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Pediatrics ATI death and dying
Terms in this set (18)
Parental grief may last how long?
Children who have sustained a loss may experience
physical symptoms or display behaviors like trying to be perfect or acting out for attention.
Palliative care is...
multidisciplinary, pain and symptom control, support of the child and family.
Palliative care uses what to foster a therapeutic environment?
education, support, and honest communication
What are some factors that influence loss, grief, and coping ability?
interpersonal relationships and social support networks, type and significance of loss, culture/ethnicity, spiritual/religious beliefs, prior experience with loss, socioeconomic status, current stage of development.
Infants/toddlers (birth-3 years)
Have little or no concept of death. Egocentric thinking that prevents them from understanding death. Will mirror parental emotions. May regress to an earlier stage of development.
Preschool children (3-6 years)
Have egocentric thinking. Magical thinking allows them to believe their thoughts can cause an event like death which can cause them to feel guilty or shameful. Will interpret separation from parents as punishment. View dying as temporary.
School-aged children (6-12 years)
Start to respond to logical factual explanations. Begin to have adult concept of death (inevitable, irreversible, universal), experience fear of disease process and death and loss of control, may be curious about funeral services and what happens to the body after death.
Adolescents (12-20 years)
Adult like concept of death, may have difficulty accepting death, rely more on peers rather than influence of their parents which may isolation, maybe unable to relate to peers, may become more stresses by physical changes of appearance, may experience guilt or shame.
What are some factors that increase the family's potential for dysfunctional grieving?
lack of a support system, presence of poor coping skills, association of violence or suicide with death of the child, sudden and unexpected death of the child, lack of hope or presence of pre-existing mental health issues.
What are some things as a nurse you should asses?
knowledge regarding diagnosis, perceptions/desires regarding diagnosis and care, parents' wishes regarding the child's end of life care, presence of a DNR, family coping and available supprt, the stage of grief the family and child are experiencing.
How should a nurse handle the death of an infant or toddler toward the parents?
encourage parents to stay with the child, attempt to maintain a normal environment.
How should a nurse handle the inevitable death of a preschooler?
encourage parents to stay with the child, communicate with the child in honest, simple terms, be aware that med jargon might frighten the child.
How should a nurse handle the inevitable death of a school aged child?
Encourage parents to stay with the child, encourage self-care, use language that is clear regarding the disease, allow participation in plans for funeral services.
How should the nurse handle the inevitable death of an adolescent?
Be honest and respectful when communicating, encourage self-care, allow participation in funeral plans, encourage parents or other family members to stay with adolescent.
What are some nursing interventions for palliative care?
consider child, siblings, and parents as the units of care, provide an environment that is as close to home as possible, consult with child and family for desired care, control pain
After death always be sure to...
validate the loss to the family.
What are some issues and decisions that need to be addressed at the time of death?
organ/tissue donation, autopsy, viewing of the body, sibling's attendance at the funeral.
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