Hospitalization, Illness, and Play Flashcards
(42 cards)
Hospitalization and Illness
Families and children can experience major stress related to hospitalization. The nurse should monitor for evidence of stress and intervene as appropriate.
Families should be considered clients when children are ill.
Separation anxiety manifests in three behavioral responses: protest, despair, detachment.
Each child’s understanding of illness and hospitalization is dependent on the child’s stage of development and cognitive ability.
Protest
screaming, clinging to parents, verbal and physical aggression toward strangers.
Despair
withdrawal from others, depression, decreased communication, developmental regression.
Detachment
interacting with strangers, forming new relationships, happy appearance.
Infant Level of Understanding
Inability to describe illness and follow directions.
Lack of understanding of the need of therapeutic procedures.
Infant Impact of Hospitalization
Experiences stranger anxiety between 6-18 months of age.
Displays physical behaviors as expressions of discomfort due to inability to verbalize.
Can experience sleep deprivation due to strange noises, monitoring devices, and procedures.
Can experience anxiety due to unfamiliar environment and the fear of the unknown.
Toddler Level of Understanding
Limited ability to describe illness.
Poorly developed sense of body image and boundaries.
Limited understanding of the need for therapeutic procedures.
Limited ability to follow directions.
Toddler Impact of Hospitalization
Experiences separation anxiety.
Can exhibit an intense reaction to any type of procedure due to the intrusion of boundaries.
Behavior can regress.
Preschooler Level of Understanding
Limited understanding of the cause of illness but knows what illness feels like.
Limited ability to describe manifestations.
Fears related to magical thinking.
Ability to understand cause and effect inhibited by concrete thinking.
Preschooler Impact of Hospitalization
Can experience separation anxiety.
Can harbor fears of bodily harm.
Might believe illness and hospitalization are a punishment.
School-age child Level of Understanding
Beginning awareness of body functioning.
Ability to describe pain.
Increasing ability to understand cause and effect.
School-age Child Impact of Hospitalization
Fears loss of control.
Seeks information as a way to maintain a sense of control.
Can sense when not being told the truth.
Can experience stress related to separation from peers and regular routine.
Adolescent Level of Understanding
Increasing ability to understand cause and effect.
Perceptions of illness severity are based on the degree of body image changes.
Adolescent Impact of Hospitalization
Develops body image disturbance.
Attempts to maintain composure but is embarrassed about losing control.
Experiences feelings of isolation from peers.
Worries about outcome and impact on school/activities.
Might mot adhere to treatments/ medications regimen due to peer influence.
Family Responses
Fear and guilt regarding no bringing the child in for care earlier.
Frustration due to the perceived inability to care for the child.
Altered family roles.
Worry regarding finances if work is missed.
Worry regarding care of other children within the household.
Fear related to lack of knowledge regarding illness or treatments.
Siblings experiencing loneliness, jealousy, guilt, fear, or anger.
Caregiver role strain, related to the impact of hospitalization on family process.
Assessment
Child’s and family’s understanding of the illness or the reason for hospitalization.
Stressors unique to the child and family (needs of other children in the family, socioeconomic situation, health of other extended family members)
Past experiences with hospitalization and illness.
Developmental level and needs of child/family.
Parenting role and the family’s perception of role changes.
Support available to the child/family.
Coping strategies for periods of crisis.
Nursing Intervention (General)
Teach the child and family what to expect during hospitalization.
Encourage family members to stay with the child during the hospital experience to reduce the stress.
Maintain routine as much as possible.
Encourage independence and choices.
Explain treatments, procedures, and cares to the child.
Provide developmentally appropriate activities.
Nursing Interventions for Infant
Place infants whose parents are not in attendance close to the nurses station so that their needs can be met quickly.
Provide consistency.
Nursing Interventions for Toddlers
Encourage parents to provide routine care for the child, such as changing diapers and feeding.
Encourage the child’s autonomy by offering appropriate choices.
Provide consistency in assigning caregivers.
Nursing Interventions for Preschoolers
Explain procedures using simple, clear language. Avoid medical jargon and terms that can be misinterpreted.
Encourage independence by letting child provide self care.
Encourage the child to express feelings.
Validate the child’s fears and concerns.
Provide toys that allow for emotional expression, such as pounding board to release feelings of protest.
Provide consistency in assigning caregivers.
Give choices when possible, such as, “Do you want your medicine in a cup or a spoon?”.
Allow younger children to handle equipment if it is safe.
Nursing Interventions of Adolescents
Provide factual information.
Include the adolescent in the planning of care to relieve feelings of powerlessness and lack of control.
Encourage contact with peer group.
Play
Allows children to express feelings and fears.
Facilitates mastery of development stages and assists in the development of problem solving abilities.
Activities should be specific to each child’s stage of development.
Can be used to teach children.
A means of protection from everyday stressors.
Social Affective
taking pleasure in relationships
Sense-Pleasure
objects in the environment catching the child’s attention.
