When communicating with a preschooler who is admitted to the hospital for a fractured arm, which is the best method for the nurse to describe the preschooler's impending surgery?
a. Encourage the preschooler to put a bandage on a teddy bear's arm.
b. Explain what surgery will be like, using abstract terminology.
c. Explain to the preschooler how long the surgery will take and that it will be done by noon.
d. Inform the preschooler that fixing the fractured arm will make it possible to play sports in the future.
ANS: A
Preschoolers tend to think of their illness, their separation from parents, and any painful treatments as punishment. Play can be used to help children express their feelings about an illness and to role play coping strategies. Allowing the young child to manipulate syringes and give "shots" to a doll or put a bandage or restraint on a teddy bear's arm gives the child a chance to act out his feelings. The child becomes "the aggressor." Play can be a major channel for communication in the nurse-client relationship involving a young child. Preschool children develop communication themes through their play and work through conflict situations in their own good time; the process cannot be rushed. When working with a school-age child, the nurse should search for concrete examples to which the child can relate rather than giving abstract examples. Abstract thinking occurs in the formal operations stage. Children who are 7-11 years of age are in Piaget's concrete operations stage, in which they master the use of numbers and other concrete ideas such as classification and conservation. Children who are 12+ years of age are in Piaget's formal operations stage, in which they tend to think about the future.
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