Two-month-old Charlie is admitted for vomiting and dehydration. He is the 4th child of 37-year-old Mary and 48-year-old Ted who have recently moved to the area after Ted relocated with his company. Mary has been very anxious about the child's condition, frequently asking the nurse if "he is doing alright." Ted visits in the evening allowing Mary to go home to see the other children. A neighbor has been helping with after school care for the other children, ages 6 and 10-year-old twins. Charlie will be going for a pyloromyotomy in the morning to correct his pyloric stenosis. Charlie is very irritable, crying almost constantly. He is receiving IV fluids to correct his dehydration and is NPO. His IV is in his right hand which he usually sucks on for comfort.

1. How has this illness affected this child? This family? What coping mechanisms are being used here?
2. How important is it that Mary stay with Charlie? If she were unable to room-in what changes would need to be made in Charlie's care?
3. How would Charlie respond to this illness if he was 18 months old?
4. How are Charlie's siblings affected by his hospitalization?