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Children's Understanding of Health and Illness. Developmental ConsiderationsInfantSeparation (highest age risk)Stranger Anxiety (6-18 mos)Refer to Table 17-3: Stages of Separation Anxiety. Children's Understanding of Health and Illness. Developmental ConsiderationsToddlerSeparation anxiety
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1. Child HealthNursingPartnering withChildren & Families Chapter 17
Nursing Care of the Hospitalized Child
2. Children’s Understanding of Health and Illness Developmental Considerations
Infant
Separation (highest age risk)
Stranger Anxiety (6-18 mos)
Refer to Table 17-3: Stages of Separation Anxiety
3. Children’s Understanding of Health and Illness Developmental Considerations
Toddler
Separation anxiety
Loss of self-control
4. Children’s Understanding of Health and Illness Developmental Considerations
Preschooler
Regression (highest age risk)
Separation anxiety and fear of abandonment
Inability to distinguish fact/ fiction
Unable to understand reason for hospitalization
5. Children’s Understanding of Health and Illness Developmental Aspects
School age
Loss of control/ privacy
Adolescent
Aware of the physiologic, psychologic and behavioral causes of illness
Concerned with appearance
Separation from peer group
6. Stressors of Hospitalization for Children at Various Developmental Stages
Refer to Table 17-2
7. Children’s Understanding of Health And Illness Psychological Aspects
Infant
Issues with attachment
Toddler
Disruption of routine/ separation from parents
Preschooler
Loss of self-control
Fear of dark
Injury
8. Children’s Understanding of Health and Illness Psychological Aspects
School-aged children
Pain
Bodily Injury
Death
Adolescents
Loss of control/ privacy
Fear of altered body image
9. The Effects of Hospitalization on the Child and Family Children’s understanding of health and illness is primarily based on their cognitive ability at their developmental level
Previous experiences with healthcare professionals
10. The Effects of Hospitalizaiton on the Child and theFamily Parents
Disrupt usual routine
Fears/ anxiety
Coping abilities (made more difficult if lack of financial, community or family support)
Siblings
Fears
Behavioral Disruption
11. Adaptation to Hospitalization Parents
Tailor nursing care to family’s needs and preferences
Maintain positive communication with family
Ask for parents participation in care
Explain all aspects of treatment, keep family “in the loop”
Provide information to family (ie teaching materials etc.)
12. Adaptation to Hospitalization Siblings
Inform siblings about their brother/ sister’s condition (using age-appropriate language and concepts at their developmental level)
Encourage siblings to visit (as appropriate)
Discuss what to expect before the visit w/ the child, then f/u on how they are feeling after.
13. Adaptation to Hospitalization Scheduled Admission
Child/ parent
Preparation
Tours
Play
Written visual material
Child Life
Talking with peers with similar experience (adolescents)
14. Adaptation to Hospitalization Refer to Box 17-4 (p 537): Nursing Considerations in Preparing Parents and Child for Planned Short-Stay Admission
15. Adaptations to Hospitalization Nurses can assist the parents in preparing the child for hospitalization by…
Read stories about the experience
Talk about going to the hospital
Encourage child to ask questions/ draw pictures
Visit hospital beforehand
Plan hospital stay/routine as much as possible
Be honest
16. FIGURE 17–2 The child’s anxiety and fear often will be reduced if the nurse explains what is going to happen and demonstrates how the procedure will be done by using a doll. Based on your experience, can you list five actions you can take to prepare a school-age child for hospitalization?
17. FIGURE 17–3 Jasmine’s parents are taking the time to prepare her for hospitalization by reading a book recommended by the nurse. Such material should be appropriate to the child’s age and culture. Why do you think that having the parents read this material is valuable?
18. Adaptation to Hospitalization Unanticipated admission
Orientation to unit/environment
Explain all of the procedures
Opportunities for parents/ child to express fears
Stress-reduction methods
19. Adaptation to Hospitalization Special units and types of care:
Short-stay unit
Outpatient unit
Ambulatory surgical unit
General pediatric unit
Emergency Departments
NICU/ PICU
Acute care or long-term rehabilitative unit
20. Adaptation to Hospitalization Nursing care focuses on providing family-centered care
Promoting the child’s and family’s coping strategies to deal w/ hospitalization
Promoting optimal development and safety
Minimizing disruption of the child’s usual routine
21. Safety Measures for the Hospitalized Child Refer to Box 17-3
22. Nursing strategies to Improve the Illness/ HospitalizationExperience of Parents/ Children Various Practice Settings
Emergency Department
Psychological considerations
Same day surgery
Thorough discharge teaching instructions
23. Preoperative checklist Refer to Box 17-7
24. FIGURE 17–6 This child has just undergone surgery and is in the post anesthesia care unit (PACU). Although the child’s physical care is immediate and important, remember that both the child and the family have strong psychosocial needs that must be addressed concurrently. It is important to reunite the family as soon as possible after surgery.
25. Nursing strategies to Improve the Illness/ HospitalizationExperience of Parents/ Children Practice Settings
ICU
Psychological considerations
Parental decision making/ involvement in care
Hospital Care
Mediation administration
Developmental considerations
26. Variations in Med Administration Refer to Table 17-6:
Oral
Rectal
Ophthalmic and otic
Topical
Intramuscular
Intravenous
27. Nursing strategies to Improve the Illness/ HospitalizationExperience of Parents/ Children Hospital (con’t)
Educational needs
Individual education plan (IEP)
Teaching
Partnering w/ parents
28. Adaptation to Hospitalization Preparation for Procedures
Psychological preparation
Using language the child understands
Physical preparation
Signed consent, pre-medicate
Performing the procedure
Treatment room
29. Assisting Children through procedures Refer to Table 17-7:
Infant
Toddler
Preschool child
School-age child
Adolescent
30. Strategies to Promote Coping and Normal Development of the Hospitalized Child These strategies help to meet the psychosocial needs of the hospitalized child
Rooming in
Child Life Programs
Child life specialist
Therapeutic Play
31. Assessing the child and family in preparation for discharge Assess the family’s ability to manage the child’s care
? Any special adaptation to home environment/ or other facility
Collaborate w/ parents to teach them treatment procedures and proper equipment use
Have family member demonstrate proper care of equipment, and any procedures necessary
32. Professional Practice Standards for Pediatric Nursing Practice Collecting health data
Analyzing the assessment data in determining diagnoses
Identifying expected outcomes individualized to the child and family
Developing a plan of care that prescribes interventions to attain expected outcomes
Implementing the interventions identified in the plan of care