CCA206 Care Of Children And Adolescents


A registered nurse is an essential member of any healthcare team (Islam et al., 2019). Young children are continually fragile and easily afflicted by a variety of illnesses. As a consequence, nursing professionals must correctly assess various types of problems and, based on that, provide patients with the right form of therapy (Lip & Huei, 2021). In this essay a case study of William (Bill) Giovanni who is a 16 years old kid suffering from Acute appendicitis will be analyzed. In past, the patient has suffered from asthma, fructose intolerance, and lactose intolerance. Also, currently, he is a heavy smoker having 10-15 cigarettes a day. The main aim of this essay is to analyze the role of a registered nurse in doing various types of important assessments and providing medication to cure William (Bill) Giovanni’s issues.  

Pathophysiology Of The Clinical Diagnosis

Acute appendicitis is primarily induced by a severe luminal blockage, which is frequently triggered by a faecolith or lymphatic hyperplasia, affected feces, or, in rare cases, an appendiceal as well caecal growth. Whenever the appendix is occluded, symbiotic germs can grow, leading to severe infection (Mennie et al., 2020). Decreased vascular outflow with regional illness can cause elevated stress inside the appendix, which can lead to ischemia. Ischemia inside the abdominal membrane can produce necrosis, which could also induce the appendix to break open if left ignored. The blocking of the abdominal orifice raises luminal and intracellular tension, leading to minor denervation and lymph stagnation. The appendix membrane develops ischemic as well as necrotic. The blocked appendix subsequently becomes infected with germs. Aerobic organisms predominate in the early stages of appendicitis, followed by mixed aerobic bacteria and anaerobic organisms subsequently in the illness. Escherichia coli, Peptostreptococcus, Bacteroides, as well as Pseudomonas, are some of the bacteria that have been linked to acute appendicitis (MiShrA, Kumar & SinhA, 2018). Acute appendicitis, if left ignored, may develop into mucosal destruction and penetration, localized embolization, and rupture.

Signs And Symptoms Of The Clinical Presentation

The following are some of the clinical characteristics of appendicitis. Nausea that starts mostly on the bottom part of the bottom abdominal and spreads. Nausea that originates above the navel and frequently spreads to the bottom lower abdominal. Coughing, walking, or similar jarring motions aggravate the discomfort (Reddan et al., 2018). Headache, nausea, and a decrease in hunger are all symptoms. The temperature of low intensity might develop as the disease advances. Congestion or diarrhea, stomach swelling, and constipation are all common symptoms. The location of the discomfort might differ based on the age as well as the location of the appendix (Turkmenoglu et al., 2020). William Giovanni experiences moderate bilateral below abdomen discomfort for one night, confined to his right half in the previous two hours, along with accompanying rebound soreness, vomiting, hot flushing, and excessive sweating.

Influence Of Growth And Development In Nursing Assessment

For most teenagers, reaching 16 is a major thing. Not only is childhood freedom growing, but kids have been also growing better aware of whatever they wish to achieve in the long term. Those planning to enter university may be exploring campuses or studying for standardized examinations. In terms of parenthood, 16-year-olds may offer both families and carers both delight but also stress. Together with all of the causes to really be proud of how young kid is maturing and achieving objectives, there also certain to encounter a number of setbacks together the road (Uinarni et al., 2020). In this case, the patient William (Bill) Giovanni does not have any blood relatives other than his 20 years old brother Owen Giovanni. So, he does not have proper healthy growth and development in both education and cultured way and has a bad habit of heavy smoking which is impacting his careful planning. Also, his less awareness of health makes him very weak and his pain-bearing abilities have decreased. So the nurse has to provide him pain killer drugs and based on that modify other nursing interventions. In this way, the patient’s growth and development have influenced the whole nursing intervention.

Informed Consent

Gillick competence is a decision-making operational capacity (Zouari et al., 2018). Since it is a task-specific framework, increasingly complicated operations need higher degrees of competency. When determining Gillick’s competency for surgery, a health practitioner must determine whether or not a young kid is able to take such a choice (Vineeth, 2019). Here the patient, Bill is 16 years 11 months old so he does have the proper right to give any type of consent to taking high dosed medicine. Also, other than his 20 years old brother he does not have any other relative who can give proper consent to his medication. So here based on the Gillick competence the informed consent before giving surgery must be taken from both Bill and his brother Owen.

Child Protection Responsibilities

According to the Children, Youth, and Families Act of 2005, a professional nursing staff performs a crucial responsibility in the protection, detection, and treatment of children violence including neglecting, as well as the continuous treatment, teaching, as well as assistance of adolescents with associated family members (Eun et al., 2021). A nurse practitioner dealing with youngsters, teenagers, and households should be able to evaluate, diagnose, record, and execute prompt treatment techniques in the administration of each potential instance of juvenile abuse. In this case, the main responsibilities of the appointed registered nurse Bill are to analyze all of his current issues and the cause of the issues and based on that take the best possible decisions to solve his all issues and make proper surgery to cure his acute appendicitis.

Psychosocial And Cultural Needs

Psychological treatment, according to nurses, includes giving holistically patient care, religious healing, assistance to the client and household, and demonstrating compassion. Moreover, emotional care includes interaction involving caregivers and patients, and also interaction among caregivers. Here the patient Bill is belonging to the aboriginal and Torres group. So, the nurse also gives him treatment favorable for these cultured people (Elliott et al., 2019). This involves talking with the boy and knowing about all of the factors which impact him physically and emotionally and based on that giving care to solve his issues.

How The Nurse Can Create And Sustain A Safe And Emotionally Supportive Environment 

Registered Nurses are fundamental to providing secure, high treatment mostly at the person and systemic levels. Nursing staff should handle issues, make choices, establish strategies, and work together with other members of the team (Coombs et al., 2019). Nursing staff must detect and fix deficiencies in treatment that might jeopardize clients’ health. Clients desire to be acknowledged and recognized, therefore caregivers should establish a supporting connection with clients by attending to patients and speaking words that they understand. They have to sense protected by being aware of whatever is going on. In this case the nurse at first talk about Bill’s brother and know all-important personal and medical detail about Bill. After that based on the nursing staff needs to do the surgery properly by giving emotional support and helping him to stop smoking and taking drugs in the future to secure good health in the future (Desfina et al., 2022).

Registered Nurses Role

In this case study, the registered nurse has a lot of responsibilities, from before the surgery until after the surgery of appendicitis. The registered nurse should  Prevent a lack of fluid capacity. If the client tolerates it and is neither NPO, mouth fluid consumption must be promoted, and input and discharge must be documented (Al Lawati, Al Rawahi & Al Yazidi, 2021). Protection of the patient against infection must be done by the Registered nurse at the time of surgery. Following the operation, the nursing assistant positions the client in a High-posture fowler’s to relieve strain on the wound surrounding internal tissues, hence lowering discomfort. Liquids in the mouth. Intravenous fluids might be supplied if permitted. Registered Nurses are accountable for detecting clients’ complaints, administering drugs inside their area of practice, offering additional discomfort relief methods, and cooperating alongside additional specialists to enhance patients’ pleasure and relatives’ comprehension and adaption. In this case the appointed registered nurse analyses all of the issues Bill and all of the background of his medical history. Based on that the registered nurse has to give him a proper dose of Morphine to reduce the pain of his acute appendicitis (Allan & Al-Habbal, 2018). After that, the registered nurse have to give him other medication Metronidazole, and Amoxicillin, and prepare him for his surgery.


According to the findings of the preceding study, various key steps must be followed in an attempt to properly cure Acute appendicitis, covering all of the difficulties. Their difficulties must be thoroughly evaluated before implementing the best possible treatment approach. Having followed that, the risk factors affiliated with the therapy regimen should be assessed, and Bill should receive suitable nurse treatment to address all of her worries. Consent forms, child protection obligations, behavioral and cultural requirements, how the nursing may build and maintain a secure and psychologically positive environment, and the overall function of Registered Nurses are all being investigated. Based on this, it can be concluded that the nurse practitioner should use a range of care approaches and risk evaluation methods in order to enhance service performance.


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