5 Hospitalized Child Nursing Care Plans

By
Paul Martin, BSN, R.N.
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Whether it is a brief hospital admission, a follow-up check-up, surgery, or recurrent hospitalizations due to chronic illness, a child who is hospitalized creates a crisis within the family. Child’s responses to hospitalization are associated to the developmental level but usually include fear of separation, loss of control, injury, and pain.

The smoothness of transition from home to the hospital relies on how well the child has been prepared for it and how the child’s physical and emotional needs have been satisfied. Providing support to the family, supplying them with information, and empowering their participation in the child’s care adds to the adjustment and well-being of all concerned.

Nursing Care Plans

The major nursing care plan goals for a child who is hospitalized include increased ability to perform self-care activities, relief of anxiety, and an increased sense of power of family in making decisions and absence of injury.

Here are five (5) nursing care plans (NCP) and nursing diagnosis (NDx) for hospitalized child:

  1. Self-Care Deficit
  2. Deficient Diversional Activity
  3. Anxiety
  4. Powerlessness
  5. Risk for Trauma
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Anxiety

Anxiety: Vague uneasy feeling of discomfort or dread accompanied by an autonomic response.

May be related to

  • Change in health status
  • Change in environment
  • Threat to self-concept
  • Situational crisis

Possibly evidenced by

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  • Expressed concern over procedures, pain, loss of control, separation from significant others
  • Increased apprehension; fear; helplessness; uncertainty
  • Changes in vital signs
  • Crying; clinging
  • Distress over hospitalization
  • Financial stresses caused by required absence from employment
  • Refusal to interact with staff
  • Restlessness

Desired Outcomes

  • Child and family will experience reduce anxiety.
Nursing InterventionsRationale
Assess child’s and parents’ level of
anxiety, child’s developmental level, understanding of illness, and reason for hospitalization, and responses to this and prior hospitalizations during admission.		Provides information about sources and level of anxiety associated to illness and hospitalization; sources of anxiety and responses differ with age of child and  include separation, pain and bodily injury, loss of control, enforced dependence, fear of unknown, fear of equipment,
unfamiliar environment and routines, guilt, fear and concern for child’s recovery, feelings of powerlessness.
Assess social and emotional history of child and family for strengths and effective coping ability.Provides information about strengths and about weaknesses to draw upon to cope with hospitalization.
Allow verbalization of feelings and concerns about condition and procedures and listen individually to child and parents.Provides an opportunity to express feelings and fears to lessen anxiety and promote adjustment to hospitalization.
Allow the child to play out feelings.
Accept feelings and responses expressed
by the child.		Allows the child to reveal feelings without fear of punishment.
Provide consistent same personnel in handling written care plan, care for child; schedule personal contact with the child within workday.Promotes continuity and uniformity of care to sustain a trusting relationship.
Provide orientation to hospital
environment and room, routines, meal
and play time, introduction to staff
members, forms to sign and hospital
policies.		Familiarizes child and family with the environment, develop security, and decreases fear of unknown.
Interact child in a positive approach; use child’s proper name; avoid communicating, either verbally or
nonverbally, any rejection, judgments, or negativism.		Develops rapport and trust and maintains identity.
Provide a calm, accepting environment and avoid hurrying through interactions
and care.		Assists child and family in building trust and achieving emotional stability.
Maintain a quiet environment, control visitors, and interactions.Decreases stimuli that increase anxiety.
Encourage involvement of child and
parents in planning and interventions of care; allow parents to remain with child;
allow to hold and cuddle the child.		Promotes participation and adaptation to hospitalization, reduces anxiety; allows demonstration of love and affection for the child.
Allow child and parents to incorporate
home routines as much as possible;
bring toys, tapes, photographs and
favorite foods from home as appropriate.		Promotes security and reduces anxiety associated with new experiences.
Assess and recognize regressive
behavior as a part of the illness and assist the child in handling dependency associated with the hospitalization.		Allows for behaviors common to hospitalizations and loss of control.
Provide support to child during any
procedures or distressing features
associated with care, including intrusive procedures, exposure of body parts, need for personal privacy and privacy of others.		Diminishes anxiety and fear caused by possible bodily injury.
Use therapeutic play to explain and prepare the child for procedures; repeat any teaching as needed.Allows the child to comprehend and become accustomed to articles used for care or procedure.
Acquaint parents and child that behavior caused by anxiety and fear is normal and
expected.		Avoids feeling of inadequacy and fear of punishment.
Inform and explain all procedures and plans in simple, understandable language to child and parents based on their intellectual level and age; pace information according to child/parental needs.Provides easily understood information, which decreases anxiety.
If surgery is planned, provide information on the surgical procedure to be done, purpose of surgery, and duration of hospitalization and preoperative and postoperative care.Prepares the child for surgical intervention with minimal anxiety.
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See Also

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