Hospitalized Child:Pediatric Assessment.doc - Chapter 35...

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Chapter 35: The Ill Child in the Hospital and Other Care Settings Settings of care: 1. Differentiate the various settings for providing healthcare for the pediatric patient. a. ED, OR, outpatient and day facilities, rehab, Med-surg unit, IC, school based clinics, community clinics, home care Stressors associated with illness and hospitalization: 2. What are some common stressors affecting hospitalized children and their responses to illness, hospitalization, and related care? a. Age, cognitive development, preparation, coping skills, and culture influence a child's reaction to illness b. Hospitalization can create a number of threats or fears for children, which fall into five main categories: (1) bodily injury and pain, (2) separation from parents, (3) fear of the unknown, (4) uncertainty about limits and expected behaviors, and (5) loss of control and autonomy c. Children’s Response to Illness: i. Fear of the unknown ii. Separation anxiety iii. Fear of pain or mutilation iv. Loss of control v. Anger vi. Guilt vii. Regression 3. Describe the stages of separation: a. Protest: child is agitated, resists caregivers, cries, and is inconsolable b. Despair: child feels hopeless and becomes quiet, withdrawn, and apathetic c. Detachment: child becomes interested in the environment, plays, and seems to form relationships with caregivers and other children; if parents reappear, the child might ignore them 4. Which specific age group experiences the most negative impact from separation anxiety? What are common responses to separation anxiety for children in the different age groups? a. 5.What is regression and how can the nurse best assist the child/family to adapt to hospitalization when a child experiences regression? a.Children may regress in toileting or cry for a bottle although they have been weaned for several monthsb.They might want more attention at bedtime or have temper tantrumsc.The older child might react to separation by clinging or crying or have fears about shadows on the walls or noises in the hallsd.Tell parents that the child might continue some regressive behaviors at home for a period of time following hospital discharge Factors affecting a child’s response to hospitalization: 6.How does each of the following affect a child’s response to hospitalization? i. Affect their reaction to illness ii. The content, the time frame, the setting, and the method of preparation are all based on the child's growth and development
i.

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