The nurse is giving a 5-year-old child a vaccine injection. The child cries loudly during the procedure. Which of the following interventions would be appropriate for the nurse to perform after the injection?

A 5-year-old child is in Erikson’s stage of Initiative vs. Guilt and Piaget’s preoperational stage. At this age, children learn best through play, imitation, and sensory engagement. They have active imaginations and may fear unfamiliar environments like operating rooms.

Rationale for correct answer:

2. Dressing up in surgical attire is a form of medical play, which is effective for preparing preschoolers for procedures. It helps the child become familiar with the hospital environment, reduces anxiety, and gives the child a sense of participation and control. This kind of interactive teaching is ideal for their developmental stage.

Rationale for incorrect answers:

1. Explaining the procedures is helpful but must be very concrete and simplified. Preschoolers do not possess the conceptual ability to understand from an explanation what procedure will be performed. If done alone without hands-on involvement, it may not be effective for a 5-year-old who still has limited abstract thinking.

3. Telling the child why the surgery will make them healthier is too abstract for this developmental age. Preschoolers do not fully understand future health benefits and are more focused on immediate experiences and sensations.

4. Having the child meet another child who had surgery introduces unpredictability. The peer may share frightening or confusing information, which could increase anxiety instead of alleviating it.

Take home points

• Medical play is an ideal teaching method for preschoolers because it uses imagination and sensory involvement to reduce fear.
• Children at this age benefit from active participation, not just verbal explanations.
• Concrete, familiarization strategies, like dressing up, using dolls, or exploring safe medical tools, help children feel more in control.
• Nurses should tailor preoperative education to the developmental stage, hands-on, play-based learning is best for age 5.

Preschoolers communicate best through play, storytelling, and symbolic expression, not through direct verbal explanation. Puppetry is a developmentally appropriate technique that allows the child to express feelings and fears indirectly and safely.

Rationale for correct answer:

4. Using puppets enables non-threatening, imaginative communication, which is ideal for 5-year-olds. It helps the child express thoughts and emotions while feeling safe and engaged. The puppets can also model procedures or hospital routines, promoting understanding and emotional processing.

Rationale for incorrect answers:

1. Keeping a diary is not appropriate for a 5-year-old, who is likely still learning basic writing skills. At this age, children express themselves better through non-written forms such as drawing, play, and verbal storytelling.

2. Reading a fairy tale about scary adventures could intensify anxiety, especially in a hospitalized child. Preschoolers may interpret fiction as reality and internalize frightening stories, worsening their fears.

3. While parental insight is helpful, relying solely on the mother to interpret the child’s emotions does not build communication between the nurse and child. Direct interaction with the child, using developmentally appropriate methods, is crucial for trust and rapport.

Take home points

• Play-based communication, such as puppetry, is highly effective for preschoolers.
• Avoid techniques that are too advanced such as diaries or emotionally confusing such as scary stories.
• Nurses should aim to connect with the child directly, using imaginative and familiar tools.
• Understanding a child’s cognitive and emotional stage enhances therapeutic communication and reduces anxiety in the healthcare setting.