Patient Care and Family Support

This assignment delves into a case study about Anne, a patient experiencing appendicitis. It highlights the crucial aspects of providing empathetic and courteous care, effectively managing her pain, and offering comprehensive support to both Anne and her family. The focus is on using various pain assessment tools, implementing psychosocial and palliative care strategies, and educating the family about preventative measures and self-care practices to ensure a successful recovery and positive patient experience.

Running head: NURSING ASSIGNMENT
Nursing Assignment
Name of the student:
Name of the university:
Author note:

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This essay is about Anne who is a 10 year old girl and has been suffering from right iliac
fossa pain. She was taken to a local hospital and was diagnosed with appendicitis. The
doctors decided to perform appendectomy. They also found a gangrenous perforated
appendix with peritonitis. Since she was suffering from severe infection and there were a lot
of complications, she was advised hospitalization for 10 days of IV antibiotics and pain
management. This essay demonstrates the pathophysiology of appendicitis, growth and
developmental theories such as JMD theories which includes psychoanalytical theory by
Freud, Piaget theory and Maslow’s hierarchy of needs theory. It also demonstrates
family centered care and the effects of hospitalization on the patient and family
members. This essay demonstrates how evidence based information can be implemented
into contemporary Australian nursing practice.
Appendicitis occurs due to the obstruction of the lumen of the appendix and it also
occurs due to several bacteria such as yersinia species, adenovirus, cytomegalovirus,
actinomycosis, foreign substances, tumors and tuberculosis. Obstruction involves the filling
of lumen distal with mucous which increases to intra luminal and intramural pressure and
also causes distension (Cobb, 2017).This results in rapid multiplication of bacteria residing
inside the appendix. Bacteria that are most commonly found in the appendix are Bacteroides
fragilis and Escherichia coli. Pathophysiology involves several symptoms such as reflex
anorexia, nausea and vomiting, and visceral pain that occur due to the dilatation of the
appendix. The small venules and capillaries get affected by thrombosis when the pressure of
the lumen becomes more than the venous pressure thus causing and congestion and swelling
of the appendix. Inflammation occurs in the serous membrane of appendix which leads to
increase in pain. Due to the thrombosis of small arterioles bacteria start leaking out thus
leading to the formation of pus inside the appendix (Drake et al., 2014). The pus also forms a
layer outside the appendix region. Due to the infection of bacteria and ischemia inflammation

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occur which results in the death of cells and gangrene. The condition further worsens and
results in perforation of the appendix due to gangrenous appendix. It also results in peritonitis
which involves swelling of the innermost layer of the abdomen and organs present in it.
Perforation of the appendix is most commonly found in children as compared to adult
individuals.
There are several growth and development theories such as JMD theories which
includes psychoanalytical theory by Freud. He was the first to identify the development of an
individual through several stages such as oral stage, anal stage, phallic stage, latency and
Genital stage. This theory played an important role in helping nurses in understanding the
behavior and condition of mental health in different patients (Hahn, Coricelli & Matteo,
2016).It also helps in understanding different behaviors of patients related to ego and id.
Anne belongs to the Latency stage since its range is from 6-12 years so the major
development task for her is to focus on relationships. Freud theory helps individuals to accept
who they are and improve their health and well being.
Piaget theory focuses on the fact that interaction with the environment plays a
significant role in the development of human beings. The nurses gain knowledge and
understand the main features of developmental psychology and it helps them to assess the
stage of development a child has attained (Mischel, 2013).This helps them accomplishing
several tasks of development. Piaget’s theory has made a significant contribution in
understanding the intellectual level and cognitive development in children.
Maslow’s hierarchy of needs theory is a theory of psychology that aims to motivate
individuals and is based on a five stage model that includes biological and physiological
needs such as air, food, drink, shelter, warmth, and sleep. Safety needs include protection and
security, law, stability, order, and freedom from fear (Maslow, 2013).Love and belongingness

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needs include, friendship, intimacy, trust and acceptance, receiving and giving love and
affection, social interaction among family, friends, and work. Esteem needs include
achievement, independence, status, dominance, which plays a very important role in realizing
potential of self, self-fulfillment, seeking personal advice for growth and development. This
theory helps nurses and health care professional to motivate patients suffering from different
types of disorders and diseases (Maslow, 2013).
A proper communication to patients plays an important role in improving the hospital
journey and reduces the anxiety, stress and depressive symptoms. Lack of proper
communication leads to issues such as a delay in treatment and sometimes may cause adverse
health effects among them. This decreases their bonding with healthcare professionals such
as clinicians and nurses and creates misunderstanding and confusion about the treatment and
the precautionary measures that should be taken. It may lead to mental issues such as anxiety
and may have a negative impact on the psychological condition of the patients.
Family centered care plays an important role in improving the well being of the
members of the patient. It involves providing care sucgh as emotional care, motivation and
guidance which helps them to prevent depressive symptoms and other health disorders related
to it. Healthcare staff should have a responsible attitude towards their patients as well as their
family members. The doctors and the nursing staff should act as a guide and provide support
in all their problems and issues (Festini, 2014).They should advise them about the
precautionary measures to be followed .This will improve the psychosocial health of the
family members of the patient and help her in getting cured in less amount of time. Cognitive
development is the field of studying psychology that focuses on the development of child on
the basis of his or her ability to learn, process the information and the development of brain
(Lehne & Rosenthal, 2014).

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Cognitive behavioral therapy can be provided to Anne that would assist in changing
their behavior and attitude towards life. The main objective of this therapy is that it works
only on the issues and the problems and not on the causes of the symptoms faced by the
individuals. These issues occur due to the psychological issues they face when they are
diagnosed with a disease (Ehde, Dillworth & Turner, 2014).Cognitive issues occur because
the information is not encoded by the brain and stored in a proper manner .The nurses should
be patient enough to command communicate with the family members with empathy and also
understand their needs and demands. Palliative care should be given to her in a proper
manner which is special type of care to that provides relief from both physical and mental
pain and stress.
Nurses should learn how to perceive, comprehend and transmit messages during an
interaction with them. They should communicate with them in an effective manner. Person
centered care should be provided to the young individual suffering from depression. It
involves discussion with the family members of the patients about their disease and the
treatment procedure that should be followed (Mischel, 2013).They should provide
appropriate health care services by using proper communication skills and ensure patient
satisfaction. She should be given a proper counseling and psychosocial care to get rid of
emotional health like pain, anxiety, distress and low self esteem occurred due to the health
issues.
There would be negative effects of hospitalization of the child, on the child and her
family. The main reason behind it is that she is very young to bear the pain of the surgical
procedure and she has been advised to stay in the hospital for 10 days which is quite longer
for a child of 10 years. She might also not feel comfortable with nasogastric tube and other
therapies such as morphine patient controlled analgesia, intravenous therapy and triple
intravenous antibiotics. The family members of the patient also suffer from several issues due

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to hospitalization such as financial crisis, responsibilities related to house old, negative
effects on the education of other children, and boredom (Ågotneset al.,2016). The
hospitalization of Anne might lead to a huge loss in their restaurant business as well leading
to depression and other mental issues in the family members. The family members of the
patient should be taken care of by the hospital staff and helped whenever in need regarding to
the treatment of patient and other issues related to accommodation and transport. The nurses
should be respectful and compassionate towards them and also think from their point of view
by solving all their queries regarding the treatment prescribed (Lehne & Rosenthal,
2014). This will have a positive impact on the well being and the emotional health of the
family members.
Clinicians practicing patient care should have a sense of responsibility towards their
patients as well as their family members. Proper information regarding the illness,
medications and the preventive measures to be followed should be given to the family
members (Gordon et al., 2012).This will help them to develop a trustworthy relation between
the two would develop a positive thinking and reduce the stress about the treatment given to
her. It reduces the complications in patients that lead to decrease in post operative
complications. It also decreases the cost and the duration for which the patient is hospitalized.
Various strategies should be followed to provide proper education to family members for a
successful discharge and improve patient care and satisfaction.
It can be summarized that Anne should be treated empathetically and with
courteousness and should be counseled properly so that she can explain the severity of her
pain. Various tools for the assessment of pain should be used if she is feeling discomfort. .
The nurses and other healthcare professionals should help her and provide psychosocial care
along with palliative care so that she gets well soon.Her family members should also be

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advised to take precautionary measures to prevent the mental and physical issues and take
proper rest and sleep intake so that they do not have any negative health effects.

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References
Ågotnes, G., Jacobsen, F. F., Harrington, C., & Petersen, K. A. (2016). A Critical Review of
Research on Hospitalization from Nursing Homes; What is Missing?. Ageing
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Cobb, T. (2017). Appendicitis following blunt abdominal trauma. The American Journal of
Emergency Medicine.
Drake, F. T., Mottey, N. E., Farrokhi, E. T., Florence, M. G., Johnson, M. G., Mock, C., ... &
Flum, D. R. (2014). Time to appendectomy and risk of perforation in acute
appendicitis. JAMA surgery, 149(8), 837-844.
Ehde, D. M., Dillworth, T. M., & Turner, J. A. (2014). Cognitive-behavioral therapy for
individuals with chronic pain: Efficacy, innovations, and directions for
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Festini, F. (2014). Family-centered care. Italian journal of pediatrics, 40(1), A33.
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