Question 1

The nurse is discussing a pending hospitalization of an 8-month-old infant with the parents. What should the nurse encourage the parents to do when preparing the child for this hospitalization?

Accepted Answer

Because an infant cannot understand explanations of surgery or treatments, oral preparation is minimal. Remind parents to pack special items such as a favorite toy because this object provides a special kind of security for which there is no substitute. The infant is not old enough to appreciate a new pair of pajamas. Reading a story will have no meaning to the child. The child will not understand a suitcase being packed.

Question 2

The mother of an infant is unable to visit the child in the hospital for 3 days. At first, the baby cries relentlessly but then becomes quiet and withdrawn. What reaction does the nurse identify as occurring with this child?

Accepted Answer

In separation anxiety, the stage of protest is when the child cries loudly and is unable to be comforted. In denial, the child is silent with an expressionless face. The infant's behavior is not because of fatigue, confusion, or the illness.

Question 3

The nurses on a pediatric unit are planning an open house for parents and children to visit the unit in an attempt to reduce the stress when hospitalized. In order to support the 2020 National Health Goals regarding childhood hospitalization and stress, what type of materials should the nurses prepare for the families?

Accepted Answer

Hospitalization is a stressful event to children. There are specific 2020 National Health Goals to address stress in hospitalized children. Nurses can help the nation achieve these goals by helping reduce the stress of hospitalization or health care and hospitalization so families use preventive services to help children stay well rather than totally use emergent or ill child care services. The nurses should provide a checklist of preventive services needed by children to prevent hospitalizations. Location of the cafeteria, where to park, and visiting hours will not reduce the stress of hospitalized children.

Question 4

The nurse is assessing a preschool-age child who is being hospitalized for the first time for a surgical procedure. The child expresses the desire to go home and is scared. Which nursing diagnosis should the nurse identify as appropriate for the child at this time?

Accepted Answer

The child is scared about being hospitalized for the first time. The most appropriate nursing diagnosis would be fear related to being away from home for the first time. The child is being admitted, so anxiety related to pending hospitalization would not be appropriate. There is no enough information to support the child being at risk for social isolation. The child is not asking for information about the illness so the diagnosis regarding health-seeking behavior is not applicable at this time.

Question 5

The mother of an infant is upset to learn that the baby's diarrhea caused the infant to become quite ill. What should the nurse explain about an infant that makes diarrhea an important problem to treat?

Accepted Answer

In the adult, extracellular water represents approximately 23% of total body water; in a newborn, extracellular water is closer to 40%. This means that an infant does not have as much water stored in the cells as an adult and so is more likely to lose a devastating amount of body water with diarrhea. Because of this, there is no such thing as "only diarrhea" in a child younger than 1 year of age. Infants do not have shorter intestines than adults. Infants do not have a higher proportion of fluid than adults. Infants do not have a fluid content that is proportionally less than that of an adult.

Question 6

The nurse is caring for a 4-year-old confined to bed. Which play experience should the nurse use as being the most age appropriate for the patient?

Accepted Answer

Age-appropriate play for a preschool-age child using materials available to the nurse includes pouring breakfast cereal into a basin so the child can dig, similar to playing in sand. Learning to write may not be fun for the child. Checkers is more appropriate for a school-age child. Preschool-age children might get bored with watching television. They need an activity in which they participate.

Question 7

A school-age child who is in the playroom is prescribed to receive an injection. What should the nurse do when preparing to administer this medication to the child?

Accepted Answer

The best children's hospital units are equipped with a playroom or play space that is maintained as a "pain-free" zone. No medical procedures, not even painless ones, should be performed in this area. The nurse should not provide the injection in the playroom. Asking the child and other children if the injection can be given in the playroom violates the "pain-free" zone.

Question 8

Which items should the nurse select as the best to support therapeutic play for a child who receives daily injections of medication?

Accepted Answer

The nurse should provide the child with equipment that has been used with them. The child may poke at a doll with a syringe without a needle or with a small rubber tube attached to simulate a needle or enjoy giving it a "shot" since this is the child's experience. The child does not have a cast and does not have bandages. An anatomically correct puppet is not necessary for the child who receives daily injections.

Question 9

The nurse is completing the teaching for parents of a toddler recovering from a fracture. Which outcome should the nurse identify to help determine if teaching has been effective?

Accepted Answer

Promoting safety for children is a responsibility for all health care providers. Care of a child who is ill or one with a unique concern at home includes assessing the safety of the house and providing family teaching. The expected outcome after teaching would be that the child waits for the parent to assist before walking down a set of stairs. The child is a toddler with a fracture. The child will not be able to resume normal activity level at home. The child is too young to be independent. Locking a gate could be a safety hazard. The child may decide to climb over the gate and fall down the stairs.

Question 10

The nurse is planning care for a school-age child being admitted to the hospital for a chronic illness. Which hazards of hospitalization for children will the nurse use to plan this patient's care? (Select all that apply.)

Accepted Answer

Hazards that may occur with children with an illness includes unclear definition of acceptable and expected behavior; losing control over the ability to make decisions; experiencing physical discomfort and pain; and being separated from routines, parents, and peers. Meeting new people is not a hazard for child hospitalized with an illness.

Question 11

The nurse is helping the parents explain to a toddler the need to go to the hospital for a tonsillectomy. When explaining the procedure to the child, which phrase should the nurse and parents avoid using?

Accepted Answer

One chief fear of toddlers is the fear of mutilation. It is always better to use the word "fix" rather than "cut" when talking about surgery with young children, because "cut" automatically suggests pain and mutilation. Saying that bad tissue will be cut out of the throat can conjure up a horrific scene for a toddler and should not be used. Eating popsicles, having the parents with the child, and getting medicine to feel better are appropriate phrases to use when discussing surgery with a toddler.

Question 12

A preschool-age child is being admitted to the hospital for treatment of cellulitis. The child's parents appear upset and frightened. Which question should the nurse use to elicit information concerning the parents' understanding of why the child is being admitted to the hospital?

Accepted Answer

When admitting a child to the hospital, the nurse should determine what the parents' understanding is of why the child is being admitted. This could be best assessed by asking if the parents have any questions about the child's admission. The nurse may or may not be able to tell the parents everything they need to know. Minimizing the parent's concerns is an inappropriate response. The parent's understanding of why the child is in the hospital may be different than what the physician may have said or believes.

Question 13

While hospitalized, a school-age child began sleepwalking. The nurse teaches the parents how to handle sleepwalking once the child is discharged. Which statement indicates that this teaching has been effective?

Accepted Answer

It is untrue that sleepwalkers should not be wakened. The child should be woken gently, be reoriented, and then returned to bed after reassurance of being safe. The child can be woken up. The child should not be shaken. The child should not be encouraged to play before going back to bed.

Question 14

The nurse is planning to meet the spiritual needs of a 6-year-old child who is hospitalized. Which child behavior should the nurse encourage to provide security to the child who is in a strange environment?

Accepted Answer

Bedtime prayers may be especially important to young children because they lend security in a strange environment. Hanging a religious picture, providing with a Bible, and having the hospital chaplain visit will not necessarily provide security to a child in a strange environment.

Question 15

The nurse is identifying ways to increase the oral fluid intake of a preschool-age child. Which interventions should the nurse use with this patient? (Select all that apply.)

Accepted Answer

Practice guidelines to encourage fluid intake at any age include offering small full glasses of fluid, provide the favorite fluid, encourage popsicles if permitted, and provide a straw if not contraindicated. The nurse should try changes in temperature of offered fluids for variety.

Quiz 36: Nursing Care of a Family With a Child Who Is Ill