Pediatrics: 34

The parents ask how to assist their 8-year-old child with the impending death of their preschool-aged child due to cancer. They report that their 8-year-old child keeps asking questions about how the sibling will die and they are worried that there is a fixation about the death. How will the nurse respond?

"Children at this age are curious about death; these questions are normal and answering will help with processing the grief."

A parent asks for help explaining the death of a sibling to a 5-year-old. Which response by the nurse is most appropriate?

"Explain the death using past experiences, such as when a pet died."

Which statement by the parents of a terminally ill client indicates to the nurse that they are in the stage of grief known as denial?

"I am optimistic that this new medication will cure her."

A child hospitalized with cancer expresses fear about going to sleep, that the child might die during the night. Which is the best nursing response?

"I can sit with you while you are falling asleep tonight."

The nurse is caring for a 14-year-old client who has a gunshot wound and whose prognosis is poor. The client will have testing to determine if brain death has occurred. The parents ask if organ donation will be an option if the client is determined to be brain dead. How will the nurse reply?

"Organ donation may be an option; we can discuss this with your child's primary health care provider."

The parents of a 5-year-old boy who is very near death are at the bedside. The parents ask, "Can he hear what we are telling him?" Which response by the nurse would be most appropriate?

"Yes, he can hear what you are telling him and may be able to understand most of it."

Which interventions should the nurse implement to strengthen a caregiver's coping skills as the terminally ill child approaches death? Select all that apply.

Offer reassurance that the caregivers are providing loving care. Encourage caregivers to rest and eat properly throughout the day. Explain that everything is being done to keep the child comfortable. Educate the caregivers on the visible signs of the approaching death.

The nurse is caring for a dying preschool-age child. Which action by the nurse is most appropriate?

Plan for someone to stay with the child as much as possible.

The nurse is caring for a terminally ill 14-year-old adolescent. What nursing intervention is most important ?

Promote open communication to the adolescent about what to expect.

The parents of a dying child have expressed the desire to have hospice care at home. What is the nurse's priority responsibility at this time?

Provide names of area hospices.

A terminally ill school-age child is awake at 2 AM and continues to put on the call light. What should the nurse do regarding this child's behavior?

Sit with the child until sleep comes.

The nurse is discussing care options with the parents of a terminally ill child who has taken a significant decline. In this situation, what is the greatest benefit of hospital care over home care?

the ability to provide care for the child and yet still be supported by nurses

The nurse is working with a support group for parents who have lost children. Which parent may have experienced anticipatory grief?

the parent of a child who had a near-drowning and died years later as a result of a complication

The best way to assist a preschool-aged child deal with death is to tell the child:

"Grandpa has died."

A hospice nurse has been preparing parents for the death of their child. How does the nurse recognize that the parents are dealing with anticipatory grief?

The parents have prepared a scrapbook of pictures of their child.

A family whose school-aged child died unexpectedly in an auto accident has agreed to donate their child's organs. Which initial action should the nurse take?

Notify the hospital's organ donor coordinator of the possible donation.

How would a nurse best advise the family to discuss the seriousness of the diagnosis with their terminally ill 6-year-old?

Tell the child, because the nurse and family are able to help the child with fears.

The nurse is caring for a preschool-age child who is aware of impending death. Based on the child's development, the nurse would incorporate an understanding of which concept into the child's plan of care?

The child has an underlying fear of being separated from parents

A family has a child who is dying. The nurse is working with the family to help them identify personal issues that need to be resolved. What does the nurse teach this family about the positive effects of settling this "unfinished business"? Select all that apply.

Upon resolution, the family will be able to spend more time with the child. Resolving the issues helps the siblings understand death. Resolving the issue allows family members a chance to share a love for the child.

The parents of a child diagnosed with a terminal illness tell the nurse, "This isn't fair!" What is the most therapeutic nursing response?

"This must be very difficult for your child and family."

The nurse is talking to a group of children who are 8 and 9-years-old and have lost someone close to them through death. Which of the following statements made by these children best characterizes the expected concept of death at this age?

"I guess we will all die sometime."

In which situation does the nurse anticipate symptoms of grief over the loss of a loved one to last longer than typically expected?

16-year-old who committed suicide over a break-up

When viewing grief in various age groups, death is viewed as which of the following by 5-year-old children?

They view death as reversible.

Jill is 20 weeks' gestation, and the fetus is diagnosed with anencephaly. Jill has decided to continue the pregnancy and donate the fetus's organs. Which action by the nurse would be most appropriate?

Document the information on Jill's electronic health record and alert the health care provider about Jill's decision.

A new nurse is caring for a child in the final stages of dying. Which nursing action would require the nurse mentor to intervene?

administering oral pain medications for pain relief

The nurse is caring for a client diagnosed with a stage IV cancer. Due to the nature of the diagnosis and limited treatment options, which emotion from the parents does the nurse anticipate?

anticipatory grief

Parents tell the nurse that they will do anything to help their child with leukemia get well, even donating everything they have to charity. How does the nurse respond to this situation?

Acknowledge that this must be very difficult for them.

An American Indian family is facing the imminent loss of their child. How should the nurse address cultural differences?

Ask the parents if there are any traditions they wish to include.

A nurse manager is concerned because the parents of a 10-year-old child dying of cystic fibrosis are finding it difficult to visit their child. How might the nurse manager help this child?

Assign nurses to provide one-to-one care.

Which nursing consideration is most important when communicating with pediatric clients at the end of life?

client's developmental level

A 14-year-old adolescent admitted to the hospital is diagnosed with a terminal illness. Which nursing intervention would be most effective in fostering communication about the terminal illness?

encouraging the adolescent to attend a peer support group

The nurse should be aware that the preschooler thinks of death as:

punishment for thoughts and actions.

The nurse is caring for a child who is in the dying process. What intervention should the nurse prioritize?

relieving the child's pain and discomfort

Following the death of a grandparent, a child is heard saying, "Gramma died and she is in heaven." Twenty minutes later the same child is heard saying, "Let's go have supper at Gramma's house." These statements would most likely have been said by a child of which age?

3 years old

The parents of a 6-year-old have just been told that their child will die shortly. At which age does the nurse realize that children are capable of understanding death?

9 years

An 8-year-old child is receiving end-of-life care for a terminal illness. The nurse observes that the caregivers are sitting nervously at the side of the room. What suggestion(s) will the nurse make to the caregivers to support the needs of the child? Select all that apply.

Gently touch or hold the child's hand. Speak softly to the child. Apply lip balm to the child's lips. Play quiet music

A 4-year-old child is facing death and cries frequently for the parents. What is the nurse's most therapeutic action?

Encourage the parents to remain with their child.

The family of a terminally ill client is asking about the benefits of hospice care. Which statement by the nurse provides accurate information?

Hospice is designed to meet the individual client's needs.

The nurse is caring for an infant born at 24 weeks' gestation in the neonatal intensive care unit. At 3 weeks of life, the infant has many complications of prematurity and an uncertain prognosis in the neonatal intensive care unit. The parents have been visiting the infant less frequently and have been less interested in participating in care. The parents ask the nurse when they can start trying again for another pregnancy. What does the nurse think is the cause of the parents' behaviors?

anticipatory grief