Chapter 19. Family-Centered Care of the Child During Illness and Hospitalization
MULTIPLE CHOICE
1. What is a principle of palliative care that can be included inthe care of children?
a. Maintenance of curative therapy
b. Child and family as the unit of care
c. Exclusive focus on the spiritual issues the family faces
d. Extensive use of opiates to ensure total pain control
ANS: B
The principles of palliative care involve a multidisciplinary approach to the management of a
terminal illness or the dying process that focuses on symptom control and support rather than on
cure or life prolongation inthe absence of the possibility of a cure. inpediatric palliative care, the
focus of care is on the family. Palliative care requires the transition from curative to palliative
care. The transition occurs when the likelihood of cure no longer exists. Spiritual issues are just
one of the foci of palliative care. The multidisciplinary team focuses on physical, emotional, and
, social issues as well. Pain control is a priority inpalliative care. The use of opiates is balanced
with the side effects caused by this class of drugs.
DIF: Cognitive Level: Applying REF: dl. 792 TOP: Nursing Process: Planning
MSC: Client Needs: Psychosocial Integrity
2. What factor is most important for parents implementing do not resuscitate (DNR) orders?
a. Parents beliefs about euthanasia
b. Presence of other children inthe home
c. Experiences of the health care team with other children inthis situation
d. Acknowledgment by health care team that child has no realistic chance for cure
ANS: D
Earlier implementation of DNR orders, use of less aggressive therapies, and greater provision of
palliative care measures are associated with an honest appraisal of the childs condition.
Euthanasia involves an action carried out by a person other than the patient to end the life of the
patient suffering from a terminal condition. DNR orders do not involve euthanasia but give
permission for health care providers to allow the child to die without intervention. Parents state
that regardless of the number of children they have, the death of a child is a new experience and
nothing can prepare them for it. Health professionals may base their discussions with families on
prior experiences, but families base their decision on an honest appraisal of their childs
condition.
DIF: Cognitive Level: Applying REF: dl. 794
TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
3. A school-age child is diagnosed with a life-threatening illness. The parents want to protect
their child from knowing the seriousness of the illness. The nurse should provide which
explanation?
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