UP NHM CHO 7 Sept 2022 (Shift-2)
Child Health Nursing (Pediatrics)
Medium
Loss of control in hospitalized children can be minimized by:
Appeared in: UP NHM CHO 7 Sept 2022 (Shift-2)
Explanation
- Hospitalization often involves confinement and restricted activities, which directly threatens a child's developing sense of autonomy.
- Increasing freedom of movement, even within the room or to a playroom, allows the child to exert independence and feel less helpless.
- This intervention directly counteracts the enforced dependency of being a patient, helping to minimize negative psychological impacts like regression or withdrawal.
- According to developmental theories, fostering autonomy is critical, especially for toddlers, and restricting it can lead to negativism and developmental delays.
Why Other Options Were Wrong
- Option A: This is incorrect because children, particularly toddlers and preschoolers, rely on predictable routines for a sense of security. Introducing new routines daily would increase stress, confusion, and the feeling of being out of control.
- Option B: This is incorrect because excluding children from decisions about their care exacerbates feelings of powerlessness. Even simple, age-appropriate choices give them a sense of control.
- Option D: This is incorrect because a lack of information breeds fear and mistrust. Children's imaginations can create scenarios far more frightening than the reality. Age-appropriate, honest explanations are essential for coping.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Psychosocial care of hospitalized children and strategies to mitigate loss of control as background academic context rather than a clinical decision trigger.
- A child's perception of control during hospitalization directly impacts their cooperation with treatment, psychological adjustment, and long-term attitudes toward healthcare.
- Nurses must actively assess for signs of distress related to loss of control, such as regression (e.g., bedwetting), withdrawal, or uncooperativeness, and implement empowering strategies.
- What if? - If a child is on strict bed rest (e.g., in traction) and cannot have increased freedom of movement, the nurse must focus on other autonomy-promoting strategies. This includes giving the child maximum control over their immediate environment (e.g., choosing TV shows, arranging personal items) and offering as many choices as possible in their daily care (e.g., meal choices, timing of a bath).
How to Approach the Question
- First, identify the core concept of the question: finding a positive intervention to reduce a negative psychological impact ('loss of control') in a vulnerable population ('hospitalized children').
- Analyze each option through the lens of a child's developmental needs for autonomy, predictability, and understanding.
- Evaluate Option A (new routines): This disrupts a child's need for predictability and security, thus increasing their sense of lost control.
- Evaluate Option B (no decisions): This directly removes a child's autonomy, worsening the feeling of powerlessness.
- Evaluate Option D (minimal info): This creates fear and uncertainty, which contributes to a sense of lost control.
- Evaluate Option C (freedom of movement): This directly enhances physical autonomy and independence, counteracting the restrictive hospital environment.
Concept Tested & Keywords
- Concept Tested: Psychosocial care of hospitalized children and strategies to mitigate loss of control.
- Stem keywords: Loss of control, hospitalized children, minimized
- Lead-in keywords: minimized by
Question ID
QVvXzmL9OJoJdh58Zki8al
Reference Book
E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 1 (pp 36-238 of 713) p. 63-65
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 13020-13022
Practise the full UP NHM CHO 7 Sept 2022 (Shift-2)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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