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Examination: Management of preoperative anxiety in children
Examination Management of preoperative anxiety in children 1. Events that children may find stressful before surgery include 1. the admission process. 2. having blood drawn. 3. receiving injections. 4. separation from parents. 5. anesthesia induction. a. 1 and 3 b. 2 and 4 c. 2, 4, and 5 d. 1, 2, 3, 4, and 5 2. Child life specialists a. are physicians trained in child development. b. strive to alleviate the stress and anxiety that accompany illness or hospitalization. c. focus on and support the needs of the patient but refer the parents to preoperative nurses for support. 3. Music therapists can 1. encourage children to write songs before surgery to express their feelings and concerns. 2. help nonverbal children express their feelings through improvisation with rhythm instruments. 3. use music to facilitate the sedation process and potentially lessen the need for postoperative pain medication. 4. use auricular acupuncture to lessen children’s anxiety. a. 1 and 3 b. 2 and 4 c. 1, 2, and 3 d. 1, 2, 3, and 4 4. Disadvantages of the use of anxiolytics in pediatric patients include that © AORN, Inc, 2006
1. medication affects may peak and wane too soon. 2. use of oral medications may delay discharge to home. 3. the price of the medication adds an extra expense. 4. the administration process may increase anxiety. 5. medicated children must be monitored to ensure they remain safe. a. 1 and 3 b. 2 and 4 c. 1, 2, 3, and 4 d. 1, 2, 3, 4, and 5 5. A thorough assessment of a child allows the nurse to 1. ask the child what he or she understands about the upcoming surgery. 2. clarify misunderstandings and provide additional information. 3. determine the child’s coping style. 4. establish a solid bond with the child and parent. a. 1 and 3 b. 2 and 4 c. 1, 2, and 3 d. 1, 2, 3, and 4
AORN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. AORN is providerapproved by the California Board of Registered Nursing, Provider Number CEP 13019. Check with your state board of nursing for acceptance of this activity for relicensure.
6. Managing preoperative anxiety requires the nurse to identify the interactive effects of anxiety in the parents because anxiety in a parent can transfer to the child. a. true b. false 7. One report indicates that nurses are responsible for influencing family satisfaction with parental presence NOVEMBER 2006, VOL 84, NO 5 • AORN JOURNAL • 805
Examination
NOVEMBER 2006, VOL 84, NO 5
during induction of anesthesia by a. providing parental preparation in order for parents to help decrease their child’s preoperative anxiety. b. focusing most of their attention during induction on the needs and concerns of the parents. c. waiting until after induction to answer parental question to better address actual experiences rather than theoretical concerns. 8. Methods to reduce separation anxiety for an infant or toddler include 1. administering IV sedative medications before taking the patient to the OR. 2. allowing the child to keep a transitional object (eg, teddy bear). 3. allowing parents to come into the postanesthesia care unit as soon as possible. 4. allowing parents to remain with their child during induction of anesthesia or at least minimize the time between separation and induction. 5. not separating the parents and child if at all possible. a. 1 and 3 b. 2 and 4 c. 2, 3, 4, and 5
d. 1, 2, 3, 4, and 5 9. Methods that a nurse can employ to help alleviate preoperative anxiety for a child in preschool or early childhood include 1. conveying dignity by respecting the child’s privacy. 2. determining the child’s perceptions by encouraging questions from both the child and his or her parents. 3. providing detailed information in clear, simple, brief language. 4. reassuring the child that the condition is not the child’s fault. 5. stimulating the senses with therapeutic play. 6. using parental input about their child’s likes and dislikes and strengths and weaknesses. a. 1, 3, and 5 b. 2, 4, and 6 c. 1, 2, 3, 5, and 6 d. 1, 2, 3, 4, 5, and 6 10. Children in the __________year-old age group are fascinated by their increasing abilities to reason and use logic and may try to assert their independence. a. six- to 12b. 10- to 13c. 14- to 16-
Common Chemical May Be Harmful to Lungs
A
chemical compound present in many common deodorizing products may be harmful to the lungs, according to a July 27, 2006, news release from the National Institutes of Health. Researchers analyzed data from 953 adults aged 20 to 59 years and found that increasing blood levels of a volatile organic compound (VOC) called 1,4 dichlorobenzene (ie, 1,4 DCB) modest reduced pulmonary function. Volatile organic compounds are emitted as gases from thousands of commonly used products such as air fresheners, mothballs, pesticides, paints, and cleaning products and also are pres-
806 • AORN JOURNAL
ent in automotive exhaust and tobacco smoke. Researchers studied 11 common VOCs, including benzene, styrene, toluene, and acetone, and found that only the compound 1,4 DCB was associated with reduced lung function. Researchers found that 96% of the participants had detectable blood concentration levels of 1,4 DCB. Chemical in Many Air Fresheners May Reduce Lung Function (news release, Bethesda, Md: National Institutes of Health, July 27, 2006) http://www.nih.gov/news/pr /jul2006/niehs-27.htm (accessed 8 Aug 2006).
Answer Sheet Management of preoperative anxiety in children
P
lease fill out the application and answer form on this page and the evaluation form on the back of this page. Tear the page out of the Journal or make photocopies and mail to:
Event #06120 Session #7904
AORN Customer Service c/o Home Study Program 2170 S Parker Rd, Suite 300 Denver, CO 80231-5711 or fax with credit card information to (303) 750-3212.
Contact hours: 5.6 Fee: Members $28 Nonmembers $56
Additionally, please verify by signature that you have reviewed the objectives and read the article, or you will not receive credit.
Signature ________________________ Program offered November 2006
1. Record your AORN member identification number in the appropriate section below. (See your member card.) 2. Completely darken the spaces that indicate your answers to examination questions one through 10. Use blue or black ink only. 3. Our accrediting body requires that we verify the amount of time you required to complete this 5.6 contact hour (280minute) program.__________ 4. Enclose fee if information is mailed.
The deadline for this program is Nov 30, 2009
AORN (ID) # _______________________________ Name _____________________________________ Address ___________________________________ City_______________________________________ State __________ Zip ____________ Phone number______________________________ RN license #________________________________ State __________________________ Fee enclosed _______________________________ or bill the credit card indicated ■ MC ■ Visa ■ American Express ■ Discover Card # ____________________________________ Expiration date Signature _________________________________________________ © AORN, Inc, 2006
A score of 70% correct on the examination is required for credit.
(for credit card authorization)
NOVEMBER 2006, VOL 84, NO 5 • AORN JOURNAL • 807
Learner Evaluation Management of preoperative anxiety in children Objectives To what extent were the following objectives of this Home Study Program achieved? 1. Discuss factors associated with increased levels of anxiety in children. 2. Describe opportunities for interdisciplinary collaboration in relieving preoperative anxiety in children. 3. Explain use of a family-centered approach to relieving preoperative anxiety. 4. Identify interventions to prevent preoperative anxiety according to a child’s developmental stage.
This evaluation is used to determine the extent to which this Home Study Program met your learning needs. Rate these items on a scale of 1 to 5. Purpose/Goal: To educate perioperative nurses about how to manage preoperative anxiety in children.
Content To what extent 5. did this article increase your knowledge of the subject matter? 6. was the content clear and organized? 7. did this article facilitate learning? 8. were your individual objectives met? 9. did the objectives relate to the overall purpose/goal?
Test Questions/Answers To what extent 10. were they reflective of the content? 11. were they easy to understand? 12. did they address important points?
Learner Input 13. Will you be able to use the information from this Home Study in your work setting? a. yes b. no 14. I learned of this Home Study via a. the Journal I receive as an AORN member. b. a Journal I obtained elsewhere. c. the AORN Journal web site. 15. What factor most affects whether
you take an AORN Journal Home Study? a. need for contact hours b. price c. subject matter relevant to current position d. number of contact hours offered What other topics would you like to see addressed in a future Home Study Program? Would you be interested or do you know someone who would be interested in writing an article on this topic? Topic(s): ___________________________ ___________________________________ ___________________________________ Author names and addresses: ________ ___________________________________ ___________________________________
808 • AORN JOURNAL • NOVEMBER 2006, VOL 84, NO 5
© AORN, Inc, 2006
1. medication affects may peak and wane too soon. 2. use of oral medications may delay discharge to home. 3. the price of the medication adds an extra expense. 4. the administration process may increase anxiety. 5. medicated children must be monitored to ensure they remain safe. a. 1 and 3 b. 2 and 4 c. 1, 2, 3, and 4 d. 1, 2, 3, 4, and 5 5. A thorough assessment of a child allows the nurse to 1. ask the child what he or she understands about the upcoming surgery. 2. clarify misunderstandings and provide additional information. 3. determine the child’s coping style. 4. establish a solid bond with the child and parent. a. 1 and 3 b. 2 and 4 c. 1, 2, and 3 d. 1, 2, 3, and 4
AORN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. AORN is providerapproved by the California Board of Registered Nursing, Provider Number CEP 13019. Check with your state board of nursing for acceptance of this activity for relicensure.
6. Managing preoperative anxiety requires the nurse to identify the interactive effects of anxiety in the parents because anxiety in a parent can transfer to the child. a. true b. false 7. One report indicates that nurses are responsible for influencing family satisfaction with parental presence NOVEMBER 2006, VOL 84, NO 5 • AORN JOURNAL • 805
Examination
NOVEMBER 2006, VOL 84, NO 5
during induction of anesthesia by a. providing parental preparation in order for parents to help decrease their child’s preoperative anxiety. b. focusing most of their attention during induction on the needs and concerns of the parents. c. waiting until after induction to answer parental question to better address actual experiences rather than theoretical concerns. 8. Methods to reduce separation anxiety for an infant or toddler include 1. administering IV sedative medications before taking the patient to the OR. 2. allowing the child to keep a transitional object (eg, teddy bear). 3. allowing parents to come into the postanesthesia care unit as soon as possible. 4. allowing parents to remain with their child during induction of anesthesia or at least minimize the time between separation and induction. 5. not separating the parents and child if at all possible. a. 1 and 3 b. 2 and 4 c. 2, 3, 4, and 5
d. 1, 2, 3, 4, and 5 9. Methods that a nurse can employ to help alleviate preoperative anxiety for a child in preschool or early childhood include 1. conveying dignity by respecting the child’s privacy. 2. determining the child’s perceptions by encouraging questions from both the child and his or her parents. 3. providing detailed information in clear, simple, brief language. 4. reassuring the child that the condition is not the child’s fault. 5. stimulating the senses with therapeutic play. 6. using parental input about their child’s likes and dislikes and strengths and weaknesses. a. 1, 3, and 5 b. 2, 4, and 6 c. 1, 2, 3, 5, and 6 d. 1, 2, 3, 4, 5, and 6 10. Children in the __________year-old age group are fascinated by their increasing abilities to reason and use logic and may try to assert their independence. a. six- to 12b. 10- to 13c. 14- to 16-
Common Chemical May Be Harmful to Lungs
A
chemical compound present in many common deodorizing products may be harmful to the lungs, according to a July 27, 2006, news release from the National Institutes of Health. Researchers analyzed data from 953 adults aged 20 to 59 years and found that increasing blood levels of a volatile organic compound (VOC) called 1,4 dichlorobenzene (ie, 1,4 DCB) modest reduced pulmonary function. Volatile organic compounds are emitted as gases from thousands of commonly used products such as air fresheners, mothballs, pesticides, paints, and cleaning products and also are pres-
806 • AORN JOURNAL
ent in automotive exhaust and tobacco smoke. Researchers studied 11 common VOCs, including benzene, styrene, toluene, and acetone, and found that only the compound 1,4 DCB was associated with reduced lung function. Researchers found that 96% of the participants had detectable blood concentration levels of 1,4 DCB. Chemical in Many Air Fresheners May Reduce Lung Function (news release, Bethesda, Md: National Institutes of Health, July 27, 2006) http://www.nih.gov/news/pr /jul2006/niehs-27.htm (accessed 8 Aug 2006).
Answer Sheet Management of preoperative anxiety in children
P
lease fill out the application and answer form on this page and the evaluation form on the back of this page. Tear the page out of the Journal or make photocopies and mail to:
Event #06120 Session #7904
AORN Customer Service c/o Home Study Program 2170 S Parker Rd, Suite 300 Denver, CO 80231-5711 or fax with credit card information to (303) 750-3212.
Contact hours: 5.6 Fee: Members $28 Nonmembers $56
Additionally, please verify by signature that you have reviewed the objectives and read the article, or you will not receive credit.
Signature ________________________ Program offered November 2006
1. Record your AORN member identification number in the appropriate section below. (See your member card.) 2. Completely darken the spaces that indicate your answers to examination questions one through 10. Use blue or black ink only. 3. Our accrediting body requires that we verify the amount of time you required to complete this 5.6 contact hour (280minute) program.__________ 4. Enclose fee if information is mailed.
The deadline for this program is Nov 30, 2009
AORN (ID) # _______________________________ Name _____________________________________ Address ___________________________________ City_______________________________________ State __________ Zip ____________ Phone number______________________________ RN license #________________________________ State __________________________ Fee enclosed _______________________________ or bill the credit card indicated ■ MC ■ Visa ■ American Express ■ Discover Card # ____________________________________ Expiration date Signature _________________________________________________ © AORN, Inc, 2006
A score of 70% correct on the examination is required for credit.
(for credit card authorization)
NOVEMBER 2006, VOL 84, NO 5 • AORN JOURNAL • 807
Learner Evaluation Management of preoperative anxiety in children Objectives To what extent were the following objectives of this Home Study Program achieved? 1. Discuss factors associated with increased levels of anxiety in children. 2. Describe opportunities for interdisciplinary collaboration in relieving preoperative anxiety in children. 3. Explain use of a family-centered approach to relieving preoperative anxiety. 4. Identify interventions to prevent preoperative anxiety according to a child’s developmental stage.
This evaluation is used to determine the extent to which this Home Study Program met your learning needs. Rate these items on a scale of 1 to 5. Purpose/Goal: To educate perioperative nurses about how to manage preoperative anxiety in children.
Content To what extent 5. did this article increase your knowledge of the subject matter? 6. was the content clear and organized? 7. did this article facilitate learning? 8. were your individual objectives met? 9. did the objectives relate to the overall purpose/goal?
Test Questions/Answers To what extent 10. were they reflective of the content? 11. were they easy to understand? 12. did they address important points?
Learner Input 13. Will you be able to use the information from this Home Study in your work setting? a. yes b. no 14. I learned of this Home Study via a. the Journal I receive as an AORN member. b. a Journal I obtained elsewhere. c. the AORN Journal web site. 15. What factor most affects whether
you take an AORN Journal Home Study? a. need for contact hours b. price c. subject matter relevant to current position d. number of contact hours offered What other topics would you like to see addressed in a future Home Study Program? Would you be interested or do you know someone who would be interested in writing an article on this topic? Topic(s): ___________________________ ___________________________________ ___________________________________ Author names and addresses: ________ ___________________________________ ___________________________________
808 • AORN JOURNAL • NOVEMBER 2006, VOL 84, NO 5
© AORN, Inc, 2006