A nurse is reinforcing teaching with a parent of a child who has a new prescription for a budesonide inhaler. Which of the following adverse reactions should the nurse include in the teaching?

Rationale for Correct Choices:

• Consult the child life specialist for guidance: A child life specialist can help the parent navigate the difficult conversation with their adolescent, providing strategies for addressing sensitive topics like metastasis and death.
• Reinforce teaching to the parent regarding the adolescent's potential emotional responses: Educating the parent on common emotional responses helps them prepare for and better support their adolescent through this challenging time.

Rationale for Incorrect Choices:

• Encourage the parent to hide their emotions from their adolescent: Hiding emotions can create barriers to trust and communication, which can make the adolescent feel isolated or confused.
• Instruct the parent to withhold the test results from their adolescent: Withholding important information can prevent the adolescent from understanding their condition and making informed decisions about their care.
• Discourage the parent from discussing the possibility of death with their adolescent: Avoiding discussions about death can prevent the adolescent from processing their emotions and understanding the reality of their situation.
• Collaborate with the RN to initiate a referral for admission to hospice care: Hospice care should only be considered after emotional support and clear communication have been established, not prematurely without addressing emotional needs first.

A. Understands that death is permanent: Preschoolers generally do not understand the permanence of death. They may view death as temporary or reversible, as their cognitive development is still in the preoperational stage, where they are not fully able to grasp abstract concepts like the permanence of death.
B. Perceives death as a punishment: Preschoolers may view death as a punishment or something they caused, due to their egocentric thinking. They may think that their actions or behaviors (e.g., being "bad") have led to death, as they often see the world from a very self-centered perspective.
C. Has feelings of isolation: Feelings of isolation are more commonly seen in older children or adolescents who understand death better and may have social concerns. Preschoolers are more likely to be confused or fearful about death rather than experiencing isolation.
D. Worries about physical body changes: While preschoolers may be curious about their bodies, their primary focus is usually on the emotional and social aspects of death (e.g., fear of separation from loved ones), rather than worrying about physical body changes associated with dying.