This document provides information on caring for hospitalized children. It discusses the stressors children face during hospitalization, including separation from parents, loss of control, and fear of injury. It outlines the developmental stages of separation anxiety and interventions to support children and their families. These include minimizing separation, creating a child-friendly environment, preparing children for procedures, providing age-appropriate explanations, assessing and treating pain, and using play and distraction. The document emphasizes the importance of involving parents, explaining hospital routines, and respecting the child's needs, autonomy, and bill of rights while hospitalized.
HOSPITALIZATION: Effect on children and their parentsShivani Thakur
The experience of hospitalization in children can be considered as a process of effort for returning to health and, on the whole, the regaining of the individual's status in the world.
Nurse can ease this process by showing the importance of experience and feelings of individuals at the time of hospitalization and help people to adapt themselves to their new surroundings.
Effect of Hospitalization on Child and Family Jyotika Abraham
Understand the effects of Hospitalization on the child who is admitted along with the siblings, parents and caregivers and the family. Also, understand the Nurses' responsibility towards the admitted child and the family. This Ppt. deals with the Nurses responsibility in detail not only towards the child but also towards the family as they are also tremendously affected by the hospitalization of their child. Understand the stress caused by child hospitalization, the defence mechanisms used by the child, the stressors of hospitalization in children of different age groups, Post hospitalization behaviour, beneficial effects of hospitalization, parental reaction, sibling reaction, informed consent for care, situations in which consent is required. Nursing management and therapeutic care, the safety of the hospitalized child, special hospital situations and discharge.
HOSPITALIZATION: Effect on children and their parentsShivani Thakur
The experience of hospitalization in children can be considered as a process of effort for returning to health and, on the whole, the regaining of the individual's status in the world.
Nurse can ease this process by showing the importance of experience and feelings of individuals at the time of hospitalization and help people to adapt themselves to their new surroundings.
Effect of Hospitalization on Child and Family Jyotika Abraham
Understand the effects of Hospitalization on the child who is admitted along with the siblings, parents and caregivers and the family. Also, understand the Nurses' responsibility towards the admitted child and the family. This Ppt. deals with the Nurses responsibility in detail not only towards the child but also towards the family as they are also tremendously affected by the hospitalization of their child. Understand the stress caused by child hospitalization, the defence mechanisms used by the child, the stressors of hospitalization in children of different age groups, Post hospitalization behaviour, beneficial effects of hospitalization, parental reaction, sibling reaction, informed consent for care, situations in which consent is required. Nursing management and therapeutic care, the safety of the hospitalized child, special hospital situations and discharge.
Describes the major stressors in child's life, and their reactions to them,reaction to bodily injury and pain, reaction of child to illness, pain, separation and treatment, reaction of parents, siblings and role of nurse to sase them.
Trends and Modern concepts of Pediatric Nursing RAVI RAI DANGI
In India, pediatric nursing was not given due in recognition in syllabi in the earlier periods of nursing training but with the introduction of under graduate degree programme in nursing in madras university CMC vellor,RAK Delhi, pediatric nursing as a course was introduced date back from 1950s.Child health nursing is undergoing tremendous advancement just like pediatric medicine and surgery. The current trends in the practice are based on researches that have taken make place in the field of pediatric nursing
Cost containment is a management technique utilized to reduce the cost of hospitalization. It is reduced in many ways in hospitals either by cutting nursing positions or by improving process of care and tightening non labour resources.
At the end of unit 2, the students will be able to:
Appreciate the differences between children and adult
Describe the hospital environment for a sick child
Explain the impact of hospitalization on child
Discuss the grief and bereavement
Outline the role of a child health nurse
Explain the principles of pre- and post-operative care for children
Perform pain assessment in children
TRENDS IN PEDIATRICS AND PEDIATRIC NURSING
Pediatric regarded as the medical science which enables an anticipated newborn to grow into a healthy adult, useful to the society
Describes the major stressors in child's life, and their reactions to them,reaction to bodily injury and pain, reaction of child to illness, pain, separation and treatment, reaction of parents, siblings and role of nurse to sase them.
Trends and Modern concepts of Pediatric Nursing RAVI RAI DANGI
In India, pediatric nursing was not given due in recognition in syllabi in the earlier periods of nursing training but with the introduction of under graduate degree programme in nursing in madras university CMC vellor,RAK Delhi, pediatric nursing as a course was introduced date back from 1950s.Child health nursing is undergoing tremendous advancement just like pediatric medicine and surgery. The current trends in the practice are based on researches that have taken make place in the field of pediatric nursing
Cost containment is a management technique utilized to reduce the cost of hospitalization. It is reduced in many ways in hospitals either by cutting nursing positions or by improving process of care and tightening non labour resources.
At the end of unit 2, the students will be able to:
Appreciate the differences between children and adult
Describe the hospital environment for a sick child
Explain the impact of hospitalization on child
Discuss the grief and bereavement
Outline the role of a child health nurse
Explain the principles of pre- and post-operative care for children
Perform pain assessment in children
TRENDS IN PEDIATRICS AND PEDIATRIC NURSING
Pediatric regarded as the medical science which enables an anticipated newborn to grow into a healthy adult, useful to the society
Prenatal development: germinal, embryonic &fetal period; Factors that can have a serious negative impact on the development of the unborn: maternal health, radiation, maternal nutrition, medication and drugs, age of the parents, diseases in the pregnant woman and the emotional state of the mother.
Take Print out in both front and back. or
after print out these copy, take a photo copy of both front and back then make number of copy as your wish.
finally, cut into two equal half's
(tear into 2 equal parts)
Enhancing pediatric care: A comprehensive presentation on hospitalized child ...Rachel Masih
This PowerPoint presentation provides a thorough overview of strategies and protocols for managing hospitalized child, aiming to improve pediatric care and enhance the overall well-being of young patients.
Stressor and effect of hospitaliztion on child and familymanishasammal
INTRODUCTION
It is a stressful experience for both children and their family. Hospitalization leads to interruption of child’s active growth and development. The child is removed from daily routine loss of contact with siblings, relatives and pers.
DEFINITION
A stressor is any event or stimulus that causes an individual to experience stress.
“Barbara kozier”
Stress is the pressure experienced by a person in response to life demands. Selye
During our chapter reading group facilitation, my partner and I prepared an hour long presentation on the topic End of Life and Palliative Care. The basis of the presentation was from the weekly assigned chapters in our class textbook. We were required to present an engaging lecture, presentation, and/or hands-on activity for the class.
Separation anxiety is a developmental stage
during which the child experiences anxiety when
separated from the primary caregiver (usually the mother).
http://www.nlm.nih.gov/medlineplus/ency/article/001542.htm
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Hospitalization
1. PEDIATRIC HEALTH NURSING
UNIT V : CARE OF CHILD & FAMILY DURING
HOSPITALIZATION
MUHAMMAD SULIMAN
Post RN BSc.N
ROYAL COLLEGE OF NURSING
SWAT
1
2. Objectives
At the end of this session the students will be able to:
Identify the stressors of illness and hospitalization for
children during each developmental stage.
List essential priorities of nursing care upon a child’s
admission to the hospital.
Review nursing interventions that prevent or minimize
the stress of separation during hospitalization.
Discuss nursing interventions that minimize the stress of
loss of control during hospitalization.
Describe nursing interventions that minimize the fear of
bodily injury during hospitalization.
2
3. Cont…
Outline nursing interventions that support
parents, siblings, and family during a child’s illness
and hospitalization.
Describe nursing interventions needed when
children are admitted to special units such as the
emergency department.
3
4. Introduction
Often, illness and hospitalization are the first crises
children must face. Especially during the early
years, children are particularly vulnerable to
these stressors because (1) stress represents a
change from the usual state of health and
environmental routine and (2) children have a
limited number of coping mechanisms to resolve
stressors. Major stressors of hospitalization
include separation, loss of control, bodily injury,
and pain.
4
5. Cont…
Children’s reactions to these crises are influenced
by their developmental age; their previous
experience with illness, separation, or
hospitalization; their innate and acquired coping
skills; the seriousness of the diagnosis; and the
support system available. Children also
expressed fears caused by the unfamiliar
environment or lack of information; child–staff
relations; and the physical, social, and symbolic
environment (Samela, Salanterä, and Aronen,
2009).
5
6. Experience of Hospitalization
Hospitals can be threatening, frightening and painful
environments where children are faced with strangers
who want to ‘do’ things to them. Illness, trauma and
hospital care are often the most traumatic things children
experience, even with the presence of their parents.
Hospitals used to be places of long stays, routine, rigidity,
restricted visiting, limited emotional care and often
painful experiences for children. Much of this has
changed; however, it does not necessarily alleviate how
children experience what is happening to them.
What is trivial to an adult can be a major stressor to a child.
6
7. SEPARATION ANXIETY
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. In contrast, through the stage of despair,
the crying stops, and depression is evident. The
child is much less active, is uninterested in play or
food, and withdraws from others.
7
8. Cont…
The third stage is detachment, also called denial.
Superficially, it appears that the child has finally
adjusted to the loss. The child becomes more
interested in the surroundings, plays with others,
and seems to form new relationships. However, this
behavior is the result of resignation and is not a sign
of contentment. The child detaches from the parent
in an effort to escape the emotional pain of desiring
the parent’s presence and copes by forming shallow
relationships with others, becoming increasingly
self-centered, and attaching primary importance to
material objects.
8
9. Cont…
This is the most serious stage in that reversal of the
potential adverse effects is less likely to occur
after detachment is established. However, in
most situations, the temporary separations
imposed by hospitalization do not cause such
prolonged parental absences that the child
enters into detachment. In addition, considerable
evidence suggests that even with stressors such
as separation, children are remarkably
adaptable, and permanent ill effects are rare.
9
10. Cont…
Although progression to the stage of detachment is
uncommon, the initial stages are frequently observed
even with brief separations from either parent.
Unless health team members understand the
meaning of each stage of behavior, they may
erroneously label the behaviors as positive or
negative. For example, they may see the loud crying
of the protest phase as “bad” behavior. Because the
protests increase when a stranger approaches the
child, they may interpret that reaction as meaning
they should stay away.
10
11. Cont…
During the quiet, withdrawn phase of despair,
health team members may think that the child is
finally “settling in” to the new surroundings, and
they may see the detachment may respond to
the child’s behavior by staying for only short
periods, visiting less frequently, or deceiving the
child when it is time to leave. The result is a
destructive cycle of misunderstanding and unmet
needs.
11
12. In the protest phase of separation anxiety, children cry loudly and are
inconsolable in their grief for the parent.
12
13. During the despair phase of separation anxiety, children are sad, lonely,
and uninterested in food and play.
13
14. Young children may appear withdrawn and sad even in the presence of a
parent.
14
15. MANIFESTATIONS OF SEPARATION
ANXIETY IN YOUNG CHILDREN
Stage of Protest
Behaviors observed during later infancy include:
• Cries
• Screams
• Searches for parent with eyes
• Clings to parent
• Avoids and rejects contact with strangers
15
16. Cont…
Additional behaviors observed during toddlerhood
include:
• Verbally attacks strangers (e.g., “Go away”)
• Physically attacks strangers (e.g., kicks, bites, hits,
pinches)
• Attempts to escape to find parent
• Attempts to physically force parent to stay
Behaviors may last from hours to days.
Protest, such as crying, may be continuous, ceasing
only with physical exhaustion.
Approach of stranger may precipitate increased
protest.
16
17. Stage of Despair
Observed behaviors include:
• Is inactive
• Withdraws from others
• Is depressed, sad
• Lacks interest in environment
• Is uncommunicative
• Regresses to earlier behavior (e.g., thumb sucking,
bedwetting, use of pacifier, use of bottle)
Behaviors may last for variable length of time.
Child’s physical condition may deteriorate from
refusal to eat, drink, or move.
17
18. Stage of Detachment
Observed behaviors include:
• Shows increased interest in surroundings
• Interacts with strangers or familiar caregivers
• Forms new but superficial relationships
• Appears happy
Detachment usually occurs after prolonged separation
from parent; it is rarely seen in hospitalized children.
Behaviors represent a superficial adjustment to loss.
18
19. Experience of parents
Much research has identified the adverse experience of
hospitalization on children. However, there can be impacts
on parents that in turn affects the child:
• Anxiety when separated from their child
• Feelings of guilt
• Conflict between parents if they are not able to stay with
their child
• Emotional impact of the ill child on their ability to cope
• Physical demands of maintaining life and being at the
hospital
• Development of postnatal depression.
19
20. Hospital environment
• Not child friendly
• Many hospitals designed for adults
• Noise and alarms may be frightening
• Presence of machinery
• Staff not aware of children’s needs
20
21. The staff
• Having to interact with strangers
• Staff who are more oriented toward adults
• Not considering the specific needs of children
and families
• Staff who do not understand the child’s
developmental needs for support, preparation
and care.
21
22. Circumstances
• Emergency situations in which the survival
needs override those of the child
• When the child has experienced trauma
• Safety of the child when there is a concern
about abuse
• The child requires interventions that he/she
does not want.
22
23. Pain and discomfort
• Procedures can be frightening and painful
• Not all staff recognize children’s experiences
• Pain experiences can lead to long-term problems
• Children frightened of needles and equipment
23
24. Factors that mediate children’s
experiences of hospitalization
Involvement of children in their care Age, development and understanding
Support from parents or carers Involvement of parents in care
Use of play and distraction to support
children
Previous experiences of health care
Correct management of pain and
discomfort
Resilience of child (and parents)
Good transitional care Length and place of stay
Care by specifically educated children’s
nurses
Child friendly hospital environment
24
25. Minimizing separation
• Involve parents in care
• Plan care with parents
• Provide facilities for parents to stay
• Bring comforters, photos, toys, music to
remind child of home
• Support for parents with financial difficulties
• Monitor attachment
25
26. Child friendly hospital environments
• Staff trained to care for children
• Decoration, furniture and surroundings child
focused
• Provision of play areas and school facilities
• Place for parents to stay
• Safe environment
26
27. Considering the child during interventions
• Provide pre-hospital preparation programme
• Age-appropriate explanation and consent
• Involve the child in care, especially for young
people
• Respect the child’s growing autonomy
• Involve play therapists
27
28. Avoiding pain and discomfort
• Assess the child’s pain or potential for pain
• Ensure pain relief or prophylactic support
• Provide clear and age-appropriate
explanations
• Use of specific assessment tool to measure
and monitor pain
28
29. NURSING TIP
In many hospitals, child life specialists—health care
professionals with extensive knowledge of child growth and
development and of the special psychosocial needs of children
who are hospitalized and their families—help prepare children
for hospitalization, surgery, and procedures. Although the
structure of a program may vary depending on the size of the
pediatric facility, the patient population, and the availability of
ancillary services, the two primary program objectives for child
life are consistent: (1) to reduce the stress and anxiety related
to the hospitalization or health care– related experiences and
(2) to promote normal growth and development in the health
care setting and at home (Thompson, 2009).
29
30. POSTHOSPITAL BEHAVIORS IN CHILDREN
Young Children
They show initial aloofness toward parents; this
may last from a few minutes (most common) to
a few days.
This is frequently followed by dependency
behaviors:
• Tendency to cling to parents
• Demands for parents’ attention
• Vigorous opposition to any separation (e.g.,
staying at preschool or with a babysitter)
30
31. Cont…
Other negative behaviors include:
• New fears (e.g., nightmares)
• Resistance to going to bed, night waking
• Withdrawal and shyness
• Hyperactivity
• Temper tantrums
• Food peculiarities
• Attachment to blanket or toy
• Regression in newly learned skills (e.g., self-toileting)
31
32. Cont…
Older Children
Negative behaviors include:
• Emotional coldness followed by intense,
demanding dependence on parents
• Anger toward parents
• Jealousy toward others (e.g., siblings)
32
33. GUIDELINES FOR ADMISSION
Preadmission
Assign a room based on developmental age, seriousness of
diagnosis, communicability of illness, and projected length of
stay.
Prepare roommate(s) for the arrival of a new patient; when
children are too young to benefit from this consideration,
prepare parents.
Prepare room for child and family, with admission forms and
equipment nearby to eliminate need to leave child.
Admission
Introduce primary nurse to child and family.
Orient child and family to inpatient facilities, especially to
assigned room and unit; emphasize positive areas of
pediatric unit.
33
34. Cont…
Room—Explain call light, bed controls, television,
bathroom, telephone, and so on.
Unit—Direct to playroom, desk, dining area, or other areas.
Introduce family to roommate and his or her parents.
Apply identification band to child’s wrist, ankle, or both (if
not already done).
Explain hospital regulations and schedules (e.g., visiting
hours, mealtimes, bedtime, limitations [give written
information if available]).
Perform nursing admission history .
Take vital signs, blood pressure, height, and weight.
Obtain specimens as needed and order needed laboratory
work.
Support child and assist practitioner with physical
examination (for purposes of nursing assessment).
34
36. Eric’s Daily Schedule
7:30 AM – Breakfast,
- morning bath
3:00 PM – Tutor
– Study time
9:00 – Medications,
dressing change
4:00 – Physical therapy
11:00 – Physical therapy 5:30 – Dinner
12:00 PM – Lunch 9:00 – Medications, dressing change
9:15 – Bedtime
Time structuring is an effective strategy for normalizing the hospital
environment and increasing the child’s sense of control.
36
37. BILL OF RIGHTS FOR CHILDREN AND TEENS
In this hospital, you and your family have the right to:
• Respect and personal dignity
• Care that supports you and your family
• Information you can understand
• Quality health care
• Emotional support
• Care that respects your need to grow, play, and learn
• Make choices and decisions
From Association for the Care of Children’s Health: A pediatric bill of rights,
Bethesda, MD, 1991, Author.
37
38. FUNCTIONS OF PLAY IN THE HOSPITAL
Provides diversion and brings about relaxation
Helps the child feel more secure in a strange environment
Lessens the stress of separation and the feeling of
homesickness
Provides a means for release of tension and expression of
feelings
Encourages interaction and development of positive
attitudes toward others
Provides an expressive outlet for creative ideas and interests
Provides a means for accomplishing therapeutic goals
Places child in active role and provides opportunity to make
choices and be in control
38
39. Play materials for children in the hospital need to be appropriate for their
age, interests, and limitations.
39
41. Placing children of the same
age group with similar
illnesses near each other on
the unit is both psychologically
and medically supportive.
(Courtesy E. Jacob, Texas
Children’s Hospital, Houston.)
41
42. Parental presence during hospitalization provides emotional support for the
child and increases the parent’s sense of empowerment in the caregiver role.
(Courtesy E. Jacob, Texas Children’s Hospital, Houston.)
42
44. Before surgery, these children work with a child life specialist using a model
of the body organs.
44
45. The nurse is encouraging this child to deep breathe following surgery by
using a pinwheel device.
45
46. Pain Management
Pain is a concern of postoperative patients in any age
group. Most adult patients can verbally express the
pain they feel, so they request relief. However,
infants and young children cannot adequately
express themselves and need help to tell where or
how great the pain is. Longstanding beliefs that
children do not have the same amount of pain that
adults have or that they tolerate pain better than
adults have contributed to under medicating infants
and children in pain. Research has shown that infants
and children do experience pain (Gallo, 2003).
46
47. Cont..
Pain is treated with pharmacologic & non
pharmacologic interventions (complementary &
alternative therapies) to control pain &
discomfort, as well as surgical procedures used
to block pain impulse transmission.
Alternative & Complementary Therapies:
Relaxation techniques, guided imagery, &
distraction (e.g., music, TV) – relaxes and
distracts the client’s focus on pain; can increase
circulation & lower BP.
47
48. Cont..
TENS (External transcutaneous electrical nerve
stimulation) unit: Adjustable electronic stimulation
via surface electrodes to prevent complete
depolarization or block transmission of pain
impulses.
Heat (muscle relaxation) or cold (local anesthesia)
Patient controlled anesthesia (PCA) – allows client
to control the timing of the administration of the
medication.
Acupuncture – stimulates nerves and blocks
transmission of pain impulses.
Aromatherapy – induces relaxation response.
Biofeedback – promotes muscle relaxation.
48
49. Cont..
Massage – promotes deep relaxation, increases circulation to
affected par, increases energy flow
Meditation and faith – relaxation & internal focus
Reflexology – induces relaxation, increases circulation,
promotes energy flow, reduces anxiety
Therapeutic touch – decreases anxiety, improves immune
response, alters pain perception
Procedures:
o Injection of local anesthetic into nerve (e.g. dental)
o Cordotomy – severs anterolateral spinal cord nerve tracts
o Electrical stimulation – transcutaneos (skin surface), percutaneous
(peripheral nerve)
o Peripheral nerve implant electrode to major sensory nerve
o Dorsal column stimulator electrode to dorsal column
49
52. Summary
➧ The cause of the illness, its treatment, guilt
about the illness, past experiences of illness and
hospitalization, disruption in family life, the
threat to the child’s long-term health, cultural or
religious influences, coping methods within the
family, and financial impact of the hospitalization
all may affect how the family responds to the
child’s illness.
52
53. Cont…
➧ The family caregivers’ role in preparing a child for
hospitalization includes helping the child develop
a positive attitude about hospitals,
hospitalization, and illness and giving children
simple, honest answers to their questions.
➧ Rooming-in facilities allow and encourage the
caregiver to stay in the room with the child. This
helps minimize the child’s concerns with
separation from the caregiver, increases the
child’s feelings of security, and helps to decrease
the stress of hospitalization.
53
54. Cont…
➧ The nurse can help ease the feelings of isolation in a
child who is placed on transmission-based
precautions by spending extra time in the room
when performing treatments and procedures,
reading a story, playing a game, or talking with the
child.
➧ The three stages of response to separation seen in
the child include protest, in which the child cries,
refuses to be comforted, and constantly seeks the
primary caregiver. When the caregiver does not
appear, the child enters the second stage— despair—
and becomes apathetic and listless. The third stage is
denial, in which the child begins taking interest in the
surroundings and appears to accept the situation.
54
55. Cont…
➧ Preadmission education helps prepare the child for
hospitalization and helps make the experience less
threatening. During the preadmission visit the child
may be given surgical masks, caps, shoe covers,
coloring books, and even the opportunity to
“operate” on a doll or other stuffed toy specifically
designed for teaching purposes.
➧ After discharge the family should encourage positive
behavior and avoid making the child the center of
attention because of the illness.
Discipline should be firm, loving, and consistent.
55
56. Cont..
➧ Health professionals can help the adjustment of
the child scheduled for surgery by determining
how much the child knows and is capable of
learning, helping correct any misunderstandings,
explaining the preparation for surgery, and
explaining how the child will feel after surgery.
This preparation must be based on the child’s
age, developmental level, previous experiences,
and caregiver support.
56
57. Cont…
➧ Pain in children may be indicated by behaviors
such as rigidity, thrashing, facial expressions,
loud crying or screaming, flexion of knees
(indicating abdominal pain), restlessness, and
irritability. Physiologic changes, such as increased
pulse rate and blood pressure, sweating palms,
dilated pupils, flushed or moist skin, and loss of
appetite, also may indicate pain.
57
58. Cont…
➧ Play is the principal way in which children learn,
grow, develop, and act out feelings and problems. In
hospital play programs, children may express
frustrations, hostilities, and aggressions through play
without the fear of being scolded.
➧ Infants, children, and their caregivers experience
stress when a child is hospitalized, which may
increase the frequency of accidents. Safety is an
essential aspect of pediatric care. Children must be
protected from hazards. Understanding the growth
and development levels of each age group helps the
nurse be alert to possible dangers for each child.
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59. The nurse uses charts with pictures to perform patient teaching before the
child goes home.
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60. REFERENCES AND SELECTED READINGS
Berger, K. S. (2006). The developing person through childhood and
adolescence (7th ed.). New York: Worth Publishers.
Dlugosz, C. K., et al. (2006). Appropriate use of nonprescription
analgesics in pediatric patients. Journal of
Pediatric Health Care, 20(5), 316–325.
Dunn, D. (2005). Preventing perioperative complications in special
populations. Nursing 2005, 35(11), 36–45.
Hockenberry, M. J., et al. (2006). Implementing evidence based
nursing practice in a pediatric hospital. Pediatric Nursing, 32(4),
371–377.
Hockenberry, M. J., & Wilson, D. (2007). Wong’s nursing care of
infants and children (8th ed.). St. Louis, MO: Mosby Elsevier.
Lafleur, K. J. (2004). Taking the fifth vital sign. RN, 67(7), 30–37.
Little, K., & Cutcliffe, S. (2006). The safe use of children’s toys
within the healthcare setting. Nursing Times, 102(38), 34–37.
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