14.7 Learning Activities

Atraumatic Care Case Study^[1]

 Handoff Report:

This is Emma Smith, a 7-year-old female recently diagnosed with type 1 diabetes. She was brought to the emergency department by her parents after she developed the following signs and symptoms: increased thirst, frequent urination, nausea, vomiting, lethargy, and confusion. On examination, she was found to have rapid breathing, a fruity odor on her breath, and signs of dehydration. Her blood glucose level was 450 mg/dL, and her urine showed a high level of ketones.  Emma was diagnosed with diabetic ketoacidosis (DKA) and admitted to the pediatric intensive care unit (PICU) for close monitoring and treatment.  Emma’s parents were provided education about diabetes management, the importance of blood sugar monitoring, and the signs of future diabetic emergencies.  A Child Life Specialist has also been consulted to help Emily cope with her hospitalization.  We will continue to provide intravenous fluids, insulin therapy, frequent blood glucose checks, electrolyte monitoring and replacement as needed until Emma is stabilized.

1. Which of the following is the most appropriate intervention to reduce Emma’s stress during her hospitalization for DKA?

a. Minimize the involvement of Emma in any discussions about her treatment.
b. Use a Child Life Specialist to explain the procedures to Emma in an age-appropriate manner.
c. Limit parental visits to avoid overwhelming Emma.
d. Administer sedatives before each medical procedure to reduce anxiety.

2. How can family-centered care be implemented in Emma’s case?

a. Allow only one parent to visit Emma at a time to avoid overcrowding.
b. Involve both parents in the diabetes education and management plan to empower them with knowledge and confidence.
c. Limit the amount of information shared with Emma’s parents to reduce anxiety.
d. Allow the child to make independent decisions about her treatment without parental input.

3. Which of the following is an example of atraumatic care that can used in caring for Emma?

a. Explaining the procedure to Emma using medical jargon to make her feel informed.
b. Allowing Emma to choose the site for her blood draw if possible.
c. Performing blood draws without any explanation to avoid anxiety.
d. Keeping Emma’s parents away during procedures to reduce distractions.

4. What is the role of the Child Life Specialist in Emma’s care?

a. To administer medications and perform medical procedures.
b. To provide emotional support, explain procedures, and promote coping strategies.
c. To assess Emma’s vital signs and monitor her glucose levels.
d. To discuss treatment options with Emma’s parents in detail.

5. Which of the following strategies is most effective in reducing Emma’s fear of insulin injections?

a. Telling her that the injections will not hurt at all to reassure her.
b. Using a toy medical kit to demonstrate the procedure and allow her to practice on a doll.
c. Encouraging her to watch the needle insertion to show her there is nothing to fear.
d. Avoiding any mention of the procedure until it is time to perform it.

6. What is the most important consideration when providing education to Emma’s parents about managing diabetes at home?

a. Focus solely on the technical aspects of insulin administration.
b. Involve Emma in the educational sessions to help her feel more in control of her condition.
c. Encourage parents to manage the diabetes independently without involving the child.
d. Provide written materials but avoid verbal explanation to avoid overwhelming the family.