Chapter 33: Caring for Children in Diverse settings Flashcards
Bowlby Three stages of separation anxiety
Protest: occurs when the child is separated from the parents or primary caretaker. few hours to several days. Child is aggressive and in distress by crying, agitation, rejecting others.
Despair: withdrawals from others, becomes quiet without crying, exhibit empathy, depression, lack of interest, saddness.
Detachment/denial: the child forms coping mechanisms to protect against further emotional pain. The child starts to show interest again and forms relationships. They may ignore the parent if they return.
Restraint policy
Must include the reason for the restraints. Client assessment parameters identifying the need for the restraint. Use of at least one alternative method for restriction before using a restraint. Use the least restrictive type of restraint possible. The written order within one hour of application. Need for face-to-face evaluation within one hour.
Nursing consideration for restraints
Ensure that it fits properly. Secure the restraints with ties to the bed or crib frame not the side rails. Use a clove/hitch type of knot to secure the restraints. Check restraints 15 minutes after initial placement and then every hour. Assist the temperature of the affected extremity, pulse, and capillary refill at 15 minutes and every hour after. Remove the restrained every two hours for range of motion and repositioning. Encourage parent participation. Offer positive reinforcement and review the criteria for removing restraints and documenting them.
Medically fragile child
Child whose condition is considered medically complex. They require the use of medical technology and skilled nursing interventions.