Caring for Children with Complex Health Needs, Chronic Illness and at the End of Life Study Guide Exam And Actual Answers.
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Course
Complex child health
Institution
Complex Child Health
A 16-year-old boy with a chronic illness has recently become rebellious and is taking risks such as missing doses of his medication. The nurse should explain to his parents that:
a) He needs more discipline.
b) He needs more socialization with peers.
c) This is part of normal adolescence.
d) ...
Caring for Children with Complex Health
Needs, Chronic Illness and at the End of
Life Study Guide Exam And Actual
Answers.
A 16-year-old boy with a chronic illness has recently become rebellious and is taking risks such as missing
doses of his medication. The nurse should explain to his parents that:
a) He needs more discipline.
b) He needs more socialization with peers.
c) This is part of normal adolescence.
d) This is how he is asking for more parental control - Answer c) This is part of normal adolescence.
R = Risk taking, rebelliousness, and lack of cooperation are normal parts of adolescence. If the parents
increase the
amount of discipline, he will most likely be more rebellious. Socialization with peers should be
encouraged as
a part of adolescence. It is a normal part of adolescence during which the young adult is establishing
independence.
The nurse case manager is planning a care conference about a young child who has complex health care
needs and will soon be discharged home. Whom should the nurse invite to the conference?
a. Family and nursing staff
b. Social worker, nursing staff, and primary care physician
c. Family and key health professionals involved in childs care
d. Primary care physician and key health professionals involved in childs care - Answer c. Family and key
health professionals involved in childs care
,R = A multidisciplinary conference is necessary for coordination of care for children with complex health
needs.
The family and key health professionals who are involved in the childs care are included. The nursing
staff can
address the nursing care needs of the child with the family, but other involved disciplines must be
included.
The family must be included in the discharge conferences, which allow them to determine what
education they
will require and the resources needed at home. A member of the nursing staff must be included to
review the
nursing needs of the child
Lindsey, age 5 years, will be starting kindergarten next month. She has cerebral palsy, and it has been
determined that she needs to be in a special education classroom. Her parents are tearful when telling
the nurse
about this and state that they did not realize that her disability was so severe. The best interpretation of
this situation is that:
a. This is a sign that parents are in denial.
b. This is a normal anticipated time of parental stress.
c. The parents need to learn more about cerebral palsy.
d. The parents are used to having expectations that are too high. - Answer b. This is a normal
anticipated time of parental stress.
R = Parenting a child with a chronic illness can be very stressful for parents. There are anticipated times
that
parental stress increases. One of these identified times is when the child begins school. Nurses can help
parents
recognize and plan interventions to work through these stressful periods. The parents are not in denial;
they are
responding to the childs placement in school. The parents are not exhibiting signs of a knowledge deficit
or
expectations that are too high; this is their first interaction with the school system with this child
,Approach behaviors are coping mechanisms that result in a familys movement toward adjustment and
resolution of the crisis of having a child with a chronic illness or disability. What is considered an
approach behavior in parents?
a. Are unable to adjust to a progression of the disease or condition
b. Anticipate future problems and seek guidance and answers
c. Look for new cures without a perspective toward possible benefit
d. Fail to recognize seriousness of childs condition despite physical evidence - Answer b. Anticipate
future problems and seek guidance and answers
R = The parents who anticipate future problems and seek guidance and answers are demonstrating
approach
behaviors. They are demonstrating positive actions in caring for their child. Avoidance behaviors include
being
unable to adjust to a progression of the disease or condition, looking for new cures without a
perspective
toward possible benefit, and failing to recognize the seriousness of the childs condition despite physical
evidence. These behaviors would suggest that the parents are moving away from adjustment or
adaptation in
the crisis of a child with chronic illness or disability.
Families progress through various stages of reactions when a child is diagnosed with a chronic illness or
disability. After the shock phase, a period of adjustment usually follows. This is often characterized by:
a. Denial.
b. Guilt and anger.
c. Social reintegration.
d. Acceptance of childs limitations. - Answer b. Guilt and anger.
R = For most families, the adjustment phase is accompanied by several responses that are normally part
of the
, adjustment process. Guilt, self-accusation, bitterness, and anger are common reactions. The initial
diagnosis of
a chronic illness or disability often is often met with intense emotion and characterized by shock and
denial.
Social reintegration and acceptance of the childs limitations is the culmination of the adjustment process
The nurse comes into the room of a child who was just diagnosed with a chronic disability. The childs
parents begin to yell at the nurse about a variety of concerns. The nurses best response is:
a. What is really wrong?
b. Being angry is only natural.
c. Yelling at me will not change things.
d. I will come back when you settle down. - Answer b. Being angry is only natural.
R = Parental anger after the diagnosis of a child with a chronic disability is a common response. One of
the most
common targets for parental anger is members of the staff. The nurse should recognize the common
response
of anger to the diagnosis and allow the family to ventilate. What is really wrong? Yelling at me will not
change
things, and I will come back when you settle down are all possible responses, but they are not the likely
reasons for this anger.
A common parental reaction to a child with special needs is parental overprotection. Parental behavior
suggestive of this includes:
a. Giving inconsistent discipline.
b. Providing consistent, strict discipline.
c. Forcing child to help self, even when not capable.
d. Encouraging social and educational activities not appropriate to childs level of capability. - Answer a.
Giving inconsistent discipline.
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