Page 548 - Saunders Comprehensive Review For NCLEX-RN

close as possible to what he or she is used to at home.
II. The Hospitalized Preschooler

A. Separation anxiety

1. Separation anxiety is generally less obvious and less
serious than in the toddler.
2. As stress increases, the preschooler’s ability to
separate from the parents decreases.
3. Protest
a. Protest is less direct and aggressive
than in the toddler.
b. The preschooler may displace feelings
onto others.
4. Despair
a. The preschooler reacts in a manner
similar to that of the toddler.
b. The preschooler is quietly withdrawn,
depressed, and uninterested in the
environment.
c. The child exhibits loss of newly learned
skills.
d. The preschooler becomes generally
uncooperative, refusing to eat or take
medication.
e. The preschooler repeatedly asks when
the parents will be visiting.
5. Detachment: Similar to the toddler
B. Fear of injury and pain
1. The preschooler has a general lack of understanding of
body integrity.
2. The child fears invasive procedures and mutilation.
3. The child imagines things to be much worse than they
are.
4. Preschoolers believe that they are ill because of
something they did or thought.
C. Loss of control
1. The preschooler likes familiar routines and rituals and
may show regression if not allowed to maintain some
control.
2. Preschoolers’ egocentric and magical thinking limits
their ability to understand events, because they view
all experiences from their own self-referenced
(egocentric) perspective.
3. The child has attained a good deal of independence
and self-care at home and may expect that to continue
in the hospital.

D. Interventions

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