Nurse's Pocket Guide

Parents with significant impairments may need more education/support.
• Observe attachment behaviors between parental figure and
child. Determine cultural significance of behaviors. (Refer to
ND risk for impaired parent/infant/child Attachment.)
• Note presence of factors in the child (e.g., birth defects,
hyperactivity) that may affect attachment and caretaking
needs.
• Identify physical challenges/limitations of the parents (e.g.,
visual/hearing impairment, quadriplegia, severe depression).
May affect ability to care for child and suggests individual
needs for assistance/support.
• Determine presence/effectiveness of support systems, role
models, extended family, and community resources available
to the parent(s).
• Note absence from home setting/lack of child supervision by
parent (e.g., working long hours/out of town, multiple
responsibilities, such as working and attending educational
classes).
NURSING PRIORITY NO.2.To foster development of parenting skills:
• Create an environment in which relationships can be developed
and needs of each individual met. Learning is more
effective when individuals feel safe.
• Make time for listening to concerns of the parent(s).
• Emphasize positive aspects of the situation, maintaining a
hopeful attitude toward the parent’s capabilities and potential
for improving the situation.
• Note staff attitudes toward parent/child and specific problem/disability;
for example, needs of disabled parent(s) to be
seen as an individual and evaluated apart from a stereotype.
Negative attitudes are detrimental to promoting positive
outcomes.
• Encourage expression of feelings, such as helplessness, anger,
frustration. Set limits on unacceptable behaviors. Individuals
who lose control develop feelings of low self-esteem.
• Acknowledge difficulty of situation and normalcy of feelings.
Enhances feelings of acceptance.
• Recognize stages of grieving process when the child is disabled
or other than anticipated (e.g., girl instead of boy, misshapen
head/prominent birthmark). Allow time for parents to
express feelings and deal with the “loss.”
• Encourage attendance at skill classes (e.g., parent effectiveness).
Assists in improving parenting skills by developing
communication and problem-solving techniques.
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
Diagnostic Studies Pediatric/Geriatric/Lifespan Medications 511
impaired PARENTING