Pediatric nursing immunization 800 words due 1/18/2020

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N317PPT_Chapter_30.pptx

Chapter 30 Atraumatic Care of Children and Families

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Atraumatic Care

Therapeutic care that minimizes or eliminates the psychological and physical distress experienced by children and their families in the health care system

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Question #1

Is the following statement True or False?

The nurse is providing atraumatic care to a child who is undergoing surgery and the child’s family. The focus of this type of care is meeting the physical needs of the child.

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Answer to Question #1

False.

The focus of atraumatic care is minimizing or eliminating the psychological and physical distress experienced by children and their families in the health care system (Wong, n.d.).

Atraumatic care involves guiding children and their families through the health care experience using a family-centered approach by promoting family roles, fostering family support of the child, and providing appropriate information.

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Techniques for Providing Atraumatic Care

Therapeutic communication

Goal directed

Focused and purposeful

Therapeutic play

Provides emotional outlet or coping devices

Child education

Helps child understand the reason for the hospitalization/procedures

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Preventing/Minimizing Physical Stressors

Utilize a child life specialist

Specially trained individual who provides programs to prepare children for hospitalization and painful procedures

Minimize physical distress during procedures

Use positions that are comfortable to the child

Therapeutic hugging

Use distraction methods

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Distraction Methods

Have the child point toes inward and wiggle them.

Ask the child to squeeze your hand.

Encourage the child to count aloud.

Sing a song and have the child sing along.

Point out the pictures on the ceiling.

Have the child blow bubbles.

Play music appealing to the child.

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Focus of Family-Centered Care #1

Respect for the child and family

Recognition of the effects of cultural, racial, ethnic, and socioeconomic diversity on the family’s health care experience

Identification and expansion of the family’s strengths

Support of the family’s choices related to the child’s health care

Maintenance of flexibility

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Focus of Family-Centered Care #2

Provision of honest, unbiased information in an affirming and useful approach

Assistance with the emotional and other support the child and family require

Collaboration with families

Empowerment of families

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Positive Outcomes of Family-Centered Care for Children

Anxiety is decreased.

Children are calmer and pain management is enhanced.

Recovery times are shortened.

Families’ confidence and problem-solving skills are improved.

Communication between the health care team and the family is also improved.

A decrease in health care costs is seen.

Health care resources are used more effectively.

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Providing a Sense of Control for the Hospitalized Child

Provide effective communication and teaching.

Find a balance between neutral and affective communication.

Use verbal communication and nonverbal communication.

Use developmental techniques for communicating with children.

Assist family to obtain necessary information and resources.

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Question #2

The nurse is providing atraumatic care to a child hospitalized for cardiac surgery. Which is a recommended guideline when communicating with the child’s parents?

a. do not cause undue stress by providing details of the surgery

b. direct the focus of the parent from providing routine care of the child to preparing for the surgery

c. direct the parents to the physician if they have questions about the surgery

d. treat the parents as equal partners in the care of their child by allowing them to perform as much care as possible

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Answer to Question #2

d. treat the parents as equal partners in the care of their child by allowing them to perform as much care as possible.

The nurse should allow the parent to express concerns and ask questions, as well as explain equipment and procedures thoroughly. The nurse should also teach and encourage the parent to perform as much of the child’s care as is reasonable and permitted. This helps to give the parents a sense of value and control.

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Goals of Child and Family Education

Improve the child and family’s health literacy

Encourage communication with physicians or nurse practitioners

Improve health outcomes and promote healthy lifestyles

Encourage involvement of child and family in care and decision making about care

Improve compliance with care and treatment plan

Promote a sense of autonomy and control

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Specific Learning Principles Related to Parents

Adults are self-directed.

Adults are problem focused and task oriented.

Adults want an immediate need satisfied.

Adults value past experiences and beliefs.

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Question #3

Is the following statement True or False?

The nurse preparing discharge teaching for the parents of a hospitalized child should base this teaching on the fact that adults are present focused and do not value past experiences.

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Answer to Question #3

False.

The nurse preparing discharge teaching for the parents of a hospitalized child should base this teaching on the fact that adults are problem focused and value past experiences and beliefs.

Adults value independence and want to learn on their own. Adults learn best when they perceive there is a gap in their knowledge base and want information and skills to fill the gap. Adults bring an accumulated wealth of experiences to each health care encounter; this provides a rich base for new learning.

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Questions Appropriate to Ask When Performing a Cultural Assessment

Who is the person caring for the child at home?

Who is the authority figure in the family?

What is the social support structure?

Are there any special dietary needs and concerns?

Are there any traditional health practices used?

Are there any special clothes or other items used to help maintain health?

What religious beliefs, ceremonies, and spiritual practices are important?

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Red Flags Indicating Poor Literacy Skills

Difficulty filling out forms

Frequently missed appointments

Noncompliance and lack of follow-up with treatment regimens

History of medication errors

Responses such as “I forgot my glasses” or “I’ll read this when I get home”

Inability to answer questions about treatment or medicines

Avoiding asking questions for fear of looking stupid

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Techniques to Improve Learning

Slow down and repeat information often.

Speak in conversational style using plain language.

“Chunk” information and teach in small bites.

Prioritize information and teach “survival skills” first.

Use visuals.

Teach using an interactive, “hands on” approach.

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Evaluating Learning

The child or family demonstrates a skill.

The child or family repeats back or teaches back the information in own words.

The child or family answers open-ended questions.

The child or family responds to a pretend scenario in their home.

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Documentation of Child and Family Teaching

The learning needs assessment

Information on the child’s medical condition and plan of care

Goals of child education; date goal is met

Teaching method used and how received by child and family

Medications, including drug–drug and drug–food interactions

Modified diets and nutritional needs

Safe use of medical equipment

Follow-up care and community resources discussed

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