HOSPITALIZED CHILD

2. PRESENTED BY
SUCHISMITA GIRI
M.SC.TUTOR
SUM NURSING COLLEGE
SIKSHA O ANUSANDHAN UNIVERSITY

3. HOSPITALIZED CHILD:
 A child or a infant is admitted to the
hospital for diagnostic testing or therapeutic
treatment. But the impact of hospitalization
on child is sometime bad as it causes
emotional trauma and various behavioral
reactions.

4. PREPARATION OF PARENT
 Encourage trusting relationship
 Providing emotional support
 Providing age appropriate information
 Encouraging family participation
 To promote, maintain and restore health in
both children and their parents by health
counseling and teaching about their need.

5. 1)PREPARING THE INFANT:
 Rooming in practices
 Special items such as favourite toy,blanket should be
packed.
 Proper explanation regarding the unfamiliar medical
equipment to the family member.
 Keep routines as normal as possible.
2)PREPARING THE TODDLER:
 Toddler do not understand the concept of time ;So it is
best to tell your child about hospitalization before 1 to 2
days.
 Simple explanation
 Reassure your child
 Allow your child to bring a favourite toy to the hospital.
 Encourage your child to use play medical kits and dolls to act
out his or her understanding of the experience.

6. 3)PRESCHOOLERS ( 4-5 YEARS) :
 Prepare children in this age group by explaining what they
will see, hear ,smell and fell while in the hospital.
 Use simple ,reassuring explanation without too many
details.
 Provide reassurance that you will stay in the hospital as
much as you can.
 Read books with pictures of medical equipment.
4)SCHOOL AGE CHILDREN:-
 Talk about your child’s fear & answer question honestly.
 Interact the child with another child who had undergone
through the same condition.
 Have child explain back their understanding.
 Encourage child’s friend to visit.
 Give as many choices as possible.

7. TEEN AGERS(13 YEARS AND OLDER):
 Teen have a need for independency& privacy.
It is important to include teens in all
discussions and decisions about their care.
 Be open & honest when answering question.
 Encourage your adolescent to ask questions
about hospital care, procedures and schedules.
 It is helpful to support to your teen & give him
or her realistic choice to provide a sense of
control while in the hospital.

8. PSYCHOLOGICAL IMPACT ON PARENTS:
 Separation from the child
 Other people taking care of their children
 Feeling of inadequacy
 Anxiety, anger
 Guilty
 Fear of unknown that what will happen to future.
PHYSIOLOGICAL IMPACT ON PARENTS:
 Trembling
 Coarse or wavery voice
 Restlessness
 Irritability
 Aggressive behaviour

9. IMPACT ON INFANT:
 Emotionally disturbed
 Suffer from sensory deprivation
 Older infants(8-12months)show separation
anxiety by excessive crying and clinging to
parents.
IMPACT ON TODDLER:
 According to
Robertson(1958,1963)reaction of children
to hospitalization includes protest, despair
and denial or detachment.

10. a)PROTEST:
The toddler protests by crying,restless,attempts
to escape to find parents and may verbally or
physically attack nurses who try to provide care.
b)DESPAIR: Toddler shows despair by becoming
quiter,withdrawn,apathetic and depressed. The
child cries frequently.
c)DENIAL OR DETACHMENT: They start denying the
need of parental love. The child does not cry in
absence of mother and becomes more attached
to nurses.

11. IMPACT ON PRESCHOOL CHILD:
 Stress and separation anxiety
 Regression
 nightmare
 Extremely dependent on care givers
IMPACT ON SCHOOL CHILDREN:
 fear,anxiety,anger and frequent guilt
 Fear of mutilation and death is seen in school
children.
IMPACT ON ADOLESCENT:
 Hospital rules and regulation may cause frustration
in adolescents
 find it difficult to accept dependency and
restrictions.

12. MEANING OF STRESS:
 Stress is described
as a physiological or
psychological
stimulus that can
produce mental
tension or
physiological
reactions that may
lead to illness.

13. STRESSOR:
 A stressor is any event or stimulus that causes an
individual to experience stress.
INFANT (0-12 MONTHS):
Things that may cause stress include-
 Being separated from parents
 Trust concerns
 Not as much time for stimulation or play
 Change of schedule, routine and environment
TODDLER(1 TO 3 YEARS):
Things that may cause stress include--
 Being separated from parents
 Loss of independence
 Restricted movement
 Meeting new people

14. PRESCHOOL AGE(3 TO 5 YEAR):
Things that may cause stress include-
 Being separated from parents
 Fear that his body will be changed or hurt
 Thinking about procedures or diagnosis in magical ways or as a
punishment.
SCHOOL AGE(6 TO 12 YEAR):
Things that may cause stress include-
 Loss of control of his body
 Loss of independence ,loneliness, isolation and depression
ADOLESCENT(12 TO 19 YEARS):
Things that may cause stress include-
 Loss of independence
 Concern about body images
 Lack of trust
 Threat to competence

15.  Crying frequently
 Alteration in feeding

34.  Ascertain what child knows. Clarify using
scientific terminology and how body
function.
 Use audio visual ,pictures, body outlines.
 Direct question more to the child when
teaching them.
 Give positive feed back.
 Allow for privacy.
 Include in decision making.
 Encourage the child in self care, play ,school
work.

37. PREVENTING OR MINIMIZING SEPARATION:-
 Primary goal is to prevent separation
particularly in children younger than 5
years of age.
 Welcome the presence of parents at all
time throughout the child’s hospitalization
 A system of family centered care.
 Parental visit should be frequent.
 If the parents can’t room in they can leave
a favourite article from whom the children
gain comfort and reassurance from them.

38.  Feeling of loss of control results from
separation, physical restriction, changed
routine etc.
 Promoting freedom of movement during
procedure can be completed by placing child
in parents lap.
 Maintaining child’s routine-one technique that
can minimize the disruption in child’s routine
is time structuring.
 Encouraging independence; promoting
children’s control involves maintaining
independence and the concept of self-care can
be most beneficial.

39.  Preparation of children for painful
procedures decreases their fears.
 For children, who is fear of mutilation of
body parts, the nurse repeatedly stress the
procedure and evaluate child’s
understanding.
 Employ pain reduction techniques.

42.  Play and recreation are a natural part of childhood
and vital to normal development.
 Children are able to learn master experiences,
expressed themselves, cope with anxiety, create,
achieve and develop skills through play and
recreational activity.
 Play also helps children learn to adopt to the health
care experience

43. INFANT:
 Listening to music such as lullabies
 Providing familiar toys and objects from
home such as stuffed animal ,music,
blankets and rattles.
 Offering rattles, rings and keys
 Placing toys to encourage kicking, rolling
and crawling
 Toys should be soft to hug and provide
comfort
 Playing peek-a-boo.

44. TODDLER:
 Providing familiar toys and objects such as stuffed
animal, music and blanket.
 Listening to favourite music
 Watching favourite movies or cartoons
 Scribing with crayons and paper
 Painting
PRE SCHOOL:
 Playing board games such as candyland,chutes and ladder,
memory
 Reading with an adult
 Counting object
 Building with blocks
 Participating in group activities and peers
 Playing with puppets and dolls, and playing house.

45. SCHOOL AGE:
 Listening to favourite music
 Playing board games
 Playing card games
 Playing video games
 Reading
 Keeping journals and scrap books
ADOLESCENT:
 Writing in journals and scrapbook
 Writing poems and stories
 Using computer