NURS 345 Exam 2 Review Questions
and Correct Answers
Infant's understanding of illness ✅-unaware of effects but senses parent distress
Infant responses to hospitalization ✅-sleep-wake cycles disrupted
-feeding routines disrupted
-displays excessive irritability
-separation anxiety -starting about 9 months
What helps relieve the separation anxiety for infants and toddlers ✅consistency of
nursing care, providers
Toddler and pre-schooler's understanding of illness ✅-understanding of cause and
effect is not fully developed
-have a general concept of body
-beginning to understand the concept of safety and germs
Toddler responses to hospitalizations ✅-frightened to lie supine
-associates pain with punishment
-does not understand why parents will not help him
Preschoolers responses to hospitalization ✅-fear ghosts, monsters, body parts leaking
out, tubes are permanent
-may perceive it and illness as punishment
-want to play-- allow because it reduces stress
School age understanding of body ✅-maturing
-younger: internal body contains heart and bones
-older: better understanding of body
School age responses to hospitalizations ✅-increased sensitivity to environment (hear
everything)
-demonstrate detailed recall of events from hospitalizations later on
Adolescents understanding of illness ✅-more aware of physical, psychological, and
behavioral causes of illness and injury
-younger: can describe location and function of major organs
-older: perceives effects of illness and injury on appearance
Adolescents responses to hospitalizations ✅-denial
-regression (in development)
-withdrawal (especially with a history of repeated hospitalizations)
,-intellectualization
-projections
-displacement
At what age can a child swallow a pill ✅generally around 5
Oral medications and children ✅-if they cant swallow a pill, check with pharmacy to
see how to/if you can crush it and mix it with something
-mix with very sweet foods, not applesauce
-child should be in an upright position
Rectal medications and children ✅-children have small colons so use the smallest
finger and see if you can cut it in half lengthwise to thin it
-use lubrication
-hold buttocks together for a few minutes afterwards (especially in infants)
Opthalmic medications and children ✅-explain the process and hold their head in the
correct position
-warm it to room temperature
Topical medications and children ✅infants' skin is very thin so it will absorb very
easily→ be very careful to use the correct dose
Im medications and children ✅-infants and younger: vastis lateralis
-can use the deltoid once it develops enough muscle (usually around 18 months)
-25 gauge
Iv medications and children ✅-their veins are so small and fragile we preserve the line
until it falls out
-infants: hands, feet, scalp
-older children: don't put it in their dominate hand if you can help it
Infants preparation for procedures ✅-tell them just before and be completely ready to
start the procedure right after
-want to make sure they are immobilized, but it shouldn't be the parents job
Toddlers preparation for procedures ✅-tell them just before and be completely ready to
start the procedure right after
-immobilize them; allow them to scream and cry and the comfort them afterwards
-provide rewards
Preschoolers preparation for procedures ✅-tell them just before and be completely
ready to start the procedure right after
-provide a brief explanation
-respond well to distractions
, -provide rewards
School-age children preparation for procedures ✅-still don't want to tell them far in
advance
-don't give them the option of if they want to do if, but allow some time to relax
-they sometimes like to be in control and don't want anyone holding them down
-provide rewards
Adolescents preparation for procedures ✅-may want a verbal or written explanation
-teach the use of distraction or imagery
-explore their concerns and answer questions
-often want to know their results and when they'll be ready
Purpose of pre-op ✅to reduce fear, stress, and anxiety
Pre-op period ✅-reduce fear and anxiety
-help them understand what they will see on their body when they come back
-use dolls and surgery materials to have them get comfortable, child life may help
-can keep stuffed animals until last minute
Components of the pre-op checklist ✅-consent
-name band on and correct
-allergies
-prosthetic devices removed
Check for any loose teeth (especially around 6 and 7 when they start losing teeth)
-make sure they go to bathroom
-npo order followed
Post-opp care ✅-assess airway, vitals, incisions, drainage tubes, and urine output
-pain management
-monitoring iv fluids
-assisting with mobility
-advancing nutrition as tolerated
Fluids and surgery ✅-surgery can cause fluid loss and edema (3rd spacing)
-monitor is and os carefully
4 stress reduction techniques ✅-recreation
-rest
-relationships
-routines (particularly with preschoolers and younger)
Examples of therapeutic play ✅-child dresses up as doctor or nurse and gives shot to
baby doll
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