Child and Adolescent Nursing: Pathophysiology, Growth and Developmental Theories, Family-Centered Care, and Effects of Hospitalization

Running head: CHILD AND ADOLESCENT NURSING
CHILD AND ADOLESCENT NURSING
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1CHILD AND ADOLESCENT NURSING
Introduction
In nursing profession, child and nursing care involve care for a sick newborn to an
adolescent to make him recover from any road accident (Cockcroft, 2012). These professional
work as a part of multidisciplinary teams and their key roles include assessing and planning the
requirements involved in childcare unit, dealing with emergencies, supervising junior staff,
organizing workload and preparing notes of the events (Shields et al., 2012). In this assignment
discussion about Anne (10) whose signs and symptoms have been recognized as appendicitis has
been informed. Further, after describing the pathophysiology of presented problem, evaluation of
the nurse's role in delivering the appropriate nursing care in relation to Anne’s case study will be
described with growth and developmental theories, family-centered care and the effect of
hospitalization on the child will be mentioned in this assignment.
Pathophysiology
The appendix is a finger-shaped pouch present in the lower right side of the abdomen and
inflammation of this pouch is called as appendicitis. As per Singal et al. (2012) there is no
specific role of this vestigial organ in the human body, however, the presence of lymphatic tissue
imparts in the immune system. As per Bhangu et al. (2015) the emergence of appendicitis in
teenage or young adults determines due to the pathophysiological role of different lymphoid
aggregates, which is present in a huge amount in the appendix during this period. Therefore, as
per this theory of Chandrasegaram et al. (2012), such obstruction commences inflammatory
changes in the surrounding tissue which eventually rises the intraluminal pressure and ischemia
(Singal et al., 2012). Further, the inflammation in the appendix makes it enlarged and the
surrounding tissues such as peritoneum and percicecal fat becomes inflammatory. The primary

2CHILD AND ADOLESCENT NURSING
event of obstruction occurs in the luminal obstruction, which could have resulted due to
hyperplasia in lymphoid tissues, parasites and foreign bodies, fecaliths, and presence of
metastatic and primary tumors. Within this as per the research of Nasiri et al. (2012), fecaliths
and the fecal stasis are one of the major reasons for the obstruction which is followed by fruit
seeds, vegetable matters, and intestinal worms (Chandrasegaram et al., 2012). Due to untreated
obstruction, perforations and rapid distension of the appendix are witnessed, which is a sign of
acute appendicitis. As the luminal pressure within appendix increases venous pressure, mucosal
ischemia starts developing, and once the pressure is beyond 85mm Hg, thrombosis occurs, which
commences the arterial flow, vascular congestion, and engorgement of the appendix (Bhangu et
al., 2015). Further due to extending inflammation to the peritoneum, serosa and nearby organs,
visceral afferent nerve fibers which are associated with the spinal cord at T8 to T10, are
stimulated due to which the epigastric and the umbilical pain occurs (Nasiri et al., 2012). During
this phase, the pain shifts from the naval area to the lower right side of the abdomen. If it is not
treated even in this phase, it compromises the arterial blood flow with a permanent infraction, it
leads to perforation and gangrene and the time required for this changes ranges from 24 to 36
hours of shifting of the pain. Besides this extreme pain, patients suffer from nausea, vomiting
tendency and anorexia, which makes the condition much worse pathophysiologically (Singal et
al., 2012).
Growth and developmental theories
Growth and developmental theories are important in nursing studies so that while caring
for a patient, a nursing professional can prepare a framework of care, are able to provide logic
and explanations to the interventions (Moon, 2013; Karmiloff-Smith, 2018). Where growth is