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Hospitalized Child

Hospitalized Child. Presented by Marlene Meador RN, MSN, CNE. What age is most effected by separation anxiety?. 0-8 months 9-36 months Preschool School aged Adolescent. Stages of Separation. Protest Despair Detachment.

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Hospitalized Child

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  1. Hospitalized Child Presented by Marlene Meador RN, MSN, CNE

  2. What age is most effected by separation anxiety? • 0-8 months • 9-36 months • Preschool • School aged • Adolescent

  3. Stages of Separation • Protest • Despair • Detachment

  4. Nursing Interventions:How does the nurse meet the needs of the hospitalized child in each age group? • Infant • Toddler-Preschool • School- aged • Adolescent

  5. Family’s Response to Hospitalization • Perception • Support system • Coping mechanism

  6. What determines the family’s response to a child’s hospitalization?

  7. What is the best method for communicating with the family of a hospitalized child? • What factors influence the family’s ability to interact with the hospital staff? • What nursing interventions should receive highest priority when communicating with these families?

  8. Nursing Interventions for the family of a hospitalized child: • Augment coping mechanisms- (what specific factors influence client teaching?) • Reinforce information and encourage questions (who would have difficulty with asking questions?) • Anticipate discharge needs (when should this begin?)

  9. PPEN • Why is this an effective tool for assisting the child and the family? • How would the nurse assist the child and family to arrive at the PPEN? • Is this a static assessment?

  10. Preparation for Hospitalization • What nursing interventions prepare a child for hospitalization? • Are the interventions the same for all children? • Who should the nurse include in these preparations?

  11. Developmental Milestones • Infant- Trust vs. Mistrust • Toddler- Initiative vs. Guilt • Preschool- Industry • Adolescence- Identity vs. Identity diffusion

  12. Nursing Care of the Child with Special Needs: • Special equipment- visually or hearing impaired, wheelchairs, • Specialized care- feeding tubes, trachs/vents • Assess family coping ability- who is primary caregiver • Assess support systems • Involve additional members of the healthcare team

  13. Promoting Coping and Normal Development • Child life specialists: assist with preparing child for procedures, and to adjust to illness and hospitalization. • Therapeutic play: emotional outlet, teaching strategy, assessment tool • Anticipate child/family’s needs

  14. Difficult Families • What is the nurse’s best response to a family identified as “difficult”? • What additional information does the nurse require? • What is COPE, and how is it helpful with families in crisis?

  15. COPE: Convey genuine caring, concern and interest in the child’s wellbeing. • C- collaboration • O- objective • P- proactive • E- evaluate Avoid placating or condescending phrases.

  16. Pain Assessment • Infant- grimacing, poor feeding, restlessness, crying • Toddler- clinging to parent, crying, pulling or rubbing area of pain, anorexia, vomiting, restlessness.

  17. Pain Assessment cont… • Preschool- verbalize pain, guard injured extremity, anorexia, vomiting, sleeplessness. • Adolescent- verbalize pain, may not understand “type” of pain. Possibly reluctant to call for help.

  18. Pain Assessment Tools: • FACES- smile to worst hurt (tears) • FLACC- face, legs, activity, cry and consolability (p. 1215-1216) • NIPS- neonatal pain during/after procedures- facial expression, cry quality, breathing patterns, arm & leg position, state of arousal

  19. Physiological response to pain: • What happens to VS? • How does the nurse assess anxiety in a hospitalized child? • How does sleeplessness impact healing?

  20. Nursing interventions: pharmacologic • PCA- what age can use this most effectively? • Ketoralac- why is this effective? What specific nursing interventions apply to this medication? • Why are NSAIDS used with children? • What lab values and contraindications are important for analgesic medications used with children?

  21. Nursing interventions: nonpharmacologic • What actions should the nurse include with each of the following? • Positioning for comfort (turning or elevation) • Thermal therapy (heat or cold) • Diversion therapy • What actions would work best with an infant?

  22. If you have any questions or concerns regarding this information please contact Marlene Meador via email mmeador@austincc.edu Or cell phone 512-422-8749

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