Maternity and Pediatric Nursing Ch 32

on an ongoing basis

When caring for the child with a chronic condition, the nurse provides education to the parents

Degenerative disorders Accidents resulting in spinal injury Congenital anomalies

When documenting a chronic condition, which groups of illness would be considered? Select all that apply.

primary or case-management nursing

When planning for the care of the hospitalized child with a long-term illness, the best pattern to use for staffing of nurses would be:

realistic child goals

When the nurse is caring for a child with a chronic condition, which is most important when planning care?

when the child is admitted to the health care facility

When would be the best time for the nurse to begin planning for home care for the child with a chronic illness?

progresses slowly and shows little change

Which characteristic best describes a condition that is considered a chronic illness?

sexuality

Which educational topic is often overlooked when teaching an adolescent about living with a chronic condition?

shock at the news of the condition

Which initial response does the nurse anticipate receiving from parents of a client who is newly diagnosed with a chronic condition?

strong immune systems

Which of the following does the nurse recognize as the best predictor that the family of a child with chronic illness will meet their challenges?

being overprotective

Which parental action identified by the nurse potentially delays the ability of the child with a chronic condition to exhibit signs of appropriate growth and development?

nursing interventions/planning care

Which part of the nursing process is most altered when caring for a child with a chronic illness?

"I understand my child will grow up but needs to develop as much independence as possible."

Which statement made by the mother of an infant who is born with severe intellectual disability indicates an appropriate understanding of her infant's long-term needs?

the caregivers

Who does the nurse identify as the primary advocate for the child with a chronic condition?

By having a sibling with Down syndrome, a stigma is attached to him or her.

A 12-year-old sibling of a child with Down syndrome is overheard telling a friend from school on the telephone, "I don't have any brothers or sisters. I am an only child." What does this child feel about the sibling with Down syndrome?

denial

A 12-year-old with juvenile rheumatoid arthritis has pain and swelling of the hands. During a visit with the occupational therapist, the parent states, "I want her to become involved with volleyball at school. She won't participate in any sports like her sister." What caregiver response is the parent exhibiting?

"how did you feel about your daughter's behavior in the waiting room?"

A 5-year-old girl with sickle-cell disease has had a temper tantrum in the office waiting room, and the mother has dealt with it inadequately. How should the nurse address the parent's apparent lack of discipline when the pair is in the examination room?

Shock Disbelief Denial

A newborn is diagnosed with spina bifida. What initial reactions might the nurse expect to observe in the parents of the newborn? Select all that apply.

rejection

A nurse admits a 10-year-old with spina bifida who is confined to a wheelchair. When asking the parent and child questions, the parent appears disinterested and distant, allowing the child to answer all questions. What typical caregiver response is this parent displaying?

Find time for special activities with the healthy children. Explain the ill child's condition as simply as possible. Involve healthy siblings in the care of the ill child. Set behavioral limits for all children in the family.

A nurse informs parents of a chronically ill child that to help siblings cope, they should do which of the following? Select all that apply.

listening to the family express positive and negative feelings during the journey of the illness

A nurse is caring for a 3-year-old child with a chronic disease. Which of the following actions by the nurse will encourage therapeutic communication with the child's caregivers?

"Your child has the same socialization needs as other children who don't have an intellectual disability."

A nurse is interacting in conversation with the parents of an 8-year-old child with intellectual disability who wants to join a scout club at school. The parents explain that they are uncertain if this would be a good experience for their child. Which would be the best response by the nurse?

"What does your condition mean to you?"

A nurse is working with an older child who has a chronic condition. When assessing the impact of the condition on the child, which question would the nurse most likely ask first?

rejection

A nurse observes the mother of a child newly diagnosed with leukemia yelling at the patient for taking too long to brush his teeth, eat his breakfast, and even color a page in his new book. The nurse realizes that this is an example of which of the following?

Making adjustments in care by doing ongoing interviews

A nurse understands that it is important to help a family adjust to a child's chronic health condition. This is best done by doing which of the following?

The focus in pediatric patients is to attain new skills. The need for treatment may not be new. The family must simultaneously learn to care for the child.

A rehabilitation nurse who works with adult stroke patients has been offered a position to work with children in the same rehabilitation facility. What concepts must the nurse understand about pediatric rehabilitation that may be different than the rehabilitation for adults? Select all that apply.

Contributing to the teen's individualized education plan team

A school nurse is meeting with the family of a teen with a chronic mental illness. Which of the following interventions will best help to promote a positive learning environment for the teen?

respite care

A single parent of a child with leukemia tells the nurse that exhaustion has set in and she would love the opportunity to have a day to just visit with a friend and relax. For what type of care could the nurse make a referral?

denial

A woman has just been told that her 5-year-old has leukemia. She says, "How can this be?" The mother is exhibiting signs of which of the following?

use family to assist with care and spend time together as a couple

The nurse at a specialty clinic has developed a therapeutic relationship with the family of a child with a chronic condition. Which family suggestion would the nurse reinforce as helpful to maintaining the family structure?

identify the actual, perceived, or potential loss

The nurse has been caring for a 12-year-old girl who was diagnosed with type 1 diabetes one year earlier. The girl has managed the medical component of her condition fairly well but her mother says she is suffering emotionally. The girl says she "wishes she could have her old life back and be a healthy person again." Which of the following should the nurse do first?

accomplish growth and development milestones

When caring for a child with a chronic illness, a high priority goal that the nurse should establish for the patient is which of the following?

Have the child socialize with peers with and without disabilities.

When caring for an adolescent with a disability, it is best for the nurse to promote which of the following?

an integrated school with children who are not disabled

It is generally well accepted that children who are physically challenged or intellectually disabled do best in which school setting?

anger hostility helping to care for ill child jealousy protecting the ill child from negative reactions of others

Parents of a chronically ill child can expect siblings to react in which of the following ways? Select all that apply.

"your activity is not limited; what types of things would you like to do?"

The nurse has been caring for an 8-year-old girl with asthma. Her parents are compliant with her treatment regimen, and the girl has experienced no exacerbation of her symptoms in over 12 months. When the nurse inquires about her participation in sports or other extracurricular activities, the girl says that she can't participate because she is sick with asthma. Which response by the nurse would be most appropriate?

"Let's talk about whether your condition may affect your sexual relationships."

The nurse has cared for a family of two girls, ages 15 and 13, for many years. The older sister has short stature with associated incontinence and respiratory complications. The younger sister has recently begun her freshman year at the same high school and has a very active social life. The 15-year-old girl confides that she has no friends and that she fears she will never have a boyfriend. She whispers that she is afraid she will never get to experience sex because of her problems with incontinence. Which response by the nurse would be most effective?

The child needs to feel part of the world in which friends are involved

The nurse informs the parents of an 11-year-old hospitalized with an acute exacerbation of asthma that they should encourage visits and calls by peers. What rationale can the nurse provide for the parents?

exploring the girl's perception of her body image and health status

The nurse is caring for a 12-year-old girl with a chronic endocrine condition that has resulted in weight gain, facial hair, and acne. During a routine examination, the girl confides that she doesn't participate in any extracurricular activities or have any social life because she is so unattractive. She feels it is pointless to get involved with anything or anyone because she is always going to be "fat and ugly." When responding to the girl, which of the following would be the priority?

risk for caregiver role strain related to no other caregivers

The nurse is caring for a 3-year-old with an exacerbation of a chronic condition that was diagnosed at birth. The nurse assesses that the caregiver is a single parent and she appears frustrated and angry with the nursing staff. She states that she has other children at home that she had to get the neighbor to watch. What is an appropriate nursing diagnosis to include in the plan of care for this patient?

denial

The nurse is caring for a child who was born physically challenged because of an orthopedic condition. The feeling that parents often manifest first when told their child will have this condition permanently is:

set appropriate limits for both and hold them to those limits

The nurse is caring for a family who has twins and one twin has a chronic condition. The parent states that both children require discipline but are unsure which approach is best. Which nursing suggestion is most helpful?

a family discussion on stigma

The nurse is completing a psychosocial assessment on a child with a chronic condition. The child states that he is sad because his brother does not say "Hi" in school or offer to walk home together. As the nurse is developing a teaching plan for the family, which will be included?

a caregiver-selected activity or rest

The nurse is coordinating a camp for children with chronic conditions. The goals of the camp include providing a support group for the children and respite time for the caregivers. Which activity is encouraged for the caregivers?

the child will achieve the highest level of growth and development

The nurse is helping develop a plan of care for a 10-year-old child with a chronic illness. Which goal would be the priority for this child?

determining what opportunities are available

The nurse is planning care for the child with a chronic condition. To establish a realistic goal related to increasing child socialization, which information is most helpful?

"this must be hard for you

The nurse is talking to a 12 year old sibling of a child with a chronic condition in the waiting room at the pediatrician's office. The sibling states, "I hate coming here and waiting. It is such a long car ride. I just want to get home." Which nursing response is best?

The condition interferes with daily functioning

The nurse is working with a group of children who have chronic illnesses. Which of the following is most important for the nurse to keep in mind when working with these children?

The caregivers are hoping to find the diagnosis is incorrect.

The parents of a child who has just been diagnosed with a chronic illness state that they are "shocked" and "dismayed" at the diagnosis. They make the following statement to the nurse: "We have an appointment with another specialist closer to our home to have our child seen by that provider." Which of the following would most likely be a reason the caregivers might make a statement like this?

physical development psychological development cognitive development

The pediatric nurse is aware that chronic illness can affect which of the following for a child?

Small spaces where a wheelchair cannot fit An activity which is difficult for the client to do Allowing students to partner without including the client

The school nurse is observing a middle school child with a chronic condition participating in a group activity in school. As the child is moving his/her wheelchair to find a partner, which situation would the nurse note as encouraging social exclusion? Select all that apply.

picking a game that the other can play but the child cannot participate in

The school-aged child with a chronic health condition is interacting with a group of peers in the classroom during recess. Which scenario would the nurse classify as discrimination?

Increase their social interaction. Decrease feelings of grief, anger, and guilt. Increase adjustment to living with a chronically ill child.

What goals can the nurse help the parents of a child with cerebral palsy achieve? Select all that apply.

Condition lasting at least 6 months

when describing chronic conditions to a group of students, which of the following would the instructor include as a characteristic?