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4 Dying Child Nursing Care Plans

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By Paul Martin, BSN, R.N.
Dying Child Nursing Care Plans
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Meeting the physical, emotional, and psychosocial need of a dying child is important to support the totally dependent child and grieving family in experiencing the best quality of life possible. The child’s terminal illness and care can affect the whole family, hence, the nurse initial role is to establish rapport in order to build and develop effective communication that assists in alleviating unnecessary fears and anxiety about impending death and supporting anticipatory grieving.

Nursing Care Plans

Nursing care plan for a dying child involves providing substantial and appropriate age-related information about death and dying to allay anxiety, providing optimal pain relief through pharmacological and non-pharmacological methods, assisting the child to move through the stages of awareness and acceptance, and helping the family cope through the stages of grieving.

Here are four (4) nursing care plans (NCP) and nursing diagnosis (NDx) for a dying child:

  1. Acute Pain
  2. Anxiety
  3. Anticipatory Grieving
  4. Dysfunctional Grieving

2. Anxiety

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Anxiety

Nursing Diagnosis

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  • Anxiety

May be related to

  • Prognosis
  • Pain
  • Diagnosis, tests, treatments
  • Side effects of medication

Possibly evidenced by

  • States: fear of death, loss of control, loneliness
  • Increased feelings of helplessness and hopelessness
  • Poor prognosis of terminal illness

Desired Outcomes

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  • Child and/or parent will verbalize decreased anxiety.
Nursing InterventionsRationale
Assess level of anxiety, fears and concerns, ability to express needs, and how anxiety is manifested.Provides information needed for interventions to alleviate anxiety and enhanced comfort.
Allow the child to rate anxiety level as mild, moderate, severe, or incapacitating.Ranking determines evaluation of improved or worsening anxiety levels.
Encourage expressions of fears and inquires about the terminal stage of illness, answer all questions honestly based on what family has been told about prognosis.Provides an opportunity to vent feelings and fears to reduce anxiety.
Allow a family friend to stay with the child or remain with the child during stressful times in the absence of the parents.Promotes comfort of child and provides support during anxious and fearful times.
Assist child and family to identify at least two coping mechanisms to use for coping with anxiety (specify suggestions such as humor, deep breathing, meditation, relaxation, exercise, talking to a spiritual advisor, engage in pleasurable activities).Coping mechanisms help mitigate the stress of anxiety. Humor is not always out of place and may be helpful to diffuse tension if judiciously used.
Provide calm reassurance and kindness, be available to the child at all times as needed for support.Promotes comfort and love of the child to reduce anxiety.
Administer appropriate pain control and
preparation prior to invasive procedures (e.g., application of eutectic mixture of local anesthetics [EMLA] cream prior IV insertion).		Promotes comfort and minimizes  emotional distress related to invasive procedures (action of EMLA).
Orient family members of physical changes in the child as death approach.Prepares them for the changes and recognition of an impending death.
Inform child and parents of all expected
care and activities.		Promotes understanding of physical needs of dying child and limiting activities to those that are essential.
Include child and parents in as much planning and care as possible without
forcing participation.		Promotes interactions and attitude of caring within the family.
Allow parents to communicate to the child
and sit or lie near the child as desired.		Reduces the possibility of added stress for the child; minimizes child’s fear of being alone.
Reassure child and parents that they are
not to hold responsible for illness and its
consequences.		Lessens fear and guilt brought about by the terminal nature of the illness.
Provide parents and family members contact numbers and means of obtaining information about the child.Provides a source of communication about the child’s condition.
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2. Anxiety

Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other nursing care plans for pediatric conditions and diseases:

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Paul Martin, BSN, R.N.
Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession.
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