Chapter 36: Nursing Care of a Family with an Ill Child
A child is on a calorie count. Which is the best way for the nurse to record the child's intake?
"Ate a slice of wheat toast with butter and jelly."
While the nurse is playing with a 5-year-old child, the child draws a picture of a person with two legs, a head, and no arms. What would be the nurse's best response about this picture?
"Can you tell me about the person in your picture?"
A young child is observed saying, "I give shots to all the bad children" as the child is giving shots to all the dolls. Which response by the nurse is best in this situation?
"Do you think the only children who get shots are bad children?"
Which play activities would a nurse use to assess muscular-skeletal function in a 7-year-old? Select all that apply.
"Follow the Leader" "Simon Says" tossing beanbags into a container
A nursing student is learning tips when caring for children. The instructor informs students that they should not call children "honey." What explanation for avoiding this term is the best reason the nurse would give?
"Honey" can cause children to worry that they have been confused with another child.
The nurse is caring for a 10-year-old child dying of leukemia. The mother requests that the nurse allow her to bathe the child. The child has multiple IV lines, electrodes, oxygen tubing, and an NG tube. Which of the following is the best response by the nurse?
"I think that would be a great idea. Would you like some help with all the tubes?"
When a parent leaves a preschooler in the hospital, what is an appropriate statement to let the child know when the parent will return?
"I will be back after you have lunch."
The nurse is caring for a 7-year-old child in the pediatric unit. The parent states, "My child has suddenly become very clingy since we have been here." Which response by the nurse is appropriate? (Select all that apply.)
"I will let your child help me order the next meals and choose snacks." "Regression is normal at this age when a child is in a different setting."
A 5-year-old is scheduled for a tonsillectomy. Which statement to the child by the nurse is most therapeutic?
"The doctor is going to fix your tonsils while you are at the hospital."
The nurses suspects a 7-year-old child is malnourished. What question would the nurse ask the parent to best assess the child's nutritional status?
"What did your child eat for breakfast?"
The nurse is conducting an admission interview with the mother of a 2-year-old child. What history question is most important at this time?
"What is your child's normal routine?"
A 7-year-old is being admitted for day surgery. The nurse asks the child, "Do you know why you are coming to the hospital?" The child hesitates and looks at the parent. The parent responds, "We talked about it and are ready to get started." Which is the best response by the nurse?
"Will you tell me why you are here yourself?"
The nurse is preparing a 4-year-old patient for surgery. According to hospital policy, the surgical site must be marked prior to entering the operating room. The patient shies away from the nurse when approached with a black marker. Which is the best approach for the nurse to take?
"Would you like your mother or me to draw a smiley face on your arm?"
The nurse is caring for a 12-year-old patient with neuroblastoma. The nurse enters the room to hang a new bag of IV fluid. The mom looks up and states she feels helpless and there is nothing she can do for her child. Which of the following is the best response for the nurse to make?
"Your presence here is very important to your child. Is there some part of his daily care that you would like to do yourself?"
A 5-year-old child is scheduled for an elective outclient surgical procedure. When should the parents tell the child about the upcoming surgery?
5 days before it is scheduled
A nursing student correctly identifies an older infant who fixes the eyes on a new caregiver, becomes restless, thrashes arms and legs, and begins to cry as likely experiencing which of the following?
8-month anxiety
The nurse cares for multiple neonates. Which neonate is at highest risk for meconium aspiration syndrome?
A neonate born at 43 weeks' gestation to a mother who is 34 years of age
The nurse recognizes which person as needing further education?
A nursing assistant who is obtaining vital signs in the playroom
The nurse is completing an admission assessment on a patient in an acute care setting. Which of the following approaches is the most effective for the nurse?
Be certain the parents are present during the admission assessment.
As part of the admission process, the nurse assesses the child's cultural background. What is the significance of knowing a child's cultural background?
Behaviors and values are passes from one generation to the next.
Which interventions are appropriate to include in the plan of care for a hospitalized infant? Select all that apply.
Provide swaddling. Hang a mobile over the crib. Caress the infant while bathing.
A 4-year-old is ordered to bedrest. Which activity would be most appropriate for promoting play?
Providing a basin with water and toys while bathing the child
A nurse understands the importance of providing for a positive hospital stay for both the patient and his or her parents. One of the best ways to make sure this is achieved is by doing which of the following?
Providing for continuity of care
The nurse expects a 3-year-old to perform which action?
Ride a tricycle.
The nurse is correct to identify which psychological factor that often causes sleep deprivation while the client is in an acute care setting?
Separation anxiety
A pediatric nurse observes signs of separation anxiety and suggests rooming- in. The goal of rooming-in is to prevent which?
Separation anxiety for both pediatric client and caregiver
Which nursing intervention will help reduce a child's anxiety about hospitalization?
Show the child all equipment to be used, including sounds
The parents of a hospitalized toddler have been away for 2 days. When the parents come to visit the toddler, the child initially looks at the parent, then turns away, and continues playing with some toys. What should the nurse encourage the parent to do?
Speak to the child and engage in play with the child.
A 5-year-old girl was brought to the emergency room following a car wreck in which she sustained a head injury. She has been thoroughly assessed, including having a skull x-ray, which showed no signs of fracture. The child is conscious and demonstrates no signs of neurologic injury. Which of the following actions should the nurse anticipate performing next?
Teaching the parents of the child how to evaluate consciousness and assess for signs of intracranial pressure for the next 24 hours at home
A 16-year-old is hospitalized. What intervention does the nurse include in the plan of care?
Tell friends to come visit the adolescent.
A preschooler is hospitalized with asthma. His mother needs to leave to go home and check on her other children. It is close to dinner time and she plans on returning first thing in the morning. What should she tell her son before leaving to help in the transition?
Tell him she will be back after he wakes up tomorrow.
Postoperatively, the child needs to take deep breaths to expand the lungs. Which intervention(s) would be most successful with a 7-year-old child? Select all that apply.
Have the child blow a cotton ball across the surface of a bedside table. Play "Simon Says," in which Simon says, "Take a deep breath." Allow the child to score points for reaching a high number on an incentive spirometer.
A nurse is caring for an infant who has been admitted the hospital for surgery. Which of the following interventions should the nurse implement to ensure the continued growth and development of the infant during his stay?
Provide a singular room for the child and family in the neonatal intensive care unit
A school-aged child is scheduled for surgery. Which action would be most helpful to reduce the child's stress and anxiety?
Provide a tour of the surgery unit and allow the child to see, hear, and feel equipment that will be used during the stay.
A 15-year-old admitted for asthma exacerbation is nearing discharge and is requesting to take a shower. Which nursing intervention is most appropriate?
Provide privacy and needed supplies
When planning play activities for a hospitalized 9-year-old, the nurse considers that the child is at which developmental stage?
sense of industry
Parents bring their infant to the clinic because the baby has been vomiting and had diarrhea for the past 3 days. The nurse assesses the infant and finds dry mucous membrane and lethargy. Which other finding would support a nursing diagnosis of fluid volume deficit?
sunken fontanel
During hospitalization, which age group has the greatest potential to demonstrate regression?
toddlers
A 3-year-old child is admitted with poor nutritional status, weight loss, poor skin turgor, and dull hair. What lab test does the nurse anticipate being performed on this child to determine if the child is in negative nitrogen balance?
total protein
When evaluating the developmental level of a 2-year-old, the nurse would expect the child to perform which action?
using a cup to drink
A young patient has been corrected by nurses numerous times for running in the hallway. Which is the best action to take to modify this behavior?
Allow the child to accompany nurses to obtain a wheelchair.
A 10-year-old child will require daily shots for a new diagnosis of diabetes. Which equipment should be included when planning for therapeutic play?
An insulin syringe, an alcohol pad and fluid filled vial
The identification band on a infant was removed for performance of a procedure. What is the priority nursing intervention?
Apply a new band after verifying identity using two identifiers
A nurse working on the oncology floor is educating the family of 2-year-old child about the chemotherapy treatment that was ordered. The nurse knows that informed consent is needed for this treatment and provides which of the following interventions as the priority action?
Asking questions to verify the parents' understanding of chemotherapy
The nurse is caring for a child 3 hours after a motor vehicle accident, in which the child experienced a spinal cord injury at the C2 level. Which nursing action would the nurse implement?
Assure the ventilator alarms are addressed immediately
A nurse caring for a hospitalized 3 week old finds the infant's name band on the floor. Which is the nurse's best action?
Get two more name bands and place one on the infant's arm and the other on the infant's leg.
Which nursing intervention would be most appropriate for a 9-year-old hospitalized for shoulder dislocation?
Developing a collaborative plan for activities
A nurse is caring for a young client with pneumonia who has slight nausea and does not feel like eating. The client is sipping on fluids. The child's mother says that she is worried and wants the nurse to make the child eat. What is the best nursing action?
Encourage but do not force the child to eat.
A 4-year-old child is admitted to the hospital. The child is fearful. Which nursing intervention should be implemented to help this child?
Encourage the parents to stay with the child.
A 3-year-old is admitted to the hospital for pneumonia. Which intervention would be most effective in reducing separation anxiety?
Encouraging rooming-in
The nurse working on a pediatric floor understands the importance of promoting growth and development in all hospitalized patients. Which of the following activities would be an example of encouraging initiative in preschoolers?
Encouraging them to color in a medication schedule
A nurse is caring for a family whose child has been admitted to the hospital for orthopedic surgery. Which of the following should the nurse do to promote a positive hospital stay for the child and the family?
Limit diagnostic procedures to only those necessary to minimize the length of the hospital stay
The nurse is caring for a 6-month-old patient who has been hospitalized since birth. Which of the following nursing interventions is the most beneficial to this patient's psychosocial health?
Maintain consistent caregivers to promote trust and attachment.
A nurse is trying to maintain the healthy nutritional intake of a 7-year-old girl who has been admitted to the hospital for surgery. Which of the following should the nurse do encourage proper fluid intake in this child?
Offer the child popsicles
A hospitalized child has mouth ulcers. Which fluids would the nurse offer to the child? Select all that apply.
Pedialyte popsicles milk
What action by nurses can help achieve the 2020 National Health Goals?
Promote use of preventive services to help children stay well.
The nurse is working with a family whose daughter is dying of a brain tumor. When addressing the situation with the child's siblings, the nurse should prioritize what consideration?
The children's stages of growth and development
The parents of a 4-year-old are concerned the child cries when they leave the hospital. Which actions are most appropriate in this situation? Select all that apply.
The parents say good-bye, kiss the child, and leave. The parents tell the child they will come back to have breakfast with the child. The nurse holds and rocks the child to calm the child when the parents leave.
At what age are children able to see the body as a system?
age 10 to 11 years
Which nursing intervention best supports the concept of atraumatic care for a hospitalized child?
allowing adolescents to keep the hospital door closed
A 12-year-old child needs a nasogastric tube. Prior to inserting the tube, the nurse gives the child a nasogastric tube to handle. This approach meets which type of learning need?
concrete level learning
The nurse is caring for a 5-year-old in traction for a fractured femur. Which activity would the nursing include in the plan of care for this child?
crayons and coloring books
An adolescent is engaged in what psychosocial task?
establishing an identity
By the year 2020, the National Health Goals will address increasing the care provided for children with special needs in which environment?
in family-centered, comprehensive, and coordinated systems
Which sign of illness has less diagnostic value in children as compared to adults? Select all that apply.
nausea vomiting
The nurse is conducting a tour with a group of 6- to 8-year-olds scheduled for surgery that will require a 4-day hospitalization. Which area of the hospital will the nurse give the children time to explore?
playroom
When developing a plan of care, the nurse knows that children in which age group are most likely to view illness as a punishment for being bad?
preschool age
A young hospitalized patient whose parents have just left for a few hours begins to cry uncontrollably, thrashes about, and will not allow the nurse to provide comfort. This patient is exhibiting which stage of separation anxiety?
protest
The nurse is planning care for a young child with dehydration. Which strategy would promote increased fluid intake? Select all that apply.
providing small full glasses of fluid letting the child drink through a straw using games like "Simon Says" to make drinking a game offering the child popsicles and Jello
Group arts and crafts with an adult leader are a play activity most appropriate to children at which developmental stage?
school age