75. A 6-year-old child is having burn care following premedication for pain. The child is not cooperative for dressing changes and begins screaming and kicking. What is the best action by the nurse?
A. Inform the child that cooperation is necessary for proper healing and will shorten the hospital stay.
B. Allow the parents to change the dressings with coaching from the nurse.
C. Allow the child to participate in the dressing change process as much as possible.
D. Inform the child that restraints will be used if there is no cooperation.
Rationale: C. The school-age child is striving for feelings of achievement and control. Giving the child the opportunity to help with the procedure will provide a sense of control and accomplishment. Effective pain management improves the chance the child will participate. A shortened hospital stay is no guarantee with or without cooperation and should never be used as leverage with a child. The parents may not be able to tolerate the procedure and may not wish to participate. The school-age child will not respond well to threats and further loss of control.
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