Chapter 29: Care of the Hospitalized Child Maternal Prep - U

The nurse is admitting a 14-year-old child for a tonsillectomy and is preparing the child for the procedure. Which communication is best?

"Are you wondering about anything related to your tonsillectomy?"

The nurse is caring for a 7-year-old child who will undergo an appendectomy. When teaching the child about the procedure, the child tells the nurse, "I'm scared I'm going to die." How should the nurse first respond?

"I understand you're scared."

The nurse is providing education on hospitalizations to parents of children with chronic disorders. Which statement will the nurse include about the purpose of rooming-in on pediatric units?

"It is to provide the child security and stability while hospitalized."

The nurse is caring for a preschooler who requires postsurgical breathing exercises. Which approach will best elicit the child's cooperation?

"Let's see who can blow these cotton balls off the table first."

A 6-year-old child diagnosed with pneumonia is admitted to the hospital for treatment. The child states to the nurse, "I think I am here because I am going to die. This is where my grandmother and uncle both died." Which response by the nurse is most appropriate?

"People come here for many reasons. We will give you the best care we can."

The nurse is working with a group of caregivers of children in a community setting. The topic of hospitalization and the effects of hospitalization on the child are being discussed. Which statement made by the caregivers supports the most effective way for children to be educated about hospitals?

"We are going to take our child to an open house at the hospital so she can see the pediatric unit."

A 10-year-old is scheduled for an appendectomy in 6 hours. The child is placed on NPO status and wants to know why he cannot have anything to eat or drink. What is the best explanation by the nurse?

"We cannot give you anything to eat or drink before your procedure because we do not want you to get an upset stomach."

While the nurse is admitting a 5-year-old client, the caregiver asks, "What can I do to make my child feel secure? This is our first hospitalization." Which nursing response is best?

"You staying with your child will provide the most security."

Which approach by the nurse best demonstrates the correct way to prepare a Hispanic child for a planned hospital admission?

Allow the child to put on surgical attire and "operate" on a doll to teach what will be happening.

A child's caregiver tells the nurse, "I plan to room-in with my child." Which action will the nurse take?

Ask if the caregiver would like to help the nurse with bathing the child and with the next dressing change.

What can a nurse do during an emergency admission to alleviate some of the child's and family's fears/anxieties over the situation? Select all that apply.

Ask the family members health history questions while the child is being initially treated. Place an identification bracelet on the child, explaining that this will help the hospital staff know who he or she is at all times. Undress the child for a physical examination as soon as they arrive. Remain calm, explaining procedures to both the family and the client in a caring manner.

The nurse is providing developmentally appropriate care for a toddler hospitalized for observation following a fall down the steps. Which measures might the nurse consider when caring for this child? Select all that apply.

Avoid leaving small objects that can be swallowed in the bed. Encourage parents to stay to prevent separation anxiety.

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?

Children this age often show regressive behaviors and have nightmares following hospitalization due to fear of another separation.

The nurse is caring for a preoperative pediatric client. What would it be best for the nurse to do with this client?

Determine how much the child knows and is capable of understanding.

The caregiver of an 8-month-old child in the pediatric intensive care unit (PICU) states a strong desire to hold the child. The caregiver states, "I know I cannot hold my child due to the equipment and their condition, but I wish I could touch my child." Which action by the nurse is appropriate?

Encourage the caregiver to sit beside the child, caressing and stroking the child.

The LPN enters a 3-year-old client's room and states it is time to go to the treatment room for their daily intramuscular ceftriaxone injection. The parent responds, "It has been a long day. Can we just do it in here?" Which action by the nurse is appropriate?

Explain why it is necessary to take the client to the treatment room.

A child is scheduled for a diagnostic procedure later today. The mother has been at the hospital with the child for the past 2 days and needs to go home. Which nursing intervention would be most beneficial for this caregiver?

Get the mother's cell phone number and tell her you will call her when the child goes down for the procedure.

The nurse is caring for a hospitalized adolescent. What intervention can the nurse use to promote a sense of control for the adolescent?

Give the adolescent a meal card to select food choice options for each meal.

The nurse is caring for a preoperative pediatric client. What would it be best for the nurse to do with this client

Give the adolescent a meal card to select food choice options for each meal.

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?

Go slowly with the acquaintance process.

A 2-year-old child is admitted to the hospital for dehydration. This is the first time the child has been in the hospital, and the caregiver has not arrived but is en route. The child is crying and appears afraid. Which intervention by the nurse is appropriate for this child?

Hold and rock the child until the caregiver arrives.

Visitors arrive at the nurse's station with latex balloons for a pediatric client. The visitors ask the nurse for a client's room location. Which action by the nurse is priority?

Inform the visitors latex balloons are not allowed on the unit.

Caregivers of a hospitalized toddler are being given safety instructions upon admission to the pediatric floor. Which action by the caregiver would be most important to the toddler's safety?

Keep the crib side rails up at all times.

A nurse is admitting a 7-year-old to the hospital. The child's parents will be unable to stay with him. What can the nurse do to help the child meet his developmental, emotional, and intellectual needs?

Make a referral to the child-life program.

A child is admitted with a highly contagious infection. Which nursing action is a priority?

Place the child on appropriate precautions for the diagnosis.

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?

Place the infant in a room close to the nurses' station.

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?

Prepare the child for hospitalization by explaining what to expect and showing him or her around the hospital.

The nurse is preparing a hospitalized 7-year-old girl for a lumbar puncture. Which actions would help reduce her stress related to the procedure? Select all that apply.

Pretend to perform the procedure on her doll. Teach her the steps of the procedure. Introduce her to the health care personnel.

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.

Provide a room for the class with hospital gowns, masks and equipment used on children. Tour the hospital, including the playrooms on the pediatric floors. Let the children lie in the beds, use the call lights and practice being a patient.

The nurse is caring for a 10-year-old child who is in a contact isolation room. Which intervention would be appropriate for this child?

Provide age-appropriate toys and games.

A 7-year-old child is upset because the family has to wear personal protective equipment (PPE) while in their room. When the family enters, the child cries and requests the PPE be removed. Which action by the nurse is appropriate?

Reinforce teaching to the child of why the PPE is required.

The pediatric nurse is caring for a group of children. Which clinical situation will the nurse identify as being a safety concern?

Sleepy mother holding her sleeping child at the child's bedside.

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.

Spend extra time to talk while in the room. Read a story while in the room. Play a game while in the room.

The nurse is caring for a preschool aged child following abdominal surgery. Of the following nursing actions, which is the highest priority?

The nurse uses pain assessment tools.

Which client does the nurse understand would be the best candidate for patient-controlled analgesia (PCA)?

a 7-year-old who understands that when the button is pushed he will get medication to help relieve pain

Health care providers follow transmission-based precautions when caring for children with documented pathogens or children suspected of having highly transmissible pathogens. Which of the following are included in transmission-based precautions?

airborne precautions droplet precautions contact precautions

The pediatric nurse would use standard precautions in caring for which client on her floor?

an adolescent who has a broken arm

The following assessments are gathered from an 8-year-old pediatric client returning from surgery. Which information would need to be reported to the physician promptly?

anuria for 7 hours

The nurse is performing an admission of a 10-year-old child. Which action(s) by the nurse demonstrate ways to minimize distress and establish a trusting and caring relationship with the child and family? Select all that apply.

explaining the actions before performing them initiating introductions maintaining eye contact at the appropriate level asking the child to help develop the child's daily schedule

Which intervention is most important in assuring a child's cooperation and reducing his or her fear during an emergency room visit?

having the parent stay with the child

The nurse is caring for a client placed on droplet precautions. Which teaching is priority for the nurse to reinforce for the caregivers?

how to use and apply personal protective equipment

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?

immediately upon the client's admission to the unit

A school-aged child needs to have an IV started. Where would be the best place for the nurse to perform this procedure?

in a treatment room

A young child has been admitted to the hospital and is displaying signs of the second stage of separation response. Which behavior by the child demonstrates this stage? The child:

lies in the bed, looking at the wall.

On the first postoperative day, a 4-year-old child who was hospitalized for an emergency appendectomy has begun to cry relentlessly, will not let the nurse touch him or her, and keeps asking for the parent. The pediatric nurse is aware that this client is in which stage of separation?

protest

The nurse caring for a 6-month-old infant can best reduce the stress of hospitalization by:

supporting the parent and his or her caregiving efforts.

A 12-year-old child is being discharged from the hospital. The nurse provide discharge instructions to:

the child and the parent.

The nurse is caring for a 10-year-old child admitted for a surgical procedure to be done the next day. The nurse takes the child to a special area in the playroom and lets the child "start" an IV on a stuffed bear. This is an example of:

therapeutic play.

A nurse caring for a 5-year-old who had abdominal surgery yesterday is trying to teach the child how to take deep breaths. The best way that the nurse can accomplish this is by:

using a pinwheel.

In caring for pediatric clients, which statement best describes when the will nurse follow standard precautions to provide care for a client?

when providing care to any client

The public health nurse is educating parents of young children about awareness of the hospital. When is the best time to educate the children about the hospital?

when the children are capable of understanding basic functions of community resources

The nurse is caring for a hospitalized toddler who is prescribed bedrest. Which item(s) would the nurse recognize as appropriate for the toddler? Select all that apply.

boxes to put toys in and/or take out toys stacking blocks or small boxes nursery rhymes or sing-along songs on tape

A nurse realizes that a child's hospitalization is stressful for the family for which reasons? Select all that apply.

cause of the illness the illness's treatment guilt about the illness past experiences of illness and hospitalizations disruption in family life

A nurse asks a 5-year-old to use a color scale during a pain assessment. The nurse gives the child crayons and the child picks a red crayon to indicate the pain level. This indicates that the child is experiencing which level of pain?

most pain

The nurse is caring for a hospitalized pediatric client placed on transmission-based precautions. Which activity(ies) will the nurse include in the plan of care to provide diversion and limit boredom? Select all that apply.

Provide a collection of age-appropriate books and puzzles for the client. Encourage the client's caregivers to engage the client in activities the client enjoys. Plan a nursing schedule to allow time for the nurse to play a game with the client. Encourage the client to perform appropriate physical exercises in the room. Assist the client to use electronic devices to communicate and virtually visit with friends.

A 3-year-old who has just been admitted with pneumonia needs to have an intravenous (IV) line inserted for antibiotic therapy. What is the best nursing action?

Take the patient to the treatment room to have the IV inserted.

A 5-year-old scheduled for surgery in the morning wakes at 2 am and asks the nurse for something to eat and drink. What should the nurse tell this client?

that not having food or drink before surgery will prevent an upset stomach

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?

the pediatric treatment room

The nurse is caring for a 10-year-old boy who is in traction. The boy has a nursing diagnosis of deficient diversional activity related to confinement in bed that is evidenced by verbalization of boredom and lack of participation in play, reading, and schoolwork. What would be the best intervention?

Enlist the aid of a child-life specialist.

After teaching a group of students about therapeutic play, the instructor determines that additional teaching is needed when the students identify what as a characteristic of therapeutic play?

use of a highly structured format

A nurse getting ready to conduct preoperative teaching with a 9-year-old child realizes that the best method when teaching young clients is to:

use short sessions.