Appendicitis Theory Samples for Students †MyAssignmenthelp.com

Question: Discuss about the Appendicitis Theory Of Anne. Answer: Introduction Appendicitis is the inflammation of the vermiform appendix. Acute appendicitis may be followed by perforations in the appendix, due to ischemic necrosis. If the appendix burst then it may give rise to peritonitis. Appendicitis causes sharp pain in the right abdomen. An appendectomy is the surgical removal of the infected appendix. The paper focuses on Anne, a 10 year old patient being subjected to Appendectomy. The post surgical period may bring about complication in the child if not treated carefully. Hence the paper aims to describe about the growth and the developmental theory related to pediatrics nursing care, the family centered care and the impact of hospitalization on the family and the patient. Pathophysiology Appendicitis is the acute inflammation of the vermiform appendix (Bhangu et al., 2015). The inflammation is thought to be caused by a number of facts such as lymphoid hyperplasia, fecaliths, parasites and other foreign bodies. Fecal stasis and fecaliths are considered to be the most common cause of appendiceal obstruction (Bhangu et al., 2015). In the pediatrics or the adolescence, the appendicitis is mainly caused by the lymphoid aggregate that is actually presence in large number at this age group. As per the theory, the inflammation is caused due to the obstruction, which further raises the intraluminal pressure and finally ischemia (Bhangu et al., 2015). As a result the appendix grows in size and the causes inflammatory changes in the surrounding fat and the peritonium. The febrile pain occurring in the right iliac fossa is due to the appendicitis infection. The bacterial infection and the ischemia that produce inflammation can produce to gangrene and necrosis due to which it may perforate (Drake et al., 2014). The progression of the perforation from obstruction does not take more than 72 hours. The perforation is due to the recreation of the inflammatory fluids and accumulation of the infectious bacteria in the abdominal cavity (Bhangu et al., 2015). On further inflammation of the surface of the peritonium, peritonitis is developed. Nursing care Anne is just a girl of 10 years and requires utmost care. One of the most important goals for the appendicitis is the pain and tenderness management followed by the IV fluids. Surgery followed by proper rest and medications can rule out the complications but it should be kept in mind that Anne is a 10 years old girl who is just on the verge of entering the adolescent period, hence anynursing care should done considering her age and the needs. Growth and development There are four areas of the developmental theories such as the biophysical factors, psychosocial factors, cognitive factors and the moral factors. Innursing these developmental theories are required to provide appropriate care as per the age. Erikson's developmental theories can help nurses to analyze the patients symptomatic behavior (Chinn Kramer, 2013). It is natural that a burden of any disease can be traumatic for a child of 10 years and hence should be dealt in a more holistic way. Eriksons psychosocial stages help the nurses to under the behavioral patterns of each age group. For example, from birth to 18 months the psychosocial stage is trust vs. Mistrust, where if a care giver is able to anticipate what the baby needs then the inevitable moments of frustration in the child could be avoided (Kaakinen et al., 2013). In child of about 18 months to 3 years the psychosocial stage is dependant of autonomy vs. shame. In this stage the child will be developing a sense of autonomy a nd will be doing some of the tasks on their own. An individual who will remain fixed at the transition between the growth of hope and autonomy will develop paranoiac fears. Anna is of 10 years and hence belongs to the next developmental stage, Industry vs inferiority, which is also termed as the stage of latency. In this stage a child generally thrives to develop complex and failing to do so develops inferiority complex in the individual. In a clinical setting under the supervision of caregivers, even the simple toilet tasks are done under the supervision of the nurses. Anne might feel is uncomfortable to seek help each time. At this stage of development children becomes aware of their sexuality and thus Anne might want a caregiver of the same gender (Townsend, 2013). A knowledge of the developmental psychological can be beneficial to the nurses for detecting which developmental stage the child had reached, as it would help him/ her to plan the correct stimulation plan (Kaakinen et al., 2013). Many times it has been found the nurses treat the children against their will. Before undertaking anynursing action, starting from the administration of any medications, or to undergo any medical tests, the patient should be asked for a formal consent. According to Chinn Kramer, (2013), engagement of the child in their care regimen has brought about better outcome in patients. Even a child, as young as 7 years can express an informed agreement. According to Kulik et al.,(2013), this can bring about moral growth and development of autonomy in the young patient. Salminen et al., (2013) have focused on the neurodevelopment and decision making skills among the adolescents. This will bring about a growing sense of autonomy in the child. Reflecting on the developmental theories Ericksons trust and mistrust theory can be used as Annes interpersonal relationship with the nurses might help her to recover from pain and the emotional distress. It is evident that the child was administered with morphine as a painkiller. Improper doses of morphine can have several side effects on a child's health. Excessive effect of morphine can have a lethal effect on the underdeveloped organ system of the child. It can even place the child at the risk of respiratory or cardiac arrest. Since the child is on the verge of puberty, her body is subjected to certain developmental and well as endocrinal changes, which has to be taken care of during the nursing actions. Anne is only 10 years old and his organ system are not as developed as that of the adults and hence the care regimen should be different from that of the adults. Nurses have to be more careful regarding the application of the IV medications. According to Hartwich et al.,(2016), It requires a dearth of knowledge of how the physiology of a child changes from birth to adolescents, along with the effects of certain drugs in their bodies, making any treatments tricky and risky. The metabolism of drugs is quite different in children t han that of the adults. Gorter et al., (2015), have stated that the amount of the fluid in a child's body is greater than that of the adults, hence the circulation of morphine takes place more effectively in their bodies as morphine is hydrophilic in nature. It is evident that Anne had returned with nasogastric tube drainage. It should be kept in mind that errors in the placement of the nasogastric tube may bring about complications. The child might have a nosebleed if mispositioned. The tissue in that area is sensitive and can may get damaged causing bleeding. The nasogastric tube insertion can be dangerous if inserted into the airway instead of the food pipe. It should also be assessed whether the child is having a clear airway, as it may augment the secretion in the nostrils, if the child is suffering from cold. Family centered care Child care has adopted the philosophy of a family centered care approach for maximizing the wellbeing of the pediatrics patient (Ball et al., 2013). The illness of a child may have traumatic effect both on the child and the family. The family centered care philosophy is founded in collaboration with the nurses, family, hospital and the other members of the collaborative team (Davidson et al., 2013). Nurses should work in collaboration with the families for developing the best plan of care for the patient (Ball et al., 2013). It should be remembered that parents are the micro-system of the child's ecology and are experts in their child's care. The presence of Anne's family members during the health related procedures such as, ultrasounds or during the dressing of the wounds can be relieving for both the child and the family. Families come with different cultures and one of the roles of the nurses is to acknowledge and accepts the diversity (Festini, 2014). Cultural and spiritual belie fs have an immense effect on a child's wellbeing. Nurses should work with the families such that the practices can be used in the care of the child if suitable. For example, some families believe on religious practices such as prayers. The socio-economic status of the family can have a profound effect on the type of care provided to the child (Festini, 2014). Effect of hospitalization on the child and the family The case study reveals that Anne is the oldest among the five children. Hence their elder sister's illness might have caused anxiety in them to. Furthermore it is also evident that her parent owns and runs an Indian restaurant. Such a surgery and treatment can bring about high cost burden upon them. The hospital environment including the attitude and the behavior of the nurses can affect the well being of the patient. The hospital environment should be non hostile; the course of the treatment should be transparent keeping the patient's interest at the foremost (Macy,2013). A multidisciplinary should be appointed in case the case turns critical. Nurses should be careful while monitoring the vital signs and administering medications. Conclusion Children are special patients and deserve a unique type of care, which should include treating the whole family. Due to the underdeveloped organ system of the patient the nurses should be very careful while applying any sorts of nursing interventions. The effects of the drugs pose different effects than that of the adults (Smith et al., 2013). Physical illness may cause about emotional distress in the child and due to the growing age the child may suffer for cognitive insecurities. Including the parents in the decision making process may improve the health outcomes. 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