Pediatric Nursing: The Ill or Hospitalized Child

Posted by Suster Gila on Februari 05, 2009

Nursing Care of the Ill Child

Meaning of Illness to Child
  1. Infant: Change in familiar routine and surrounding. Separation from love Object.
  2. Toddler: Fear of separation, desertion; separation anxiety highest in this age group. Cause of illness perceived as a concrete condition, circumstance, behavior.
  3. Preschool: Fear oof bodily harm or mutilation, castration. Fear of intrusive procedures. Separation anxiety less intense than the toddler.
  4. School Age: Fear of physical nature illness. Concern regarding separation from peers and ability to maintain position in group. Cause of illness perceived as external, although located in body.
  5. Adolescent:Anxious regarding loss of independence, control, identity. Concern About privacy. Malfunction organ or process perceived as cause of illness. Ability to Explain illness.

Respon to Separation
  1. Greatest impact between age 1 and 3.
  2. Three phase identified:
  • A. Protest.
  • B. Despair.
  • C. Detachment.

Sign and Symptoms of separation anxiety
  1. Protest: Last from hours to days. Child: Cries and screams. Searches with eyes for parent(s), Clings to parent when present. Avoid and reject contact with strangers. Display anger. Attach stranger verbally and physically. Attempt to physically prevent parent(s) from leaving.
  2. Despair: Duration Varies. Child: Is quiet, withdrawn. Shows limited interaction. Is depressed, sad. Is uninterested in environment. is non communicative. Regress to earlier behavior (e.g., thumb-sucking, bed-wetting, use of bottle). Frequent refuses to eat.
  3. Detachment: Rarely seen in acute setting. seen in prolonged separation or long-term care setting. Child: Shows increased interest in surroundings. Interact with strangers or familiar caregivers. Form new but superficial relationships. Appears happy. Shows only passive or superficial interest in parents.

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