Pediatrics Care of the Hospitalized Child
Card Set Information
Pediatrics Care of the Hospitalized Child
LCCC Nursing Pediatrics
For Gosselin's Exam 1
What are some variable that affect a child's response to hospitalization?
Type and amount of preparation
Length of hospitalization and frequency
Coping abilities of both the child and the parents
Reason for hospitalization
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
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
What are the infant's needs when they lose control during the hospital stay?
Consistent loving caregivers
When they lose control, what are the toddler's needs?
Daily routines and rituals
Loss of control may contribute to regression of behaviors, negativity, and temper tantrums
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
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
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
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
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)
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)
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
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
How can the nurse prevent or minimize separation?
THIS IS THE PRIMARY NURSING GOAL!!
Family centered care
Parents are not visitors (respect privacy, respect family discussions, traditions, routines, etc)
Bring in familiar items from home
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
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
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
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