KWB (26)

Format: Multiple Select Client Needs: Physiological Integrity: Basic Care and Comfort Cognitive Level: Apply Integrated Process: Nursing Process Page and Header: 1069, 1071, Box 30.2, During the Procedure 17. The NR is preparing to perform a dressing change a b o i r n b . c a o m 1 / t e 3 s - t year-old client who is being treated for burns he received 2 weeks ago. The client prefers not to take pain medication before the dressing change because it causes drowsiness. What nursing interventions would provide atraumatic care? Select all a t b h i r a b . t c o a m p / t e p s l t y. A) The NR asks the client if he would like the television on during the dressing change. B) The NR asks the client if a small group of n u a b r i r s b i . n c o g m / s t e t s u t dents can observe the dressing change. C) The NR encourages the client to wear headphones to listen to music during the dressing change. D) The NR encourages the biological parents to talk to the child about taking pain medication prior to the procedure. E) The NR tells the client that the dressing cha a n bi g rb e .co w m / i t l e l st not be performed unless pain medication is taken. Ans: A, C Feedback: Minimizing stress prior to and during a procedure helps provide atraumatic care. Since the child chooses to not take pain medication, watching television or using headphones during the procedure provides distraction to the discomfort of the procedure. Students observing does not provide distraction. The child has chosen for the last 2 weeks to not receive pain medication, so having the biological parents talk to the childagain does not provide atraumatic care. The NR cannot force the child to take painmedication. Format: Multiple Select Client Needs: Psychosocial Integrity Cognitive Level: Apply Integrated Process: Communication and Documentation Page and Header: 1074, Developmental Techniques f o a r b i C r b o . c m o m m / t e s u t nicating with Children Page 16

a b ir b . c o m / t e s t 18. The NR is admitting a 7-year-old child to the medi c a l- s u r g i cal unit. The child answers questions with very short answers, makes little eye contact with the NR,and looks to the biological parents to answer most questions. Which interventions would be appropriate during this admission assessment? Select a l a l b t i r h b . a c o t m a / t e p s p t ly. A) Tell the child that you are going to be their NR so it would be best if they answered your questions. B) When asking questions, look at the child as w e a b l l i r b a . c s o m t / h t e e s t biological parents. C) Sit at the child‘s eye level during the admission questioning process. D) Stop asking questions for the present time and return later when the child feels more comfortable. E) Ask the child if they are always nervous around new people. Ans: B, C Feedback: The goal is to establish rapport with the client and encourage communication. It is common for young children to be shy, so it is acceptable for the NR to ask both the child and biological parents questions until the child feels comforta a b b l ir e b.c t o a m l / k te i s n t g with the NR. Sitting at eye level is less intimidating and may help in establishing a trusting relationship. Telling the child that they need to answer the questions appears as condemning the child ‘ s behavior. Admission questions a a r b e i r b . i c m o m p / t o e s r t tant and can ‘ t be delayed until a later time. Asking the child if they are nervous around new people is intimidating and may further block communication. Page 17