A nurse is caring for a child who has had diarrhea for 3 days.
Which of the following actions should the nurse take?

Choice A rationale

Worrying about physical body changes is more typical of older children or adolescents who have a greater understanding of body image and self-concept. Preschoolers are usually not as concerned about changes in their physical appearance in relation to death, as their cognitive development is not yet at that level of comprehension.

Choice B rationale

Feelings of isolation are more commonly associated with older children and adolescents who have a better understanding of social relationships and separation. Preschoolers are more focused on immediate relationships and may not fully grasp the concept of isolation as it relates to death.

Choice C rationale

Preschoolers often perceive death as a punishment due to their egocentric thinking and limited understanding of cause and effect. They may believe that their actions or behavior have directly caused the death or that it is a form of retribution. This perception is a normal part of their cognitive and emotional development.

Choice D rationale

Understanding that death is permanent is a cognitive milestone that typically develops in later childhood. Preschoolers generally do not comprehend the finality of death and may see it as a temporary or reversible state. Their thinking is more concrete and influenced by their immediate experiences and observations. .

Choice A rationale

While acknowledging that hitting a child is wrong is important, the nurse must use therapeutic communication techniques to support the adolescent. Directly stating that the parent was wrong may cause the adolescent to feel defensive or ashamed, and it may not be the most effective way to provide emotional support. The goal is to create a safe and trusting environment where the adolescent feels comfortable discussing their experiences. The nurse should focus on providing empathetic and non-judgmental support to help the adolescent process their feelings and access appropriate resources.

Choice B rationale

Telling the adolescent not to disclose their abuse to anyone else unless it is okay by them is inappropriate and goes against the principles of safeguarding and mandatory reporting. Healthcare professionals have a duty to protect vulnerable individuals and report suspected abuse to the appropriate authorities. This response could inadvertently discourage the adolescent from seeking help or disclosing further information. It is essential to follow protocols for reporting abuse while ensuring the adolescent feels supported and understands that the nurse is taking steps to ensure their safety.

Choice C rationale

Reassuring the adolescent that the abuse is not their fault is an important aspect of providing emotional support and validation. Victims of abuse often struggle with feelings of guilt, shame, and self-blame. By explicitly stating that it is not their fault, the nurse helps to alleviate these feelings and reinforces that the adolescent is not to blame for the abusive behavior. This response aligns with principles of trauma-informed care and helps to build a trusting relationship between the nurse and the adolescent, which is crucial for their emotional healing.

Choice D rationale

Implying that the other parent did nothing to stop the abuse can lead to further emotional distress for the adolescent and may cause feelings of betrayal or abandonment. This response may not provide the necessary support or validation the adolescent needs in that moment. The nurse should focus on addressing the immediate emotional needs of the adolescent and providing reassurance and support. Discussions about the roles of other family members should be handled delicately and may require the involvement of counseling or social services.