Question 1

A child is being discharged from an ambulatory care center after an inguinal hernia repair. Which discharge interventions should the nurse implement? (Select all that apply.)

Accepted Answer

The discharge interventions a nurse should implement when a child is being discharged from an ambulatory care center should include dietary restrictions, being very specific and giving examples of "clear fluids" or what is meant by a "full liquid diet." The nurse should give specific information on pain control and send a pain scale home with the family. All complications that may occur after an inguinal hernia repair should be discussed with the parents. The pain medication, as prescribed, should be given before the child leaves the building and prescriptions should be filled and given to the family before discharge.

Question 2

A nurse is admitting a toddler to the hospital. The parent needs to leave for a brief period. Which figure depicts the reaction the nurse expects from the child?

Accepted Answer

The major stress from middle infancy throughout the preschool years, especially for children ages 6 to 30 months, is separation anxiety, also called anaclitic depression. During the stage of protest, children react aggressively to the separation from the parent. They cry and scream for their parents, refuse the attention of anyone else, and are inconsolable in their grief. When the parent leaves even for a short time this is the expected reaction and the figure that depicts the child not wanting the parent to leave is what the nurse should expect as a reaction from the child. The child sitting alone sadly depicts a child in the despair stage. In this stage depression is evident. The child is much less active, is uninterested in play or food, and withdraws from others. The child sitting on the parent's lap is withdrawn and sad, even in the presence of the parent. The child depicted playing a game is adjusting to the hospitalization with play.

Question 3

A nurse plans therapeutic play time for a hospitalized child. What are the benefits of play? (Select all that apply.)

Accepted Answer

Play is an effective, nondirective modality for helping children deal with their concerns and fears, and at the same time, it often helps the nurse gain insights into children's needs and feelings. Play and other expressive activities provide one of the best opportunities for encouraging emotional expression, including the safe release of anger and hostility. Nondirective play that allows children freedom for expression can be tremendously therapeutic. Play therapy is a structured therapy that helps disturbed children. It should not be confused with therapeutic play.

Question 4

A child is being admitted to the intensive care unit (ICU) and the parents are with the child. Which creates stressors for children and parents in ICUs? (Select all that apply.)

Accepted Answer

The ICU can create physical and environmental stressors for children and their families. Equipment noise (monitors, suction equipment, telephones, computers), unfamiliar smells (alcohol, adhesive remover, body odors), and sleep deprivation all are stressors found in the ICU. Privacy as opposed to no privacy and a caring nurse as opposed to unkind or thoughtless comments from staff help reduce the stressors of the ICU.

Question 5

Which is an effective strategy to reduce the stress of burn dressing procedures?

Accepted Answer

Children who understand the procedure and have some perceived control demonstrate less maladaptive behavior. They respond well to participating in decisions and should be given as many choices as possible. The dressing change procedure is painful and stressful. Misinformation should not be given to the child. Analgesia and sedation can and should be used. Encouraging the child to master stress with controlled passivity is not a positive coping strategy.

Question 6

Which is an important consideration for the nurse when changing dressings and applying topical medication to a child's abdomen and leg burns?

Accepted Answer

Frequent hand and forearm washing is the single most important element of the infection-control program. Topical medications should be applied with a tongue blade or gloved hand. Dressings that have adhered to the wound can be removed with tepid water or normal saline. Dressings are applied with sufficient tension to remain in place but not so tightly as to impair circulation or limit motion.

Question 7

A nurse is interviewing the parents of a toddler about use of complementary or alternative medical practices. The parents share several practices they use in their household. Which should the nurse document as complementary or alternative medical practices? (Select all that apply.)

Accepted Answer

When conducting an assessment, the nurse should inquire about the use of complementary or alternative medical practices. Administration of chamomile tea at bedtime, hypnotherapy for relief of pain, and acupressure to relieve headaches are complementary or alternative medical practices. Using Tylenol for fever relief and a cool mist vaporizer at the bedside to reduce "stuffiness" are not considered complementary or alternative medical practices.

Question 8

A child has just been unexpectedly admitted to the intensive care unit after abdominal surgery. The nursing staff has completed the admission process, and the child's condition is beginning to stabilize. When speaking with the parents, the nurses should expect which stressors to be evident? (Select all that apply.)

Accepted Answer

Intensive care units, especially when the family is unprepared for the admission, are a strange and unfamiliar place with many pieces of unfamiliar equipment. The sights and sounds are much different from those of a general hospital unit. Also, with the child's condition being more precarious, it may be difficult to keep the parents updated and knowledgeable about what is happening. Lights are usually on around the clock, seriously disrupting the diurnal rhythm. There is usually little privacy available for families in intensive care units.

Quiz 19: Family-Centered Care of the Child During Illness and Hospitalization