The nurse is caring for a 13-year-old girl hospitalized for ...

[mcmcdaniel]

The nurse is caring for a 13-year-old girl hospitalized for complications from type 1 diabetes. The girl has a nursing diagnosis of powerlessness related to lack of control of multiple demands associated with hospitalization,
 
  procedures, treatments, and changes in usual routine. How can the nurse help promote control?
 
  A) Ask the child to identify her areas of concern.
  B) Encourage participation of parents in care activities.
  C) Offer the girl as many choices as possible.
  D) Enlist the family's assistance in creating a time schedule.

Question 2

The nurse is caring for a 4-year-old girl who has been hospitalized for over a week with severe burns. Which would be a priority intervention to help satisfy this preschool child's basic needs?
 
  A) Encourage friends to visit as often as possible.
  B) Suggest that a family member be present with her 24 hours a day.
  C) Explain necessary procedures in simple language that she will understand.
  D) Allow her to make choices about her meals and activities as much as permitted.

[Tonyam972]

Answer to Question 1

Ans: C
The nurse needs to offer the girl as many choices as possible, such as options for food and drink (as her diet allows), hygiene, activities, or clothing options to promote feelings of individuality and control. Two of the other options engage the parents in the process. A 13-year-old girl is capable of making her own choices regarding activities, schedules, and routine, but she may not be able to identify her areas of concern.

Answer to Question 2

Ans: C
Preschoolers fear mutilation and are afraid of intrusive procedures since they do not understand the body's integrity. They interpret words literally and have an active imagination; therefore, procedures should be demonstrated and/or explained in simple terms. Adolescents typically do not experience separation anxiety from being away from their parents; instead, their anxiety comes from being separated from friends, and therefore encouraging friends to visit is a priority intervention. Toddlers are especially susceptible to separation anxiety and would benefit from a family member being present as much as possible. School-age children are accustomed to controlling self-care and typically are highly social; they would benefit from being involved in choices about meals and activities.