9stress-hospital-group-final
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9.stress hospital group final
Introduction to Art (San Diego State University)
Studocu is not sponsored or endorsed by any college or university
9.stress hospital group final
Introduction to Art (San Diego State University)
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STRESS HOSP/ILLNESS
Nursing of Children and Their Families
Nurs 250
Major Stressors of Hospitalization and Illness
1.
Separation
2.
Loss of Control
3.
Bodily Injury (or fear of bodily injury)
4.
Pain
Common responses seen in
:
a.
Infants:
b.
Toddlers/Preschool:
c.
School-age:
d.
Adolescent:
1.
SEPARATION:
o
Attachment refers to the emotional bond between a child and their primary caregiver.
o
Separation anxiety is a normal developmental stage characterized by fear or distress
experienced by a child when separated from their primary caregiver.
Stages of Separation Anxiety in Young Children:
Stage of Protest
Behaviors observed during later infancy include the following:
• Cries
• Screams
• Searches for parent with eyes
• Clings to parent
• Avoids and rejects contact with strangers
Additional behaviors observed during toddlerhood include the following:
• 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.
Stage of Despair
Observed behaviors include the following:
• 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.
Stage of Detachment
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STRESS HOSP/ILLNESS
Nursing of Children and Their Families
Nurs 250
Observed behaviors include the following:
• 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.
Nursing Care:
a. Infants: Provide comfort through physical contact, such as holding or cuddling.
b. Toddler: Reassure the child of their safety and provide a familiar object.
c. Preschool child: Provide clear explanations, encourage independence, and involve them in
activities.
2.
LOSS OF CONTROL:
May result from the loss of control over their environment and routine during
hospitalization.
Common responses seen in:
a. Infants: Crying, fussiness, and decreased appetite.
b. Toddlers/Preschool: Regression in behavior, crying, and clinginess.
c. School-age: Anger, frustration, and anxiety.
d. Adolescent: Withdrawal, irritability, and feelings of powerlessness.
Nursing Interventions (Minimizing Loss of Control):
●
Provide a predictable routine and allow for autonomy in decision-making when possible.
●
Educate the child and family on their illness and treatments.
●
Encourage the child to participate in activities and play.
●
Promote communication with their caregiver and familiar surroundings.
3.
BODILY INJURY: May result from medical procedures, such as injections or surgery.
Common responses seen in:
a. Toddler/Preschoolers: Crying, clinging, and fear of unfamiliar people and objects.
b. School-age: Worry, fear, and avoidance of medical procedures.
c. Adolescent: Anger, frustration, and feelings of loss of control.
Nursing Interventions (Preventing or Minimizing Fear of Bodily Injury):
●
Explain medical procedures in a developmentally appropriate manner.
●
Provide opportunities for the child to express their fears and concerns.
●
Use comforting techniques, such as distraction or deep breathing.
●
Encourage the child to participate in decision-making related to their care.
●
Allow access to items that are crucial to adolescence (or even younger) like cell phones, tablets,
dvd player, wifi, and video games
●
Be aware of medical terminology and vocabulary used use tv vs monitor
4.
PAIN: Assessment of Children's Pain: Pediatric Pain Assessment tools, such as the FACES Pain
Scale or the Wong-Baker FACES Pain Rating Scale.
Children's Responses to Pain:
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STRESS HOSP/ILLNESS
Nursing of Children and Their Families
Nurs 250
●
Infants: Crying, fussiness, and changes in sleep and feeding patterns.
●
Toddlers/Preschool: Crying, whining, and clinginess.
●
School-age: Verbal complaints, increased anxiety, and avoidance of activities.
●
Adolescents: Withdrawal, irritability, and decreased cooperation.
Pain Management:
a. Biobehavioral interventions: Distraction, imagery, and deep breathing.
b. Pharmacological management: Medications, such as ibuprofen or acetaminophen, and local
anesthetics
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