Outcome Criteria

V Clients verbalize decreased anxiety. NOC: Anxiety Control

INTERVENTIONS

Assess source and level of anxiety and need for information and support that will relieve it.

RATIONALES

Provides information about degree of anxiety and need for interventions and support; sources for parents may be guilt and uncertainty about surgery, treatments and recovery, possible loss of child; sources for the child may be the multiple procedures of diagnosis and surgery and the effects of postoperative treatments.

Allow expression of concerns and inquiries about disease and possible consequences of surgery and prognosis.

Encourage parents to stay with the child or open visitation, provide a telephone number to call for information about condition of child.

Provide continuing nurse assignment with the same personnel; encourage parents to participate in care.

Orient child to the surgical and ICU unit, equipment, noises and staff.

Teach parents and child about the disease process, surgical procedure, what to expect with procedures done preoperatively, and what will be experienced postoperatively including radiation and chemotherapy and its benefits and effects (alopecia, stomatitis, nausea, vomiting, diarrhea are possible but temporary).

Explain all procedures and care in simple, direct, honest terms and repeat as often as necessary; reinforce physician information if needed and provide specific information as needed.

Teach parents and child the extent of surgery with the removal of a kidney and the staging process; discuss their understanding of the pathology report postoperatively and clarify information as needed.

Utilize therapeutic play, drawings, models for instruction of child.

Provide parents and child with information about community agencies and support groups.

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