Running Head: Child and Family nursing Child and Family nursing Name of the StudentName of the University Author Note
1CHILD AND FAMILY NURSINGIntroductionThe paper deals with the case study of Anne. She is presented to the emergencydepartment for the right iliac fossa pain. The surgical team decided for appendectomy afterobservation of signs and symptoms. The clinical handover showed a gangrenous perforatedappendix with peritonitis. She is under pain management and antibiotic therapy for infection. Shewill remain in hospital for 10 days. In response to the case study the, essay discusses thepathophysiology of the presenting complaint in the case study. Further, the role of the nurse indeveloping appropriate nursing care is evaluated in the essay. PathophysiologyRight illiac fossa pain occurs in the surface of the human abdomen inside the rightinferior part. The common cause of the presentation to the emergency room is the infection inright iliac fossa. It is manifested as fever and pain. This localises the pain and tenderness and iscommon in the patents with appendicitis as appendix is located in right iliac fossa. Therefore,Anne may have the right iliac fossa pain due to appendicitis and is the most common diagnosis[ CITATION Kha16 \l 1033 ]. She was presented to the emergency room for right iliac fossapain and was also diagnosed as appendicitis based on her signs and symptoms. Appendicitis is caused by various factors that obstruct the appendiceal lumen. Thevarious factors may be lymphoid hyperplasia, foreign bodies, and inspissated stool. The commoncause being lymphoid obstruction. The obstruction increases the pressure in the lumen. It resultsin the continuous secretion of the mucus and fluids from the mucosa and its stagnation. Duringappendicitis, the bacterial population in the intestine multiply, accumulating more white blood
2CHILD AND FAMILY NURSINGcells. Inflammatory response ensues with the bacterial growth and edema. Due to accumulationof pus, more intraluminal pressure is formed [ CITATION Ska15 \l 1033 ]. The pressure in the appendiceal lumen increases with the obstruction, rising above theappendiceal veins. It results in the venous outflow obstruction, appendiceal wall ischemia anddiminishing of epithelial integrity. This further increases the bacterial invasion in the appendicealwall, resulting in gangrenous appendix. This localised condition becomes worst with thrombosisof the appendicular artery and veins. It causes perforation and gangrene of the appendix and isthe most common complication of appendicitis. The gangrenous appendix will perforate and theappendiceal contents will spill into the peritoneal cavity. It is during this continuing process thatperitonitis and periappendicular abscess may occur. Diffused peritonitis may occur if the bodydoes not wall of the process [ CITATION Obi14 \l 1033 ].The common emergency procedure for the appendix is the Appendectomy, the surgicalremoval of appendix. In case of Anne, after appendectomy, the handover on return to ward is thegangrenous perforated appendix with peritonitis. In case of Anne the appendix is perforated sothe patient will have longer duration of symptoms. It also increases the need of fluid resuscitationand broad spectrum of intervention as Anne has perforated disease along with peritonitis. Hence,this process has increased her hospital stay. She is administered with antibiotics to fight theinfection. Morphine PCA is the effective in relieving pain and IV therapy is used to relive thefluid loss [ CITATION Sal15 \l 1033 ]. Evaluation of the nurse role In order for the nurse to develop appropriate care for Anne post operation, the nurse mustbe aware of her growth and development. Anne is 10 years old and the expected developmental
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