Nursing Care and Communication for a Child with Appendicitis

Assessment 2 Template
Clinical Scenario – Written Report
Student Name and I.D.
Introduction
This assignment will be discussing the second scenario of Karam a seven-year-old boy with a 24-
hour history of abdominal pain. He was diagnosed with appendicitis and was taken to theatre
directly upon admission for appendicectomy. The patient was accompanied to the emergency
department by his father, Saad. Karam lives with his mother Jamal, his father Saad and two
younger sisters. They are refugees from Syria and have stayed in the country for one year. Karam
speaks and understands English as he has joined a school, but his parents have a limited
understanding of the English language. This report will, therefore, address priority nursing care of
Karam and communication needs that need to be discussed for both the patient and family
members.
Nursing Care
The one specific aspect of nursing care for Karam is pain that is related to the post-operative
procedure or appendicectomy (Mello et al. 2016 pp.12-18). Pain is an unpleasant sensation
experienced, mainly due to tissue damage or nerve damage. The severity of the pain is ain rating in
children can be challenging as they are not able to express exactly how they are feeling. It is also
affected by their developmental milestone. The nurse can, therefore, use a pain rating scale to
determine the severity of pain. The Wong-Baker faces pain rating scale uses facial expression to
rate pain on a scale of 0-10. A score of 0 is given when the child is smiling, and this shows that the
child is pain-free. A score of 10 is given when the child is crying and irritable, and it is an
indication that the child is in a lot of pain (Polomano et al. 2016 pp.1505-1519). The nurse can also
use verbal communication as school-going children can verbalise when in pain. Pediatric pain
management can sometimes be difficult due to their understanding, and it is much dependent on
the developmental age and stage of the child.
Children are greatly affected by psychological pain based on how they interpret the pain they are
feeling. Therefore, the nurse should use different approaches when providing nursing care such as
administration of analgesics (Lee, Rashi, Thomson and Cordingley 2019 pp.e12952). The nurse
can explain to the child the cause of the pain and his condition in a simple language that the child

can understand. The nurse should also explain in simple terms the benefits of pain relief
medication and what will happen if they don't take the drug. Most of the school-going children do
not like taking medicine. The nurse should, therefore, use a language that is not suggestive of
choosing either of taking the drug or not. Even though the patient has a right to refuse medication,
children have no understanding of the consequences. If they refuse, therefore, the nurse should try
other ways. This includes giving the child the drug with their favourite drink. The nurse can also
distract them with something they love most. Exposing the child to a different environment can
also help the child accept to take the medication. Involving the parent is also very important. This
is because children trust their parents more and therefore involving them can help a lot (Sing,
Cheung and Wong 2015 pp.419-428).
Incorporating the principles of the United Nations Convention on Rights of the child (UNCRC) in
providing nursing care is essential in the management of young children (Fenton-Glynn, 2019).
The main principles are non-discrimination, best interests of the child, right to life, survival and
development (Lundy and Byrne 2017 pp.52-70). Karam is a refugee, and therefore, according to
UNCRC, they should receive health care without discrimination just like any other child in the
country. Respecting a child's privacy and confidentiality is also essential to the child as it also
promotes respect from others. Child's best interest should always be considered so long as it does
not cause harm to the child or anyone else. Karam refused to take medication but based on this
scenario. This can be disadvantageous to the child. Therefore any other appropriate way can be
used to make sure he benefits from the intervention. Every child has a right to life and survival.
Providing proper health care to the patient such as appropriate pain management, infection
prevention, proper nutrition and also psychological support is crucial for physical, mental and
psychological development. Child education concerning his health is also essential in development.
Collaborative management is also vital in order to foresee ant challenges that may arise and
therefore prevent them from occurring (Fraser and Stasa 2017 pp.24-37).
Communication
Communication is a crucial aspect of healthcare. The main problem in communication, according
to this scenario, is the language barrier between the patient's parents and the health care provider
and also the developmental age and stage of the patient. For effective communication to occur the
sender of the information should be able to relay information through a medium, and the recipient
acknowledges the receipt of the knowledge and understanding through feedback (Austin and
Pinkleton 2015). Any problem in any stage of communication interferes with effective
communication. Karam's parents have minimal knowledge of the English language. Karam, on the
other hand, is still young to synthesise and understand everything that is explained to him
adequately (Smith and Ford 2013 pp.92-94).
This can be overcome by involving an interpreter who can understand both English and Karam's
parents' language. However, the parents should know about the interpreter for patient's privacy and
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