A nurse is caring for a child with asthma who is prescribed to use an albuterol inhaler with a spacer. The parents ask how albuterol helps the child’s breathing.
Which of the following responses will the nurse include? Select all that apply.

Choice A rationale

Egocentrism is a characteristic of cognitive development typically seen in the preoperational stage (2-7 years), where children believe everyone sees the world as they do. However, expressing sadness about being home alone does not specifically indicate egocentrism.

Choice B rationale

Magical thinking, also a characteristic of the preoperational stage, involves beliefs that thoughts can cause actions. Feeling sad about being home alone could be a manifestation of this, as the child might believe their sadness can change the situation.

Choice C rationale

Centration is the tendency to focus on one aspect of a situation and neglect others. The child’s statement does not provide evidence of centration.

Choice D rationale

Reversibility, the understanding that actions can be reversed, is a characteristic of the concrete operational stage (7-11 years)14. The child’s statement does not provide evidence of reversibility.

Choice A rationale

Distracting the patient and then taking the blanket for washing might seem like a practical solution, but it can lead to trust issues. The patient may feel betrayed or tricked, which can negatively affect the therapeutic relationship between the nurse and the patient.

Choice B rationale

Acknowledging that the blanket seems to be his favorite and allowing him to keep it with him is the best course of action. The blanket likely provides comfort and security to the patient.

Taking it away, even temporarily, can cause distress. The nurse should respect the patient’s attachment to the blanket and look for alternative solutions for maintaining hygiene, such as offering to clean the blanket when the patient is ready to part with it temporarily.

Choice C rationale

Telling the patient that you want to take the blanket home to wash and that you will bring it back might not be reassuring enough for the patient. The patient may worry about the blanket getting lost or not returned, which can cause unnecessary anxiety.

Choice D rationale

Suggesting getting him another blanket so that he will not mind giving up the current one might not work. The patient’s attachment is likely to the specific blanket, not to blankets in general. A new blanket will not have the same familiarity and comforting effect as the old one.