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Pediatrics Ch 21
Health Care Delivery Systems, Seperation Anxiety, Hospitalized Children
| Question | Answer |
|---|---|
| What has made well organized outpatient facilities and satellite clinics for preventative medicine and care of the child who is ill available to low income families | Medicaid and other such services |
| Who is often the nurse practitioner for children in the healthcare system | What are the primary health care delivery systems available to children |
| What are the benefits of a satellite clinic | Convenient with flexible coverage |
| What are the benefits of outpatient research centers | Highly specialized care for children with particular disorders, often at little or no expense to the patient |
| What are the advantages of elective surgery at outpatient surgery clinics | Lower cost, lower risk of nosocomial infection, recuperation at home with no separation from family |
| What should be done to prepare an infant for treatment | Involve the parents, Include familiar objects, Soothe, distract, and hug afterwards |
| What should be done to prepare a toddler or preschool child for treatment | Involve the parents, Offer simple explanations, Give permission to express discomfort, Offer one direction at a time, Allow for choices, Use distraction, Hug afterwards |
| What should be done to prepare a school age child for treatment | Involve the parents, Offer simple explanations, Give permission to express discomfort, Offer one direction at a time, Allow for choices, Use distraction, Hug afterwards, Let them examine equipment, Encourage verbalization of fears, Offer a small reward |
| What should be done to prepare a teen for treatment | Provide privacy, Involve them in treatment, Explain treatment, procedures, equipment, Suggest coping techniques |
| What makes the difference between an atmosphere that is warm and friendly and one that makes the child feel dehumanized | Attitudes of clinic personnel |
| What does proper preparation for treatment do | Decrease anxiety, Increase cooperation, Assist the child in coping with the experience |
| How does the children’s hospital unit differ from adult divisions | Children’s meets the needs of parents and children, Has a casual and cheerful atmosphere, Furniture is child sized, Ceilings are soundproof, Special treatment rooms, Playroom |
| What is done if a child is unable to be taken to the hospital playroom | Bedtime play activities are organized |
| What factors determine to reaction of the child to hospitalization | Age, Amount of preparation, Security of home life, Previous hospitalizations, Support of family and medical personnel, Child’s emotional health |
| What are the major causes of stress for all children | Separation, Pain, Fear of body intrusion |
| What influences the stress level of a child | Developmental age, Parent’s maturity, Cultural and economic factors, Religious background, Past experience, Family size, State of health on admission |
| What must be incorporated into the plan of care for the hospitalized child | Familiar rituals and routines |
| When may separation anxiety occur | 6 months and older |
| When is separation anxiety most pronounced | At the toddler age |
| What are the stages of separation anxiety | Protest, Despair, Detachment/Denial |
| What may occur is the detachment/denial stage is prolonged | An irreversible disruption of parent-infant bonding |
| What happens when a child in the despair stage of separation anxiety is visited by the parents | The protest stage resumes |
| How does a child in the detachment stage react when a parent arrives for a visit | Disinterest in the parent |
| What are the nursing goals in the care of an infant | Assist with parent-infant attachment, Protect from excessive frustration, Promote sensorimotor activities |
| What are the nursing goals in the care of a toddler | Reassure parents, Maintain toddler’s trust, Allow the child to master threatening experiences through soothing techniques and play, Provide individualized care |
| What should the nurse and parent do before leaving the room of a toddler | Explain when they will return in terms the toddler understands |
| When should a toddler be warned/told about a potentially negative experience to occur in the hospital | Immediately before it happens |
| What must accompany use of a restraint for toddlers | Increased emotional support |
| What should be said, with a preschooler, instead of shot | Medicine under the skin |
| What should be said, with a preschooler, instead of incision | Special opening |
| What should be said, with a preschooler, instead of put to sleep/anesthesia | Special sleep |
| What should be said, with a preschooler, instead of electrodes | Stickers |
| What should be said, with a preschooler, instead of x-ray | Special picture |
| What should be said, with a preschooler, instead of stretcher/gurney | Rolling bed |
| What should be said, with a preschooler, instead of catheter | Tube |
| What should be said, with a preschooler, instead of take | Check |
| What is the hospitalized preschooler typically afraid of | Bodily harm. Invasive procedures |
| What is the hospitalized toddler typically afraid of | Being separated from caregiver |
| What is the hospitalized early adolescent concerned with | How the illness will affect their appearance, functioning, and mobility |
| What is the hospitalized middle adolescent concerned with | Independence |
| What is the hospitalized late adolescent concerned with | Postponement of career and future plans |
| Which minors are considered emancipated and do not need parent’s permission for treatments | Married & Military |
| What should discharge charting of minors include | Who accompanied the child, identification given, time of discharge, child’s behavior and condition, method of transportation, vital signs, weight, medications, and instructions given to caregiver |
Created by:
futurenurse
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