Chapter 8, Atraumatic Care of Children and Families
1. The nurse is providing atraumatic care to children in a hospital setting. What are principles
of this philosophy of care? Select all that apply.
a. Avoid or reduce painful procedures.
b. Avoid or reduce physical distress.
c. Minimize parent–child interactions.
d. Provide child-centered care.
e. Minimize child control.
f. Use core primary nursing.
ANS: A, B, F
Feedback:
When using atraumatic care, the nurse would avoid or reduce painful procedures, avoid or
reduce physical distress, use core primary nursing, maximize parent–child interactions,
provide family-centered care, and provide opportunities for control, such as participating in
care, attempting to normalize daily schedule, and providing direct suggestions.
PTS: 1 REF: p. 204, Introduction, Box 8.1
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand NOT: Multiple Select
2. The nurse is consulting with a child life specialist (CLS) to help minimize the stress of
hospitalization for a child. Which services would the CLS provide? Select all that apply.
a. Medical preparation for tests, surgeries, and other medical procedures
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b. Support before and after, but not during, medical procedures
c. Activities to support normal growth and development
d. Grief and bereavement support
e. Emergency room interventions for children and families
f. Only inpatient consultations with families
ANS: C, D, E
Feedback:
The CLS would provide activities to support normal growth and development, grief and
bereavement support, and emergency room interventions for children and families. The CLS
would also provide nonmedical preparation for tests, surgeries, and other medical
procedures; support during medical procedures; and outpatient consultation with families
(American Academy of Pediatrics, Committee on Hospital Care and Child Life Council,
2014, reaffirmed 2018).
PTS: 1 REF: p. 204, Utilizing the Child Life Specialist
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
KEY: Integrated Process: Communication and Documentation
BLM: Cognitive Level: Understand NOT: Multiple Select
3. The nurse is implementing interventions to prevent physical stressors for a 9-year-old child
receiving chemotherapy in the hospital. How will the nurse provide atraumatic care for this
child?
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a. Use restraint or “holding down” of the child during the procedure to prevent
injury.
b. Have the parent stand near and/or rub the child’s feet during the procedure.
c. Insert a saline lock if the child will require multiple doses of parenteral
medications.
d. Avoid using numbing techniques for multiple blood draws or IV insertion.
ANS: C
Feedback:
The nurse should insert a saline lock if the child will require multiple doses of parenteral
medications. During painful or invasive procedures, the nurse should avoid traditional
restraint or “holding down” of the child and use alternative positioning such as “therapeutic
hugging.” If therapeutic hugging is not an option, the nurse could have the parent stand near
the child’s head, not his feet to provide visual and verbal comfort. The nurse should also use
numbing techniques for blood draws or IV insertion.
PTS: 1 REF: p. 204, 205, Introduction, Table 8.1
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
4. The nurse contacts a child life specialist (CLS) to work with children on a pediatric ward.
What is the primary goal of the CLS?
a. Decrease anxiety and fear during hospitalization and painful procedure.
b. Keep children who are hospitalized distracted from pain.
c. Perform medical procedures using atraumatic principles.
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ANS: A
Feedback:
The CLS is a specially trained individual who provides programs that prepare children for
hospitalization, surgery, and other procedures that could be painful (Child Life Council,
2010a, 2010b). The goal of the CLS is to decrease the anxiety and fear while improving and
encouraging understanding and cooperation of the child. The CLS may use distraction
techniques and act as a liaison, but that is not the primary goal of the CLS role. The CLS
does not perform medical procedures.
PTS: 1 REF: p. 205, Utilizing the Child Life Specialist
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
KEY: Integrated Process: Caring BLM: Cognitive Level: Understand
NOT: Multiple Choice
5. The nurse is preparing a child and his family for a lumbar puncture. Which would be a
primary intervention instituted to keep the child safe?
a. Distraction methods
b. Stimulation methods
c. Therapeutic hugging
d. Therapeutic touch
ANS: C
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