Chapter 2: Family-Centered and Community-Based Maternal and Pediatric Nursing

Home care is most successful when:

each member of the family can share the household tasks of the patient

The nurse uses family-centered care to care for children in a pediatric office. Upon what concept is family-centered care based?

he family is the constant in the child's life and the primary source of strength.

A nurse is working at a community women's health clinic. The nurse is involved in primary prevention activities. Which activity would the nurse be performing?

immunizations

A pregnant client is being discharged. The nurse is educating the client about the advantages of continuing her treatment at home. Which advantages would the nurse include? Select all that apply.

increased individual teaching increased self-care lifestyle assessments

A family of a mother, father, and a 6-year-old boy was recently enlarged to include a new baby sister. What type of family does this represent?

nuclear

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

A nurse is caring for a client who has frequent visitors. The client informs the nurse that he belongs to a communal family. Which is the most likely characteristic of a communal family?

several people living together and sharing work

A nurse working in a busy urban family clinic has noted a high percentage of single mothers. What should the nurses in this clinic be prepared to offer these single mothers?

support when a problem related to childrearing occurs

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

A nurse working in the community is involved in providing primary prevention. Which intervention would be most appropriate to implement?

teaching parents of toddlers about ways to prevent poisoning

The nurse is visiting a family with a toddler and school-age child. Which teaching should the nurse provide to the parents that would be appropriate for both children?

Actions to ensure safety

The home care nurse is teaching home health assistants about home visit safety. Which statement by the home health assistant would require intervention by the nurse?

"I have become a member of the family, so I eat meals with them sometimes."

A mother has come to meet with local school officials regarding admission of her child with spina bifida. The child requires catheterizations several times a day and the mother is requesting information on admission of the child for school and what accommodations can be made for the child's health care needs. What is the best response to the mother?

"Your child may be mainstreamed into a regular classroom and assisted with catheterizations by the school nurse."

The case manager is looking over the inpatient census on the floor to determine which client would be the best candidate for discharge with home health care follow-up. Which client would the case manager recommend to the practitioner for discharge?

10-year-old boy with an infected laceration on his leg who has been treated with IV antibiotics for 3 days. Explanation:

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.

A young child has been brought to the emergency department (ED) groaning and crying with pain located, "in their tummy." The parent states the child did not want to eat supper and was lethargic all evening. When the parent went to pick the child up at bedtime, the child was, "burning up with a fever" and reporting nausea. On admission, WBCs are elevated. The child also guards the abdomen when it is palpated and cries when hands are removed from the abdomen (rebound tenderness). The nurse begins paperwork for potential emergency surgery. Knowing this is a single-parent family due to divorce, which precautions should the nurse implement?

Ask to clarify which parent has the legal, custodial rights to consent for procedures.

Advocacy for the client is an important aspect of community-based nursing. What is one way a nurse can advocate for a pediatric client?

Assist the family to apply for Medicaid or other forms of health care reimbursement.

The nurse is preparing to obtain a health history from a client with preeclampsia who is at home. In which area should the nurse conduct the assessment?

Bedroom, where it is quiet and private

The nurse interviews a family that consists of a husband and wife. Both have been married previously and are living with two children. The children are the biological children of the mother and were born before the remarriage. The nurse would document this family structure as which of the following?

Blended family

Families today tend to spend less time together than families did historically. What is one factor that could be used to explain this trend?

Children participate in many school activities

A 13-year-old client who is newly diagnosed with type 1 diabetes is being discharged home with home care follow-up. What is the most appropriate goal for the nurse to select related to the nursing diagnosis of Health-Seeking Behaviors related to Skills Needed to Continue Home Care?

Client will self-administer insulin injections using appropriate technique.

A home care nurse is visiting a pregnant client from the Arab culture. During the health history the husband frequently answers questions for the client. How should the nurse respond?

Continue with the health history.

The nurse is assessing the needs of a family with a young child recently diagnosed with muscular dystrophy. The nurse determines case management should be a priority for this family as it will best prioritize which overall goal?

Coordinate the activities to deal with the complex health care system

The nurse is caring for a 4-year-old boy with Ewing sarcoma who is scheduled for a computed axial tomography (CAT) scan tomorrow. Which is the best example of therapeutic communication?

Describing what it is like to get a CAT scan using words he understands

The nurse is assessing a family in which the parents are going through a divorce. There are three siblings in the family: a 4-year-old girl, a 10-year-old boy, and a 15-year-old girl. Which of the following is an important framework for the nurse to use when assessing the response of each child to the divorce?

Developmental stages

A nurse is teaching a new mother about self-care measures. Which action would the nurse do as the final step in this process?

Document the teaching and effectiveness.

A 4-year-old adopted child has begun to ask questions about when she was born. Which suggestions by the clinic nurse would be considered the most appropriate answer for this child related to her birth? Select all that apply.

Explain to the child that she grew inside another woman, but after the birth she was given to her adoptive mom and dad to raise. Avoid criticizing the biological parents but reinforce how much the adoptive mom and dad love them.

The functions of the family are important in preserving our society with its beliefs, norms, and values. There are five major functions of the family unit; what is one of them?

Giving and teaching emotional support

A nurse is providing care for a child diagnosed with beta-thalassemia who is receiving a blood transfusion. The child reports being bored and asks to go to the playroom. What is the best action for the nurse to take?

Have a child-life specialist find an appropriate activity to occupy the child during the transfusion.

An extended family is experiencing a crisis. Excessive work demands have caused the primary parents to work longer hours, but the grandmother who usually watches the children after school is recovering from hip replacement surgery. What can the nurse suggest to help this family through this period of time?

Identify another extended family member to assist while the grandmother recovers.

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.

The biggest benefit of health care provided in the home is:

Inclusion of the entire family in health care planning and provision

Which information is true of home care as a whole?

It is increasing because new technology makes so many procedures available in the home.

The home health nurse enters the gated front yard of the client. A large aggressive dog appears on the front porch. What is the most appropriate action by the nurse?

Leave the yard and return to the car.

The nurse determines that a small nuclear family has achieved the family task of division of labor. What did the nurse assess in this family to come to this conclusion?

Mother cares for children while father works outside of the home.

The nursing instructor is teaching a session on the increase of health care costs associated with the advancement of modern technology. The instructor determines the session is successful when the students correctly choose which focus of community-based health care that has been implemented to combat the increased cost?

Preventing disease and its sequelae

A nurse is providing care for a child hospitalized with a diagnosis of aplastic anemia. In planning the child's care, which intervention(s) will assist the child in adapting to being hospitalized? Select all that apply.

Provide opportunities for the parents to participate in the child's care. Encourage the parents to bring personal items to make the child feel more at home. Make the child's room off limits to invasive procedures.

The camp nurse is reviewing the health information of the participants at a school-age summer camp for children with diabetes. What topic would be most appropriate for this group of campers?

Self-administration of insulin

The nurse instructs a client who is at 28 weeks' gestation on the correct use of the fetal heart monitor at home. Which observation indicates that teaching has been effective?

The client has a log with the date, time, and number of fetal heart beats counted.

During a home care visit, the nurse learns that a pregnant adolescent is concerned about being lonely at home. What should the nurse suggest to help with this problem?

The family could have dinner together in the same room.

The nurse is caring for several clients in the prenatal clinic. Which action by the nurse demonstrates cultural competency?

The nurse asks each client about dietary restrictions and preferences during the postpartum period.

A pregnant woman reports she does not see the value in attending prepared childbirth classes because she plans to have an epidural to manage the discomfort from the contractions. What information should be included in responses by the nurse? Select all that apply.

There are many different topics included in prepared childbirth classes aside from pain management." "Preparation for labor and birth can enhance your experience and coping abilities." "You can learn tools to assist you in the labor process both before and after your epidural."

One type of medicine a patient on home care receives could be given with any of the following schedules. Which of the following would be most effective in helping compliance?

Three times a day at 10 am, 2 pm, and 10 pm

The pediatric nurse caring for abused children knows that foster care, also known as home care, is a child welfare service in which children are placed in homes away from their parents in an effort to ensure their emotional and physical well-being.

True

A community health nurse is actively involved in various community projects. The nurse is providing a secondary prevention activity by organizing which event?

a skin cancer screening fair

A couple with infertility has decided to adopt an infant and receive a call several months later that an infant is available. The social worker gives them the history of the biological mom, a teenager who tried to conceal her pregnancy by dieting and taking laxatives. However, at 26 weeks' gestation, the teenager shared her pregnancy with the family and received prenatal care. Given this history, the couple should be counseled to observe the infant for which possible abnormality?

abnormal neurologic development

During assessment for a child with cystic fibrosis who is new to the practice, the nurse notes that the father keeps asking about costs and if there is a "cheaper" way of providing the care that the child needs without compromising health. For example, instead of buying prepackaged normal saline for breathing treatments, he asks if they can boil water (and containers with lids) and add the salt to the water in proper portions. When documenting this assessment, the nurse would identify the father as playing which role in the family based on the aforementioned questions?

allocation of resources

The nurse is concluding her initial visit with a client at 28 weeks' gestation on bedrest for premature rupture of membranes. What information should the nurse consider when determining the timing of the next home visit?

amount of supervision and health education needed by the client

The nurse is providing home care for a 6-year-old girl with multiple medical challenges. Which activity would be considered the tertiary level of prevention?

arranging for a physical therapy session

A community-based nurse has a different set of skills than those of counterparts who work in a hospital. Community-based nurses also face unique issues and challenges. What is one of the unique aspects of community-based nursing?

autonomous action

A couple has recently been divorced. The couple has joint custody of their 15-year-old daughter. The nurse recognizes that the daughter is now at a 50% greater risk for:

beginning smoking or drinking alcohol.