Introduction:
The following report is considered with the evaluation of the pathophysiology referring to the case study of Anne, a 10-year-old girl diagnosed with appendicitis. The review of the pathophysiology of appendicitis in the context of growth and development theories, family-centered care, and the impact of hospitalizing the child have been illustrated in the report presented below.
The pathophysiology of appendicitis suggests that the appendix is a vestigial organ in the human body without any definite functions. The appendix is generally filled with food remnants as well as cecum which could create infections due to obstruction. The sole approach for the treatment of appendicitis is the removal of the appendix through surgery. Appendicitis is the commonly observed form of inflammation on the lower abdomen and it is prominently observed in 7% of the total world population (Curtis, et al., 2016). The infection rates are prominently observed in males as compared to females and teenagers as compared to adults as well as with frequent occurrence between the ages of 10 and 30.
The disease is associated with prominent symptoms such as low-grade fever, nausea, vomiting, and loss of appetite. As per Fegran, et al, the majority of cases include references to the rebound tenderness and local tenderness as well as the observation of appendiceal infection based on the specific location of the appendix that is affected. Constipation is also a prominent indicator of the disease and further implications that can be derived from the pathophysiology of appendicitis include references to the clinical manifestations (Fegran, et al., 2014). The clinical manifestations refer to the profound symptoms of the affliction including anorexia, nausea, mild fever, moderate malaise, and vomiting. In addition to these factors, the observation of constipation accompanied by occasional diarrhea and localized or generalized abdominal pain could be considered the foremost factors associated with the pathophysiology of appendicitis.
The notable aspects of the diagnostic evaluation of appendicitis in the case study also reflect on the pathophysiology. Diagnostic evaluation could be possible through physical examinations, WBC count estimation, analysis of urine samples, ultrasound or CT scan, and x-ray of the abdominal area. It is also essential to notice the essential medications that can be administered to patients suffering from appendicitis in the pathophysiology of the disease. The process of pathophysiology is associated with the description of the disorders in the physiology of an individual in the condition of disease and therefore the symptoms and visibly prominent changes in the case of Anne with her initial symptoms of iliac fossa pain.
The intervention of nurses:
Nurses are required to administer a wide range of responsibilities to provide the required healthcare services to Anne in case of her identified appendicitis. The foremost responsibility is to determine the signs and symptoms frequently and monitor them which includes an evaluation of the severity of the pain, fever, tachycardia, distension, and rigidity. Nursing intervention reflects the requirement of assisting the patient in achieving comfort as well as restricting Anne from activities that could aggravate pain (Hockenberry& Wilson, 2014).
According to Hockenberry, Wilson & Rodgers, the prompt preparation of the patient for surgery before the procedure is also a notable responsibility of nurses in the case of appendicitis. Nurses should also assume the tasks of responding to cases of emergency pain and situations by communicating with healthcare service providers immediately (Hockenberry, Wilson & Rodgers, 2016). The discrete palpation of the abdomen and the examples of symptoms observed in case of complications after surgery. The objectives of nursing intervention are observed in the context of supporting activities such as instructing the patients on precautions to be followed after surgery. Nursing interventions are also associated with the restriction of patients from consumption of harsh laxatives, stool softeners, and increased consumption of fluids.
Growth and development theories:
The prospects of growth and development theories in nursing are noticed in their relevance for determining the appropriate treatment plans and nursing schedules that can be presented for Anne’s case study. As per Keers, et al, The growth and development theories reflect on the prominent demarcation between the physical increase in size and the improvement in cognitive reasoning and skills for adaptability (Keers, et al., 2013).
Some of the prominent theories such as Freud’s psychosexual development theory and Erikson’s stages of psychosocial development theory can be considered viable references for judging the treatment parameters administered by nurses.
Family-centered care:
Family-centered care is essential in the case of Anne owing to several factors such as her background and age as well as responsiveness to surgical operations. According to Keers, et al, the family-centered care model is associated with the treatment of pediatric, neonatal, and adolescent cases of diseases and the treatment of Anne involves references to care for adolescents wherein the prominent factors such as issues of consent, impact on siblings, the role of family, cultural influences and specific influences in the case study (Keers, et al., 2013). The cultural influence can be formidably observed in the case of Anne since she belongs to an Indian family background which is generally associated with an extended family structure.
Despite the factors that Anne would receive optimal healthcare and support services, it is necessary to center her care approaches with references to the family environment setting. The noticeable factor that can be observed as an indication of the requirement for family-centered care in the case of Anne is the existence of four siblings of Anne and the preferences of Anne for living in a homely environment (Keers, et al., 2013). This factor should be addressed effectively for modifying the healthcare settings in the family environment of Anne.
Effects of hospitalization:
The effects of hospitalization on the child could be reflected in the child as well as the family. The child is probably subject to physiological as well as considerable mental stress as a result of the treatment. The treatment should be dependent on the family-centered care component that has been assumed for the case of Anne and the child’s perception of the hospital or the health care settings would be a promising influence on the psychology of the patients(Mahoney, et al., 2013). Generally, adolescents tend to associate with visual imagery and form perceptions of particular environments to which they are exposed. Therefore Anna has to be comforted by the presence of her family during the ten days of her stay in the hospital for treatment purposes.
As per Nordén, Hult & Engström, the administration of IV antibiotics and pain management in the case of Anne indicate the potential impact of physical stress leading to symptoms such as pain due to intravenous administration of antibiotics. Presently her condition is characterized by the gangrene in the perforated appendix which requires her to be subject to a nasogastric tube and morphine. Therefore it can be essentially concluded that the admission of Anne to the hospital would also be equally impactful on the family in terms of finances as well as the psychological effort required to deal with the situation (Nordén, Hult & Engström, 2014). The worsening of the condition of appendicitis in Anne has led to complexities in treatment which have to be addressed by alternate treatment measures.
The recommended treatment approach administered for appendicitis in the case of Anne i.e. appendectomy has to be preceded by a comprehensive period of preparation wherein antibiotics have to be used for removing the infection of gangrene in the perforated appendix. The surgery can be executed without any complications only through a reduction in the gangrene infection observed in the perforated appendix (Perry, et. 2013). Therefore a clear impression of the different treatment procedures that could be administered to Anne for the treatment of her appendicitis has been apprehended as a promising description of the outcomes that can be reflected in the hospitalization outcomes of the child.
According to Perry et al, the intensive nature of relaxing agents such as morphine could be impactful on sensory and cognitive functions of Anne leading to physiological outcomes such as impairment of senses and irritation. Lack of fatigue and considerable body weight loss are also observed as a result of intravenous antibiotic treatment (Perry et al., 2013). The family would also be impacted by the hospitalization of Anne the involvement of five siblings and the responsibility of Anne’s parents to address the requirements of her siblings who are younger than her.
Conclusion:
The report highlighted the pathophysiology of Anne, a 10-year-old girl diagnosed with appendicitis. The primary objectives of the report have been realized in the form of a description of the impact of nurse intervention in the case study. The profound entities that could be observed as functional inclusions in the report refer to the significance of growth and development theories as well as family-centered care in the delivery of apt healthcare services to Anne. The report also illustrated the impacts rendered by the hospitalization of Anne on her as well as her family alongside facilitating recommendations to improve the scenario.
References
Curtis, K., Foster, K., Mitchell, R., & Van, C. (2016). Models of care delivery for families of critically ill children: an integrative review of international literature. Journal of Pediatric Nursing, 31(3), 330-341.
Fegran, L., Hall, E. O., Uhrenfeldt, L., Aagaard, H., &Ludvigsen, M. S. (2014). Adolescents and young adults’ transition experiences when transferring from pediatric to adult care: a qualitative meta-synthesis. International journal of nursing studies, 51(1), 123-135.
Hockenberry, M. J., & Wilson, D. (2014). Wong’s nursing care of infants and children. Elsevier Health Sciences.
Hockenberry, M. J., Wilson, D., & Rodgers, C. C. (2016). Wong’s essentials of pediatric nursing.Elsevier Health Sciences.
Keers, R. N., Williams, S. D., Cooke, J., & Ashcroft, D. M. (2013). Prevalence and nature of medication administration errors in health care settings: a systematic review of direct observational evidence. Annals of Pharmacotherapy, 47(2), 237-256.
Kudchadkar, S. R., Yaster, M., & Punjabi, N. M. (2014). Sedation, sleep promotion, and delirium screening practices in the care of mechanically ventilated children: a wake-up call for the pediatric critical care community. Critical care medicine, 42(7), 1592.
Lotz, J. D., Jox, R. J., Borasio, G. D., & Führer, M. (2015).Pediatric advance care planning from the perspective of health care professionals: a qualitative interview study. Palliative medicine, 29(3), 212-222.
Mahoney, A. E. D., Hancock, L. E., Iorianni-Cimbak, A., & Curley, M. A. (2013).Using high-fidelity simulation to bridge clinical and classroom learning in undergraduate pediatric nursing. Nurse Education Today, 33(6), 648-654.
Nordén, C., Hult, K., &Engström, Å. (2014). Ambulance nurses’ experiences of nursing critically ill and injured children: a difficult aspect of ambulance nursing care. International emergency nursing, 22(2), 75-80.
Perry, S. E., Hockenberry, M. J., Lowdermilk, D. L., & Wilson, D. (2013). Maternal child nursing care.Elsevier Health Sciences.
Smith-Miller, C. A., Shaw-Kokot, J., Curro, B., & Jones, C. B. (2014). An integrative review: fatigue among nurses in acute care settings. Journal of Nursing Administration, 44(9), 487-494.
Smith, J., Swallow, V., & Coyne, I. (2015). Involving Parents in Managing Their Child’s Long-Term Condition—A Concept Synthesis of Family-Centered Care and Partnership-in-Care. Journal of Pediatric Nursing, 30(1), 143-159.
