Some of the first stressors faced by children from infancy through the preschool years are related to illness and hospitalization. Separation anxiety, also known as anaclitic depression, particularly affects children age 6-30 months. There are 3 stages of separation anxiety: protest, when the child refuses attention from others, screams for the parent to return, and cries inconsolably; despair, when the child is withdrawn, quiet, uninterested in activities or meals, and displays younger behavior (eg, use of pacifier, wetting the bed); and detachment, when the child suddenly appears happy and interested in building relationships. Nursing care of hospitalized clients experiencing separation anxiety focuses on maintaining a calm environment and a supportive demeanor to build trust between the nurse and the child, and encouraging connection with family and familiar environments, even when they are absent. Key interventions include: Encouraging the parents to leave favorite toys, books, and pictures from home Establishing a daily schedule that is similar to the child’s home routine Maintaining a close, calming presence when the child is visibly upset Facilitating phone or video calls when parents are available Providing opportunities for the child to play and participate in activities (Option 3) When the child is visibly upset, it is important to provide a calming presence and implement strategies to reduce the child’s anxiety. Leaving the child alone at such times can further increase stress. (Option 5) Providing pictures of the child’s family is actually beneficial, as it reminds the child of something familiar and safe.

NCLEX Daily Practice Questions