Acute Appendicitis in Pediatrics and Adolescents

Running head: SCD IN PEDIATRICS AND ADOLESCENTS
Acute Appendicitis in Pediatrics and Adolescents
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Acute Appendicitis in Pediatric and Adolescents
Introduction
Managing pediatric clients can be really exciting and challenging at the same time. This
is because pediatric clients require a special approach of communication and rapport building to
achieve their compliance and trust. Furthermore, the pediatric patients are usually accompanied
by their families or caregivers; therefore, the nurse must not only meet the needs of the patient,
but also of the family. The nursing process is a significant tool and bedrock of clinical nursing
and nursing practice. The latter is crucial for effective planning and provision of patient-centered
nursing care (Alfaro, 2016). Accurate diagnosis relies on comprehensive and accurate
assessment of the patient. This paper will decipher the pathophysiology and nursing management
of a 10-year old client managed with acute appendicitis.
Pathophysiology
Appendicitis is a condition that involves the inflammation of the appendix. In 40% of the
cases, appendicitis is asymptomatic and may go unnoticed (Sommers & Fannin, 2015).
Appendicitis could either occur as acute or chronic. The clinical features of appendicitis are
decreased appetite, nausea, vomiting and abdominal pain. The disease is one of the most
common causes of abdominal pain (Lewis et al. 2014). Appendicitis commonly occurs between
the age of 5 and 40 years. Some of the risk factors for appendicitis include living in rural areas,
male gender, and high-income households.
Some of the conditions that present with similar symptoms include gastroenteritis, lobar
pneumonia, pancreatitis, ulcerative colitis, abdominal trauma, intussusceptions and Merkel’s
diverticulitis in children (Lewis et al. 2014). In women, similar features are seen in ectopic
pregnancy, pelvic inflammatory disease, endometriosis and ovarian torsion. The diagnosis of

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appendicitis usually relies on the clinical features. Laboratory and imaging tests can be applied in
instances where a diagnosis is not clear. Ultrasound and computed tomography are usually the
imaging tests of choice for appendicitis (Brown et al. 2017). Complete blood count could be
done to determine if there is an elevation in the levels of WBCs and urine test to rule out UTIs or
ectopic pregnancy.
The first intervention for a patient presenting with clinical features of appendicitis would
manage the pain that is usually excruciating. Morphine is usually administered to the patients
scheduled for an appendectomy at 0.1 mg/kg morphine sulfate to a ceiling dosage of 10 mg/kg
run over 5 minutes (Brown et al. 2017). Acute appendicitis is basically treated by surgical
interventions to reduce the risks associated with the complications that could occur if it bursts.
The surgical procedures are laparotomy or laparoscopy (Sommers & Fannin, 2015). Antibiotics
are generally effective in non-complicated cases where the appendix has not ruptured.
Role of Nurses
Nurses play a critical role in the management of pediatric and adolescent patients
including monitoring and evaluating them, participating in the development of and treatment
action plan and educating the patients and referring them when necessary. Nurses should identify
the clients that are unable to manage their condition effectively and teach them within the
confines of an effective asthma action plan. An effective treatment action plan is a written
document that is developed through collaboration of the patient and the caregivers to help them
manage their condition more effectively. An action plan describes the patients’ daily treatment,
the medications that the client is using and the time when the medications are due.
Growth and Development Theories