NUR 236 PrepU Chapter 30: Atraumatic Care of Children and Families

A parent wants to wait outside the room while a procedure is completed on his young child, saying, "I don't think I can stand to see you do this!" The nurse's best response is:

"Certainly. I will stay with your child during the procedure."

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 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."

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."

A nurse is preparing discharge instructions to the parent of a child diagnosed with beta thalassemia. The child will need to take subcutaneous deferoxamine. As the nurse begins the instruction, the parent says "This is all so overwhelming. Can we do this another time?" How should the nurse respond?

Agree to come back later and discuss the parent's concerns.

A nurse is preparing to administer medication to a preschool-age child. What can the nurse do to ensure communication with the child is effective?

Allow the child to choose between juice, water, or soda to take the medication.

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 15-year-old client following an open reduction and internal fixation (ORIF) of the humerus after an injury and fracture. The client is wincing, diaphoretic, and staying very still in bed to avoid moving the injured arm. The nurse asks if the client has pain, and the client says "it is okay" (above). What should the nurse do for this client?

Assess the client's pain using a 0 to 10 scale.

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.

A nurse is talking with a 10-year-old child and parent about the current treatment plan for the child's asthma. The child stands behind the parent and does not ask questions or look at the nurse. What should the nurse consider the child's behavior could indicate?

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

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 teaching the caregivers of a child with cystic fibrosis. What is most important for the nurse to teach this family?

Encourage everyone in the family to use good handwashing techniques.

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.

A 13-year-old adolescent with leukemia expresses concern to the nurse over the numerous recent hospital admissions required. The adolescent states a feeling of powerlessness. Which action by the nurse is most appropriate?

Include the adolescent in discussions about health care decisions.

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 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 nurse is working with an interpreter to meet the health needs of a family with limited skills in the dominant language. Which action is not recommended?

Talking one-on-one with the interpreter at numerous points throughout the session with the family present.

The nurse is caring for a 3-year-old child who must have a lumbar puncture. Which action provides the greatest contribution toward atraumatic care?

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.

The nurse is caring for a 13-year-old client with ulcerative colitis who has a new temporary colostomy. Which nursing intervention is priority?

Teach the client how to perform colostomy care.

The registered nurse (RN) and licensed practical nurse (LPN) are caring for a hospitalized child. Which action by the LPN will cause the RN to intervene?

The LPN holds down the child while another nurse starts an IV.

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.

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 teaching needs of the parents of an 8-year-old boy with leukemia. Which assessment should the nurse explore as a potential issue with the parent's health literacy?

The parents missed the last scheduled appointment.

Which method of communication is appropriate for the nurse to use when caring for a 7-month-old infant?

Use a soothing and calming tone when speaking to the infant

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?

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A preschool child fell off a tricycle and broke an arm that will require surgical repair. The nurse wants to prepare the child for surgery. Which is the best technique the nurse could use to teach the child about what to expect?

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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

The nurse is planning a teaching session for a group of 12-year-old girls and has determined personal hygiene is a subject that would be of benefit to all. Which method of teaching would be most appropriate for this group?

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The nurse is caring for an 8-year-old client admitted to the hospital for an appendectomy. The client is an immigrant newly arrived in the country. How can the nurse determine the best foods to provide in the postoperative diet?

Ask the family and child about preferred foods.

The nurse is preparing to assess the pain of a postoperative 9-year-old client from a different culture. The charge nurse says, "Those people never admit to pain or take pain medications. You should just mix the medication in with their food." What should the nurse do?

Explain to the charge nurse that this is a stereotype and treatment without consent; then go and assess the client's pain.

The nurse is assessing the learning needs of the parents of 5-year-old girl who is scheduled for surgery. Which nonverbal cue should the nurse use to show interest in what the family members are saying?

Nod head while the mother speaks.