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35 Cards in this Set
- Front
- Back
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What are some factors that can influence a child's response from being hospitalized? |
Age Stage of development Previous experiences Coping abilities Available support Seriousness of illness |
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What are three common stressors that children experience during hospitalization? |
Separation Loss of control Bodily injury and pain |
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What are the three stages of separation anxiety? |
1) protest phase 2) despair phase 3) detachment phase |
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What happens during the protest phase? |
Intense crying and putting up a fight (clings) Looks for parent Rejects strangers Could last from hours to days |
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What happens during the despair phase? |
Child is inactive and withdrawn and not interested Child is sad and depressed Refusal to eat This stage varies in length |
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What happens during the detachment phase? |
Child superficially appears to have adjusted More interested in surroundings Interacts with others and detaches from parent Most serious stage |
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Referring to loss of control, what are the infants' needs? |
Trust Consistent care Daily routines |
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Referring to loss of control, what are the toddlers' needs? |
Autonomy Daily routines |
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What may a toddler's loss of control be contributed to? |
Regression of behavior, negativity, temper tantrums |
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Referring to loss of control, what are the preschoolers' needs? |
Egocentrism and magical thinking May view illness/hospitalization as a punishment Preoperational thought |
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Referring to loss of control, what are the school age children's' needs? |
Independence and productivity Fears of death, abandonment, permanent injury Still want parental involvement |
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Referring to loss of control, what are the adolescents' needs? |
Independence Separation from peer group (they will act out) Respond with frustration and anger Need information on their condition |
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How can the fear of injury and pain affect someone in later life? |
The fear may persist into adulthood and result in the avoidance of care |
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How do infants respond to pain? |
Become rigid and trashing Crying loudly Facial expressions of pain If there is too much stimuli they will detach and shut down |
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How do young children respond to pain? |
Crying and screaming "OW" Thrashing of limbs Attempts to push away |
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How do school-age children respond to pain? |
Will try to stall... "Wait a minute" Become rigid May resort to behaviors of a young child |
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How do adolescents respond to pain? |
Less vocal and less motor activity They have increased muscle tension and body control Have more verbalization... "You're hurting me" |
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When can we see the effects of hospitalization on the child? |
Before admission, during hospitalization, or after discharge |
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What is the most important aspect to consider about the effects of hospitalization on a child? |
Their concept of the illness |
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What risk factors can increase the vulnerability to stressors of hospitalization |
Temperament (bad) Age (especially 6 months - 5 years) Males Cognitive challenges Multiple/continuing stressors (ex. frequent illness) |
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What are some beneficial effects of hospitalization on children? |
Recovery from their illness Better coping skills New social experiences |
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What are some responses from parents to the stress of hospitalization of their children? |
Disbelief, anger, guilt, fear, frustration (they want more info), depression |
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How can sibling react to their sibling being hospitalized? |
Lonely, worried, anger, guilt, jealousy |
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How can the family roles change when a child becomes sick (or after their sickness)? |
Sibling can become jealous Sick child may feel obligated to play sick role Parents usually continue to overprotect their child and give them lots of attention |
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Is it good for parents to continue to be overprotective? |
No Family has to come back to reality and need to ease off |
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Patient-Family Centered-Care Approach |
:) |
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What is the primary nursing goal with PFCC? |
Minimize or prevent separation! Especially for children under 5 years |
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How can nurses normalize the hospital environment? |
Promote freedom Maintain child's routine Allow self-care Schoolwork Encourage friends and visitors |
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How can nurses minimize stress in children? |
By using play! Use toys, activities, therapies |
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How does play help children in the hospital? |
Distracts them Helps child feel more secure in unfamiliar environment May reduce stress of separation Means of expression Allows child to have an active role and be in control |
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How can nurses maximize those potential benefits from being hospitalized? |
Encourage parent-child relationships Provide education & socialization & support Promote self-mastery |
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Do children change after being ill or hospitalized? |
Those under 4 may experience temporary changes in behavior following discharge |
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What could some of those changes be? |
May cling to parents Become more demanding Develop new fears Temper tantrums Changes in routines |
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How can nurses do to provide care for the whole family? |
Do a family assessment Discharge planning Encourage family in planning and care Give them information |
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What can recognizing family strengths provide? |
Empowers families to cope Builds confidence Improves decision-making |
