hospitalized child learning for bsc nursing students

1. CARE OF
SICK CHILD

2. INTRODUCTION
 The sick child need hospitalization.
 It is a stressful experience for both children and their families.
 Hospitalization leads to interruption of child's active growth and development.

3. DEFINITION
The confinement of a child or infant in a hospital for diagnostic
testing or therapeutic treatment.

4. PURPOSE
Sick child are admitted to the hospital for a variety of reasons including:
 Scheduled tests
 Procedures or surgery
 Emergency medical treatment
 Administration of medication
 To stabilize or monitor an existing condition

5. Hospital Environment for Sick Child
1. SOCIAL ENVIRONMENT: It means the people around. When a
child is admitted in hospital, his social environment includes
members of health team and other patients and their relatives.
2. PHYSICAL ENVIRONMENT: it means setting or place and the
things around. It includes the ward or room, machines and
equipments. They are unfamiliar objects, sounds and smell in
hospital.
3. CHANGE IN ROUTINE: the children admitted in hospital may
have to undergo various diagnostic and therapeutic procedures
which are stressful for both children their family.

6. Preparation of hospital Environment for the child
 Nurses’ warm approach and their concern can help the child and
his family to cope up with hospitalization in a positive way.
 The child and his family should be introduced to the physician
incharge of the child and other members of health team who are
going to take care of the child in hospital.
 The child and his family should be acquainted with the ward and the
places they may be required to go during hospital stay.
 The child should be made familiar with the equipment around him
and their sounds.
 Likes and dislikes of the child related to food should be kept in mind
while planning for his diet.

7.  The environment should be calm and quiet to promote sleep.
 Parents should be allowed to stay with the child.
 Parents should be involved in care of the child.
 There should be provision of play and recreation in the hospital.
 The ward setting should be pleasing and attractive. For example, the walls of the ward may have cartoon
characters painted over, bed linen and hospital dress for patient may have floral print or nursery pattern.
Also, there should be a separate room for painful procedures. So that all children of the ward do not get
disturbed while any painful procedure is being done on any patient.

8. ADMISSION OF THE CHILD TO HOSPITAL
 Each child within a family needs love and security to develop feelings of trust and self- esteem.
 Each child is a unique individual who has needs based on his or her family background, level of growth and
development and degree of illness.
 The paediatric nurse seeks to promote, maintain and restore health in both child and their parents.
 Each ill child should be under the accountable care of one professional nurse.
 Within a safe environment, the child who is admitted needs expert physical care, emotional support.
 The terminally ill child and family and the patient should be supported emotionally so that child can die with
dignity and with feeling of being loved.

9. Impact of Hospitalization on child and family
1. Impact on parents/response of parents: The parents of a hospitalized child experience an increase in stress
as a result of a number of factors which include:
 Lack of information and knowledge related to child’s illness.
 Fear of procedures and treatment of child.
 Fear of unknown that what will happen to child in future.
 Fear of financial burden on family.

10. EFFECTS OF HOSPITALIZATIONON THE FAMILY
 Anxiety
 Fear
 Anger
 Disappointment
 Self-blame
 Guilt feeling
 Lack of confidence
 Competence for caring the child in illness and wellness

11. 2. Impact of hospitalization on child: Hospitalization is a completely new experience for infants and children.
Since parents tend to be anxious, their feeling of fear is communicated to their children. Impact of hospitalization
on pediatric patients depends upon their age and stage of development.
 Reaction of infants: Infants under 6 months of age tend to show less anxiety in response to hospitalization
than in later months. Infants may be emotionally disturbed due to separation from their parents. They may
suffer from sensory deprivation if the nursing personnel do not provide loving care that they need. Older
infants (8-12 months) show separation anxiety by excessive crying and clinging to parents.

12.  Reaction of toddlers: It depends on the degree of separation from mother, loss of freedom or autonomy
and fear of Pain and restraints, they assume hospitalization as punishment.
1. Protest: the child protest by crying, is restless, attempts to escape to find parents, they may try to
physically attack nurses.
2. Despair: they show despair by becoming quieter , withdrawn, apathetic and depressed. Cries frequently,
find comfort by thumb sucking, bedwetting, regression, and tightly holding the objects.
3. Denial or detachment: denying the needs of parental love. The child does not cry in absence of mother.
Becomes attached to nurses.

13.  Reaction of preschool child: stress and separation anxiety, regression, nightmares. The child may
become extremely dependent on caregivers.
 Reaction of school children: fear, anxiety, anger, and frequent guilt. Fear of mutilation and death is
seen in schoolchildren, crying and less motor aggression toward caregivers than younger children.
 Reaction of adolescents: difficult time in adjusting to hospitalization. Hospital rules and regulations
may cause frustration, In addition, adolescents find it difficult to accept dependency and restrictions. They
may also experience emotional swings resulting in behavior that is warm and acceptable 1 minute and rude
the next.

14. EFECTS OF HOSPITALIZATION ON CHILDREN
 POST HOSPITAL BEHAVIOR:
 IN YOUNG CHILDREN:-
 Initial aloofness towards parents
 Tendency to cling to parents.
 Demands for parent’s attention
 Vigorous opposition to any separation
 nightmares
 Withdrawal and shyness

15.  Temper tantrum
 Food finickiness
 Attachment to toy
 Regression in newly learned skills.

16.  IN OLDER CHILDREN :
 Emotional coldness
 Anger
 Jealousy
 NEONATE:
 Interruption in early stages of development
 Impairment of bonding and trusting relationship
 Inability of the baby to respond to parents and family members.

17. Role Of Nurse In Care of Hospitalized Children
Nurses can play a significant role in helping the child and family members to cope up
with stress of hospitalization.
1.Care of Infants: After the admission of an infant to the hospital and completion of
pediatric history assessment, the nurse’s major responsibility is to:
 Encourage participation of parents in meeting the physical and emotional needs of
infant.
 The nurse can make parents participate in administration of medications,
procedures, feeding the infants, etc.
 In this way, she can minimize the separation anxiety among infants; also the
parents are prepared for post hospitalization care of the infant.

18. 2. Care of toddlers
Nursing care of toddlers during hospitalization focus on:
 Preserving the toddler’s trust in parents .
 Helping the child express anger, and
 Encouraging frequent visits of parents, so that child is not deprived of parental love.
 Any regressive behavior of the toddler should be accepted without any punishment to the toddler.
 Depending on the child’s condition, he should be encouraged to play and be physically active.

19. 3. In preschool children
 Rooming- in can be practiced, so as to allow maximum contact between parents and
preschooler.
 These children may be allowed to express their feelings through play, so that trauma
of hospitalization is reduced.
 The child should be encouraged to participate in self-care activities, if possible.

20. 4. In school children
 School-aged children view hospitalization as punishment. Immobilization is the most difficult aspect
of hospitalization for them.
 Children must be encouraged to watch TV, read books, etc., so that they do not feel bored.
 Hospitalization makes them feel like they are losing self-control and independence.
 Children in this age group have developed a sense of modesty, so it should be considered while
giving any sort of physical care to them.
 Children must be provided privacy during care.
 They must be encouraged to take active part in their treatment and self-care.
 Children should be allowed to express their fears, anxiety, and doubts.
 The nurse should help the children to talk about their feelings and therapeutic communication
should be encouraged.

21. 5. In adolescents
 The role of nurse when caring for adolescents includes understanding the
emotional impact of illness on them, helping them to participate in their
treatment program, and providing the care that they need.
 Adolescents when admitted in hospital enter a where they are unaware of what
will happen to them which leads to fear and anxiety. So, nurse should routinely
communicate with them and provide the needed information.
 Reassurance and encouragement toward self-care will help adolescents gain
their self- esteem and independence.

22. NURSING INTERVENTIONS
Preventing or minimizing separation
Minimize loss of control
Promoting freedom of movements
Maintaining child routine
Prevent or minimize bodily illness or pain
Providing developmentally appropriate activities
Providing opportunities for play and expressive activities.

23. MODERN CONCEPTS OF
HOSPITALIZATION
1) Visiting
2) Rooming In
3) Care By Patient Unit
4) Self Care
5) Parent Support Group

24. THANK YOU