Chapter 29 Care of the Hospitalized Child

A 3-year-old client has been hospitalized for 1 week with her mother rooming-in; however, the mother has gone home to tend to other family responsibilities for a few days. After being inconsolable for the first 24 hours after the mother's departure, the nurse notes the child is now lying quietly in bed sucking her thumb. Which response should the nurse prioritize in this situation?

"Are you feeling sad? Your mom didn't want to leave, but she will be back after two more breakfasts."

The mother of a 4-year-old returns to the hospital after being away for 3 days. She is anxious and excited to be back; however, the toddler turns his back to herand scoots away as she attempts to pick him up. Which response should the nurse prioritize in this situation?

"His distrust is normal and may have lingering effects, but you should touch and soothe him as much as possible."

In a preadmission visit, a 9-year-old girl says she is afraid her tonsillectomy will hurt too much. Which statement by the nurse would be best to help the child feel more comfortable and less afraid?

"I understand that you're worried. It will hurt for only a few days; we'll give you something to help stop the pain when you need it."

A few days after discharge, the parent of an 8-year-old calls the pediatric clinic, expressing concern about the child's behavior now that she is home. The child has been treating her siblings badly and using inappropriate language. Which suggestion should the nurse prioritize to this caregiver as an appropriate way tohandle this situation?

"Respond to her behavior in a firm, loving, consistent way."

The nurse is meeting with a group of families to assist them in dealing with the hospitalization of their child. Which comment by a family member should alert the nurse to assist the family in coping with the situation?

"Sometimes I wonder if the reason she is sick is because I have so many responsibilities at work and at home."

What actions can a pediatric hospital staff take to lessen the stress of hospitalization for a child? Select all that apply.

Allow children to wear their own clothing. Perform any treatments in the procedure room. Involve Child Life in teaching about upcoming surgeries.

The grandmother of a 1-year-old with cancer comes to visit the child in the PICU. She sits close to the bed but doesn't touch the child. Which action by the nurse would be most appropriate?

Encourage the grandmother to rock the child in a rocking chair.

The nurse has been assigned to care for a child who is on transmission-based precautions. This nurse has not cared for this child before. Which action would be the best way to help the child feel comfortable with the nurse?

Let the child see the nurse's face before the mask is put on.

The nurse is caring for an adolescent just transferred from PACU to the inpatient unit. As the nurse helps the child settle into the unit, which nursing intervention should the nurse prioritize?

Monitor for any change in vital signs.

A 10-year-old boy who had an appendectomy had expressed worry that following the procedure he would have lots of pain. Two days after the procedure the child is claiming he is having no pain. Which nursing intervention should the nurse prioritize when assessing this child?

Observe him for physical signs which might indicate pain.

A team of nurses has been chosen to devise a program to help educate children and their families about the hospital and being hospitalized. Which activity should the nurses plan to best achieve this goal?

Plan an open house and invite the families of the community to come tour the hospital.

The nurse is preparing discharge teaching for a child and the caregivers after a week of hospitalization. Which activity should the nurse prioritize in this plan?

Plan to review information and procedures with the family caregivers before discharge.

The nurse must follow certain precautions in order to protect everyone from the spread of disease. Which action will the nurse prioritize when utilizing transmission-based precautions?

Precautions are followed if a client has a disease that can be easily spread.

The pediatric unit in the hospital is designed to make the child feel comfortable and secure. Which action will best accomplish this goal?

Procedures and treatments are done in a room other than the child's hospital room.

The nurse is caring for a 14-year-old child who is scheduled to have surgery the next day. What would be the most appropriate intervention for the nurse to implement to help prepare this child for surgery?

Show the child models of the body that include the organs or parts of the body the child will be having surgery on.

The nurse working in the pediatric unit of the hospital is always monitoring for safety issues on the unit. The nurse determines the greatest concern related to safety of the hospitalized child is related to which situation?

Taking a child in and out of bed, doing frequent checks and procedures, and caregivers sitting at the side of the bed all bring on an opportunity for the side rails to be left down.

The nurse is reviewing a client's chart and notes that the child is in droplet precautions for pneumonia. What protection would she need to take in caring forthe child?

gown, gloves, and mask

The nurse is doing the preoperative preparation for a 6-year-old who is having surgery. What is most important for the nurse to document in the child's preop chart?

the number of loose teeth the child has and which teeth are missing

The nurse is working with a child-life specialist to assist a young preadolescent who is preparing for treatment for cancer. Which technique will the nurse and specialist prioritize to assist this child in better understanding what will be happening in the treatment of the cancer?

therapeutic play

The nurse is preparing a presentation depicting the various ways pathogens are spread around. The nurse will illustrate that pathogens passed around via insects is referred to as which mechanism?

vector

The nursing instructor is discussing the various modes of transmission for pathogens. The instructor determines the session is successful when the students correctly point out that microorganisms transmitted by food, water, or blood are spread via which mechanism?

vehicle

The nurse administering the preoperative medications to the child going to surgery would anticipate which of the following related to giving preoperative medications?

A sedative to be given one-and-a-half to two hours before surgery and an analgesic-atropine mixture given just before the child leaves for the operating room.

The nurse is preparing a child for surgery and is demonstrating and evaluating the child for using a patient-controlled analgesia device after surgery. The nurse would determine which client would be most appropriate to use this device?

a 7-year-old who has told the nurse about using the control button

The nurse is providing care for a 4-year-old being treated in the emergency department. Which intervention demonstrates a nurse's understanding of the basic principle of emergency care when addressing the child's need for a sense of security?

The nurse conducts the assessment while gently reassuring both the child and the parents.

The nurse is caring for a child who is recovering from a surgical procedure. The nurse will contact the primary care provider if anuria is noted within which time frame?

within the first 6 hours following surgery

A 5-year-old boy is brought to the emergency room with a possible broken arm. His 18-year-old sister, who is also his primary caregiver, has come with him. The boy is relatively calm, but his sister is so upset she is nearly hysterical. The nurse notes that as her behaviors show more anxiety, the boy is getting more upset and his anxiety is also increasing. What initial action would be best for the nurse to take in this situation?

While attending to the child, reassure the sister and suggest interventions she can help with.

The nurse at a pediatric clinic is preparing a 5-year-old child for admission to the hospital for surgery. Which response should the nurse prioritize when asked by the child what happens at the hospital?

"Some people go here to have babies, or when they're sick or hurt, so they can try to get better."