NRSG257 Child Adolescent And Family Nursing

Question      

Choose one (1) of the case studies below. Your Assessment will be written in academic essay format.  Using evidence specific to your chosen case study, address the following two (2) points:

1. Describe the pathophysiology of the presenting complaint in the case study. 

2. Evaluate the nurse’s role in delivering developmentally appropriate nursing care in relation to your chosen case study. Address:
  • growth and developmental theories,
  • family centred care and,
  • the effects of hospitalisation of the child, on the child and family

Case Study 1

Anne is a 10 year old girl who has presented to the emergency department in the local hospital with right iliac fossa pain. On further assessment by the emergency registrar, appendicitis is suspected. The surgical team agree that the signs and symptoms are associated with appendicitis and take Anne to theatre for an appendectomy.

The handover on return to the ward is that the surgical team found a gangrenous perforated appendix with peritonitis. Anne has returned to the ward with a nasogastric tube in situ on free drainage, morphine PCA, IV therapy and triple IV antibiotics.

Due to the severity of the infection and the potential complications, Anne will need to remain in hospital for 10 days of IV antibiotics and pain management.

Anne is the oldest of five children and her parents own and run an Indian restaurant in the city.

Case Study 2

Jay is a four-month old boy admitted to the paediatric unit via emergency with vomiting, decreased feeds, no bowel actions and intermittent spasmodic abdominal pains. During the spasmodic pain episodes, Jay draws his legs up and has a high pitched cry.

After a diagnostic ultrasound, intussusception was thought to be the cause of the presenting symptoms and Jay was admitted to the ward. His treatment plan included observation, electrolyte monitoring and IV therapy until a contrast enema could be implemented to correct the intussusception.

The approximate length of stay for Jay will be 2 days, during which time, Jay’s mother is informed that the rotavirus vaccine that Jay had at 4 months has increased the incidence of this condition amongst infants. Jay’s mother is now having serious doubts regarding future vaccines for Jay.

Case Study 3

Sue is a 15-year-old indigenous girl who lives in a remote town in rural Australia. Sue was diagnosed with cystic fibrosis in infancy. Since then, Sue has been prescribed a regimen of pancreatic enzymes, periodic antibiotics, inhalers and exercises.

Sue has presented to the local hospital complaining of shortness of breath and tells the triage nurse that she has cystic fibrosis.

A health history taken by the triage nurse on arrival reveals that Sue has had a two-year history of smoking cigarettes and is not always compliant with her medication or cystic fibrosis management plan.

Sue lives with her mother and 6 younger brothers and sisters. 
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