NUR 236 PrepU Chapter 33: Caring for Children in Diverse Settings
A nurse with no pediatric experience has been transferred to a pediatric unit to work for the day. Which comment by the nurse indicate knowledge of developmental considerations when providing hygiene needs to a 3-month-old infant?
"I plan on using a sponge bath to bathe the infant."
A nurse is educating the parents on how to help their 10-year-old daughter deal with an extended hospital stay due to surgery, followed by traction. Which response indicates a need for further teaching?
"I should not tell her how long she will be here."
The nurse is educating the parents of a 7-year-old boy scheduled for surgery to help prepare the child for hospitalization. Which statement by the parents indicates a need for further teaching?
"It is best to wait and let him bring up the surgery or any questions he has."
The nurse is providing education on hospitalizations to parents of children with chronic disorders. Which statement will the nurse include about the purpose of rooming-in on pediatric units?
"It is to provide the child security and stability while hospitalized."
The nurse is caring for a preschooler who requires postsurgical breathing exercises. Which approach will best elicit the child's cooperation?
"Let's see who can blow these cotton balls off the table first."
A new home health care nurse asks her preceptor for some hints to help establish a good relationship with her pediatric clients and their families. What is the best response by the preceptor?
"Make sure you find out things that the child is interested in. This will give you things to talk about."
The nurse is caring for an 11-year-old girl preparing to undergo a magnetic resonance imaging (MRI) scan. Which statement would best help prepare the girl for the test and decrease anxiety?
"The machine makes a very loud rattle; however, headphones will help."
A mother in the outpatient setting is explaining how she plans to prepare her 5-year-old for hospital admission. What remark indicates the parent requires additional teaching?
"We told him to use his manners and behave like a big, brave boy."
Which approach by the nurse best demonstrates the correct way to prepare a Hispanic child for a planned hospital admission?
Allow the child to put on surgical attire and "operate" on a doll to teach what will be happening.
A preschooler is admitted to the pediatric floor for dehydration and is frightened. Which nursing intervention would be least effective in alleviating the child's anxiety?
Explain all procedures using medical terminology.
A 6-year-old child will be hospitalized for a surgical procedure. How can the nurse best ease the stress of hospitalization for this child?
Prepare the child for hospitalization by explaining what to expect and showing him or her around the hospital.
The nurse is reviewing a job description of a school nurse. Which activity would the nurse question?
Provide immunizations to students.
A 6-year-old with leukemia is placed on reverse isolation. What nursing actions could prevent depression and loneliness in this client? Select all that apply.
Spend extra time to talk while in the room. Read a story while in the room. Play a game while in the room.
The nurse is preparing to discharge a 5-year-old child from the hospital who will require dressing changes to a wound at home. The parents have been taught the appropriate wound care measures during the stay in the hospital. Which action by the parents assures the nurse that learning occurred?
The parents have performed the wound care and dressing change with the nurse's supervision the last 2 days prior to discharge.
The nurse is caring for a 7-year-old boy in a body cast. He is shy and seems fearful of the numerous personnel moving in and out of his room. How can the nurse help reduce his fear?
Write the name of his nurse on a board and identify all staff on each shift, every day.
The pediatric nurse would use standard precautions in caring for which client on her floor?
an adolescent who has a broken arm
Which intervention is most important in assuring a child's cooperation and reducing his or her fear during an emergency room visit?
having the parent stay with the child
The nurse is assigned to care for a 7-year-old child following hernia repair. When will the nurse begin to plan for the client's discharge?
immediately upon the client's admission to the unit
A school-aged child needs to have an IV started. Where would be the best place for the nurse to perform this procedure?
in a treatment room
What will the nurse view as best maintaining normalcy in the life of a 10-year-old boy who is experiencing a lengthy hospitalization?
keeping up with his schoolwork
On the first postoperative day, a 4-year-old child who was hospitalized for an emergency appendectomy has begun to cry relentlessly, will not let the nurse touch him or her, and keeps asking for the parent. The pediatric nurse is aware that this client is in which stage of separation?
protest
The nurse is developing a preoperative plan of care for a 2-year-old toddler. The nurse will focus attention to which of the toddler's age-related fears?
separation anxiety
The charge nurse is planning staffing on a pediatric unit. Which client will the charge nurse assign to the registered nurse?
the 1-year-old client with a respiratory disorder prescribed oxygen therapy
The nurse is caring for a 10-year-old child admitted for a surgical procedure to be done the next day. The nurse takes the child to a special area in the playroom and lets the child "start" an IV on a stuffed bear. This is an example of:
therapeutic play.
A 12-year-old client is hospitalized. Which finding will the nurse expect while providing care to this client?
uncomfortable during genital assessment
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.
The nurse is preparing a postsurgical care plan for an infant girl located on a general hospital unit that only occasionally admits children. To ensure the infant's safety, what should the nurse include in the plan?
Place the infant in a room close to the nurses' station.
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.
A preschool teacher calls the hospital and wants to introduce the concept of a hospital to her preschool class in case they ever get sick and need to be admitted. What resources could the child life specialist provide for this group to aid in their learning? Select all that apply.
Provide a room for the class with hospital gowns, masks and equipment used on children. Tour the hospital, including the playrooms on the pediatric floors. Let the children lie in the beds, use the call lights and practice being a patient.
The nurse is working with a group of caregivers of children in a community setting. The topic of hospitalization and the effects of hospitalization on the child are being discussed. Which statement made by the caregivers supports the most effective way for children to be educated about hospitals?
"We are going to take our child to an open house at the hospital so she can see the pediatric unit."
The nurse is caring for a preoperative pediatric client. What would it be best for the nurse to do with this client?
Determine how much the child knows and is capable of understanding.
The nurse is caring for a hospitalized toddler who is prescribed bedrest. Which item(s) would the nurse recognize as appropriate for the toddler? Select all that apply.
boxes to put toys in and/or take out toys stacking blocks or small boxes nursery rhymes or sing-along songs on tape
The nurse is caring for an 18-month-old boy hospitalized with a gastrointestinal disorder. The nurse knows that the child is at risk for separation anxiety. The nurse watches for behaviors that indicate the first phase of separation anxiety. For which behavior should the nurse watch?
crying and acting out
The nurse is caring for a child who has been hospitalized for 6 days and whose caregivers are unable to stay with the child. The child cried most of the day for the first 3 days but now is quiet and withdrawn. This behavior in the child is an example of which stage of separation?
despair
A nurse getting ready to conduct preoperative teaching with a 9-year-old child realizes that the best method when teaching young clients is to:
use short sessions.
The toddler needs elbow restraints to keep his hands away from a facial wound. What will the nurse do to best ensure their safe use?
Remove one restraint at a time on a regular basis to check for skin irritation.