Child and Adolescent Nursing: Pathophysiology, Growth Theories, Family-Centred Care and Effects of Hospitalisation

This essay discusses child and adolescent nursing, including pathophysiology, growth theories, family-centred care, and effects of hospitalisation. A case study is used to illustrate the role of nurses in delivering effective care to children.

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Child adolescence and family ursingN
9/9/2018

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The essay brings about the discussion on the child adolescence and family nursing
and the related aspects. For the purpose of the description and analysis of the nursing in the
healthcare, a case study has been chosen. It also describes the role of nurse in delivery
effective nursing care to the children. The later part of this essay leads to the demonstration
of the family centred care approach, effects of the hospitalisation of the child on the child and
the family. Therefore, these concepts in relation to the case study have been clearly stated
well which further derives remedies to the issues represented through the case (Sista et al,
2015).
Pathophysiology
The case study taken for the describing and analysing the issues or problems from the
disease represents a 4-month old boy, Jay who is admitted to the paediatric unit in a hospital
via emergency. The boy was identified with a number if symptoms such as intense abdominal
bleeding, vomiting, reduction or low-level feeding, and the changes in the bowel actions.
Patients with these symptoms feel high and intense pain and cry out loud in some cases. With
reference to the case, Jay also drew his legs up and felt intense pain. After the diagnosis and
the ultrasound, it was stated that these symptoms are the cause of intussusception.
The term intussusception refers to the severe state or condition of the human body in
which a part of the intestine slides into the adjacent intestine. Intussusception is found to be a
common illness or health issue to the children or infants who are less than 2 years of age.
This situation often blocks the flow of the foods and fluids in the body. In every 1000 infants
who take birth, every 1 to 4 children face the same problem. Primarily the issue has been
observed mostly between the infants who are 5 to 9 months old. It results in symptoms such
as intermittent spasmodic abdominal pain, vomiting, and makes the children cry out in pain
(Applegate & Sadigh, 2018).
Pathophysiology has been undertaken for the assessment of the Jay’s case. It can be
defined as the disturbance in the normal mechanical, biological and the physical functions of
the human body, which is often the result of any disease or illness. In a simpler sense, it
refers to the altered or disordered functions in the living organism. The state of the
individual’s homeostasis is affected by the same.
Intussusception explains about the telescoping of the one portion of the bowel into the
next, therefore the pathophysiology includes certain terms such as ileum, i.e. the last part of

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the small intestine, cecum, and the jejunum. The problem states that the ileum enters the
cecum, however the prolapsing of the ileum or jejunum into itself is rarely found situation.
Almost, in every case it has been found that the occurrence of intussusception takes place
when the intussusceptum is closely located to the intussuscipiens. Intussusceptum refers to
the part which is invaginated with another part during intussusception (Yen et al, 2016).
The term intussuscipiens is the part of the bowel which receives the invaginated part
during intussuception. The situation occurs due to the peralistic action of the proximal
segment into distal segment. This invagination of one part often blocks the blood supply
which leads to ischemia. The mucosa here is sensitive to the ischemia and creates a red-
currant jelly stool, which is often observed in less number of cases. Therefore, the presence
of the red-currant jelly stool must be treated differently depending on the case. Hence, the
above discussion defines about the pathophysiology of the intussusception in the children
(Smolowitz et al, 2015).
The problem described through the pathophysiology of the case often caused blood
supply to stop and the lack of blood supply may cause the intestinal walls to die. This can
further cause infection in the lining of abdominal cavity. Thus the intussusception leads to the
major illness, which can be rectified by effective health care services or effective role of the
nurse. The role of nurse is crucial in taking care of the child or adolescent intussusception.
From the beginning till the final diagnosis or the treatment of the problem nurses play an
important role. They must deliver their services by maintaining a NPO status, which will
contribute in examining the patient timely and assessing the condition of the child. It is
considered essential step because the pain may lead to the situation of proferation (Chauhan
et al, 2017).
The effective delivery of the services is often the result of an appropriate leadership
style in the healthcare. This further explains the nurse’s role in monitoring the change,
explaining the situation of the patient to their parents, about severe pain and the causes, also
how to deal with the child effectively. The nurse is also responsible to give assurance to the
parents regarding the diagnosis and the results for the condition of the child (Ruvalcaba-
Romero et al, 2017).

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Child growth and development theories
The essay focused on the illness in the infants or the children in their younger years
therefore it requires certain theories of the child growth and development. As the case study
focused on the development of the child in nursing and healthcare, therefore certain concepts
are essentially important to be considered. With context to the case, as Jay, babies of his age
that generally includes 4-7 months aged babies, learns to understand things slowly and
gradually. They learn to coordinate their new perceptive abilities, which include vision,
touch, and hearing. In addition, it also states about the motor skills such as grasping, rolling-
over, and crawling are some of the expected development milestones. Thus, it describes about
the motor skills, language skills, and the other social and emotional skills which he might
have acquired till that age (Holloway & Galvin, 2016).
Discussing the development of the children in their younger age, it must be
understood; that the children must be involved in the medical related. The child growth and
development theories in respect to the case study of Jay include the cognitive, psychosocial,
behaviourist and the ecological theories with respect to the illness. The theories and concepts
ensure the wellbeing of the child and adolescents (Crain, 2015).
Family–centred care
The concept of delivery the effective services to the children with such disease or
illness, is often supported with the use of the family centred care approach. The approach
includes the involvement of the family members or parents in the treatment of the illness. The
nurses in the healthcare settings provide a family-centred approach which may be neonatal,
paediatric and the adolescent nurse. Paediatric care has now adopted the family-centred
approach, in order to enhance the well-being of paediatric patients. Therefore, the nurses have
identified their responsibilities towards both the family as well as the child in such cases. This
will ensure the wellbeing and wellness of the child effectively in consideration to the family
(Coyne, Hallström & Söderbäck, 2016).
The concept also accepts the racial, socio-economic background and differences of
the family, and the cultural diversity of the families in context to the healthcare practices. The
approach encourages the family support and responds to both the child and family
developmental needs. There is a greater role of the family in the nursing of the child and
adolescents in their younger age. Nine elements of this approach which includes recognising

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the family and the family members as the constant in the child’s life, facilitating parent-
professional collaboration at all different levels of healthcare (Betancourt et al, 2016).
It is effectively applicable with the case of Jay, in which the nurses and the healthcare
can effectively improve the state of wellbeing of the child. The inclusion of the family with
the Jay’s treatment will help in easy and fast recovery from the illness, as the family members
understands him well. It can be stated that the social, emotional, and developmental support
is integral to the healthcare which can be easily facilitated by the family members of the Jay.
As it will lead to the better and positive outcomes, and will enhance the level of satisfaction
to both the patient and the family. The symptoms diagnosed as in the Jay’s case includes the
policies such as keeping the open visiting hours, for the family members and the extended
family. It also includes their participation in effective decision making for their child. Thus,
the approach is considered to be effective (Lawrence et al, 2016).
Effects of hospitalisation of child
With the context to the given case study, it has been mentioned that due to the
application of the rotavirus vaccines, the situation became worse with him and the other
infants. As Jay, was diagnosed with the intussusception, it was natural that there is an
essential role of the hospitalisation and medication. Applying medical procedures affect the
child and the family both significantly. Hospitalisation and the treatment of the illness are the
stressful experiences for the child and his family. As the child lives in an environment which
is often surrounded by a number of other patients, and other professional and non-
professional staff affects the child negatively is one of the issue of the hospitalisation. These
all situations exert an influence over child. This in turn makes the family nervous or
conscious regarding the treatment of their child, and the outcomes in the longer term
(Schoeps et al, 2018).
To conclude the above discussion, it has been analysed that the effective child and
adolescent nursing is a major concern in today’s scenario. The purpose of gaining a better
understanding of the factors and diseases affecting wellness is demonstrated by the case study
of Jay. Moreover, the role of the nurse and the medical procedures are crucial to the children
or infants. The essay described about the intussusception and the effective treatments for the
illness, which will improve the wellbeing of the children. The treatment is considered with
respect to the effects of hospitalisation on the child and family. Hence, the healthcare

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institutions must incorporate the effective way of treating the patients and consider their
physical, social, and emotional aspects of health.

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References
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