promote a sense of control for the adolescent?

Give the adolescent a meal card to select food choice options for each meal.

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?

Go slowly with the acquaintance process.

Visitors arrive at the nurse's station with latex balloons for a pediatric client. The visitors ask the nurse for a client's room location. Which action by the nurse is priority?

Inform the visitors latex balloons are not allowed on the unit.

In caring for pediatric clients, which statement best describes when the will nurse follow standard precautions to provide care for a client?

when providing care to any client

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

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

The caregiver of an 8-month-old child in the pediatric intensive care unit (PICU) states a strong desire to hold the child. The caregiver states, "I know I cannot hold my child due to the equipment and their condition, but I wish I could touch my child." Which action by the nurse is appropriate?

Encourage the caregiver to sit beside the child, caressing and stroking the child.

The caregiver of an 8-month-old child in the pediatric intensive care unit (PICU) states a strong desire to hold the child. The caregiver states, "I know I cannot hold my child due to the equipment and their condition, but I wish I could touch my child." Which action by the nurse is appropriate? You Selected:

Encourage the caregiver to sit beside the child, caressing and stroking the child.

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

Encourage the family and client to participate in a program to prepare for the hospitalization.

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?

He sits quietly and is uninterested in playing and eating.

A child is admitted with a highly contagious infection. Which nursing action is a priority?

Place the child on appropriate precautions for the diagnosis.