Chapter 30 Peds Coursepoint
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." "I am going to give you this shot and it will put you to sleep." "You will end up in the 'ICU' where you will wake up with some electrodes on your chest." "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."
"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." It is appropriate to use the word "tube" and not a "catheter." It is appropriate to call a "gurney" a "rolling bed." It is better to call dye "special medicine." Terms used in the other options may be misunderstood by a 4-year-old child.
The nurse is caring for a 7-year-old child scheduled for a tonsillectomy the next day. The client states, "I really wish I was not having surgery tomorrow. I am not excited about this. Maybe I will be better by tomorrow." Which response by the nurse is most appropriate? "I hope you are better tomorrow, too." "You sound worried. Let's talk about tomorrow." "I had my tonsils removed at your age and everything was just fine." "Would you like to go see an operating room?"
"You sound worried. Let's talk about tomorrow." Therapeutic communication is an interaction between two people that is planned (deliberately intending to determine the true way a child feels), has structure (use specific wording techniques that will encourage the response you expect to elicit), and is helpful and constructive (at the end of the exchange the nurse will know more about the child than at the beginning, and the child, ideally, also knows more about a particular problem or concern). The child seems worried; therefore, the nurse would discuss the child's feelings with the child to determine the best course of action. It is not appropriate for the nurse to state "hope you are better" or "everything was fine" as these are not therapeutic. If possible, it would be appropriate for the child to tour the operating room prior to surgery, after discussion the child's feelings. Seeing the location may help alleviate some fears.
When teaching an adolescent about home care after hospitalization, what is most important for the nurse to do? Focus the discussion on skill techniques. Use the same type of language as the adolescent. Allow opportunity for the adolescent to express feelings. Provide assurance the nurse will maintain confidentiality.
Allow opportunity for the adolescent to express feelings. Adolescents, struggling for identity, can be responsible for their own self-care if they understand how the new action they are being taught will affect them. Affective learning is important for the adolescent to express his/her feelings about what has happened and their illness. Adolescents have a strong need to be exactly like their friends. This means they will rarely continue with any action that makes them conspicuous in front of their peers. The nurse should not use the same language as the adolescent because there may be pertinent information that would not be shared if the nurse is not translating the adolescent's language correctly. Maintaining confidentiality is always important, and assurance should be given to the adolescent that the nurse will not share information with the adolescent's friends, but that is not the most important task for the nurse at this time.
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? Show the child a video about medication administration. Use medical terminology when discussing the medication with the child. Allow the child to choose between juice, water, or soda to take the medication. Allow the child to determine if he or she wants to take the medication at that time.
Allow the child to choose between juice, water, or soda to take the medication. When a child is ill and medication is needed to be administered the child should not have a choice in the timing of medication administration. The medication is administered for the benefit of the child. The preschooler does, however, have choices in the matter. The preschooler can choose how he or she wants to take the medicine, that is, in a medicine cup or through a syringe, if the child wants to squirt the medicine by himself with nursing support or what type of liquid the child would like the medication mixed with. Showing a preschool-age child a video does not accomplish the education, because a child of this age sees the person on the screen separate from himself/herself. The nurse should always speak to the child in words the child can understand.
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? Notify the health care provider that the parents still have questions. Reassure the parents that they have been fully briefed on their child's treatment. Answer the parents' questions as completely as possible. Encourage the parents to focus their attention on their child.
Answer the parents' questions as completely as possible. Because the health care provider has discussed the child's care, the nurse should answer the parents' questions as completely as possible. Telling the parents that they have been fully briefed negates their concerns and is inappropriate. Encouraging the parents to focus on their child also negates their concerns. Unless the parents ask specifically for the health care provider, the nurse can answer the parents' questions.
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. Allow the toddler to make independent choices regarding the procedure. Remind the toddler that he or she will have privacy and be covered during the examination. Use appropriate medical terminology for the ear, the examination, and the result.
Approach the toddler while the toddler is being held by the parent. Toddlers are often fearful at their developmental level. Nurses should approach toddlers at a slow pace and while the toddler is being held by the parent to allay this fear. Nurses should use the toddlers' preferred words for objects or actions so these children can better understand, rather than using correct medical terminology the child will not understand. Privacy is most important to the adolescent age group. Toddlers are too young to make independent health care choices.
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? Inform the child of priority problems. Assist the child to control emotions. Provide a plan of action. Assess the perception of the problem.
Assess the perception of the problem. Therapeutic communication is an interaction between two people that is planned (e.g., the nurse deliberately intends to determine how a child truly feels), has structure (e.g., the nurse uses specific wording techniques that will encourage a truthful response) and is helpful and constructive (e.g., at the end of the exchange the nurse will know more about the child than in the beginning and ideally the child will know more about a particular problem or concern). The initial goal in working with this child is to determine the child's perception of the problem. Once that is accomplished, the nurse can develop a plan of care to identify priority problems and help the child deal with the fear.
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 team of nurses and unlicensed assistive personnel. Assign unlicensed assistive personnel to care for the child to give the parents a break. Assign a core primary nurse. Assign a medication nurse and a primary nurse.
Assign a core primary nurse. Family-centered care is the gold standard for pediatric nursing. It decreases anxiety for both the parent and the child, recovery times are shortened and pain management is enhanced. When a primary nurse is assigned to the child and family, they have an identifiable source to help meet their needs. Oftentimes when more than one person is providing care, effective communication is lost. The family is the primary source for the child and they should not be separated. Having a medication nurse and primary nurses tends to fragment care. The unlicensed assistive personnel can provide basic care for the child, but the parents to be offered to communicate how much involvement they wish in their child's care.
The nurse is caring for a parent of a 10-month-old infant. The parent is upset and states, "I have so many questions, but the doctor seems too busy to answer my questions." What is the best action by the nurse? Assist the parent in preparing a list of questions for the health care provider's next visit. Explain to the parent that the health care provider will be back and will answer questions at that time. Encourage the parent to remain at the infant's bedside so as not to miss any future consultant visits. Ask the parent if he or she would like the nurse to ask the health care provider the questions when the provider visits next.
Assist the parent in preparing a list of questions for the health care provider's next visit.
The nurse is caring for a parent of a 10-month-old infant. The parent is upset and states, "I have so many questions, but the doctor seems too busy to answer my questions." What is the best action by the nurse? Assist the parent in preparing a list of questions for the health care provider's next visit. Explain to the parent that the health care provider will be back and will answer questions at that time. Encourage the parent to remain at the infant's bedside so as not to miss any future consultant visits. Ask the parent if he or she would like the nurse to ask the health care provider the questions when the provider visits next.
Assist the parent in preparing a list of questions for the health care provider's next visit. Empowering parents so that they can be active partners in their child's care is part of family-centered care. Helping the parent state and write questions will provide information to which the nurse can respond; it will also help the parent interact more effectively with the health care provider and other health team members. Relaying the parent's questions may be helpful on limited occasions but places the nurse between the parent and the health care provider, relaying information in a "third party" manner. Keeping the parent at the bedside watching and waiting causes unnecessary stress. Supporting the busy schedule of the health care provider burdens the parent further.
A 4-year-old adopted child has begun to ask questions about when she was born. Which suggestions by the clinic nurse would be considered the most appropriate answer for this child related to her birth? Select all that apply. Explain to the child that she grew inside another woman, but after the birth she was given to her adoptive mom and dad to raise. Tell the child that her biological mom could not care for her after birth because she was HIV positive. Inform the child that her biological mom was in prison and would not be able to care for her for a long time. Explain that her biological mom could not care for her so she was given away. Avoid criticizing the biological parents but reinforce how much the adoptive mom and dad love them.
Avoid criticizing the biological parents but reinforce how much the adoptive mom and dad love them. Explain to the child that she grew inside another woman, but after the birth she was given to her adoptive mom and dad to raise. At least by 4 years, children are old enough to fully understand the story of their adoption: they grew inside the body of another woman who, because she could not care for them after they were born, gave them to the adopting parents to raise and love. It is important for parents not to criticize a birth mother as part of the explanation because children need to know, for their own self-esteem, that their birth parents were good people and they were capable of being loved by them, but things just did not work out that way. At age 4, children do not understand HIV status, not being able to provide for the needs of an infant, or prison terms.
A 6-year-old reports pain in the stomach upon eating. The nurse replies, "Let me see if I have this right. Every time you eat anything, you get a pain in your tummy?" The nurse is using which technique of therapeutic communication? Open-ended questions Reflecting Clarifying Perception checking
Clarifying Clarifying consists of repeating statements others have made so both people can be certain that the message is understood. This is an example of clarifying. Reflecting is restating the last word or phrase. Open-ended questions invite a variety of responses and allow the client to give all the pertinent information needed to answer the question. Perception checking documents a feeling or emotion that is reported. It is a way of understanding others accurately instead of jumping to conclusions.
A family is anxious for information about the status of their ill infant. The parents do not understand the dominant language, but their 14-year-old child is competent in the language, both spoken and written. The health care provider is present, but an interpreter is unavailable. What should the nurse do? Coordinate health care provider and interpreter schedules and arrange an information-sharing session for later in the day. Have the child and health care provider discuss the information thoroughly and help the child share these data with the parents. Support the child while the child interprets for the parents and the health care provider at the bedside. Develop a written account of the infant's status with the health care provider that the child can read and explain to the parents.
Coordinate health care provider and interpreter schedules and arrange an information-sharing session for later in the day. An interpreter is essential. Explanations need to be given and questions relayed and answered. The interpreter needs understanding of the health care environment, not just the language. The parents are anxious for information and "not knowing" is difficult. However, children in the family should not be used as interpreters. This may upset family dynamics by giving a great deal of power to a child.
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? Tell the child different ways to perform the technique so the child can choose. Demonstrate the technique by performing it the same way each time. Allow the child to review instructional pamphlets as the nurse is teaching. Suggest the child tell the nurse how he or she wants the range-of-motion exercises to be done.
Demonstrate the technique by performing it the same way each time. For a 9-year-old child, consistent instruction using hands-on techniques is best. All the attention should be focused on the nurse as the nurse is teaching. Achievement and accomplishment are very important to the school-age child. Gaining control over the situation by learning what the nurse is teaching is important to the child's self-esteem. Teaching different ways to perform a technique would be confusing to the child; he or she would likely not learn the skill correctly. The child is not able to dictate how to perform the skills
The nurse is teaching the caregivers of a child with cystic fibrosis. What is most important for the nurse to teach this family? Be sure the child exercises daily. Watch out for signs that family members are overly stressed. Avoid overprotecting the child. Encourage everyone in the family to use good handwashing techniques.
Encourage everyone in the family to use good handwashing techniques. The child with cystic fibrosis has low resistance, especially to respiratory infections. For this reason, take care to protect the child from any exposure to infectious organisms. Good handwashing techniques should be practiced by the whole family; teach the child and family the importance of this first line of defense. Practice and teach other good hygiene habits.
A nurse is preparing to start an intravenous (IV) line in a child with severe pneumonia. The nervous child asks the nurse to wait until later to do the procedure. How should the nurse proceed? Inform the child that the procedure will have to happen immediately. Explain to the child why the IV is needed and find creative games to utilize while inserting the IV. Call the health care provider to see if the medication can be given in liquid form by mouth. Ask the parent to hold the child down so that the procedure can be completed.
Explain to the child why the IV is needed and find creative games to utilize while inserting the IV. When a procedure is necessary the nurse should use a firm, positive, and confident approach that provides the child with a sense of security. The child should be allowed to express feelings of anger, anxiety, fear, or frustration but also know the procedure is necessary. In atraumatic care, the nurse should use a topical anesthetic at the IV site prior to the IV insertion to minimize pain. The parents should not be used as a restraint. This causes severe anxiety for the parent and the child. If an IV is prescribed to be placed, then most likely IV medications will be needed. Just because the child does not want the IV, the child should not be allowed to dictate care.
A 7-year-old child with sickle cell anemia who comes to the hospital frequently appears withdrawn and depressed. The client refuses to talk to anyone or even admit to feeling sad. What would be the best thing for the nurse to do that might help the child deal with his or her feelings? Tell the client a joke. Get the client to draw a picture. Play a happy song for the client. Leave the client alone.
Get the client to draw a picture. A useful nonverbal technique to assess how children feel about a frightening experience is to ask them to draw a picture. Children cannot always verbally express what they are feeling. Being able to convey feelings on paper can open the door for the nurse or child life specialist to help the child deal with the problem. Humor will not fill the void. It is not effective with depression because it is not interpreted as humor. Usually children are looking for a firm support person to be with them, not an amusing one. Using music can be helpful, but the child should pick the type of music that will then convey the mood. The nurse should not leave the child alone. Doing so will only add to further isolation.
The nurse is caring for a hospitalized pediatric client. Which intervention will the nurse include to encourage family-centered care? Encourage the caregivers to room-in with the client and siblings to visit when possible. Have a team meeting with the client, family, and involved health care providers. Have the family members meet with a child psychologist to ensure the child's needs are being met. Have the primary health care provider meet with the family to tell them about the child's plan of care.
Have a team meeting with the client, family, and involved health care providers. Family-centered care involves a partnership between the child, family, and health care provider in planning, providing, and evaluating care. It works well with children of any age and in all arenas of health care, from preventive care of the healthy child to long-term care of the chronically ill child. All providers should be involved in the child's plan of care, not just the health care provider or nurses. Encouraging rooming-in and sibling visitation is important for stability and to limit the client's anxiety, not for family-centered care. The child would only need to be assessed by the psychologist if the child were demonstrating emotional difficulties associated with the disease.
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? Ask the adolescent questions about the previous hospitalizations. Encourage the adolescent to have friends visit while in the hospital. Talk to the adolescent about the diagnosis and current prognosis. Include the adolescent in discussions about health care decisions.
Include the adolescent in discussions about health care decisions. Adolescents feel empowered when health care professionals communicate directly with them. Health care professionals should include the adolescent in discussions and avoid talking about the client in the adolescent's presence. Adolescents are aware of terminology related to diseases and should have a say in treatment decisions. The adolescent should be taught about the disease and treatment to empower the client to make informed decisions. Asking questions about previous hospitalizations does not facilitate in giving the client a sense of empowerment, nor does it provide the nurse with needed information at this time. Due to the client's diagnosis, visitors may not be allowed. Friends are important at this age; however, they will not assist in empowering the client. Discussing the diagnosis and prognosis is important and should be done by the primary health care provider.
The nurse is preparing to reduce a young parent's anxiety about a child needing hospitalization. Which action should the nurse prioritize? Tell the parent about the tests being performed. Let the parent know you will relay any messages she has for the doctor. Include the parent in the medical decision-making. Schedule time to address the parent's concerns.
Include the parent in the medical decision-making. The family-centered care approach is a researched-based philosophy that promotes family coping with a child needing medical attention. The nurse should collaborate with the family to address the family's needs, as well as the medical care of the child. Including the parent in the process of medical decision-making would be the priority. The other choices (letting the parents know about the tests to be performed; relaying messages; addressing concerns promptly instead of setting aside to discuss all the concerns simultaneously) would be additional ways to include the parents in the process and relay necessary information to be able to make informed decisions.
A 7-year-old child who has recently immigrated with the family is brought to the school nurse because the child refuses to eat lunch. Which response should the nurse prioritize? Eat lunch with the child. Discuss the situation with the child. Investigate for potential cultural issues. Refer the family to a nutritionist.
Investigate for potential cultural issues. Culture influences the family's health beliefs. A newly immigrated family may have attitudes toward food that are culturally founded. The nurse should seek to clarify the cultural food influences of the family and the needs of this child. Discussing the issue with the parents may be an option if the nurse is unable to detect a possible cultural connection by talking with the child. Referring the family to a nutritionist would be inappropriate.
A 10-year-old child with sickle-cell anemia is frequently in the pediatric center of a hospital. What intervention can the nurse provide that will allow the child the sense of control that meets the goals promotes atraumatic care? Advocate for minimal laboratory blood draws. Promote family-centered care. Provide appropriate pain management. Maintain the child's home routine related to activities of daily living.
Maintain the child's home routine related to activities of daily living. To promote a sense of control that meets the goals of atraumatic care, the nurse would attempt to maintain the child's home routine related to activities of daily living. In the hospital, the nurse would use primary nursing. The nurse would encourage the child to have a security item present if desired. Other measures include involving the child and family in planning care from the moment of the first encounter, empowering them by providing knowledge, allowing them choices when available, and making the environment more inviting and less intimidating. The nurse could advocate for minimum blood draws, but with the child's disease this will likely not happen. The nurse can help the child with reassurance and topical pain medication for laboratory draws to prevent the discomfort of multiple needlesticks. These actions, however, do not offer the child a sense of control.
A 9-year-old child with rheumatoid arthritis has difficulty moving the hands as well as other joints due to pain. The child refuses to participate in the prescribed physical therapy. What would be the best way for the nurse to make sure the child continues to exercise the joints? Give the client a coloring book about arthritis. Show a video about exercising. Play a game like "Simon Says" to introduce exercises. Give the client a pamphlet about the importance of exercise.
Play a game like "Simon Says" to introduce exercises. School-aged children love to play games. By playing "Simon Says" and introducing different exercises to help with movement, the nurse may help stimulate the client to want to be active. Reading about exercises and seeing them demonstrated by a person or in a video will not increase the child's desire, especially since the child is in pain. Exercise for this child should be a pleasant experience and playing a game will help accomplish that goal.
When planning to teach a toddler about coughing and deep breathing, which would be most effective? Showing an audio-visual Demonstrating the technique Discussing the importance of coughing Playing a game with coughing and breathing
Playing a game with coughing and breathing Toddlers have vivid imaginations so teaching should be done where the child can take an active role and understand the reality instead of the imaginary. Toddlers respond best to teaching techniques that include games so they feel as if they are playing instead of learning. When the child is active in the learning process it fosters self-confidence and provides them with a sense of control over the situation. The toddler age group does best learning when they can use all their senses in the learning process. Demonstrating, instructing, or showing a video does not provide this opportunity.
A nurse is assigned to care for a 6-month-old infant hospitalized with diarrhea and dehydration. Because the infant does not have developed speech, what can the nurse do to communicate with the infant? Write on a whiteboard. Use puppets to communicate with the infant. Sing to the infant. Use a stuffed animal to tell a story.
Sing to the infant. Infants primarily communicate through touch, sight, and hearing. Communication can occur through cuddling, holding, rocking, and singing to the infant. The child cannot read, so writing on the whiteboard would be beneficial only for the parents. A 6-month-old infant uses toys as developmental tools, not communication tools. The infant may want to snuggle with the stuffed animal while the nurse tells the story or sings.
The nurse is meeting an 8-year-old girl with cancer and her family for the first time. What will best help to establish a relationship with the child and family? Select all that apply. Sitting at eye level with the child and parents. Keeping both a relaxed posture and word flow. Redirecting the conversation to maintain focus. Listening to the child and family while interjecting one's own knowledge of the events. Avoiding the use of the parents' and child's descriptors.
Sitting at eye level with the child and parents. Keeping both a relaxed posture and word flow. Redirecting the conversation to maintain focus. Sitting at eye level, keeping congruence between verbals and nonverbals, and redirecting the exchange to maintain focus are all good communication techniques and help build a positive working relationship. Listening to the child/family while continuing with the nurse's own agenda will uncover little information and signal a lack of true interest. Not using the family's or child's descriptors (and substituting with one's own) is a controlling maneuver on the part of the nurse and disallows reflection and the opportunity to truly understand and show empathy.
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? Provide information and allow the adolescent to process and ask questions. Offer choices whenever possible. Speak directly to the adolescent and consider the client's input in the decisions about care and education. Praise the adolescent often.
Speak directly to the adolescent and consider the client's input in the decisions about care and education. A teaching tip for adolescents that will 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. Adolescents are particularly sensitive about maintaining body image and the feelings of control and autonomy. Reasons as to why things are important should be conveyed to them. The nurse should collaborate with the teen to develop an acceptable solution to being compliant. The nurse should also expect some noncompliance from adolescents. Even with noncompliance in some areas, there some things the adolescent does well—and the adolescent should be praised for these accomplishments. Choices can be offered whenever possible but for a client with diabetes these choices are often limited.
A nurse is caring for a 12-year-old child who is very demanding. Within 4 hours, the child has pressed a call light 12 times for multiple reasons. What does the nurse understand may be the reason for this child's demanding behavior? The child is spoiled at home and is continuing this behavior in the hospital. The child wants to be sure the nurse is doing what he or she is supposed to be doing. The child may be insecure or afraid. The child is expecting quality care from the nurse.
The child may be insecure or afraid. Demanding behavior generally stems from insecurity or fear. The child may be so afraid that something will happen while the nurse is away that he or she constantly finds more for the nurse to do to keep the nurse available. The child does not understand what "quality" care is nor does the child understand a nurse's role. This would be a situation where the nurse could make a referral to the child life specialist. Therapeutic play may help resolve some of the fear and insecurities. The nurse should also make an attempt to see the child as often as possible knowing the child is alone. If the child is ambulatory, he or she could also be introduced to the playroom.
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? The child may not want to be treated for the asthma. The child may be developmentally delayed and not understand the conversation. The child may be angry about the diagnosis of asthma. The child may be shy and have some reluctance about communicating.
The child may be shy and have some reluctance about communicating. It is difficult to assess how shy children feel when they are reluctant to communicate about such things as the long-term effect a disease will have. If they do not proved much verbal feedback, the tendency is to believe they do not have a concern. The nurse should give the child time to warm up in the conversation. Because this child may not talk much, therapeutic play could help and involve the child in the education process. There is no way to know if the child is just shy, angry, delayed or just does not want to be treated until a way is found to communicate with the child.
The nurse is caring for a 6-year-old girl who will be undergoing a surgical procedure that will result in a temporary ileostomy. Which approach would be most effective in helping prepare the child for surgery? Use a doll to role-play the events surrounding the surgical experience and the procedure. Draw a picture that explains the procedure. Show the child photographs of another girl with her ileostomy. Show the child a teaching DVD about ileostomy care.
Use a doll to role-play the events surrounding the surgical experience and the procedure. Using a doll to help the child understand surgery and the procedure will promote understanding in a developmentally appropriate way. Children this age enjoy role-play and regularly use it in everyday life to rehearse events. Drawing a picture may be helpful and age appropriate but less effective than the role-play. Showing the teaching DVD will include information the child is not yet ready for and, unless prepared for young school-agers (unlikely), would not be at her level of understanding. Showing the child photographs of another girl with an ileostomy would be more helpful to an older school-ager. At that time peer modeling can be helpful in teaching as well as in capturing interest.
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? dolls video story pictures
dolls Preschool-age children tend to be frightened of intrusive procedures. Explaining to preschool-age children what the sibling may look like or what the environment may look like is difficult for them to comprehend. Explaining to children why the tubes are necessary, why the sibling cannot talk, and what the sibling will look like is best taught with dolls or puppets. Using dolls or puppets help children visualize details. Pointing to a place on a doll's body is not as intrusive as pointing to the child's own body. Visualizing the tubes coming out of the doll helps the child visualize details. Explaining to children why the tubes and the machines are necessary calls for clear understanding and praise for learning. Pictures, videos, and stories do not allow the child to actively participate in the learning process.
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? coloring games dolls demonstration
dolls Teaching preschool children about what to expect from a hospital experience is often taught using a series of puppets or dolls to represent different hospital personnel such as the surgeon, a nurse, and a nurse's assistant. Preschool children are particularly receptive to puppets and dolls because, with their imagination at its peak, they believe the puppet or doll is actually talking to them. Children can practice giving the doll "shots" or submitting it to procedures they will experience. Coloring, games, and demonstration can be helpful in many situations, but dolls allow the child to have a hands-on learning experience.
The community health nurse is assessing a new client who reports having recently moved to the area and living with an aunt and her parents. The nurse determines this client resides in which type of family structure? extended immediate communal blended
extended The extended family is an immediate family with other family members in the same house. The immediate family is composed of an individual's smallest family unit (commonly parents and their children), all of whom share a common household. Members of a communal family share responsibility for homemaking and child rearing; all children are the collective responsibility of adult members. In a blended family, both partners in the marriage bring children from a previous marriage into the household.
The nurse is teaching a 15-year-old boy with type 2 diabetes and his parents how to monitor glucose levels. Which communication technique is least effective? ignoring the adolescent's tirade about his therapy paraphrasing the parents' comments before responding using the adolescent's words during the conversation using reflection to clarify the parents' understanding
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.
A 9-year-old child is newly diagnosed with asthma. The nurse plans to teach the child about triggers related to the diagnosis. What would be the best approach for this child? play an allergy trivia game with the child show the child a video about planning for allergic-reactions give the child a list of foods he or she cannot eat have the health care provider teach the child this information
play an allergy trivia game with the child Learning through play is a valuable tool at this age. School-age children like to participate in their learning. Watching a video is more passive rather than active. It does not give the child the chance to ask questions or get explanations about things in the video that were not understood. Giving the child a list of what he or she cannot have is a negative approach. Using a negative approach generally causes rejection, so the child will not follow through. Educating clients and their families is a large role of nursing.
The nurse is communicating with a family about their child's illness. Which communication technique would be considered a block to effective communication with the family? using silence using clichés defining the problem clarifying
using clichés A cliché is the first level of communication. It is pleasant chatting and not intended for a relationship to extend beyond a superficial level. Introducing one's self and role allows the communication to progress to a more therapeutic level. The use of silence will allow the parents to sort out their thoughts. The nurse needs to clarify in the communication to illicit the information needed. The parents both will need to collaborate to define the problem so that a plan of care may be developed.
The registered nurse (RN) and licensed practical nurse (LPN) are caring for a adolescent clients. The RN will intervene if the LPN is seen in which situation while caring for a client? actively listening to the client while maintaining a relaxed, open body posture speaking to the client while the caregivers listen and observe asking open-ended questions when talking to the client using medical terminology to answer the client's questions
using medical terminology to answer the client's questions The RN will intervene when the LPN uses medical terminology to answer the client's questions. Terminology that the client can easily understand should be used. It is appropriate for the LPN to actively listen, speak to the client, and ask open-ended questions.