Pediatrics Care of the Hospitalized Child

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  1. What are some variable that affect a child's response to hospitalization?
    • Child's age
    • Type and amount of preparation
    • Length of hospitalization and frequency
    • Previous experience
    • Child's temperament
    • Coping abilities of both the child and the parents
    • Parent/child relationship
    • Reason for hospitalization
    • Hospital environment
  2. What are some stressors of hospitalization?
    • Separation from parents, peers, and trusted adults
    • Harm and injury
    • Loss of control, mobility, and decision making role
    • Unknown and unfamiliar events and environment
    • Unclear limits and expectations
  3. What are the three phases of separation anxiety?
    • 1. Protest Phase: Cry and scream, cling to parent
    • 2. Despair Phase: Crying stops, evidence of depression
    • 3. Detachment Phase: denial-resignation but not contentment. This may seriously affect the attachment to parent after separation
  4. What are the infant's needs when they lose control during the hospital stay?
    • Trust
    • Consistent loving caregivers
    • Daily Routines
  5. When they lose control, what are the toddler's needs?
    • Autonomy
    • Daily routines and rituals
    • Loss of control may contribute to regression of behaviors, negativity, and temper tantrums
  6. What are the preschooler's needs when they lose control during a hospital stay?
    • Egocentric and magical thinking typical of this age
    • May view illness or hospitalization as punishment for deeds
    • (Preoperative thought)
  7. When adolescents lose control, what are their needs?
    • Struggle for independence and liberation
    • Separation from peer group
    • May respond with anger, frustration
    • Need for information about their condition
  8. What are the effects of hospitalization on the child?
    • Effects may be seen before admission, during hospitalization or after discharge
    • Child's concept of illness is more important than the intellectual maturity in predicting anxiety
    • Fears and negative experiences by children may persist into adulthood and result in avoidance of needed care
  9. What are the beneficial effects of the hospitalization on the child?
    • Recovery from illness
    • Increase in Coping skills
    • Master stress and feel competent in coping
    • New socialization experiences
  10. How do parents respond to the stressors of hospitalization?
    • Disbelief, anger, guilt (Esp if sudden illness)
    • Fear and anxiety related to child's pain and seriousness of illness
    • Frustration (especially related to the need for information)
    • Depression
  11. How do siblings respond to the stressors of hospitalization?
    • Loneliness, fear, and worry
    • Anger, resentment and jealousy
    • Guilt (especially if they had wished their sibling ill-magical thinking)
  12. During hospitalization, how are family roles altered?
    • There may be jealousy between siblings
    • Ill child obligated to play sick role
    • Parents continue in pattern of overprotection and indulgent attention to the sick child
  13. What are some strategies for reducing the stress of hospitalization?
    • Preparation for hospitalization when possible (tour of hospital prior to scheduled procedures)
    • Increase the child's contact with parents
    • Pain management and procedural preparation
    • Child life programs and child life specialists
    • Reduce the amount of time the child is in the hospital
  14. How can the nurse prevent or minimize separation?
    • Family centered care
    • Parents are not visitors (respect privacy, respect family discussions, traditions, routines, etc)
    • Bring in familiar items from home
  15. How can the nurse "normalize" the hospital environment?
    • If possible, maintain the child's daily routine
    • Give the child a daily time schedule
    • If age appropriate, let the child participate in self care (brushing teeth, combing care, etc)
    • Establish a means to complete school work (tutor or cyber school)
    • Allow friends and visitors
  16. What nursing care needs to be considered during isolation?
    • Its an added stressor of hospitalization
    • Child may have a limited understanding of isolation or restraint
    • Deal with the child's fears
    • Keep in mind the potential for sensory deprivation
  17. What are some considerations for the PICU?
    • There is increased stress for the child and the parents
    • Stress can be decreased by limiting stimuli such as light and sound (install yacker tracker)
    • Parent's need information and should be included in the care plan
    • Perception of security for constant monitoring ad individualized care
  18. What are some considerations for Emergency admission to the hospital?
    • Admission counseling is essential!
    • There should be counseling after the event -"postvention"
    • The parents and child should participate as appropriate
Card Set:
Pediatrics Care of the Hospitalized Child
2014-09-15 01:02:17
LCCC Nursing Pediatrics

For Gosselin's Exam 1
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