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C. Bodily injury and pain.
Separation anxiety is a characteristic of infancy. Loss of control is a characteristic fear of school-age children. Intrusive procedures, whether or not they are perceived as painful, are threatening to the preschool child because of the poorly developed concept of body integrity. Loss of identity is a concern of adolescents because illnesses are conceptualized as the effect on the individual.
Separation anxiety is a characteristic of infancy. Loss of control is a characteristic fear of school-age children. Intrusive procedures, whether or not they are perceived as painful, are threatening to the preschool child because of the poorly developed concept of body integrity. Loss of identity is a concern of adolescents because illnesses are conceptualized as the effect on the individual.
The nurse needs to start an intravenous (IV) line on an 8-year-old child to begin administering intravenous antibiotics. The child starts to cry and tells the nurse, "Do it later, O.K.?" The nurse should:
A. Start the IV line because allowing the child to manipulate the nurse is bad.
B. Start the IV line because unlimited procrastination results in heightened anxiety.
C. Postpone starting the IV line until the child is ready so that the child experiences a sense of control.
D. Postpone starting the IV line until the child is ready so the child's anxiety is reduced.
A. Start the IV line because allowing the child to manipulate the nurse is bad.
B. Start the IV line because unlimited procrastination results in heightened anxiety.
C. Postpone starting the IV line until the child is ready so that the child experiences a sense of control.
D. Postpone starting the IV line until the child is ready so the child's anxiety is reduced.
B. Start the IV line because unlimited procrastination results in heightened anxiety.
The nurse should start the IV line, recognizing that the child is attempting to gain control. Intravenous antibiotics are a priority action for the nurse. A short delay may be possible to allow the child some choice, but a prolonged delay only serves to increase the anxiety. If the timing of the IV line start was not essential for the start of IV antibiotics, this might be acceptable. The child may never be ready. The anxiety is likely to increase with prolonged delay.
The nurse should start the IV line, recognizing that the child is attempting to gain control. Intravenous antibiotics are a priority action for the nurse. A short delay may be possible to allow the child some choice, but a prolonged delay only serves to increase the anxiety. If the timing of the IV line start was not essential for the start of IV antibiotics, this might be acceptable. The child may never be ready. The anxiety is likely to increase with prolonged delay.
A 4-year-old child will be having cardiac surgery next week. The child's parents call the hospital, asking about how to prepare her for this. The nurse's BEST response is to inform the parents that:
A. Preparation at this age will only increase the child's stress.
B. Preparation needs to be at least 2 to 3 weeks before hospitalization.
C. Children who are prepared experience less fear and stress during hospitalization.
D. Children who are prepared experience overwhelming fear by the time hospitalization occurs.
A. Preparation at this age will only increase the child's stress.
B. Preparation needs to be at least 2 to 3 weeks before hospitalization.
C. Children who are prepared experience less fear and stress during hospitalization.
D. Children who are prepared experience overwhelming fear by the time hospitalization occurs.
C. Children who are prepared experience less fear and stress during hospitalization.
Preparation will reduce stress by having the child incorporate the threat more slowly. For this age group 1 week of preparation is recommended. Preparing the child for the hospitalization will reduce the number of unknown elements. Tours, handling some of the equipment, or being told stories about what to expect will increase the familiarity with items. A reduction in fear is usually observed.
Preparation will reduce stress by having the child incorporate the threat more slowly. For this age group 1 week of preparation is recommended. Preparing the child for the hospitalization will reduce the number of unknown elements. Tours, handling some of the equipment, or being told stories about what to expect will increase the familiarity with items. A reduction in fear is usually observed.
A mother tells the nurse that she will visit her 2-year-old son tomorrow about noon. During the child's bath, he asks for mommy. The nurse's BEST reply is:
A. "Mommy will be here after lunch."
B. "Mommy always comes back to see you."
C. "Your mommy told me yesterday that she would be here today about noon."
D. "Mommy had to go home for a while, but she will be here today."
A. "Mommy will be here after lunch."
B. "Mommy always comes back to see you."
C. "Your mommy told me yesterday that she would be here today about noon."
D. "Mommy had to go home for a while, but she will be here today."
A. "Mommy will be here after lunch."
Since toddlers have a limited concept of time, the nurse should translate the mother's statement about being back around noon by linking the arrival time to a familiar activity that takes place at that time. Such statements do not give the child any information about when his mother will visit. Twelve noon is a meaningless concept for a toddler. Such statements do not give the child any information about when his mother will visit.
Since toddlers have a limited concept of time, the nurse should translate the mother's statement about being back around noon by linking the arrival time to a familiar activity that takes place at that time. Such statements do not give the child any information about when his mother will visit. Twelve noon is a meaningless concept for a toddler. Such statements do not give the child any information about when his mother will visit.
The nurse working in an outpatient surgery center for children should understand that:
A. Children's anxiety is minimal in such a center.
B. Waiting is not stressful for parents in such a center.
C. Accurate and complete discharge teaching is the responsibility of the surgeon.
D. Families need to be prepared for what to expect after discharge.
A. Children's anxiety is minimal in such a center.
B. Waiting is not stressful for parents in such a center.
C. Accurate and complete discharge teaching is the responsibility of the surgeon.
D. Families need to be prepared for what to expect after discharge.
D. Families need to be prepared for what to expect after discharge.
Although anxiety may be reduced because of the lack of an overnight stay, the child will still experience the stress associated with a medical procedure. The waiting period while the child is having the procedure is a very stressful time for families. Discharge teaching is a responsibility of both the surgeon and the nursing staff. Discharge instructions should be provided in both written and oral form. They need to include normal responses to the procedure and when to notify the practitioner if untoward reactions are occurring.
Although anxiety may be reduced because of the lack of an overnight stay, the child will still experience the stress associated with a medical procedure. The waiting period while the child is having the procedure is a very stressful time for families. Discharge teaching is a responsibility of both the surgeon and the nursing staff. Discharge instructions should be provided in both written and oral form. They need to include normal responses to the procedure and when to notify the practitioner if untoward reactions are occurring.
When completing a health history on a hospitalized child, the nurse should assess for which factors that can commonly affect the parents' reaction to the child's illness? (Select all that apply.)
A. Previous experience with illness or hospitalization
B. Available support systems
C. Medical procedures involved with treatment
D. Previous coping abilities
E. Cultural and religious beliefs
A. Previous experience with illness or hospitalization
B. Available support systems
C. Medical procedures involved with treatment
D. Previous coping abilities
E. Cultural and religious beliefs
A. Previous experience with illness or hospitalization
B. Available support systems
C. Medical procedures involved with treatment
D. Previous coping abilities
E. Cultural and religious beliefs
The following are all factors affecting parents' responses to their child's illness or hospitalization:
• Seriousness of the threat to the child
• Previous experience with illness or hospitalization
• Medical procedures involved in diagnosis and treatment
• Available support systems
• Personal ego strengths
• Previous coping abilities
• Additional stresses on the family system
• Cultural and religious beliefs
• Communicationpatterns among family members
B. Available support systems
C. Medical procedures involved with treatment
D. Previous coping abilities
E. Cultural and religious beliefs
The following are all factors affecting parents' responses to their child's illness or hospitalization:
• Seriousness of the threat to the child
• Previous experience with illness or hospitalization
• Medical procedures involved in diagnosis and treatment
• Available support systems
• Personal ego strengths
• Previous coping abilities
• Additional stresses on the family system
• Cultural and religious beliefs
• Communicationpatterns among family members
B. Lack of fit between parent and child
C. Below-average intelligence
D. Age
E. Gender
Risk factors for increased stress level of a child to illness or hospitalization:
• "Difficult" temperament
• Lack of fit between child and parent
• Age (especially between 6 months and 5 years old)
• Male gender
• Below-average intelligence
• Multiple and continuing stresses (e.g., frequent hospitalizations)
C. Below-average intelligence
D. Age
E. Gender
Risk factors for increased stress level of a child to illness or hospitalization:
• "Difficult" temperament
• Lack of fit between child and parent
• Age (especially between 6 months and 5 years old)
• Male gender
• Below-average intelligence
• Multiple and continuing stresses (e.g., frequent hospitalizations)
A. Tendency to cling to parents
C. Demands for parents' attention
E. New fears such as nightmares
Young children's posthospital behaviors include:
• They show initial aloofness toward parents; this may last from a few minutes (most common) to a few days.
This is frequently followed by dependency behaviors:
• Tendency to cling to parents
• Demands for parents' attention
• Vigorous opposition to any separation (e.g., staying at preschool or with a babysitter)
Other negative behaviors include:
• New fears (e.g., nightmares)
• Resistance to going to bed, night waking
• Withdrawal and shyness
• Hyperactivity
• Temper tantrums
• Food peculiarities
• Attachment to blanket or toy
• Regression in newly learned skills (e.g., self-toileting)
Posthospital behaviors for older children include:
Negative behaviors:
• Emotional coldness followed by intense, demanding dependence on parents
• Anger toward parents
• Jealousy toward others (e.g., siblings
C. Demands for parents' attention
E. New fears such as nightmares
Young children's posthospital behaviors include:
• They show initial aloofness toward parents; this may last from a few minutes (most common) to a few days.
This is frequently followed by dependency behaviors:
• Tendency to cling to parents
• Demands for parents' attention
• Vigorous opposition to any separation (e.g., staying at preschool or with a babysitter)
Other negative behaviors include:
• New fears (e.g., nightmares)
• Resistance to going to bed, night waking
• Withdrawal and shyness
• Hyperactivity
• Temper tantrums
• Food peculiarities
• Attachment to blanket or toy
• Regression in newly learned skills (e.g., self-toileting)
Posthospital behaviors for older children include:
Negative behaviors:
• Emotional coldness followed by intense, demanding dependence on parents
• Anger toward parents
• Jealousy toward others (e.g., siblings