objective 9 (1)

Question 1

what are the factors that influence a childs reactions to hospitalization?

Answer 1

• Promoting a positive experience
  – Attitude of personnel child comes in
  contact with is of the utmost importance
  – For many children, the only exposure to
  health care is through brief clinic
  appointments

Question 2

• Designed to meet the
  needs of the child and
  their families
• Special treatment room
  for child to be
  examined or receive
  some form of treatment
• Playrooms for the
  children are also
  available
• Daily routine
  emphasizes parent
  rooming-in
• Provision of consistent
  caregivers
• Flexible schedules to
  meet the needs of the
  growing child

Answer 2

children’s hospital unit

Question 3

what does the childs reaction to hospitalization depend on?

Answer 3

– Age
– Amount of preparation given
– Security of home life
– Previous hospitalizations
– Support of family and medical personnel
– Child’s emotional health

Question 4

what is the child’s reaction to hospitalization influenced by>

Answer 4

• Child’s developmental age
• Maturity of Parents
• Culture and economics
• Religious background
• Past experiences
• State of health on admission
• Other factors

Question 5

what are the 3 major causes of all stress for children of all ages?

Answer 5

separation
pain
fear of body intrusion

Question 6

• Occurs in infants age 6
  to 30 months
• More pronounced in
  toddlers (18 months)

Answer 6

separation anxiety

Question 7

what are the 3 stages of separation anxiety?

Answer 7

protest
despair
denial/detachment

Question 8

what does pain in patients do?

Answer 8

• secrete higher levels of cortisol,
• have compromised immune systems
• experience more infections
• show delayed wound healing

Question 9

what is PICIC?

Answer 9

pain indicator for communicatively impaired children

Question 10

what does PICIC consist of?

Answer 10

• Crying with or without tears
• Screaming or groaning
• Distressed facial expression
• Tense body
• Irritability to touch
• Difficulty in being comforted or
  consoled

Question 11

what is FLACC?

Answer 11

• Face: grimace
• Legs: restless → kicking
• Activity: quiet → arched
• Cry: moan → scream
• Consolability: touch →
  inconsolable

Question 12

what are the nonpharmacological management techniques?

Answer 12

 Drawing
 Distraction
 Imagery
 Relaxation
 Cognitive (thinking) strategies
 Back rub or hand massage
 Skin to skin contact, breastfeeding or oral sucrose
(infants)

Question 13

what is the pharmacological management?

Answer 13

• DRUG PHYSIOLOGY
  – Elimination of the drug may be prolonged because of an
  immature liver enzyme system
  – Dosages are influenced by weight and differences in
  absorption, metabolism, and clearance are expected

Question 14

what are the key concepts that WHO emphasizes is important of pain management in children?

Answer 14

– Using a two-step strategy
– Dosing at regular intervals
– Using the appropriate route of administration
– Adapting treatment to the individual child

Question 15

what are the drugs used for pain relief

Answer 15

acetaminophen
NSAIDs
opioids

Question 16

mild to moderate pain
can lead to liver failure if not dosed correctly

Answer 16

acetaminophen

Question 17

mild to moderate pain

Answer 17

NSAIDs

Question 18

moderate to severe pain
if used for long periods of time tolerance and respiratory depression can occur

Answer 18

opioids

Question 19

what are the types of opioids uses?

Answer 19

morphine
fentanyl
naloxone
local anesthetics
patient-controlled analgesia

Question 20

considered best opioid for children

Answer 20

morphine

Question 21

potent analgesic given for short surgical procedures

Answer 21

fentanyl

Question 22

used in case of opioid overdose

Answer 22

naloxone

Question 23

used for skin sutures, IV catheter placement, lumbar punctures

Answer 23

local anesthetics

Question 24

child as young as 5 or 6 can be taught to use

Answer 24

patient-controlled analgesia

Question 25

The administration of IV drugs to a patient to impair consciousness but retain protective reflexes, the ability to maintain a patent airway, and the ability to respond to physical and verbal stimuli

Answer 25

conscious sedation

Question 26

* Intrusive procedures are fear provoking * Disrupts child’s trust level * Threatens self-esteem and self-control * May require restriction of activity

Answer 26

fear

Question 27

* The loss of an achieved level of functioning to a past level of behavior that was successful during earlier stages of development * Can be minimized by an accurate nursing assessment of the child’s abilities and the planning of care to support and maintain growth and development * When the child is free of the stress that causes the regression, praise will motivate the achievement of appropriate behavior

Answer 27

regression

Question 28

what are the approaches to various cultures that involve knowing what is and is not acceptable as it relates to?

Answer 28

personal space smiling eye contact touch focus

Question 29

what is the parents reaction to the childs hospitalization?

Answer 29

* May believe they are to blame for their child’s illness * Feelings of guilt, helplessness, and anxiety * Parents are seldom the direct cause for hospital admission * Imp to listen &acknowledge parental concerns and feelings * Encourage, support and stress importance of parents and other family members in the care and recovery of the child

Question 30

what is the nurses role in hospital admission?

Answer 30

Must be prepared to meet the emotional needs of those involved *Parents should try to be as matter-of-fact as possible about this new experience for their child *It is not necessary to go into great detail with the child about what is going to happen because it may increase the child’s anxiety *Poor communication can result in unnecessary fear