PrepU Atraumatic care of children and families

The nurse is teaching injection techniques to a school-aged child newly diagnosed with type 1 diabetes. Which observation would be the best evaluation that learning was successful?

The child needs occasional cueing during return demonstration of the injection technique.

The nurse is caring for a young pregnant couple who are members of an extended family. The nurse anticipates the greatest challenge for this family will involve which factor?

limited amount of available resources

The nurse is having trouble communicating with a hospitalized child. Which communication technique would be the most beneficial for the nurse to offer the child?

drawing pictures

An adolescent who plays catcher on the baseball team begins shouting at the nurses, slams the doors, and refuses to talk to anyone after being given the news that his right arm will require surgery. Which response by the nurse would be the most appropriate in this situation?

"I understand you are angry, but please don't shout or slam doors."

The nurse notes a 2-year-old toddler with pneumonia is breathing shallow. Which method is best for the nurse to use to teach the toddler how to perform deep breathing exercises?

Allow the toddler to blow bubbles in the room

A child is hospitalized with complications related to hemophilia. The health care provider has discussed the child's plan of care with the parents, but they continue to ask questions. What action will the nurse take?

Answer the parents' questions as completely as possible.

The parents of a 2-month-old infant have learned that their infant has hemophilia. The parents are visibly upset and ask how this could have happened to them. What is the nurse's best response?

"News like this is difficult to hear. Let's talk about what this means for your child."

The nurse is educating a 4-year-old child about what to expect during an upcoming procedure. Which statement(s) is appropriate for the nurse to use? Select all that apply.

"This little tube will go in your nose and down into your belly." "When they come to get you, you will get on a special rolling bed." "They are going to give you some special medicine to help the doctor see what is happening inside your belly."

The child with cancer spends time watching TV and talking very little about a new chemotherapy regimen that is to start next week. What is the best statement the nurse could use to help the child discuss feelings about the new treatment?

"You haven't said anything about your feelings toward the new treatment plan."

The nurse is explaining a diagnostic procedure to a 7-year-old girl before the procedure begins. Which statement by the nurse best utilizes the principles of atraumatic care?

"You will lie on a special bed that moves in the machine but you can still see out."

The nurse is explaining a discharge plan to the parents of an infant being discharged from the hospital. Which characteristic regarding adult learning should the nurse incorporate into her plan?

Adults are problem-focused.

When teaching an adolescent about home care after hospitalization, what is most important for the nurse to do?

Allow opportunity for the adolescent to express feelings.

The nurse is educating a 15-year-old girl with Graves' disease and her family about the disease and its treatment. Which method of evaluating learning is least effective?

Asking closed-ended questions for specific facts.

A parent brings a toddler to the clinic for treatment of a possible ear infection. How will the nurse communicate effectively with this child?

Approach the toddler while the toddler is being held by the parent.

The nurse is caring for a child who appears fearful and is reluctant to talk. The nurse uses therapeutic communication skills to interact with the child. What initial goal does the nurse accomplish when using these skills to communicate with the child?

Assess the perception of the problem.

A nurse manager on a pediatric unit is making assignments for the day. The nurse's goals are atraumatic care for pediatric clients and minimizing parent-child separation. What method of care delivery should the nurse implement?

Assign a core primary nurse.

The nurse is caring for a parent of a 10-month-old infant. The parent is upset and states, "I have so many questions, but the doctor seems too busy to answer my questions." What is the best action by the nurse?

Assist the parent in preparing a list of questions for the health care provider's next visit.

A 6-year-old reports pain in the stomach upon eating. The nurse replies, "Let me see if I have this right. Every time you eat anything, you get a pain in your tummy?" The nurse is using which technique of therapeutic communication?

Clarifying

A family is anxious for information about the status of their ill infant. The parents do not understand the dominant language, but their 14-year-old child is competent in the language, both spoken and written. The health care provider is present, but an interpreter is unavailable. What should the nurse do?

Coordinate health care provider and interpreter schedules and arrange an information-sharing session for later in the day.

The nurse is preparing to teach a 9-year-old child how to do active range-of-motion exercises. Which technique would be most appropriate to use?

Demonstrate the technique by performing it the same way each time.

The nurse is talking with a school-age client scheduled for an appendectomy in the morning. The client tells the nurse, "I do not know what to expect and it is kind of scary." Which action(s) by the nurse is appropriate? Select all that apply.

Detail what the client should expect. Answer any questions the client may present. Document the client's fear of the procedure. Maintain eye contact while the client talks.

A mother of a 9-year-old child newly diagnosed with diabetes is struggling to comes to terms with all the blood monitoring and medications the child will need to maintain a normal quality of life. The mother works full-time and is the primary wage earner for the family. Which interventions suggested by the nurse can possibly help this family? Select all that apply.

Explore how other family members can help with a portion of the responsibility for medication administration. Suggest that a nearby grandparent help with healthy meal preparation while the mother is at work. Provide education for the child in regards to testing blood glucose levels.

A 7-year-old child with sickle cell anemia who comes to the hospital frequently appears withdrawn and depressed. The client refuses to talk to anyone or even admit to feeling sad. What would be the best thing for the nurse to do that might help the child deal with his or her feelings?

Get the client to draw a picture.

The nurse is caring for a hospitalized pediatric client. Which intervention will the nurse include to encourage family-centered care?

Have a team meeting with the client, family, and involved health care providers.

The nurse is preparing to reduce a young parent's anxiety about a child needing hospitalization. Which action should the nurse prioritize?

Include the parent in the medical decision-making.

A family with a 13-year-old child who has cystic fibrosis is having a stressful time since the father is currently unemployed while the mother works full-time. The ill child has been acting out at school. He is "sick of taking medications and doing chest expansion exercises" and "just wants to be like all the other kids." There are two stepbrothers living in the home creating problems of their own. At the moment, the ill child has a respiratory rate of 32 breaths/minute and has a productive cough with bilateral rales in both lung bases. The nurse assessing this family will document which priority NANDA related to the current family dynamics?

Interrupted family processes

The expected outcome of teaching a school-age child about bike safety is that the child will wear a helmet 100% of the time when riding a bike. How best can the nurse assure that this outcome is achieved?

Involve the family in the planning.

A 9-year-old child with rheumatoid arthritis has difficulty moving the hands as well as other joints due to pain. The child refuses to participate in the prescribed physical therapy. What would be the best way for the nurse to make sure the child continues to exercise the joints?

Play a game like "Simon Says" to introduce exercises.

When planning to teach a toddler about coughing and deep breathing, which would be most effective?

Playing a game with coughing and breathing

The nurse is teaching the parents of a newborn with a metabolic problem about the disorder and its treatment. What is the least effective teaching technique?

Provide literature for the parents to read and then have them ask questions.

A nursing instructor is teaching a class about the basic functions of families. The instructor determines the class is successful when the students correctly choose which statement as a basic function of the family?

Reproduction remains an important function of many families.

The nurse is teaching a child how to self-administer insulin. Place the steps in the order the nurse will complete them when teaching the child. Use each option once.

Show the child how to correctly perform the procedure Given time to practice and increase proficiency Have the child perform a return demonstration of the procedure Evaluate the child's performance of the procedure

A nurse is assigned to care for a 6-month-old infant hospitalized with diarrhea and dehydration. Because the infant does not have developed speech, what can the nurse do to communicate with the infant?

Sing to the infant.

The nurse is incorporating nonverbal communication with verbal communication when explaining the treatment plan for a child with type 1 diabetes. What should the nurse do to communicate effectively with this family?

Sit opposite the family and lean forward slightly.

A 15-year-old client with type 1 diabetes has been noncompliant with the dietary regimen. When educating the adolescent, what is the most important thing the nurse can do to allow the adolescent to be in control and involved in the decision-making process?

Speak directly to the adolescent and consider the client's input in the decisions about care and education.

The nurse is teaching a 6-year-old girl and parent about home care for an eye infection. Which communication techniques would be least effective with this child?

Standing beside the child when doing the teaching.

The child life nurse practitioner has been assigned to assist the hospitalized child and the child's parents. Which interventions are appropriate for the child life specialist to perform? Select all that apply.

Talking to the family about a scheduled diagnostic test. Showing the child where the pediatric playroom is located. Speaking to the physician as the child's advocate.

During the change of shift report, the nurse reports concerns about the parents of a hospitalized child understanding the written literature provided concerning the child's plan of treatment. Which observations would provide support to this concern? Select all that apply.

The child's mother provides little responses to information provided. The child's medical record contains information indicating the family frequently misses appointments. The child's mother asks the nurse to complete paperwork for her.

The nurse is assessing the learning needs for a 12-year-old boy with a chronic health condition, as well as his parents. Which aspect would be least pertinent to a learning needs assessment?

The family belongs to a mainline traditional faith community.

The child has been admitted to a pediatric unit in a hospital. Which nursing interventions use atraumatic care principles? Select all that apply.

applying a numbing cream prior to starting the child's intravenous line asking the child if he would like to take a bath before or after he takes his medication encouraging the family to bring in the child's favorite stuffed animal from home showing the parent how to unfold the chair in the child's room into a bed

A nurse is caring for a small child with leukemia who will be hospitalized frequently for chemotherapy. What type of referral can the nurse make that will help the child and family through this time?

child life specialist

A nurse is preparing to teach an 8-year-old child recently diagnosed with diabetes how to give an insulin injection. Which is the best technique for the nurse to use?

demonstration

The nurse is preparing a 4-year-old to go visit an older sibling in the pediatric intensive care unit (PICU). What teaching method would best help in this child's preparation?

dolls

During a visit with a new family, the nurse assesses one of their children. The nurse asks about current immunization status and how often the child visits the family health care provider. The nurse also asks the child about experiences with activities outside the home. The nurse reviews the importance of safety like wearing helmets. Given this data, what age group of child would one anticipate this nurse is assessing?

school-age

The nurse is caring for a 7-year-old child scheduled for a tonsillectomy the next day. The client states, "I really wish I was not having surgery tomorrow. I am not excited about this. Maybe I will be better by tomorrow." Which response by the nurse is most appropriate?

"You sound worried. Let's talk about tomorrow."

A 10-year-old child with sickle-cell anemia is frequently in the pediatric center of a hospital. What intervention can the nurse provide that will allow the child the sense of control that meets the goals promotes atraumatic care?

Maintain the child's home routine related to activities of daily living.

The parent of an infant does not speak the dominant language. The parent's 8-year-old child speaks the dominant language, and the parent wants to communicate with the nurse through the child. How should the nurse best handle teaching the parent?

Obtain an interpreter.

The nurse is educating an 8-year-old client newly diagnosed with type 1 diabetes on how to administer insulin. Which finding best indicates the nurse's education was successful?

The child demonstrates good technique in self-injection of insulin.

The nurse is planning interventions to minimize the physical distress for a 9-year-old child receiving a dressing change in the hospital. Which action by the nurse is an example of using atraumatic care for this child?

The nurse schedules the dressing change to be performed at 3 PM in the treatment room.

Which is most likely to encourage parents to talk about their feelings related to the poor prognosis their child has been given?

using open-ended questions

The nurse is explaining the differences of language development in children. Which example would be appropriate for the nurse to include in the explanation?

Boys raised with older sisters are slower to develop language skills than their siblings.

The nurse has completed diabetic education regarding insulin administration to a 14-year-old child newly diagnosed with diabetes and his family. The nurses knows the teaching was effective if the client and family:

have demonstrated correct insulin administration over the past several days.

The father of a child hospitalized after a fire questions the use of therapeutic play. He reports he does not understand the purpose. What information can be provided to him?

This type of play gives the child an outlet to deal with stress.

A nurse is providing teaching on safety to a group of parents whose children are diagnosed with hemophilia. Which statement made by a parent requires follow-up by the nurse?

"Our child always wears a helmet and body padding when playing football."

A family with two biological children has decided to adopt two more children. After the adoption of two children from China, the biological children should be assessed for which potential response to their "new" siblings? Select all that apply.

feeling inferior to adopted children since they were just "born" and not "chosen" feeling superior to their adoptive siblings since they are the "real" children of the parents

The nurse is caring for a toddler who is scheduled for an outpatient lumbar puncture. Which action by the nurse would be appropriate?

having a child life specialist interact with the toddler before and during the procedure

An adolescent remarks rather sarcastically that she feels like a "lab rat." What is the priority nursing action?

Ensure information is shared and decisions about care are made with the teen and not for the teen.

A high school nurse has noticed a trend in the reading ability of the freshman class. This high school is located in a poor, urban area where there is a high proportion of single mothers raising their children with minimal financial support. Young children many times do not have adult supervision with homework. The local school nurses discuss issues within the school area. Which suggestion by a high school nurse would be a realistic solution to the problem described in this scenario?

Organize a group of local high school students to begin a reading program in the grade school to increase interest in reading.

The nurse is preparing to perform a dressing change on a 13-year-old client who is being treated for burns he received two weeks ago. The client prefers not to take pain medication before the dressing change because it causes drowsiness. What nursing interventions would provide atraumatic care? Select all that apply.

The nurse asks the client if he would like the television on during the dressing change. The nurse encourages the client to wear headphones to listen to music during the dressing change.

Following a principle of learning, the nurse can anticipate that school-age children will best learn a skill such as bandaging if they:

are allowed to practice it.

The nurse is educating the family of a 2-year-old boy with bronchiolitis about the disorder and its treatment. The family parents speak only Chinese. Which action, involving an interpreter, can jeopardize the family's trust?

asking the interpreter questions not meant for the family

The nurse is caring for a 14-year-old girl with terminal cancer and her family. Which intervention provides the best therapeutic communication?

informing the child in terms she can understand

A couple is arguing and bickering all the time. This couple has not told the children yet that they are planning to get a divorce. When the couple discusses this with the school nurse, the nurse shares that at this early phase, children likely experience what type of feelings?

take blame for their parents quarreling and try to behave better