Family Dynamics

Which interventions does the nurse implement to empower a family who has a child with Down syndrome?

1.Help the family recognize the possible stressors. 2.Encourage the use of problem-solving strategies. 3.Refer the family to support groups and Internet resources The nurse understands that the family experiences multiple stressors, and helps the family recognize those stressors. The nurse encourages the family to use effective problem-solving skills that convey support and care, and have a calming influence on the child. The nurse also identifies proper support groups for the family to relieve stress

A health care provider recently diagnosed attention deficit-hyperactivity disorder (ADHD) in a pediatric client. When working with the family of this child, what should the nurse initially assess about the parents?

Attitudes about the diagnosis The parents' attitudes about the diagnosis are the priority because they will influence the direction of the plan of care and indicate whether they are ready to learn and participate in the plan of care

An only child who lives with the mother begins demonstrating school and emotional problems after the parents' breakup. It is decided that the child might benefit from family therapy. The nurse informs the mother that the first session will include the:

Mother and child The mother and child is the family constellation as it is now constructed; without prior discussion and permission, an invitation to anyone else constitutes an intrusion of privacy

The parents of a critically ill 7-year-old child constantly blame each other for their child's illness. What parental response suggests that the nurse's intervention has been successful?

The parents make an appointment with a family counselor. The parents need the assistance of a professional in exploring their feelings and their family relationships

A client admitted for substance abuse detoxification is displaying severe anger toward his spouse. In light of this information, the nurse manager determines that the situation was handled:

Inappropriately, because the nurse failed to effectively address the client's threat of physical harm to his wife Such behavior requires notification of the appropriate individuals of any viable threat.

A client at 8 weeks' gestation tells the nurse that she has not felt like making love with her husband since becoming pregnant and that she is concerned that her husband does not understand. What is the most appropriate response by the nurse?

A decrease in libido is common during the first trimester of pregnancy." Often the pregnant woman experiences a decrease in sexual desire during the first trimester, probably as a result of nausea and vomiting; if couples are informed about this, they are less likely to become distressed

What is the primary reason that the nurse encourages the family of an alcoholic to become involved in the treatment program?

Alcoholism involves the entire family. Research indicates that alcoholism is a family disease, with its roots in the family of origin.

The nurse is caring for a client who has a newborn with a neurological impairment. What is the most important nursing action?

Assisting the client with the grieving process Grieving is expected and necessary whenever a newborn is born less than healthy

An infant with a myelomeningocele is scheduled for surgery to close the defect. Which nursing action best facilitates the parent-child relationship in the preoperative period?

Encouraging the parents to stroke their infant Because the infant cannot be held, tactile stimulation helps meet the infant's needs and fosters bonding with the parents

A nurse who suspects that a newly admitted infant is the victim of child abuse assesses the parents' interaction with their baby. What parental behaviors might support the diagnosis of child abuse? Select all that apply.

Exhibiting difficulty in showing concern for their child Procrastinating in obtaining treatment for their child's injuries Abusive parents seek gratification of their own needs rather than of their child's needs; they may even project blame for the abuse on their child and find it difficult to conceal their hostility. Abusive parents often delay obtaining help for their child's injuries; the behavior is precipitated by a concern to conceal the injury and a lack of concern for the child. Abusive parents typically have an ill-developed nurturing role and little perception of their parenting inability.

What is the nursing action that best promotes parent-infant attachment behavior?

Keeping the new family together immediately after birth A sensitive period occurs during the first few hours of life that is important in the promotion of parent-infant attachment, although for some parents it may take longer to develop attachment behaviors.

A client with mild preeclampsia is told that she must remain on bedrest at home. The client starts to cry and tells the nurse that she has two small children at home who need her. How should the nurse respond?

Let's explore your available current support and opportunities for child care." Asking the client how she plans to manage with getting child care help addresses the problem directly while providing an opportunity for the client to examine her options

A couple arrives at the newborn nursery asking to take their newborn grandson to his mother's room. What is the best response by the nurse?

Please go on to see your daughter. I'll bring the baby to her room." Telling the couple that the baby will be brought to the client's room maintains the nurse's legal responsibility of providing for the infant's safety while still promoting a positive interaction with the client's family

The factor that is most significant for the nurse working with the family of an infant born with a genetic disorder is their:

Readiness to talk about problems their infant may have in the future When the parents verbalize recognition that their infant may have current or future problems, it usually signifies that they are beginning to face reality. Facing the reality of the situation is necessary before they will be able to provide physical care for the infant.

A nurse is interviewing a mother accused of physical child abuse. When speaking with this mother, the nurse expects her to

Reveal the belief that her child needed to be disciplined An abusive parent often indicates that he or she was trying to improve the child's behavior with physical consequences for behavior the parent considered unacceptable

At 9 pm visiting hours are officially over, but the sister of a newly admitted postpartum client remains at the bedside. What is the most appropriate nursing intervention?

Encouraging the sister to participate in care as much as the client wishes Family-centered care is focused on the whole family, including relatives; visiting hours in the birthing unit are flexible.

A pregnant client whose first child has Down syndrome is about to undergo amniocentesis. The client tells the nurse that she does not know what she will do if this fetus has the same diagnosis. The client asks the nurse, "Do you think abortion is the same as killing?" How should the nurse respond?

I really can't answer that question. Are you ambivalent about abortion?" The nurse's statement acknowledges that she is unable to answer the question; however, it is open-ended, allowing the client to communicate and reflect more on her own belief system.

A nurse is concerned when an 11-month-old infant is brought to the pediatric clinic weighing 9 lb 3 oz. The nurse suspects that the infant is suffering from physical and emotional neglect. What observations lead the nurse to suspect maltreatment? Select all that apply.

Inappropriate clothing Social unresponsiveness Frequent rocking motions Stranger anxiety begins around 5 to 6 months, when infants become responsive to the caregivers who have met both physical and emotional needs. When strangers speak to them or reach out to hold them they seem fearful, cling to the caregiver, and cry

A nurse is supportive of a child receiving long-term rehabilitation in the home rather than in a health care facility. Why is living with the family so important to a child's emotional development?

It is where child's identity and roles are learned Socialization, values, and role definition are learned within the family and help develop a sense of self. Once established in the family, the child can move more easily into society.

A nurse is concerned about a client's mother-infant bonding when on the first postpartum day she is reluctant to

Look at her newborn's face Looking at the face or seeking eye-to-eye contact with the infant is an early sign of the start of bonding with the infant

A client with a terminal illness reaches the stage of acceptance. How can the nurse best help the client during this stage?

Stay nearby without initiating conversation. The nurse's presence communicates concern and provides an opportunity for the client to initiate communication; silence is an effective interpersonal technique that permits the client to direct the content and extent of verbalizations without the nurse imposing on the client's privacy

During a well-baby visit, the parents complain that their 2-year-old daughter soils herself because she is lazy. The parents plan to make her wear her soiled clothing to teach her a lesson. The nurse is concerned about the potential for child neglect and abuse. Which nursing intervention will be most therapeutic at this time?

Teaching the parents developmental milestones in relation to acceptable discipline methods The parents' expectation of accident-free toilet training by age 2 is developmentally unrealistic, and their methods of discipline may cause harm

An older adult with peripheral vascular disease has stopped smoking, and the client's children want to make the home environment safe. What should the home health care nurse emphasize when providing instructions?

Use measures that can prevent thermal injuries The ability to perceive extremes in temperature is limited in the presence of peripheral vascular disease. Prevention of thermal injury through avoidance of hot and cold (e.g., hot water, heating pads, ice packs) is advised.

A nurse is in the process of discharging a 9-year-old boy with recently diagnosed type 1 diabetes. What parental statement indicates an issue regarding family dynamics?

We know that our child is special, so we'll go easy on the discipline." Children with diabetes should be treated like other children; they need discipline and should have limits set for their behavior