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:
Anxiety
Nursing Diagnosis
- Anxiety
May be related to
- Change in health status
- Change in environment
- Threat to self-concept
- Situational crisis
Possibly evidenced by
- 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 Interventions | Rationale |
---|---|
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. |
Recommended Resources
Recommended nursing diagnosis and nursing care plan books and resources.
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- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use. - Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively. - NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023Â (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales. - Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates. - Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing. - Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans. - Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you. - Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023. - All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
See also
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch. - Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other nursing care plans for pediatric conditions and diseases:
- Acute Glomerulonephritis | 4 Care Plans
- Acute Rheumatic Fever | 4 Care Plans
- Apnea | 4 Care Plans
- Brain Tumor | 3 Care Plans
- Bronchiolitis | 5 Care Plans
- Cardiac Catheterization | 4 Care Plans
- Cerebral Palsy | 7 Care Plans
- Child Abuse | 4 Care Plans
- Cleft Lip and Cleft Palate | 6 Care Plans
- Congenital Heart Disease | 5 Care Plans
- Congenital Hip Dysplasia | 4 Care Plans
- Croup Syndrome | 5 Care Plans
- Cryptorchidism (Undescended Testes) | 3 Care Plans
- Cystic Fibrosis | 5 Care Plans
- Diabetes Mellitus Type 1 (Juvenile Diabetes) | 4 Care Plans
- Dying Child | 4 Care Plans
- Epiglottitis | 5 Care Plans
- Febrile Seizure | 4 Care Plans
- Guillain-Barre Syndrome | 6 Care Plans
- Hospitalized Child | 5 Care Plans
- Hydrocephalus | 5 Care Plans
- Hypospadias and Epispadias | 4 Care Plans
- Intussusception | 3 Care Plans
- Juvenile Rheumatoid Arthritis | 4 Care Plans
- Kawasaki Disease | 6 Care Plans
- Meningitis | 7 Care Plans
- Nephrotic Syndrome | 5 Care Plans
- Osteogenic Sarcoma (Osteosarcoma) | 4 Care Plans
- Otitis Media | 4 Care Plans
- Scoliosis | 4 Care Plans
- Spina Bifida | 7 Care Plans
- Tonsillitis and Adenoiditis | 4 Care Plans
- Umbilical and Inguinal Hernia | 4 Care Plans
- Vesicoureteral Reflux (VUR) | 5 Care Plans
- Wilms Tumor (Nephroblastoma) | 4 Care Plans