Peds - Ch 11: Caring for Children in Diverse Settings

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A mother of a recently discharged preschooler calls the pediatric floor that provided care to her child a week ago. She reports that the child is having elimination accidents, temper tantrums and is waking up at night with nightmares. How should the nurse respond to the mother's concerns? a. The entire family needs to spend more time with the child, directing their attention to him. b. Recommend that she sternly tell the child to quit acting out or he will be punished. c. Children this age often show regressive behaviors and have nightmares following hospitalization due to fear of another separation. d. Reassure her that this is typical behavior following a traumatic event and she needs to pay more attention to him.

C Preschoolers who have been hospitalized often show regression, have temper tantrums and have nightmares following their discharge. The family is advised to be understanding but not dote on the child. Discipline should remain consistently firm and loving and they should reward positive behavior.

The nurse at a pediatric clinic is preparing a 5-year-old child for admission to the hospital for a tonsillectomy and adenoidectomy. Which response should the nurse prioritize when asked by the child what happens at the hospital? a. "Some people go here to have babies, or when they're sick or hurt, so they can try to get better." b. "It's like a big doctor's office with lots of people and beds." c. "Remember? It's where your mom went to get your baby brother." d. "People go there when they have a bad accident and get fixed."

A Young children need to know that the hospital is more than a place where "mommies go to get babies." It is also important to both avoid fostering the view of the hospital as a place where people go to die and to avoid the impression that everyone who comes in will definitely get well. Comparing the hospital to a doctor's office minimizes the seriousness and breadth of services of the hospital.

The nurse is caring for a technology-dependent school-aged child in his home. Which action best builds a trusting relationship? a. Encouraging the parents to join a support group b. Discussing care and treatment with the parent and child together c. Talking with the brother of the child who feels ignored d. Changing the date and time of the child's physical therapy to fit the family schedule

B To build a trusting relationship with the family, the nurse must remember the child is both the client and a family member. He needs to be included in all discussions. Encouraging parents to join a support group and talking with the sibling of the ill child who feels ignored are important and supportive activities. Changing the date and time of a therapy session to fit the family schedule is a case management activity. These are important elements of family-centered home care, but are not meant specifically to build trust.

The nurse is caring for a preschooler who requires postsurgical breathing exercises. Which approach will best elicit the child's cooperation? a. "Let's see who can blow these cotton balls off the table first." b. "Do you want to play a breathing exercise game with me?" c. "You need to do the breathing or you could get pneumonia." d. "You will need to cooperate. Otherwise, you might not feel better."

A Any intervention should be developmentally appropriate, and play can often serve as a vehicle for care. Turning breathing exercises into a game is likely to engage the preschooler. Telling the child he needs to do breathing exercises or he will develop another illness or not feel better is not likely to impress the young child. Connecting the two events in a meaningful way is beyond his cognitive ability. Asking if the child "wants" to play a breathing game is an open invitation for a "No" answer.

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? a. Immediately upon the client's admission to the unit b. The day the primary health care provider writes the discharge prescription c. After a home health nurse is consulted d. The morning after the client's surgical procedure

A The nurse will begin planning for the client's discharge immediately upon admission to the unit. Planning for the child's discharge and care at home begins early in the hospital experience and should start upon admission. The nurse would assess the family resources and knowledge to determine what education and referrals they may need. The nurse should not wait until a later point to begin teaching or planning. A home health consultation may or may not be prescribed.

A nurse is caring for a 6-year-old boy hospitalized due to an infection requiring intravenous antibiotic therapy. The child's motor activity is restricted and he is acting out, yelling, kicking, and screaming. How should the nurse respond to help promote positive coping? a. "Do I need to call your parents?" b. "Would you like to read or play video games?" c. "Let me explain why you need to sit still." d. "Your medicine is the only way you will get better."

B Distraction with books or games would be the best remedy to provide an outlet to distract the child from his restricted activity. The other responses would be unlikely to affect a change in the behavior of a 6-year-old.

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? a. Crying and acting out b. Embracing others who attempt to comfort him c. Exhibiting apathy and withdrawing from others d. Losing interest in play and food

A Children in the first phase, protest, react aggressively to this separation, and reject others who attempt to comfort the child. The other behaviors are indicators of the second phase, despair.

The nurse is documenting the child's intake. The child ate 4 cups of ice during this shift. How many cups of fluid did the child ingest? a. 2 cups of fluid b. ½ cup of fluid c. 1 cup of fluid d. 4 cups of fluid

A Ice is approximately equivalent to half the same amount of water which in this instance would be 2 cups of fluid.

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? a. "It is best to wait and let him bring up the surgery or any questions he has" "b. It is a good idea to read stories about experiences with hospitals or surgery" c. "We should talk about going to the hospital and what it will be like coming home" d. "We should visit the hospital and go through the preadmission tour in advance"

A It is important to be honest and encourage the child to ask questions rather than wait for the child to speak up. The other statements are correct.

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? a. "I should not tell her how long she will be here." b. "She will watch our reactions carefully." c. "She will be sensitive to our concerns." d. "We must prepare her in advance."

A Parents who do not tell their child the truth or do not answer the child's questions confuse, frighten, and may weaken the child's trust in them. The other statements are effective forms of communication.

An adolescent would benefit from being out of his hospital room. What can the nurse do to promote this? Select all that apply. a. Challenge the adolescent to a video game in the recreation area. b. Invite the adolescent to meet with other teens for lunch in a common space. c. Suggest the adolescent visit other areas within the hospital that are away from the pediatric unit. d. Encourage the teen to investigate the playroom.

A, B A video game in the "recreation area" is more appealing than investigating the "playroom." If only one activity space is available, avoid calling it the playroom to school-agers and teens. Arranging for teens to spend time together and socialize over lunch may stimulate appetites and new supportive friendships. Suggesting the adolescent leave the unit may not be safe based on his knowledge of the hospital or his condition. Doing so accompanied would be appropriate.

A school-aged child needs to have an IV started. Where would be the best place for the nurse to perform this procedure? a. Off the floor in a procedural suite b. In a treatment room c. In the playroom where there are distractions d. In the child's room, ensuring privacy.

B All treatments are performed in a treatment room so the child's room remains a "safe zone" for the child. By maintaining the client's room as a safe place, the child is reassured that that nothing bad will happen when he or she is in the room. Procedures are never performed in public places such as a playroom to maintain the child's privacy. Distractions are provided in the treatment room.

The nurse is caring for a preschooler who is hospitalized with a suspected blood disorder and receives an order to draw a blood sample. Which approach is best? a. "We need to put a little hole in your arm." b. "Why don't you sit on your mom's lap?" c. "I need to take some blood." d. "I need to remove a little blood."

B It is best to include the families whenever possible so they can assist the child in coping with their fears. Preschoolers fear mutilation and are afraid of intrusive procedures. Their magical thinking limits their ability to understand everything, requiring communication and intervention to be on their level. Telling the child that we need to put a little hole in their arm might scare the child.

A nurse is preparing to admit a child for a tonsillectomy. How should the nurse establish rapport? a. "Do you understand why you are here?" b. "Tell me about your cute stuffed dog." c. "Are you scared about having your tonsils out?" d. "Let's take a look at your tonsils."

B The nurse should start the initial contact with children and their families as a foundation for developing a trusting relationship. Asking about a favorite toy would be a good starting point. The nurse should allow the child to participate in the conversation without the pressure of having to comply with a request or undergo any procedures.

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. a. Do all nursing tasks at one time. b. Read a story while in the room. c. Play a game while in the room. d. Quickly exit the room when possible. e. Spend extra time to talk while in the room.

B, C, E A child on isolation is subject to loneliness, which can be prevented by arranging to spend extra time in the room during treatments. Also, while in the room the nurse might read a story, play a game, or just talk to the child. Quickly exiting the room and providing cluster care will increase social isolation and may make the child feel punished.

The nurse is preparing to start an intravenous (IV) line on a stable pediatric client in the hospital. Which location is most appropriate for the nurse to use for this procedure? a. The unit's play room b. Room selected by the client c. The child's hospital room d. The pediatic treatment room

D The nurse would perform procedures on stable pediatric clients in the pediatric treatment room. Using a separate room to perform procedures promotes the concept that the child's bed/room is a "safe" place. The other "safe" place for a child in the hospital is the play room and should not be used for any procedures or medication administrations. The client would not be allowed to select a location as the client may select one's room or the play room.

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? a. "We told him to use his manners and behave like a big, brave boy." b. "We have a date to visit pediatrics and tour their department." c. "We found several books for him at the library that talk about being in the hospital." d. "We watched a program for kids on public television about being in the hospital."

A Expecting manners and brave "big-boy" behavior is unrealistic. The child's coping skills are not yet well developed. Expressing true feelings should be allowed. The other preparations are helpful and promote understanding of the experience.

A nurse who has worked in a variety of settings over the past several years is trying to determine what setting she would most like to work in now. The nurse is very organized, works well in an autonomous environment, and prefers one-on-one care. Which setting would best fit this nurse's needs? a. Home health b. School nurse c. Health department d. Physician's office

A Home health would provide the most autonomy (which requires being organized), and takes place in the client's home, giving one-on-one care. All areas of nursing require organization in order to provide efficient care. A physician's office would likely provide the least amount of autonomy since the physician is always present, as well as other office staff. The health department nurse and the school nurse would favor an autonomous person, but there is still more direct supervision than with home health nursing.

A nursing instructor is reviewing a care plan written by a student on a hospitalized child. Which nursing intervention for the diagnosis of self-care deficit related to regression would the nursing instructor question? a. Assess the child's usual home routine for self-care. b. Encourage the parents to do as much self-care for the child as possible. c. Encourage rest periods for the child as needed. d. Provide child-sized equipment and devices as needed.

B Appropriate nursing interventions for the diagnosis of self-care deficit related to regression include encouraging the child and family, not just the child, to perform as much self-care as possible. Assessing usual home routines, providing appropriately sized equipment, and encouraging rest periods are all appropriate nursing interventions for this diagnosis.

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. a. Tell the children that hospitals are places for sick people to come and sometimes they don't leave. b. Let the children lie in the beds, use the call lights and practice being a patient. c. Tour the hospital, including the playrooms on the pediatric floors. d. Provide a room for the class with hospital gowns, masks and equipment used on children. e. Offer to let them see and play with the injection equipment such as syringes and needles.

B, C, D Preschoolers are curious and love to manipulate the equipment used at the hospital. By making admission to the hospital less frightening for them, they will adjust better if they have to be admitted. Mentioning people not leaving the hospital indicates they died; this is scary to the children and inappropriate for this session. Children are never allowed to play with needles or syringes - it is too dangerous.

The charge nurse is reviewing room assignments for a 5-year-old child who is very tearful. Which room assignment would be best? a. In a room with a child near the same age b. In a private room c. In a room with an older child d. In a room with a younger child

A Placing the child in a room with a child near the same age would be beneficial. This would promote sharing and bonding over similar circumstances. Rooming alone may promote feelings of isolation and despair. Placement with an older or younger child would not be of mutual benefit.

The nurse approaches a client room and notes a sign stating the client is in droplet isolation. Which precautions would be appropriate for this client? a. Gown only b. Gloves only c. Gown, gloves and mask d. Gloves and mask

C A client in droplet isolation has a disease that is spread by coughing and sneezing; anyone entering the room needs protection from the infected droplets. Droplet isolation requires a gown, mask and gloves for all people who enter come in contact with the client room.

Which approach by the nurse best demonstrates the correct way to prepare a Hispanic child for a planned hospital admission? a. Tell the child that the procedure will not hurt because we have "magic medicine." b. Allow the child to put on surgical attire and "operate" on a doll to teach what will be happening. c. Discourage questions so as to not frighten the child. d. Since the family is Hispanic, all preparation needs to be in Spanish.

B Allowing the child to put on surgical attire lets him or her see that hospital equipment is "not scary" and prepares the child for what will be seen on the day of surgery. Both the child and parents should be encouraged to ask questions. Honesty is the most important part of the program, so the nurse would never tell the child that the procedure will be painless because even the best care by the nurse may not eliminate all pain. Assuming that the family only speaks Spanish is inappropriate and could be considered profiling and rude. The nurse needs to determine the family's preference of language.

The nurse is providing teaching for the parents of an 8-year-old girl who has undergone surgery. The nurse emphasizes the importance of maintaining adequate hydration. Which response by the mother would indicate a need for further teaching? a. "I will remind her that she will need an IV if she does not drink." b. "I should offer her small amounts of fluid frequently." c. "Anything that melts at body temperature is counted as a fluid." d. "Ice chips count as fluid intake. One cup of ice equals a half-cup of water."

A The child is likely to view an IV both as frightening and as punishment. Intravenous fluids should be seen as therapy. Threats such as this should not be used to achieve compliance with eating or drinking. The other statements show understanding.

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? a. Assign the child to the same nurse each day. b. Allow the child to handle the blood pressure cuff before using it. c. Encourage a caregiver to stay with the child when possible. d. Explain all procedures using medical terminology.

D Using medical terminology will ensure that the child will not understand what is happening and only increase his or her anxiety. Allowing touching of equipment, assigning the child to the same nurse and encouraging caregivers to stay with the child all help alleviate anxiety and reduce the child's fears.

The nurse is caring for several families in the home care setting. What additional team member will the nurse have available to assist in the home setting? a. Unlicensed assistive personnel b. An emergency medicine provider c. Surgical care interns d. An infectious disease specialist

A There are many health care team members who care for a child in the home setting. The nurse will likely have a home care assistant who is unlicensed but trained in helping with activities not requiring a license. The child would have access to the other options, but not in the home setting.

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? a. Tell him not to worry; explain that everyone is here to care for him. b. Write the name of his nurse on a board and identify all staff on each shift, every day. c. Remind the boy he will be out of the hospital and going home soon. d. Encourage the boy's parents to stay with him at all times to reduce his fears.

B The best approach would be to write the name of his nurse on a small board and then identify all staff members working with the child (each shift and each day). Reminding the boy he will be going home soon or telling him not to worry does not address his concerns or provide solutions. Encouraging the boy's parents to stay with him at all times may be unrealistic and may place undue stress on the family.

A nurse with no pediatric experience has been transferred to a pediatric unit to work for the day. Which comments by the nurse indicate knowledge of developmental considerations when providing hygiene needs to a 3-month-old infant? a. "I think the baby is old enough for me to use the bathtub if I am careful." b. "I plan on using a sponge bath to bathe the infant." c. "I will be sure to only leave the infant for a very short time if I forget anything during the bath." d. "I need to find the talcum powder to use after the bath."

B A 3-month-old would require a sponge bath or tub bath to bathe because they cannot sit unaided. Talcum powder is not suggested for infants. A bathtub can be used for toddlers or older. No child should ever be left alone during bathing for any length of time.

The parents of a 10-year-old child tell the nurse they are nervous about their child being discharged to home. The parents state, "We trust you all so much that we are afraid to go home and have home health care. Do you think our child will do as well at home?" What would be the best response by the nurse? a. "Home care nurses are very qualified to give care to your child. You have nothing to worry about." b. "I understand your anxiety, but being at home helps your child's growth and development. The home care nurses will be there to support you." c. "Your child is at a much higher risk for infection in the hospital, so being home is a much better option." d. "It's scary going home but it is the best place for both you and your child."

B Caring for children at home not only improves their physical health but also allows for adequate growth and development while keeping them within their family. They are in a familiar environment with the comfort and support of family, which leads to improved care and quality of life. Reassuring the parents that the home care nurses will be there to support them further is necessary to help ease their anxiety.

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? a. Ask the family to stay with the infant at all times. b. Place the infant in a room close to the nurses' station. c. Place the infant in a room with an ambulatory adolescent. d. Put the infant in a carrier and bring her to the nurses' station.

B The infant will need close monitoring, and having the child nearby will promote frequent checks and awareness of her status. Family cannot be required to stay at all times. That may be impossible for some. One client should never be responsible for another. The infant is the nurses' responsibility. Putting the infant in a carrier and bringing her to the nurses' station is not safe.

The hospital nurse is providing discharge instructions to the caregivers of a 10-year-old child with a new prosthetic limb. Which finding will cause the nurse to contact the primary health care provider? a. The child's blood pressure is 115/75 mm Hg. b. The child is being discharged home with the caregiver. c. The child's white blood cell (WBC) count is 9,000/mm3 (9 x 109/L). d. The child was diagnosed with hypothyroidism as an infant.

B The nurse would question the child with a new prosthetic limb being sent home immediately from the hospital. Sending the child to a rehabilitation unit is best to facilitate usage of the prosthetic limb. The care in a rehabilitation unit involves an interdisciplinary approach that assists the child to reach his or her potential and achieve developmental skills. A diagnosis of hypothyroidism in infancy would not be concerning to the use of a prosthetic. The WBC and blood pressure are both within normal range for a client of this age. The normal WBC is 5,000 to 10,000 mm3 (5 to 10 x 109/L) and blood pressure range is 95-120/55-76 mm Hg.

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? a. Cooperative play b. Onlooker play c. Play therapy d. Therapeutic play

D Therapeutic play is a play technique used to help the child better understand what will be happening to him or her in a specific situation. For instance, the child who will be having an IV started before surgery might be given the materials and encouraged to "start" an IV on a stuffed animal or doll. By observing the child, you can often note concerns, fears, and anxieties the child might express. Therapeutic play helps the child express feelings, fears, and concerns. The other types of play will not accomplish this goal.

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? a. Prepare the child for hospitalization by explaining what to expect and showing him or her around the hospital. b. Have another child talk with the child to be hospitalized. c. Tell the parents to bring toys for the child from home. d. There is no way to adequately prepare a child for an impending hospitalization.

A The best way to ease the stress of hospitalization is to ensure that the child has been well prepared for the hospital experience. Not only is the child's fear reduced but also the child has a better ability to cope. Preparation allows the child a better understanding of what's happening to him or her. Good preparation allows the child to see a hospital room, handle medical equipment and gain an understanding of procedures and hospital sounds. Another child would only give explanations from his or her point of view and that child may describe a negative experience. The child's favorite toy or blanket should come with the child to the hospital as a comfort to the child, but that does not prepare the child for hospitalization.

A 5-year-old child is scheduled for hospitalization in 2 weeks. Which is the best intervention to help ease the potential stress of hospitalization in this child? a. Arrange for the child to tour the hospital. b. Allow the child to talk to a client who recently had the same procedure. c. Have the parents explain the situation. d. Encourage the family and client to participate in a program to prepare for the hospitalization.

D Many hospitals have a child-life program to make hospitalization less threatening for children and parents. The best way to ease the stress of hospitalization is to ensure that the child has been well prepared, and this can be done with such a program. The other options will help relieve some stress, but the child-life program is the best all-inclusive intervention. Having the parent explain the situation may not be best because the parents may be anxious also and they will not be able to perceive the situation from a child's perspective.

The charge nurse is planning staffing on a pediatric unit. Which client will the charge nurse assign to the registered nurse? a. The 6-year-old client admitted yesterday for oral rehydration following a mild gastrointestinal disorder b. The 12-year-old client with a urinary tract infection taking oral antibiotics c. The 8-year-old client recovering from an appendectomy who is ambulating d. The 1-year-old client with a respiratory disorder prescribed oxygen therapy

D The charge nurse would assing the RN to the most unstable client, which is the client with a respiratory disorder who is only 1 year of age. According to Child Health USA 2010, diseases of the respiratory system account for the majority of hospitalizations in children younger than 5 years of age, indicating this is a common occurance. All other clients are stable and could be cared for by licensed practical nurses at this time.

A nurse is admitting a 7-year-old child to the pediatric unit of the hospital. While the nurse is showing the child and parents the room and explaining where things are, the child becomes upset and frightened. What is the best action by the nurse? a. Tell the child that there is nothing to be afraid of and that nobody will hurt the child during hospitalization. b. Keep on showing and explaining to the parents and do not include the child. c. Ask the parents to leave the room while explaining procedures to the child. d. Go slowly with the acquaintance process.

D The child who reacts with fear to well-meaning advances and who clings to the caregiver is telling the nurse to go slowly with the acquaintance process. The child who knows that the caregiver may stay is more quickly put at ease. To provide security for the child and to provide family-centered care, it is the responsibility of the nurse to form good partnerships with families. Asking the family to leave the room in this situation would only frighten the child more. The nurse should never provide false reassurance. Telling the child there is nothing to be afraid of or nothing will hurt him or her are promises the nurse cannot make to the child.

The nurse is preparing discharge instructions for a 7-year-old child and the parents. Which instructions by the nurse will likely require further clarification? (Select all that apply) a. You may shower or take a bath in a tub 1 week from today. Until then, only sponge baths should be taken. b. An appointment has been with your physician on November 11 at 10:30am. Please call the physician's office to reschedule if you cannot make this appointment. c. Rotate injection sites as indicated by the diagram on the discharge instruction sheet. d. Monitor for the most common side effects from the medications prescribed. e. Administer the prescribed antibiotic t.i.d. in order to establish a therapeutic dose.

D, E Medical abbreviations, such as t.i.d., should not be used when providing discharge instructions. "Monitor for side effects..." is nonspecific. The medications and the side effects to monitor for should be listed. Giving visual material such as diagrams are helpful. Making the appointment for the client is helpful as well. Being specific on when bathing can occur eliminates confusion.

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? a. Monitor for any change in vital signs. b. Administer ice chips. c. Create an IV flow sheet. d. Turn the child every 2 hours.

A After the child has been returned to his or her room, nursing care focuses on careful observation of the vital signs for any signs or symptoms of complications: shock, hemorrhage, or respiratory distress. An IV flow sheet is begun that documents the type of fluid administered, the amount of fluid to be absorbed, the rate of flow, any additive medications, the site, and the site's appearance and condition. The physician should be notified if anuria (absence of urine) persists longer than 6 hours. Postoperative orders may or may not provide for ice chips or clear liquids to prevent dehydration; these may be administered with a spoon or in a small medicine cup. Frequent repositioning is necessary to prevent skin breakdown, orthostatic pneumonia, and decreased circulation. Coughing, deep breathing, and position changes are performed at least every 2 hours.

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 her and scoots away as she attempts to pick him up. Which response should the nurse prioritize in this situation? a. "His distrust is normal and may have lingering effects, but you should touch and soothe him as much as possible." b. "Now that he has seen that you have returned he will feel better, but you should leave the room for a few minutes to help him feel in control." c. "His distrust is abnormal. It may or may not go away in a day or two; we will just have to wait and see." d. "He is probably just tired from the many tests run while you were away."

A Three characteristic, consecutive stages of response to separation have been identified: protest, despair, and denial. In the denial stage, the child begins taking interest in his or her surroundings and appears to accept the situation. However, the damage is revealed when the caregivers do visit: the child may turn away from them, showing distrust and rejection. It may take a long time before the child accepts them again; even then remnants of the damage may linger. The child may always have a memory of being abandoned at the hospital.

The nurse is caring for a preoperative pediatric client. What would it be best for the nurse to do with this client? a. Explain how the therapeutic plan can be used in preparing the child for surgery. b. Teach technical terminology to the caregivers so they will understand what is being said postoperatively. c. Determine how much the child knows and is capable of understanding. d. Keep the child away from any food or drinks to ensure the child is NPO.

C The nurse must determine how much the child knows and is capable of learning in order to best prepare the child for surgery. Keeping terminology at the child's and caregivers' level of understanding is important when doing teaching. Teaching the therapeutic plan is important, but it has to be done on the level of the child's and caregivers' knowledge and build on what they already know. The child going to surgery will be NPO, but the nurse needs to know on what level to teach the child the reason for this.


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