Exam 20: Family-Centered Palliative Care

A 12-year-old boy is in the final phase of dying from leukemia. He tells the nurse who is giving him opiates for pain that his grandfather is waiting for him. How should the nurse interpret this situation?

A critically injured child has died and is being removed from a ventilator in the pediatric intensive care unit. What is a priority nursing intervention for the family at this time?

The nurse has attended a professional development program about palliative care for the pediatric population. What statement by the nurse should indicate a correct understanding of the program?

A preschooler is found digging up a pet bird that was recently buried after it died. What is the best explanation for this behavior?

A health care provider prescribes morphine sulfate (Roxanol), 10 mg PO every 4 h as needed for pain for a child with a terminal illness. The medication label states: "Morphine sulfate (Roxanol) 20 mg/1 ml." The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer using one decimal place. ________________

A 12-year-old child has failed several courses of chemotherapy. An experimental drug is available that his parents want him to receive. He has told his parents and the oncologists that he is ready to die and does not want any more chemotherapy. The nurse recognizes what to be true?

What characterizes a preschooler's concept of death? (Select all that apply.)

An 8-year-old girl has been uncooperative and angry since the diagnosis of cancer was made. Her parents tell the nurse that they do not know what to do "because she is always so mad at us." What nursing action is most appropriate at this time?

What are common respiratory symptoms dying children experience? (Select all that apply.)

What nursing intervention is most appropriate when providing comfort and support for a child when death is imminent?

The nurse is providing support to a family that is experiencing anticipatory grief related to their child's imminent death. What statement by the nurse is therapeutic?

A 7-year-old child is in the end stages of cancer. The parents ask you how they will know when death is imminent. What physical sign is indicative of approaching death?

A health care provider prescribes OxyContin (oxycodone), 3 mg PO every 4 to 6 h as needed for pain for a child with a terminal illness. The medication label states: "OxyContin 5 mg/1 ml." The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer using one decimal place. ________________

Several nurses tell their nursing supervisor that they want to attend the funeral of a child for whom they had cared. They say they felt especially close to both the child and the family. The supervisor should recognize that attending the funeral serves what purpose?

At which developmental period do children have the most difficulty coping with death, particularly if it is their own?

What factor is most important for parents implementing do not resuscitate (DNR) orders?

A child in the terminal stage of cancer has frequent breakthrough pain. Nonpharmacologic methods are not helpful, and the child is exceeding the maximum safe dose for opiate administration. What approach should the nurse implement?

The nurse is making a home visit 48 hours after the death of an infant from sudden infant death syndrome (SIDS). What intervention is an appropriate objective for this visit?

The sibling of a 4-year-old girl dies from sudden infant death syndrome. The parents are concerned because the 4-year-old girl showed more outward grief when her cat died than now. How should the nurse explain this reaction to the parents?

What statement is most descriptive of a school-age child's reaction to death?