NRSG257 : Child, Adolescent and Family Nursing : Case Study – Nursing Assignment
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Mark is an 8-year-old boy 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. He is made nil by mouth, commenced on IV therapy and admitted to the paediatric unit for a surgical review for possible theatre that evening.
The surgical team agree that the signs and symptoms are associated with a possible appendicitis and take Mark to theatre for an appendectomy. The handover on return to ward is that the surgical team found a gangrenous perforated appendix with peritonitis. Mark has returned to the ward with a nasogastric tube insitu on free drainage, morphine PCA, IV therapy and triple IV antibiotics. Due to the severity of the infection and the potential complications, Mark will need to remain in hospital for 10 days of IV antibiotics and pain management. Mark is the oldest of five children and his parents own and run an Indian restaurant in the city.
Case Study 2
Jayda is a four-month old girl admitted to the paediatric unit via emergency with vomiting, decreased feeds no bowel actions and intermittent spasmodic abdominal pains. During the spasmodic pain episodes, Jayda would draw her legs up and have a high pitched cry. After a diagnostic ultrasound, intussusception was the cause of the presenting symptoms and Jayda was admitted to the ward. Her treatment plan included observation, electrolyte monitoring
and IV therapy and antibiotics until a contrast enema could be implemented to correct the intussusception.
The approximate length of stay for Jayda will be 2 days, during which time, Jayda’s mother is informed that the rotavirus vaccine that Jayda had at 4 months has increased the incidence of this condition amongst infants. Jayda’s mother is now having serious doubts regarding future vaccines for Jayda.
Case Study 3
Steven is a 15-year-old indigenous boy who lives in a remote town in rural Australia. Steven was diagnosed with asthma at the age of two. His asthma has been well managed over the years predominantly with relievers and preventers with the occasional need for steroidal anti- inflammatory medication.
Steven has presented to the local hospital complaining of shortness of breath and relays to the triage nurse that he has a past history of asthma. A health history taken by the triage nurse on arrival reveals that Steven has had a two-year history of smoking cigarettes and is not always compliant with his asthma medication or management plan.
Steven lives with his mother and his 6 brothers and sisters.
Question :
Choose one (1) of the case studies below and address the two (2) associated questions. Your Assessment will be written in academic essay format with an introduction, body and conclusion. Using evidence specific to your chosen case study, address the following two (2) questions:
- Describe the pathophysiology of the presenting complaint in the scenario (300-500 words) and link this to question 2.
- Evaluation of the nurse’s role to deliver developmentally appropriate nursing care in relation to care of the child and family in the chosen case study including:
I. growth and developmental theories,
II. family centred care and,
III. the effects of hospitalisation of the child and family (1100-1300 words).
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