Chapter 33:

Question 1

distress related to removal from family and familiar surroundings

Answer 1

Separation anxiety

Question 2

return to a previous stage of development

Answer 2

Regression

Question 3

hospitalization issue for each stage

Answer 3

• Infant: separation anxiety
• toddler: separation anxiety
• prescshool: not so much separation anxiety, more on fears and trauma and imagination
• school aged: fears that friends will forget them, that they are missing school
• adolescent: fear injury and pain. appearance is important

Question 4

what are some behaviors and coping mechanisms children present in a hospital setting?

Answer 4

• ignoring or negating the problem
• stoicism
• acting out and anger

Question 5

what are some nursing suggestions to promote coping?

Answer 5

• breathing techniques
• distraction with books or games
• imagery and music

Question 6

four phases of providing care for child

Answer 6

• introduction
• building trust
• decision making
• providing comfort

Question 7

stages of separation anxiety

Answer 7

1. protest - may last from hours to days. reacting aggressively, crying, and rejecting others.
2. despair - displaying hopelessness, withdrawing from others, becoming quiet without crying, and apathy
3. detachment - child forms coping mechanism and shows interest with environment. They form superficial relationships with nurses and other patients and starts to play again. when parent’s comeback, they are ignored.

Question 8

What to assess for in infants when hospitalized

Answer 8

• developmental delays
• facial expression
• assess availability of caregiver to stay with infant
• weigh daily, I/O

Question 9

key concerns for toddlers

Answer 9

• separation anxiety
• developmental delays
• autonomy

Question 10

Nursing care for hospitalized preschool children

Answer 10

• focus is on special needs, fears, and fantasies
• be honest
• give some semblance of control by giving choices

Question 11

nursing care for hospitalized school aged child

Answer 11

• use concrete, meaningful words

- sense of control is important, involve the child in decision making (simple decisions)

Question 12

Nursing care for adolescents

Answer 12

• educate honestly and without judgment
• privacy
• encourage visits from friends
• collaborate with teen

Question 13

Transporting child:

Answer 13

Cradle method - up to 3 month old
over-the-shoulder - from 3 to 7 month old
football hold - up to 2 months old
wagon - small children