EX.M1HOSPITAL ASSOCIATED STRESSORS FOR CHILDREN OF ALL AGES

NURSING CONSIDERATIONS FOR THE HOSPITALIZED CHILD EXAM 2 HOSPITAL ASSOCIATED STRESSORS FOR CHILDREN OF ALL AGES -Separation from primary caregiver, parents, siblings, or peers Loss of self-control, autonomy, & privacy Painful or invasive procedures Fear of bodily injury or mutilation Separation anxiety - 6-18 months Stranger anxiety what age is most at risk for very stressful hospital stay? toddlers what are adolescents most worried about during a hospital stay? separation from peers who is most worried about fear of bodily injury or mutilation? Most worried about this for preschoolers due to fear about blood gushing out their arm and adolescents because like one pimple can ruin their year and worried about things ruining or altering their body image Infant Stressors Separation anxiety Stranger anxiety Painful procedures Immobilization Sleep deprivation - if waking them often it can disrupt their sleep cycle and will become irritable and could disrupt their eating cycle Sensory overload Infant Stressors - responses Irritability Poor feeding Sleep cycle disruptions Infant Stressors - Nursing Interventions Encourage parent/caregiver presence Decrease stimulation and adhere to routines as much as possible Promote a calm and quiet environment Hold and cuddle Topical anesthetics/pre-procedural analgesics - sweet ease (sugar water) - this is not a medication Toddler Stressors Separation anxiety Loss of self-control Painful, invasive procedures Immobilization Bodily injury/mutilation Fear of the dark Toddler Stressors - responses Cry if parents leave Afraid to lie supine - may think something bad is going to happen if they lie supine so talk through them through it Associate pain with punishment Toddler Stressors - Nursing Interventions Encourage parent/caregiver presence Let parents hold child/keep close during procedures Allow for choices - like ask what toy they want to hold why we stick you Provide a night light Topical anesthetics/pre-procedural analgesics - topical anesthetic put on skin like before putting an iv in is emala cream Explain procedures in simple terms Preschooler Stressors Separation anxiety and fear of abandonment - this age they start to understand moms coming back so can like say mommy will be back after lunchtime - For infants and toddlers you can get mom to record a song or something to help if she has to leave for some reason the baby will recognize her voice and help calm them - Transitional item may help Loss of self-control Painful, invasive procedures Bodily injury/mutilation Fear of the dark and monsters Preschooler Stressors - responses Trouble separating fantasy from reality - Make sure they know this is not their fault Fear blood will leak out if skin not intact Fears tubes are permanent May withdraw or become aggressive Preschooler Stressors - nursing interventions Encourage parent/caregiver presence and participation in care Allow for choices Provide a night light Topical anesthetics/pre-procedural analgesics Explain procedures in simple terms and give reassurance - you can start preparing them for their big kid shots that occur between 4-6 and they do better when they are prepared School-Age Stressors Separation from peers and family Painful, invasive procedures Loss of privacy, control, and control of bodily functions Fear of bodily injury and death School-Age Stressors - responses Increased fear or sensitivity to environment Worry over missed school assignments, sporting events, and time with friends and family - so be sure to get their school assignments so they don't fall behind because they like to complete tasks School-Age Stressors - nursing interventions