EAQ: Care of the Hospitalized Child

A 2-year-old child has just been admitted to the hospital with pneumonia. The child is crying and visibly upset. The nurse is beginning to perform the physical assessment when the mother asks, "Would it be better if I left the room?" What is the best response by the nurse?

"I can perform the assessment while you hug him on your lap."

Which question during the preadmission assessment by the nurse is most important to determine whether additional preparation is needed for the child's hospitalization?

"Is the child allergic to any medicine?"

A student nurse who is taking care of children in an intensive care unit (ICU) asks a registered nurse about the sleep patterns and care of those children. What would the registered nurse tell the student nurse? .

"We encourage parents to sit with and touch their child as often as possible." "We try to organize care into clusters so that the infants and children can sleep and we can turn down lights."

What behavior does the nurse expect when caring for a preschooler admitted to the hospital?

Cries quietly for the parents, Tolerates brief periods of separation Develops trust in adults

Which is the most appropriate nursing intervention to minimize separation anxiety in a hospitalized toddler?

Encourage the parents to room in.

What should the nurse working in an outpatient surgery center for children understand?

Families need to be prepared for what to expect after discharge.

Which nursing practice should the nurse follow to build trust with the family of a chronically ill child?

Include the family in the plan of care during hospitalization.

A child with a hearing impairment uses signs to communicate. Which activity would help the child to express feelings of fear that were previously suppressed?

Playing with syringes

During which phase of separation anxiety is a toddler most likely to cling to the parent?

Protest

A child with a serious chronic illness will soon be discharged home. The case manager requests that the family provide total care for the child for a couple of days while the child is still hospitalized. In light of the principles of family-centered care, which statement addresses this principle?

This is appropriate because it can be beneficial to the transition from hospital to home.

The parent of a 4-year-old patient who is being admitted asks the nurse why he or she is asking so many questions. Which explanations should the nurse offer? .

This will give you an opportunity to ask questions as well." "It is something we are required to do for every child who is hospitalized." "It will help us provide the best care by gaining more information about your child." "We can try to minimize some of the changes he will be going through by knowing your child's routines."

What is the most appropriate role for the family of a child who is hospitalized with complications of a chronic illness?

To provide total care for the child if desired

A nurse is preparing a child for a planned surgery. What measures does the nurse take to make the child comfortable and less fearful?

Use miniature versions of hospital items to explain what to expect. Use therapeutic play, in which the child can play with toy items. Emphasize any pleasurable events that the child may experience after the surgery.

A student nurse asks a registered nurse how children sleep in the ICU and not become frightened with all the lights and noises. How should the registered nurse respond?

We encourage parents to sit with their child as often as possible."

What is a common fear of hospitalized adolescents?

Altered body image

The nurse is caring for an 8-year-old child who has been hospitalized with a chronic illness. The child has a tracheostomy and a parent is rooming-in. The parent insists on providing almost all of the child's care and tells the nurses how to care for the child. When planning the child's care, the primary nurse should recognize that the parent is exhibiting which behavior?

Assuming the role of expert in care of the child

When caring for a toddler admitted to the hospital, what behavior does the nurse recognize as a sign of separation anxiety in the protest phase?

Attacking strangers verbally

A 4-year-old child is hospitalized for a chronic illness. Which behavior of the child suggests that the child is in the stage of despair because of separation anxiety?

Bed-wetting, Uncommunicative behavior, Lack of interest in the environment

A child with cerebral palsy is admitted to the hospital for corrective surgery. How should the nurse approach the subject of family participation in the child's care during hospitalization?

By discussing the parents' desire to participate in the care of the child

The nurse working in an outpatient surgery center for children should understand which concept?

Families need to be prepared for what to expect after discharge

A nurse is caring for a 6-year-old child recovering from surgery in an outpatient setting. What is the priority nursing intervention for this family at discharge?

Teaching parents when to notify the healthcare provider

A nurse is caring for a 10-year-old child who has been hospitalized due to illness. Which play activity should the nurse provide for the child to reduce separation anxiety?

Providing reading material

What change does the nurse teach the parents to expect in their child after prolonged hospitalization?

Regression in newly learned skills

What interventions by the nurse help the child and family to overcome fear and prepare for hospitalization?

Allow the family and child to express their concerns. Orient the child and family to the hospital and its routines Use puppet shows or videos to explain hospital processes

Which intervention uses a family-centered approach to help a 3-year-old child with disabilities adapt to hospitalization?

Allowing one or both parents to stay with the child

A 4-year-old child is scheduled for cardiac surgery in a week. The child's parents call the hospital to ask how to prepare the child for the upcoming hospitalization and surgical procedure. What is the nurse's best response?

Children who are prepared experience less fear and stress during hospitalization.

A nurse is caring for a child who has been hospitalized. Which is a negative action exhibited by the nurse with respect to family-centered care?

Competing with the parents for their child's affection

What are some environmental stressors for the child and family in the pediatric intensive care unit?

Constant lights, Unfamiliar sounds

The nurse is providing care to a school-age child in an ambulatory setting. What are the benefits of ambulatory care?

Minimized stressors compared to hospitalization No separation anxiety in the child Reduced chances of infection Increased cost savings

A nurse encourages a child to express feelings after a procedure. What activities are encouraged to assist in expression of feelings for children of various ages?

Dramatic play Therapeutic play Throwing activities Acceptable pounding activities

The nurse is caring for a 10-year-old child who has been hospitalized for a long period of time. What intervention by the nurse can help to minimize threats to the child's development and prevent regression?

Encourage the child to resume school work.

A 1-year-old chronically ill child has been hospitalized. What is the best nursing intervention to minimize separation anxiety?

Encourage the parents to hold their child for long periods of time

The nurse is preparing a 9-year-old child for a planned lipoma surgery. What are the roles of play activities in a planned surgery for an older child?

Help as a teaching method to achieve a therapeutic goal Encourage expression of feelings in a constructive way

A nurse finds that a 6-year-old child admitted to the hospital is showing signs of physical distress due to hospitalization. What clinical findings would have led the nurse to conclude this?

Immobilization

The nurse is providing care for a child transferred to an intensive care unit. What interventions does the nurse include in the child's plan of care?

Informs the parents that they can call the unit at any time Monitors the child's siblings' reactions during visits Asks visitors to avoid loud, abrupt noises or loud talking Explains the child's condition to the parents in simple terms

Which supportive interventions related to development are important during the hospitalization of children?

Involve parents in formulating care plans. Help preschoolers overcome their feelings of guilt. Allow adolescents to participate actively in decision making.

The nurse engages a child in play activities during the child's hospital stay. What benefits of play does the nurse expect in the child?

Makes the child feel more secure Encourages interaction Lessens the stress of separation Helps to develop positive attitudes

What intervention by the nurse helps to reduce separation anxiety in a child placed in isolation?

Move the bed to a window with open shades.

In a pediatric ward, the nurse is explaining to the parent about the various negative behaviors of younger children during the posthospital phase. About which negative behaviors should the nurse educate these parents?

Nightmares Temper tantrums Food peculiarities

What intervention by the nurse can help ease negative feelings and fear in a 5-year-old child being admitted to the hospital?

Preparing the child for the hospital experience

The nurse is preparing the family of a child for admission to an ambulatory setting for surgery. What actions does the nurse take?

Provides a tour of the facility Provides a review of the day's events Suggests items to bring to the facility Acquaints the child with the surroundings

The nurse is preparing a school-age child for hospitalization. What does the nurse include in the teaching?

Provides miniature hospital equipment for the child Describes the different aspects of hospital stay Answers any questions the child has about hospitalization ensures that the child pays attention to the information

What is the major stressor of hospitalization for children from middle infancy throughout the preschool years?

Separation anxiety

The primary nursing goal for the hospitalized child younger than 5 years is to prevent which concern?

Separation from parents

The nurse caring for a school-age child observes detachment behavior. What intervention by the nurse helps to overcome the stage of detachment or denial?

Talk to the child about the significance of the parents' visit.

The nurse is discharging a young child from the hospital. The nurse should instruct the parents to look for which post-hospital child behaviors?

Tendency to cling to parents Demands for parents' attention Resistance to go to bed

The nurse is providing care for a toddler in a hospital setting. The nurse observes that the parents are unable to visit the child often, and the child has become inactive, sad, and uncommunicative. What does the nurse conclude from the child's behavior?

The child is in the despair stage of separation anxiety.

A preschool child admitted to the hospital does not seem to be happy when the parents visit. The parents express their concern to the nurse. What is the best response by the nurse?

The child's behavior is a superficial adjustment to the separation

The nurse is providing care for a child with an injury that requires a brief hospital stay. Which nursing actions are most appropriate for building a good therapeutic relationship with the child and the family?

The nurse encourages family involvement in the caring process. The nurse learns about the religious beliefs of the child. The nurse assesses the family's feelings of anxiety or fear

What does the nurse teach the child and family about the distinctive features of ambulatory or outpatient care settings?

There is minimized separation from family.