NRSG257 Child Adolescent And Family Nursing


The Introduction should give the reader an overview of the essay and what it will discuss.

Sometimes it is easier to write an introduction after you have written out what you are going to be discussing.

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The Body Of Your Essay Is the Crux Of Your Discussion and Will Consume All Your Words.

This Essay


Growth and Developmental Theories

Family-Centered Healthcare

Hospitalization of Children: The Impacts

The conclusion should summarize the main points of the essay. It should also not introduce any new material.

Paragraph Structure

Each paragraph must contain an introductory and concluding statement.

Each paragraph should have a direct relationship with the previous and subsequent paragraphs.

This allows the essay flow.

It is important to use academic references for definitions in your essay.

It is important that you keep in mind that this essay is academic and should only be written in the third person.

There are no minimum requirements regarding the number of sources you need. However, as a guideline, academic essays may only have one source per hundred words.Definitions:

Analysis – What Experts Have to Say About the Topic?

Showcase Your Research and Consider Other Perspectives.

Synthesis – What can we make of the expert discussions?

Evaluation – What are my conclusions after I have presented the arguments based upon my analysis and synthesis?

Answer to Question: NRSG257 Child Adolescent And Family Nursing


The case study of Anne is the subject of this paper.

The patient is brought to the emergency unit for right iliac fosse pain.

After observation of the signs and symptoms, her surgeons recommended that she have an appendectomy.

A perforated gangrenous appendix was found in the clinical handover.

She is being treated for pain and infection with antibiotics.

For a total of 10 days, she will remain in hospital.

An essay is written to answer the case. It discusses the pathophysiology and the cause of the patient’s condition.

This essay examines the role played by the nurse in providing appropriate nursing care.


Right illiac fosse pain is felt in the right lower part of the human abdominal.

The most common reason people present to the emergency room with right iliac fssa infection is their pain.

It manifests as pain and fever.

This is the most common sign of appendicitis. The appendix is located in the right side iliac fossa.

Anne may experience right iliac fosse pain, which is most commonly diagnosed in appendicitis (Kharbanda, Harbanda, and al., 2016).

On the basis of her signs and symptoms, Anne was referred to an emergency room for right-iliac fossa and appendicitis.

Appendicitis can be caused by a variety of factors that block the lumen.

Some of the factors are lymphoid hypoplasia or foreign bodies.

Lymphoid obstruction is the most common cause.

The obstruction can increase the pressure in the lumen.

It leads to the continual production of the mucus, fluids from mucosa, and its stagnation.

Appendicitis occurs when the bacterial population of the intestine grows, accumulating more blood cells.

Edema and bacterial growth can cause inflammation.

Increased intraluminal pressure results from the accumulation of pus (Skarda, Karda, and others, 2015).

The pressure inside the appendiceal lumen is affected by obstructions. It rises above the appendiceal blood vessels.

It can cause venous outflow obstruction, epithelial ischemia, and appendiceal walls ischemia.

This can cause gangrenous apex.

This condition can worsen with thrombosis and blockage of the veins and appendicular arterial arteries.

It causes perforation of the appendix, and gangrene. This is the most frequent complication from appendicitis.

The gangrenous, gangrenous appendix may perforate and allow the appendiceal contents to spill into your peritoneal cavity.

Peritonitis and possibly periappendicular infections can occur during this continuous process.

Diffused Peritonitis could occur if there is no wall to the process (Obinwa Casidy, Flynn, and Flynn (2014)

Appendectomy, which is a surgical procedure to remove the appendix, is the most common emergency procedure.

Anne has to be transferred from the Appendectomy Unit with the peritonitis and gangrenous perforated appendix.

Anne’s perforated appendix means the patient will experience longer-lasting symptoms.

As Anne has perforated and peritonitis, this increases the need to fluid resuscitation as well as broad range of interventions.

The hospitalization has been extended.

Her infection is treated with antibiotics.

Morphine PCA works well to relieve pain. IV therapy can be used to stop fluid loss (Salminen et. al., 2015.

Evaluation of The Nursing Role

Anne’s growth and development is essential for the nurse to be able provide the best care.

Anne is ten years old. Her expected developmental milestones are rapid physical and interpersonal growth according to Jean Piaget.

Anne should be able to develop her cognitive skills quickly at this stage.

It includes an ability to read and perform mathematical calculations, such as addition, subtract, and multiplication.

Piaget (2015) states that children 10 years of age have good language development.

Before Anne can communicate, the nurse must determine if Anne is able and willing to talk with Anne.

The nurse will be able to communicate with Anne to help assess the pain.

You can adjust the medication based on the level of pain.

It is simple to administer antibiotics. Anne must be informed so that the medication can be used properly.

Anne might be shown videos or drawn simple illustrations by the nurse.

Anne should be able understand the terms used by the nurse when communicating with her (Salminen et. al., 2015).

Piaget’s Cognitive Developmental Theory explains that at age 10, children are expected to be well-integrated perceptual motor abilities and may be capable of discerning the difference between intention or behaviour.

At this age, children tend to improve their logical reasoning skills and sensory and motor abilities.

Anne’s situation may allow the nurse to give accurate information.

Emotional support can help calm anxiety.

Anne needs to be understood by the nurse. She must also be able explain the symptoms to Anne, such as blood pressure and temperature.

In order to avoid complications post-operatively, adequate physical endurance should be expected at this age.

Freud’s psychosexual theory explains that the child’s development will be affected by experiences of conflict. (Freud. 2014).

To reduce emotional distress and prepare for an extended stay in hospital, the nurse will need to assess the patient’s mental stamina.

Poor patience, intelligence, maturity and inability to be patient may hinder the care process.

Anne should be included in any medical procedure that will affect her child. Anne should consider the developmental milestones for the age of 10 years.

Anne’s parents should be involved as well. The nurse must evaluate Anne for deviations from developmental milestones at this age.

The nurse must take into account the child’s maturity level and her ability to communicate her feelings.

Anne should be given the chance to express herself and the nurse must respect the autonomy of both the patient and parent for the betterment of both.

The nurse must adhere the principles of ethics which include autonomy, beneficence (Non-maleficence), and social justice (Scanlon Cashin Bryce Kelly & Buckely 2016, 2016).

Care plans should be created in a way that benefits the patient’s family and not cause harm.

Paediatric nurses must promote family-centered care.

The role of the paediatric nurse in this situation is to provide information to the patient’s family about the care plan and side effects.

Anne and her parents will know that Anne can’t immediately return to play, and she shouldn’t lift heavy objects.

Anne and her parents may be notified of the appropriate diet plan for their condition, as well as alerts on changes in bowel movement.

Anne should be advised to consume adequate fluids, and to keep her hydrated.

The nurse must inform the relatives about the care of an incision.

This includes regular dressing and keeping it clean.

The nurse must inform Anne’s family about the need for emergency assistance in case Anne has trouble breathing, loses consciousness, abdominal pain or other symptoms.

It will assist the family in contacting the physician in an emergency situation (Peter and co., 2015).

The nurse must communicate clearly with the family when dealing with them and avoid medical jargon.

During treatment (urinary analysis/blood tests, medication) and the care process, the nurse must have the guardians’ informed consent.

To ensure patient-centred care, it is crucial to take into consideration the beliefs, needs, and preferences of the family members.

Hospital is the home for patients of diverse cultural and linguistic backgrounds.

Therefore, the nurse has to be able to spot communication difficulties and arrange medical interpreters.

A nurse must also take into account religious and cultural preferences.

For example, Hindu Brahmins prefer to have a bath three times daily.

It could lead to wound infection and possible dressing problems.

Family members should be provided with possible spiritual care.

A nurse must also educate the patients about complications that can occur at the surgical site.

Family members should be encouraged and supported to solve problems related to illness (Chau et. al., 2016).

The nurses need to be sensitive to the needs of the patient as well as the loved ones.

Stress and anxiety are common during an illness.

Anxiety and stress are caused by lacks of health literacy, understanding the disease, socioeconomic status, as well as a lack of awareness.

Separation from family members may be the root cause of emotional upset in children.

Different intelligence levels and temperaments result in different degrees of ability to cope with hospitalization.

It can impact both the short-term and long-term effects hospitalisation (Gorter, al., 2016,).

Anne’s family and nurses should encourage a positive attitude to foster coping skills.

It will lower the chances of complications following discharge.

Bowlby’s Attachment theory is used to guide Anne’s family’s involvement.

The need to be close to their loved ones is an innate human instinct. Providing a safe and secure environment can ensure that children are able to bond with them.

A family can feel supported and loved by being close (Goldberg Muir, Kerr, & Kerr 2013).


Appendicitis can be described as a complex illness with serious mental and physical consequences.

The assignment covered the pathophysiology for perforated Appendix and Peritonitis.

Anne’s nursing care was based on several developmental theories.

It is important to recognize that illness has a profound impact on the patient’s family. Therefore, it is necessary to implement family-centred nursing. The factors that can hinder care are briefly illustrated.

It was helpful to gain a deeper understanding of the role and responsibilities of nurses in paediatric settings.

Refer toChau, D. B., Ciullo, S. S., Watson-Smith, D., Chun, T. H., Kurkchubasche, A. G., & Luks, F. I. (2016).

The knowledge gap is bridged by patient-centered outcomes research in pediatric appendicitis.

Journal of pediatrics, 117-121.Freud, S. (2014).

About the sexual theories about children. .

Read Books Ltd.Goldberg, S., Muir, R., & Kerr, J. (. (2013).

Attachment theory: A social, developmental, and clinical perspective. Routledge.Gorter, R. R., van den Boom, A. L., Heij, H. A., Kneepkens, C. F., Hulsker, C. C., Tenhagen, M., & Van Der Lee, J. H. (2016).

The scoring system that predicts the severity of appendicitis among children.

Journal of Surgical Research.Hockenberry, M. J., & Wilson, D. (2014).

Wong’s Nursing Care of Infants and Children Ebook. . Elsevier Health Sciences.Kharbanda, A. B., Madhok, M., Krause, E., Vazquez-Benitez, G., Kharbanda, E. O., Mize, W., & Schmeling, D. (2016).

Implementation electronic clinical decision support (e-clinical) for pediatric appendicitis. . Pediatrics.Obinwa, O., Casidy, M., & Flynn, J. (2014).


Irish Journal of Medical Science, 585-591.Peter, D., Robinson, P., Jordan, M., Lawrence, S., Casey, K., & Salas-Lopez, D. (2015).

Teach-back is a way to reduce readmissions and improve patient and family education.

Journal of Nursing Administration. 35-42.Piaget, J. (2015).

Structuralism. Psychology Revivals.

Psychology Press.Salminen, P., Paajanen, H., Rautio, T., Nordstrom, P., Aarnio, M., Rantanen, T., & Sand, J. (2015).

The randomized clinical trial APPAC randomized to antibiotic therapy vs. appendectomy in uncomplicated acute apendicitis. Jama, 2340-2348.Scanlon, A., Cashin, A., Bryce, J., Kelly, J. G., & Buckely, T. (2016).

The challenges of defining the nurse practitioner scope and practice in Australia. Collegian, 129-142.Skarda, D. E., Schall, K., Rollins, M., Andrews, S., Olson, J., Greene, T., & Scaife, E. (2015).

A dynamic protocol for postoperative care is available to pediatric patients suffering from non-ruptured stomachitis.

Journal of pediatric surgeon, 149-152.