Nursing Considerations for the Child and Family with a Chronic condition

The nurse is planning care for the family of a child with a chronic illness. Which activities will the nurse recommend to decrease the risk for compassion fatigue? Select all that apply. 1. Fostering social relationships 2. Exercising 3. Developing a hobby 4. Moving away 5.Sleeping more than 9 hours per 24-hour period

1,2,3

The nurse is working with the parents of a child with a chronic condition. Which statement made by the child's parents indicates the need for intervention related to overwhelming caregiver burden? 1. "My mother moved in and helps us with the care of our family." 2. "I chose to quit my job to be home with my child, and my husband helps in the evening when he can." 3. "I have to care for my child day and night, which leaves little time for me." 4."Our health insurer sent us a rejection letter for my child's brand-name medication, and we must fill out forms to get the generic."

3

The mother of an adolescent with multiple medical and developmental issues says to the nurse: "There are times that I think about just walking out of the house and not coming back." Which would be an appropriate nursing diagnosis for this mother? 1. Caregiver Role Strain related to providing 24-hour care for a child with medical and developmental issues 2. Risk for Injury (maternal) related to overwhelming demands of the medically fragile child 3. Knowledge Deficit (maternal) related to nursing care of the child 4.Health-seeking Behaviors (maternal) related to interest in learning to care for her child

1

The nurse is conducting an educational program for parents of children with chronic conditions. Which parental statement indicates the need for further instruction? 1. "I know my child will get better and not have to take any more medication." 2. "I know my child will need assistance with activities of daily living." 3. "I know my child may need specialized education." 4."I know my child will have to stay on a special diet."

1

The nurse is providing care to several hospitalized pediatric clients. Which child has the greatest risk for a developmental disability? 1. An 18-month-old admitted with a diagnosis of near drowning 2. A school-age child newly diagnosed with type 1 diabetes mellitus 3. An toddler with sepsis 4.A 2-year-old child with a fractured femur

1

The nurse works in a clinic for medically fragile children who require home care. The nurse has noticed that a high percentage of the families parents divorce. In an attempt to reduce the divorce rate among the parents, the nurse creates an educational session for parents of medically fragile children. Which should be the focus of this session? 1. Communication 2. Financial stability 3. Ways to meet the child's physical needs 4.The state laws that have relevance to the medically fragile child.

1

The nurse provides care to pediatric clients with chronic disease process. Which diagnoses does the nurse categorize as dependent on medications or special diets? Select all that apply. 1. Diabetes mellitus 2. Epilepsy 3. Celiac disease 4. Down syndrome 5.Traumatic brain injury

1,2,3

The nurse of the family who is assuming the role of care coordinator is providing education regarding the use of a healthcare log. Which will the nurse encourage the family to include on this log? Select all that apply. 1. Role of each provider 2. Date of each appointment 3. Prescribed interventions 4. Future treatments 5.Out-of-pocket cost

1,2,3,4

The nurse provides care to pediatric clients with chronic disease process. Which diagnoses does the nurse categorize as needing increased use of healthcare services? Select all that apply. 1. Cancer 2. Sickle cell disease 3. Renal failure 4. Cystic fibrosis 5.Autism spectrum disorder

1,2,4

The nurse is planning care for a school-age child who requires oxygen, enteral tube feedings, and IV medications during the school day. To which category of chronic illness does this child belong? 1. Dependent on special diet 2. Dependent on medical technology 3. Increased use of healthcare services 4.Functional limitations

2

The nurse is providing care to a pediatric client who is newly diagnosed with a chronic condition. The parents ask, "When will our child be able to assume more responsibility for managing the disease?" Which age group will the nurse include in the response to the parents? 1. Preschooler 2. School-age 3. Adolescent 4.Toddler

2

The nurse is providing care to a toddler-age client newly diagnosed with a chronic condition. Which nursing action will prepare the family for providing care to the toddler once discharged from the hospital setting? 1. Suggesting that the parents use a mobile to provide sensory stimulation 2. Helping the parents recognize their child's capabilities 3. Allowing the child to choose the color of the gown during hospitalization 4.Suggesting the child be enrolled in a special camp to learn about the diagnosis

2

After the infant is diagnosed with a chronic health condition, the family is assigned a nurse case manager. Which will the nurse include in the explanation to the infant's parents regarding this role? 1. Limiting the number of visits to the healthcare facility 2. Preventing duplication of services 3. Improving the quality of life for the child and parents 4. Recognizing the equipment needs of the child and providing assistance with equipment acquisition 5.Visiting the child in the home to assist with physical care

2,3,4

The parents of a 4-month-old child learn that there will be long-term consequences due to the head injury sustained in a motor vehicle accident, including intellectual disability and cerebral palsy. The parents express anger at the diagnosis and project that anger on the nursing staff. Which responses by the nursing staff are appropriate? Select all that apply. 1. Referring the family to the hospital administrator 2. Recognizing that the parents' anger is a normal response to the news 3. Continuing to provide physical and emotional care to the child and family 4. Offering hospital resources to the parents in addition to continued nursing support 5.Explaining to the family that you are sorry about their child's injury but suggest they transfer the child to another hospital for their own comfort

2,3,4

The nurse care coordinator is supporting a family who wishes to become their child's care coordinator. Which statements will the nurse include in the teaching session to prepare the family for this task? Select all that apply. 1. "You won't need to set aside much time to properly coordinate your child's care." 2. "Care coordination requires ongoing assessment of your child's needs." 3. "Since you are the parent you will not be required to use cost-efficient strategies when coordination your child's care." 4. "Care coordination requires you to be educated regarding your child's diagnosis." 5."There is a care coordination workshop provided by hospital educators that will help you to learn this role."

2,4,5

The nurse is conducting a nursing assessment of the parent and child with severe cerebral palsy during a routine clinic visit. Which nursing action is appropriate based on the current data? 1. Measuring the urine output 2. Measuring the child's head circumference 3. Observing the parent-child relationship 4.Observing how the child interacts during play

3

The nurse observes that over time, the parents of a child with a chronic condition have experienced a pattern of periodic grieving alternating with denial. Which will the nurse include in the child's updated plan of care? 1. Pathologic Grieving 2. Compassion Fatigue 3. Chronic Sorrow 4.Dysfunctional Parenting

3

Which does the nurse include in the plan of care for an adolescent with a chronic condition? 1. Being more concerned for parents 2. Exhibiting less concern about appearance 3. Having an altered body image 4.Portraying a higher self-esteem

3

The nurse is partnering with the family of a hospitalized premature neonate who suffered an intraventricular hemorrhage (IVH). After 3 months in the neonatal intensive care unit (NICU), the infant is being discharged. Which activities will the nurse suggest to the family to help stimulate the infant's development? Select all that apply. 1. Using a day care for stimulation 2. Discouraging sibling interaction 3. Holding and rocking the infant 4. Interacting face to face 5.Talking softly and singing to the infant

3,4,5

The school nurse is reviewing the records of all incoming kindergarten students. Which students will require an individualized education plan (IEP)? 1. The child with diabetes controlled with insulin 2. The child with a casted arm due to a fracture 3. The child with a hearing deficit 4. The child with autism spectrum disorder 5.The child with an IQ of 60

3,4,5

A 3-year-old child, recently hospitalized for the exacerbation of a chronic illness, presents for a follow-up appointment at the pediatric clinic. The child's mother states, "He was potty trained before the hospital stay but now he is having daily accidents." Which response by the nurse is most appropriate? 1. "This is probably a reaction to the antibiotics and will disappear when the antibiotics are finished." 2. "Urinary incontinence is a common symptom of progression of cystic fibrosis. Be sure to notify the healthcare provider of this change." 3. "The child may have a urinary tract infection and needs to be evaluated." 4."Children often regress after hospitalization. Be patient and remind him to go to the bathroom frequently."

4

An adolescent diagnosed with type 1 diabetes mellitus (DM) is prescribed dietary restrictions and daily insulin injections. Which behavior does the nurse anticipate from the adolescent upon return to school? 1. Administering medication in front of peers 2. Teaching peers about the diagnosis 3. Acknowledging the condition to classmates 4.Exhibiting poor adherence to the prescribed treatment plan

4

The nurse is providing care to several pediatric clients in the hospital setting. Which client diagnosis is capable of producing chronic limitations for the child? 1. Pneumonia from the bacillus Haemophilus influenzae 2. Respiratory syncytial virus 3. Streptococcus pneumoniae, a gram-positive diplococcus 4.Congenital heart defect

4

The nurse learns that a newborn is diagnosed with phenylketonuria (PKU). Which is the most appropriate way to inform the newborn's parents about this diagnosis? 1. Calling the parents to provide the diagnosis over the phone 2. Mailing a certified letter explaining the diagnosis and requesting the parents make a pediatric office appointment 3. Planning a group meeting for all parents whose children received the diagnosis in the last two months 4.Scheduling an appointment for the parents to see the healthcare provider in person to discuss the diagnosis

4

The nurse is caring for a 17-year-old client with a chronic condition who will be transitioning into adulthood. When planning care for this client, which should the nurse consider? Select all that apply. 1. Ability to work 2. Ability to live independently 3. Psychosocial needs 4. Parental needs 5.Sibling needs

1,2,3

Which nursing action is appropriate when preparing the family of a school-age child with a chronic illness to provide care in the home setting? 1. Teaching the family about appropriate sensory stimuli, such as a mobile 2. Educating the family to allow the child choices, such as which food to eat first 3. Preparing the family for the transition of care into adulthood 4.Encouraging interaction between the child and others with the same diagnosis

4

The nurse is assigned as the care coordinator for a child with special healthcare needs. Which actions by the nurse enhance the family's ability to participate in their child's care coordination? Select all that apply. 1. Coordinating the healthcare team 2. Arranging the needed healthcare services 3. Modifying the home for care 4. Helping with decision making for meeting goals of care 5.Educating the family about the diagnosis

4,5