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MCH Exam 3 Study Guide
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MCH Exam 3 Study GuideHospitalization causes many issues - Stress is the Big one. This can be positive and
negative, please explain.Answer- Positive - Child begins to expand their world when
parents are absent. Healthcare providers can see the child adapt. If parents are gone
too long........abandonment can set in.
**Stress helps them learn how to cope.
-Negative - Long term stress (not good), however display itself in physical manifestation.
Ways to interact friendly interchange with parents/address child:Answer- *No medical
jargon
-Get to their eye level, engage child and address child
-Talk slowly & clearly (concrete words) assess child's cognitive ability
-Utilize play, transitional objects, drawings, colors, pictures
-Use a child life specialist to assist with communication & interactions
-Allow child to make noise and be upset, give child something to do.
[Make nice with parents]
What is the child most afraid of - 3 things?Answer- 3 big stressors:
-losing control or independence
-their punishment/pain
-change in body images.
**[separation from parent and family, fear of unfamiliar, fear of pain and loss of control]
How can we minimize the stress of hospitalization?Answer- **Alleviate stress and fears:
ask parents stay participate, explain procedure, and provide distractions
**Ways to min. stress - rooming in w/ patient [parent should be primary source for
coping & comfort], bring an object from home, draw pic to hang in room, offer choices of
watching movie or picking a game, therapeutic play, child life specialist, guided imagery,
role modeling (decrease fear and anxiety and coping skills), move to procedure room
[not in their own room]
Separation anxietyAnswer- -Refers to severe distress that occurs when a child is
separated from his or her primary caretaker-Begins 6 months of age and peaks in
intensity at 14-18 months and then gradually declines;start to accept fact that parents
will come back.
How do we communicate with children?Answer- Children in general - Get to their level
physically. Simple words. Eye contact. Play to demonstrate. Approachable.
Communication: Hearing deficitAnswer- sign language, pictures, computerized
electronics, eye contact, touch, turn light on. Gain their attention before speaking, face
child when speaking, speak slowly and loudly.
,Communication:Visual deficitAnswer- announce yourself, let them know that you are
there. Keep routine in the room the same. Make sure they have their glasses on. Bright
lights.
Communication: Cognitive issuesAnswer- Be gentle and kind, very short directives.
Praise. Hold boundaries.
Adapting to deficitsAnswer- **Child will learn to adapt to deficits quickly, better to
recognize problem early on before they adapt, then harder to find the problems. May
adapt to disabilities so that you may not notice them
Basic fears of children are:Answer- separation, abandonment and fear of pain/unknown.
[Infants from 6 mos. through toddler hood - fear of separation.]
Separation comfort careAnswer- -with favorite items or activity, distraction, parents
room in or go with child to procedures.
-Child will protest separation due to anxiety, [prep with tours and explanation, use
transitional objects] reinforce when they will see parent again.
-Despair follows due to grief of separation, detachment due to ongoing anger/coping
skills.
Alleviate stress and fears:Answer- -explain procedure
-distraction
-ask parent to stay and participate in care
-explain what's going on
HOW they play in each of these stages?
Note: primary school they tend to play in single sex groups.....and in high school they
group by interest groups.Answer- *5 types of play
• Solitary (0-2 Years) - infant/ toddlers. Adolescent. Child should be socialized. Can be
at any stage, but do not want this type of play only
• Parallel (2.5-3 Years) - toddlers. Two toddlers doing the same task, hasn't learned to
play with each other. Egocentric. (two children playing together but oblivious to the fact,
don't understand the concept of someone outside of themselves)
• Associative (3-4 Years) - preschool, early child. Get together to something
accomplished, but no rules.
• Organized/cooperative (4-6 Years) - school aged/adolescents. Organized sports,
rules. Concept of rules upholding. Need moderators. Sports w/Rules
• Onlooker/Spectator (2-2.5 Years) - toddlers, young preschool. RED flag if it continues
with this type of play; autism, cognitive development problems (can see in toddler or
preschooler, but should want to participate)
What is the benefit of play?Answer- - learn to socialize
-learning society rules
, -communication; express thoughts
-learning fine & gross motor skills
-creativity & conceptualize
-master skills
-get stronger (muscles)
-Enables child to explore, express, solve problems
-Cognitive and Physical development, helps form independence over time.
-provides psychosocial needs of child
Nutrition is:Answer- the single most important factor in the growth and development of
children.
Are food fads that different children encounter harmful?Answer- -No, and are usually
self- limiting.
-Adolescents have many different needs for greater caloric intake and more
concentrated iron, folic acid, and protein.
Nutritional needs for baby's/infantsAnswer- -breast milk or formula for 1 full year.
-Solids; at around 6 mo. when Surge of growth is the greatest.
Toddlers: Food fads a problem?Answer- -No, food fads are not really a problem.
-picky eaters, physiological anorexia "grazers". Introduce healthy snack foods.
-They may incur physiological anorexia and physiological anemia due to the milk
ingestion.
Nutritional assessmentsAnswer- [In toddlers] **Too much calcium= Anemia because
"calcium impedes iron absorption"
-Adolescents (puberty)- surge of growth. Muscle mass.
-Anorexia - Not eating; Control issues, body dysmorphia.
-Bulimia - Binge and purge; Body dysmorphia.
Risks with inadequate nutrition:Answer- • Cardiac and organic failure, electrolytic
imbalance, cardiac dysrhythmia, tooth enamel erosion, esophageal damage. Kids are
obsessive picky eaters.
• Older kids become obsessive and restrictive.
• Over-eaters think about meals before all else.
• In little kids they can become constipated, unhealthy.
• Anemia can be an issue. Food fads are not uncommon and if the child has a daily food
intake that is overall balanced, the parent should be comforted and instructed to
continue to track the intake.
Nutritional needsAnswer- -Infant- breast feed up to 1 year, no milk prior
-Solid foods - around 6 mo., slowly new food every 3-4 days
-Toddlers - picky eaters, physiological anorexia, grazers; no food fads are detrimental
unless purposely not eating.
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