Nursing Care of the Hospitalized Child – Key Terms (Chapter 23)

Vocabulary flashcards covering key terms from Chapter 23: Nursing Care of the Hospitalized Child, including hospital settings, family-centered care, safety, play, pain management, procedures, medications, feeding, specimens, and discharge.

Family-centered care

A care approach that emphasizes consistency, collaboration, and empowerment of the child and family during hospitalization.

Bill of Rights for the Hospitalized Child

A document outlining the rights of the hospitalized child and family; parents should receive it.

Child life specialist

A professional who provides tours, medical play, and coping support for hospitalized children.

Playroom restrictions

Area where no physical examinations, medications, or medical discussions take place.

Admission procedures

Process during admission including demographics, chief complaint, allergies, medication reconciliation, developmental milestones, toilet training, immunization history, pain response, eating patterns, spiritual and cultural needs, and comfort items.

Protest

Child is often inconsolable. This first stage can last hours up to 1 or 2 days

Despair

Child becomes inactive and uncommunicative. Appears sad & hopeless

Detachment/denial

Child appears to adapt to their parents’ absence but are still experiencing sadness and anxiety

Stranger anxiety

is also common when a young child is hospitalized; Whenever possible, the health-care team should perform evaluations while the infant or toddler is in the parent’s arms or lap

Regression

a child displaying behaviors associated with a younger developmental stage; Used to help cope with stressful events, Children should be encouraged to behave according to their age and developmental level but should never be punished for the regression, this is a normal response

Time demands and potential sleep deprivation

Hospitalization can be detrimental to rest and sleep patterns of children, Children should be encouraged to adhere to their normal bedtimes as much as possible, and Health Promotion “Tips for Sleep Success” (FA Davis green box)

Bed selection

Influenced by medical diagnoses and age, Maintain privacy and Use of cribs for infants & toddlers (facility policy)

Visiting hours

Influenced by the type of room provided

Parents at the bedside

Parents are encouraged to stay with young children around the clock, Parents should be provided with essentials such as food, internet, sleeping arrangements, and privacy and Positive effects include opportunities for education, coping strategies for the parents, greater adjustment by the child, and increased collaboration.

Safety!

Caregivers of young children who are hospitalized should be given their own safe sleeping bed or convertible sleeping chair. Remind parents never to nap or sleep with their hospitalized infants. Co-sleeping with an infant increases the risk of suffocation or injury. Also, infants must never be left unattended on the parent’s bed, even for a brief bathroom visit, because of the chance of a fall. Tell parents to notify you when they are going to shower or leave their infant or young child alone.

Factors that affect a family’s response to a child’s hospitalization

Child’s age, Nature of the disease process, Parental employment, Availability of extended family members, Trust in the hospital safety system, Presence of a child life specialist and Cultural and ethnic norms and practices

Sibling reactions to hospitalization

May experience fear, worry, anxiety, and loneliness and Could act out with jealousy or resentment

Meals for pediatric units

Ensure food options are developmentally appropriate

Safety with alarm systems

Nurses should respond immediately to sound of alarm and follow institutional procedures and Under no circumstances should parents or children be allowed to remove their security alarm devices.

Caring for a child with a sensory impairment

Be aware that these children are at greater risk for stress, anxiety, and injuries, Policies must be in place to guide care of a child with a sensory impairment so that communication is maximized and frustrations are minimized, Offer children with significant hearing impairments all available technology and communication to limit stress, If a child has learned lip-reading, be sure to engage the child’s attention before speaking, face the child directly, and use a clear, slow, even rate of speech without exaggeration and For children with visual impairments, maintain safety with clear verbal communication to reduce anxiety

Benefits of play

Creativity, Sensorimotor development, Intellectual development, Socialization and moral development, Self-awareness and Distraction from stress, anxiety, and tension (No matter what the medical diagnosis, age of the child, or developmental level, offer some form of play on a daily basis)

Types of play for Infants

solitary

Types of play for toddlers

parallel

Types of play for preschoolers

associative

Types of play for School-aged children

cooperative (formal games, contests, competitions)

Types of play for Adolescents

cooperative; abstract problem-solving (opportunities to use technology to help them feel connected.)

Functions of medical play (AKA: therapeutic play)

Accomplish therapeutic goals, Express emotions and fears, Master the unknown and Provide learning opportunities.

Follow hospital safety policy; Teach parents

How to use the call bell, Symptoms or clinical signs to report, How and when to call for help, How to use side rails on cribs, Need for supervised ambulation policies, Importance of never walking barefoot, Not to sleep with infants or young toddlers in big beds, lock up supplies and Children should not be allowed to touch monitoring or infusion equipment

Immediate consequences of untreated pain

Vital sign changes: decrease in oxygen saturation, increased BP and HR, Decreased peripheral blood flow and poor wound healing, Increased caloric consumption; potential for hypoglycemia, Mistrust in environment and health-care team and Impaired sleep and physical function