Author Question: A toilet trained 4-year-old hospitalized for several days with an acute illness has been wetting the ... (Read 77 times)

james · **on:** Jul 23, 2018

A toilet trained 4-year-old hospitalized for several days with an acute illness has been wetting the bed at night and is having incontinent accidents during the day. The nurse addresses the parents' concerns with the following statement:

1. Maybe your child should be seen by a specialist, just to make sure there are no physical problems.
2. It is normal for some children to go through a stage of regression after separation from their family or after an acute illness. Try not to be too discouraged.
3. You'll have to be very strict with discipline, so your child knows this behavior is not acceptable.
4. I'd be upset too. It must be hard to go back to using diapers.

Question 2

The parents of a toddler are concerned that their child is so messy during eating, so they just feed him. The nurse's best response is to state::

1. That's probably best. I'm sure it makes your meal time more pleasant.
2. At least you're sharing meals as a family. That's the most important.
3. Motor skills keep improving with age. Try not to get frustrated with the mess.
4. Your child will never learn if you don't let him experience.

maaaaaaaaaa · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 2
Rationale 1: Regressive behavior is not based on physiology and, unless it lasts, would not have to be further investigated.
Rationale 2: Regression is reverting to an earlier development stage (bed-wetting, using baby talk, etc.) as part of the child's experiences with separation anxiety. Nurses can assist parents by helping them understand that this behavior is normal and will pass as the child reestablishes herself as part of the family and works through her own frustration with the situation.
Rationale 3: Strict discipline may not be the best solution over understanding and caring.
Rationale 4: This option does not provide the parents with an understanding of the root of the problem.

Answer to Question 2

Correct Answer: 3
Rationale 1: This option reflects parental action that will interfere with the child's development; assuring the parents that this will improve may help them with their patience during the messy times.
Rationale 2: This option does not address the developemental need for the child to attempt feeding himself.
Rationale 3: Fine muscle coordination and gross motor skills improve during toddlerhood. At 2 years, the toddler should be able to hold a spoon and put it into the mouth correctly, albeit with some messes while he is learning. Assuring the parents that this will improve may help them with their patience during the messy times.
Rationale 4: Simply doing the skill for the child will allow no room for practice and error. However, the nurse must be careful in how this is worded, so as not to sound scolding to the parents.