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peds > care of the hospitalized child > Flashcards

care of the hospitalized child Flashcards

1
Q

hospitalized children experience 4 significant stressors, what are they?

A
  • separation from parents, caregivers, peers
  • loss of control, privacy, autonomy
  • painful/invasive procedures
  • fear of bodily injury and disfigurement
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2
Q

nursing care of hospitalized children focuses on

A
  • minimizing childs fears, anxieties, disruption of their routine, and support family
  • minimize separation anxiety, loss of control, pain and address any fears
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3
Q

what are some common fears of hospitalized infants

A
  • separation from primary caregivers
  • stranger anxiety
  • pain
  • parental anxiety, which is passed on to the infant
  • anxiety due to either a lack of stimulation or over stimulation
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4
Q

what are some ways to help with common fears with hospitalized infants

A
  • soft music
  • use of pacifier
  • encourage parental involvement/holding
  • provide medical explanations to parent
  • calming touch
  • feeding/burping
  • change diaper
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5
Q

describe separation anxiety

A
  • develops about 6 months of age
  • may feel anxious when in contact with strangers (stranger anxiety)
  • three stages
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6
Q

what are the three stages of separation anxiety and describe them

A

protest: screaming, crying, clinging to parents, may resist attempts by other adults to hold them

despair: RED FLAG; sadness, quiet, withdrawal, stop protesting, lots of crying when parent returns

denial or detachment: lack of protest when parents leave, the appearance of happiness and contentness, trust is broken in primary caregiver

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7
Q

when does stranger anxiety usually occur

A

6-18 months

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8
Q

what age group is most at risk for a stressful experience with hospitalization

A

toddlers

old enough to understand that their routine has been disrupted but dont understand why

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9
Q

what are some major stressors and common fears for toddlers during hospitalization

A
  • separation from parents
  • change in routine
  • fear of pain, invasive procedures/mutilation, change
  • afraid of the dark, strangers, “monsters”
  • loss of physical and emotional control
  • needles
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10
Q

what are some ways to help toddlers with major stressors/common fears and concerns

A
  • provide choices
  • comfort items
  • distraction
  • encourage play
  • keep to home routine as much as possible
  • parental presence
  • regression is uaully temporary to cope, do not punish
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11
Q

what are some ways to minimize separation anxiety

A
  • allow child to cry
  • parent avoid sneaking out
  • explain when parent will return
  • familiar surroundings
  • maintain usual routines
  • consistent caregiver
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12
Q

what are some common fears/stressors for hospitalized preschoolers

A
  • may feel guilty about being sick
  • may view illness/hospitalization as punishment
  • may regress in development
  • fears of being alone, in the dark, abandonment, loss of control, pain
  • fear of the unknown
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13
Q

what are some ways to help with common fears/stressors for hospitalized preschoolers

A
  • provide choice
  • participation in procedure
  • comfort object
  • distraction
  • assure procedure is NOT punishment -> active imagination
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14
Q

what are some common fears for hospitalized school aged children

A
  • loss of body function
  • loss of control
  • privacy issues
  • fear of bodily injury, pain, concerns related to death
  • separation from family and friends
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15
Q

what are some ways to help with common fears for hospitalized school aged children

A
  • full explanation/preparation (use five senses)
  • allow child to ask questions and answer honestly
  • participation in procedure
  • encourage play and normalcy
  • create opportunities for self expression
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16
Q

what are some common fears for hospitalized adolescents

A
  • body mutilation
  • loss of body function
  • change in physical appearance
  • loss of control
  • loss of independence
  • invasion of privacy
  • frustration and anger are common
17
Q

what are some ways to help with common fears for hospitalized adolescents

A
  • in depth medical explanation (if desired)
  • respect for privacy
  • offer choices
  • encourage/facilitate communication with friends and other peers
  • encourage engagement in ‘normal’ activities
  • provide opportunities for self expression
18
Q

describe how hospitalization affects the family

A
  • disrupts routines like work and children at home
  • alters roles
  • causes anxiety, stress if outcomes are unknown or serious
  • challenges coping skills
19
Q

describe how hospitalization affects siblings

A
  • may receive little attention
  • may fantasize about the illness/injury
  • may think they caused illness/injury - feel guilty
20
Q

what are some interventions for siblings

A

information
- keep em informed about hospitalized child
- phone calls home from hospitalized child or parents

visits
- visit as soon as possible
- explain what it will be like to see sibling in the hospital

support
- address fears and misconceptions

21
Q

describe preparation for hospitalization

A
  • planned or unexpected

planned:
- benefits both parents and child
- tours
- play with equipment
- photographs
- health fairs
- books

22
Q

describe preparation for procedures

A
  • developmentally appropriate
  • explain what they will see, hear, feel
  • perform procedure quickly and efficiently
  • parents in or out?
  • treatment room or patient room?
  • play/diversion during procedure
23
Q

how can you promote coping

A
  • play!
  • rooming in
  • child life therapists: therapeutic play, focus on emotional needs, available for procedures
24
Q

describe child and family teaching

A

assess:
- knowledge, cognitive level
- previous experience

resources:
- computer, videos
- books, small group discussions

interfering factors:
- feelings or beliefs

25
Q

describe chronic conditions

A
  • lasts longer than 3 months
  • develop from multiple causes
  • requires lifestyle adjustments
  • adds new stressors to the family
26
Q

what are some consequences of a chronic condition

A
  • caregiver burden
  • caregiver strain (lack of empathy and compassion)
  • maltreatment of child with chronic illness
  • financial issues

peds (15 decks)

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