Pediatric Growth and Development
The nurse is providing teaching for the parents of an 8-year-old girl who has undergone surgery. The nurse emphasizes the importance of maintaining adequate hydration. Which of the following responses by the mother would indicate a need for further teaching? "Ice ships count as fluid intake, One cup of ice equals a half-cup of water." "Anything that melts at body temperature is counted as a fluid." "I should offer her small amounts of fluid frequently." "I will remind her that she will need an IV if she does not drink."
"I will remind her that she will need an IV if she does not drink." The child is likely to view an IV both as frightening and as punishment. Intravenous fluids should be seen as therapy. Threat such as this should not be used to achieve compliance with eating or drinking. The other statement show understanding.
Which of the following will the nurse view as best maintaining normalcy in the life of a 10-year-old boy who is experiencing a lengthy hospitalization? Keeping up with his school work. Playing board games with the child life specialist. Choosing the time of his bath or shower. Writing down his oral intake on the day and evening shifts.
Keeping up with his school work. A school-ager is exactly that—someone whose life is centered around school. Doing school and homework assignments is part of his usual day when not hospitalized. Watching daytime TV is not. Choosing the time hygiene activities occur provides him some control, while tracking his oral intake is an opportunity to participate in his care. Playing board games with the child life specialist is an age-appropriate activity that provides distraction. These support him developmentally but do not normalize his day as does keeping up with school assignments. It will be easier for him to return to the classroom and feel more in step with his peers by doing this.
Development should continue during hospitalization. What play activities will the nurse choose for toddlers to accomplish this? Select all that apply. Watching a mobile Stacking blocks Pulling a toy train Putting together a large-piece puzzle Batting balloons
Stacking blocks, Pulling a toy train, Putting together a large-piece puzzle Pulling a toy train encourages movement and the development of gross motor skills important to the toddler. Stacking blocks and putting together a puzzle uses fine motor skills and an understanding of shapes and space and is stimulating cognitively. Watching a mobile is appropriate for infant and may be unsafe if the toddler could reach it. Balloons are inappropriate in the hospital setting (latex sensitivity) and are an aspiration risk. Mylar balloons may be considered safe, although attached long strings or ribbons are not.
The school nurse is caring for an 8-year-old boy with asthma. Which of the following is most likely to be part of the child's Individualized Health Plan? Storing the child's asthma inhaler in the health office. Making a monthly report of the child's asthma episodes to his physician. Helping the child modify his physical activity requirements. Giving the child his prescribed asthma medications.
Storing the child's asthma inhaler in the health office. Assisting the child in modifying the physical activity required of him is most likely to be part of the Individualized Health Plan. The nurse would record asthma episodes but probably not make a monthly report to the physician. The nurse would assist the 8-year-old with his medication regimen to promote self-care rather than administering the medications to him. The child should have ready access to his inhaler. It would not be stored in the health office.
A 15-year-old boy asks numerous questions about recovery from anesthesia and typical behaviors of someone awakening from sedation. The nurse interprets the concern of this teen to be: Anxiety related to the surgical procedure itself Adequacy of postsurgical pain control About a change in body image About his ability to control his own behavior
About his ability to control his own behavior These questions point to anxiety about how the teen may act while he has limited control of his behaviors. It is likely he does not want to appear "stupid, babyish, or uncool." All the other factors are typical adolescent concerns that may surface during the hospital stay.