Pediatrics Ch. 19

In what behavior may an infant engage as an attempt to control the environment when hospitalized?

Expressing emotions

The nurse is providing care to a school-age child in an ambulatory setting. What are the benefits of ambulatory care? Select all that apply.

Minimized stressors compared to hospitalization No separation anxiety in the child Reduced chances of infection Increased cost savings

The nurse is asked to take vital readings of a preschooler. What actions does the nurse take to prevent anxiety in the child?

Performs the procedure quickly

What intervention by the nurse can help ease negative feelings and fear in a 5-year-old child being admitted to the hospital?

Preparing the child for the hospital experience

The parents of a child in isolation ask the nurse about the kinds of toys that would be appropriate for their child. What is the nurse's best response?

Provide toys that can be disinfected after every use.

Which intervention will decrease separation anxiety when a child is in the hospital?

Providing the child's favorite blanket and toy

What factors are most likely to affect parents' reactions to their child's illness? Select all that apply.

Religious belief Strength of support system Seriousness of the threat to the child Previous experience with illness or hospitalization

The nurse needs to start an intravenous (IV) line for an 8-year-old child to begin administering IV antibiotics. The child starts to cry and begs the nurse, "Do it later, OK?" What is the most appropriate action by the nurse?

Start the IV line because unlimited procrastination results in heightened anxiety.

The nurse is caring for a child whose parents are unable to stay with the child for long hours. What action by the nurse helps to ease the feelings of separation from home?

Surround the child with familiar articles.

What action represents posthospital dependency?

The child clings to the parents after discharge.

The nurse observes that a preschool child admitted to a pediatric ward appears happy and interacts with strangers after 2 weeks. The child had initially screamed and cried for the parents and stayed away from strangers. What can the nurse conclude from the child's behavior?

The child is trying to cope with the anxiety of separation.

A child is being hospitalized for an illness. What information about hospitalization and illness does the nurse provide to the parents? Select all that apply.

The nature of the illness and treatment Home care required after discharge Child's physical reactions to illness Child's emotional response to hospitalization

The parents of a ventilator-dependent child tell the nurse that their insurance company wants the child discharged. The child's parents explain that they do not want the child home "under any circumstances." What should the nurse consider when working with this family?

The parents' desire to have the child home is essential to effective home care.

Separation anxiety is common in which age group of children?

Toddlers

Which action by the nurse would likely scare a child during a physical examination?

Using equipment that makes loud noises

Which is an example of dramatic play?

Using puppets to decrease anxiety

What does the nurse avoid when communicating with a child during emergency admission counseling?

Using the words "honey" or "dear"

A school-age child is admitted to the hospital for an extended duration. The nurse observes that the altered routine due to the hospital stay is causing inactivity in the child and lack of interest in the environment. What action does the nurse take?

Writes a daily schedule of activities and leaves it in the child's room

What is a common experience of a sibling during a sister's or brother's illness or hospitalization?

Anger

What intervention by the nurse helps to reduce separation anxiety in a child placed in isolation?

Move the bed to a window with open shades.

What are the different stages of separation anxiety in children? Select all that apply.

Protest Despair Detachment

What change does the nurse teach the parents to expect in their child after prolonged hospitalization?

Regression in newly learned skills

The nurse caring for a school-age child observes behaviors of detachment. What intervention by the nurse helps to overcome the stage of detachment or denial?

Talk to the child about the significance of the parents' visit.

The nurse removes an intravenous needle from a toddler's hand and quickly covers the area with a bandage. Why is a bandage particularly important in this age group?

Because toddlers have poorly defined body boundaries

To what do the psychosexual conflicts of preschool children make them extremely vulnerable?

Bodily injury and pain

What is the most appropriate way for the nurse help a child feel empowered to cope during a painful procedure?

Coaching the child in learning a skill that will distract her

What are some environmental stressors for the child and family in the pediatric intensive care unit? Select all that apply.

Constant lights Unfamiliar sounds

What behavior does a 3-year-old-child show in the protest stage of separation anxiety?

Cries and screams at his or her parents

A child is sad, does not communicate, and has no interest in playing. In what stage of separation anxiety is the child?

Despair

What is the most common reaction of many parents to their child's hospitalization?

Fear

What strategies can the nurse suggest to help the family of a 5-year-old child prepare for transportation home from the ambulatory setting? Select all that apply.

Have a blanket or pillow in the car. Take a basin or plastic bag along in case of vomiting. Ensure that they take all personal items home with them from the ambulatory setting. Carry the written discharge information regarding potential side effects of pain medication with them.

The nurse is providing care for a child transferred to an intensive care unit. What interventions does the nurse include in the child's plan of care? Select all that apply.

Informs the parents that they can call the unit at any time Monitors the child's siblings' reactions during visits Asks visitors to avoid loud, abrupt noises or loud talking Explains the child's condition to the parents in simple terms

A child is admitted to the intensive care unit after surgery. What psychologic stressors can affect the child? Select all that apply.

Lack of privacy Inadequate knowledge Severity of illness Parental behavior

The nurse engages a child in play activities during the child's hospital stay. What benefits of play does the nurse expect in the child? Select all that apply.

Makes the child feel more secure Encourages interaction Lessens the stress of separation Helps to develop positive attitudes

When caring for children, which child does the nurse recognize as having an increased risk for poor coping strategies?

A child undergoing multiple invasive procedures

A 2-year-old child has just been admitted to the hospital with pneumonia. The child is crying and visibly upset. The nurse is beginning to perform the physical assessment when the mother asks, "Would it be better if I left the room?" What is the best response by the nurse?

"I can perform the assessment while you hug him on your lap. I think he'll feel safer that way."

The parents of a young child tell the nurse that they cannot stay with their daughter during hospitalization. What can the nurse say to the parents that will help the child adjust to their absence?

"At this age children often need the comfort and reassurance of familiar toys from home."

A mother tells the nurse that she will visit her 2-year-old son tomorrow about noon. During the child's bath, he asks for Mommy. What is the best reply by the nurse?

"Mommy will be here after lunch."

What interventions by the nurse help the child and family to overcome fear and prepare for hospitalization? Select all that apply.

Allow the family and child to express their concerns. Orient the child and family to the hospital and its routines. Use puppet shows or videos to explain hospital processes.

When caring for a toddler admitted to the hospital, what behavior does the nurse recognize as a sign of separation anxiety in the protest phase?

Attacking strangers verbally

What is the primary nursing goal for a hospitalized toddler?

Encouraging parents to room in

The nurse is providing care to a preschool child. The parents have left familiar toys with the child because of their inability to be with the child. What further actions can the nurse take to help the child adjust to separation from the parents?

Place an identification band on the toy.

The nurse is caring for a school-age child with a leg cast. What types of play activities does the nurse include in the child's care plan?

Provides Lego blocks and building materials for the child

The nurse is preparing the family of a child for admission to an ambulatory setting for surgery. What actions does the nurse take? Select all that apply.

Provides a tour of the facility Provides a review of the day's events Suggests items to bring to the facility Acquaints the child with the surroundings

The nurse is preparing a school-age child for hospitalization. What does the nurse include in the teaching? Select all that apply.

Provides miniature hospital equipment for the child Describes the different aspects of hospital stay Answers any questions the child has about hospitalization Ensures that the child pays attention to the information

What is the major stressor of hospitalization for children from middle infancy throughout the preschool years?

Separation anxiety

Which question during the preadmission assessment by the nurse helps to determine whether additional preparation is needed for the child's hospitalization?

"Is the child allergic to any medicine?"

A school-age child is at risk for infection and is placed in an isolation room. What does the nurse tell the child to prevent stress?

Says that it is a special place that makes all the germs go away

What is a common fear of hospitalized adolescents?

Altered body image

What behavior does the nurse expect when caring for a preschooler admitted to the hospital? Select all that apply.

Cries quietly for the parents Tolerates brief periods of separation Develops trust in adults

The nurse is caring for a 10-year-old child who has been hospitalized for a long period of time. What intervention by the nurse can help to minimize threats to the child's development and prevent regression?

Encourage the child to resume school work.

When caring for a school-age child, what interventions by the nurse help the child to become a cooperative and satisfied patient? Select all that apply.

Engaging the child in a hobby Allowing the child to choose a menu Permitting age-appropriate board games

The nurse is preparing the child and the family for discharge. What does the nurse include in the teaching? Select all that apply.

Explains how to provide care for the child at home Asks return demonstration of the skills Asks the family to contact appropriate support agencies Informs about possible stressors

The nurse is providing care for a school-age child after appendectomy. The child is worried that abdominal pain again will result in another operation. What action does the nurse take?

Explains that the problem is fixed and will not return

The nurse is providing care to a 7-year-old child with a cast in a hospital setting. The nurse observes that physical restriction is causing stress in the child. What actions can the nurse take to make the child comfortable? Select all that apply.

Move the bed towards the window. Provide musical or tactile toys. Provide video game systems.

The nurse is providing care for a toddler in a hospital setting. The nurse observes that the parents are unable to visit the child often, and the child has become inactive, sad, and uncommunicative. What does the nurse conclude from the child's behavior?

O The child is in the despair stage of separation anxiety.

A child is hospitalized for a respiratory illness. What actions does the nurse take to provide comfort to the parents? Select all that apply.

Provides reassurance to the parents Informs about the skills of the staff Helps them to accept the reality of hospitalization Provides information on coping strategies

A nurse is caring for a 6-year-old child recovering from surgery in an outpatient setting. What is the priority nursing intervention for this family at discharge?

Providing guidelines on when to call their practitioner regarding a change in the child's condition

An adolescent is admitted to the hospital for a fractured femur. What are the most appropriate nursing intervention(s) in the care of this adolescent? Select all that apply.

Providing written material about the hospital Explaining the upcoming surgery to the adolescent, using anatomically correct models Providing an opportunity for the adolescent to talk with peers who have had a similar experience

A primary nursing goal for the hospitalized child than 5 younger years is to prevent:

Separation from parents

A preschool child admitted to the hospital does not seem to be happy when the parents visit. The parents express their concern to the nurse. What is the best response by the nurse?

The child's behavior is a superficial adjustment to the separation.

What does the nurse teach the child and family about the distinctive features of ambulatory or outpatient care settings?

There is minimized separation from family.

The nurse is providing care for an adolescent with minor injuries. What are the developmentally appropriate activities that the nurse includes in the adolescent's plan of care? Select all that apply.

Permits wearing street clothes Provides access to Internet Provides adequate supply of snacks Provides video game systems