Ch 30: Atraumatic Care of Children and Families

When the nurse is teaching the child how to self-administer insulin, what should the final step of the process include? A) Teaching the principles of insulin administration B) Evaluating the teaching that has occurred C) Assessing the child's willingness to learn D) Recognizing the actions of the teaching process

B) Evaluating the teaching that has occurred The only way to determine the effectiveness of teaching is to test or evaluate if learning has occurred. Structure the time and method of evaluation when first establishing a teaching plan.

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: A) "Come, stand by his head. You won't see much up there" B) "Good. That is what the team doing the procedure would prefer." C) "Stay. It will be less scary for your child." D) "This will only take a few minutes. You should be with your child." E) "Certainly. I will stay with your child during the procedure."

E) "Certainly. I will stay with your child during the procedure." Excusing the parent from the procedure is the best response. The parent's needs and abilities need to be respected and supported. Children usually receive the most support from parents. However, others can provide effective support including nurses and child life personnel. Consider, also, that an anxious parent usually means an anxious child. Assist the parent to comfort the child after the procedure.

A nurse is talking with a 9-year-old about a procedure that will be done in the morning. The child is expressing fear. What listening skills does the nurse exhibit that makes it clear the nurse is actively listening? Select all that apply. A) Standing up and turned toward the door as the child is talking B) Maintaining eye contact while the child is talking C) Nodding in response to comments the child makes D) Writing notes while the child is expressing his fears E) Sitting at the level of the child

B) Maintaining eye contact while the child is talking C) Nodding in response to comments the child makes E) Sitting at the level of the child Posture reveals to a great extent whether you are listening (sitting, not standing, to convey that you are not on the run; leaning forward, not backward; stooping to meet a child's level). Nodding, maintaining eye contact, and stopping all other activities are strong indicators you are attuned to what is being said. Making it clear that you are concentrating on what another is saying by such a motion as nodding indicates you value what the other person is saying.

A 15-year-old client with type 1 diabetes has been noncompliant with his dietary regimen. When educating the teen, what is the most important thing the nurse can do to allow the teen to be in control and involved in the decision-making process? A) Praise the client often. B) Speak directly to the teen and consider his input in the decisions about care and education. C) Offer choices whenever possible. D) Provide information and allow the teen to process and ask questions.

B) Speak directly to the teen and consider his input in the decisions about care and education. A teaching tip for adolescents to allow them control and involvement in the decision-making process is to speak directly to them and consider their input in all decisions about their care and education.

What should be the first step in developing a teaching plan for a 9-year-old who needs education about a gluten-free diet for the treatment of celiac disease? A) Developing outcome standards for the nutritional aspect of the plan B) Giving the child a pamphlet about the reason for a gluten-free diet C) Assessing the child's current level of understanding D) Collecting data of current dietary likes and dislikes

C) Assessing the child's current level of understanding Important areas for assessment include a child's current level of understanding; cognitive, physical, psychosocial aspects; and how the new knowledge will meld with the child's and family's lifestyle.

A nurse is caring for a small child with leukemia who will be hospitalized frequently for chemotherapy. What type of referral can the nurse make that will help the child and family through this time? A) Child psychologist B) Play therapist C) Child life specialist D) Occupational therapist

C) Child life specialist A child life specialist (CLS) is a specially trained individual who provides programs that prepare children for hospitalization, surgery, and other procedures that could be painful. The CLS is a member of the multidisciplinary team and works in conjunction with health care providers and parents to foster an atmosphere that promotes the child's well being.

The nurse is teaching a 15-year-old boy with diabetes mellitus and his parents how to monitor glucose levels. Which communication technique is least effective? A) Using reflection to clarify the parents' understanding B) Using the adolescent's words during the conversation C) Paraphrasing the parents' comments before responding D) Ignoring the adolescent's tirade about his therapy

D) Ignoring the adolescent's tirade about his therapy The least effective technique is ignoring the adolescent's tirade about his therapy. He is expressing frustration over his lack of control, and his emotions should be acknowledged. Paraphrasing the parents' comments recognizes their feelings. Using the teen's words during the conversation indicates active listening and interest. Reflection clarifies the parents' understanding and point of view.

The nurse is caring for a 14-year-old girl with terminal cancer and her family. Which intervention provides the best therapeutic communication? A) Presenting options for treatment B) Recognizing the parents' desire to use all options C) Supporting the child's desires for treatment D) Informing the child in terms she can understand

D) Informing the child in terms she can understand Informing the child in terms that she can understand is the best example of therapeutic communication, which is goal-focused, purposeful communication. Recognizing the parents' and child's desire regarding treatment options is part of family-entered care. Presenting options for treatment is vague.

When planning to teach a toddler about coughing and deep breathing, which would be most effective? A) Demonstrating the technique B) Showing an audiovisual C) Discussing the importance of coughing D) Playing a game with coughing and breathing

D) Playing a game with coughing and breathing Toddlers respond best to teaching techniques that include games so they feel as if they are playing instead of learning.

A nurse is talking with a school-age child with asthma who expresses concerns that peers will not want to be friends because of the disease. What therapeutic communication technique would be beneficial for the nurse to use? A) Inform the child that the parents must be present during a personal conversation like this one. B) Give vague responses when the child is asking for advice so the nurse will not be responsible if something happens. C) Have the child sit down in a chair and the nurse stand next to the child. D) Sit at the child's level and allow the child time for self-expression.

D) Sit at the child's level and allow the child time for self-expression. Sitting at the child's level and allowing the child time for self-expression are steps that improve therapeutic communication.