CNA342 Child Care: Clinical Scenario Written Report Analysis

This report presents a comprehensive analysis of a clinical scenario involving a 7-year-old Syrian boy, Karam, hospitalized with appendicitis. It focuses on providing evidence-based nursing care, emphasizing the child's developmental stage and incorporating child-centered care principles to address post-operative pain and emotional needs. The report highlights the importance of effective communication, particularly the need for clear discharge instructions and pain management strategies for the family. It identifies communication gaps and proposes solutions, including providing comprehensive information and involving the family in decision-making, aligning with family-centered care principles. The conclusion stresses the significance of holistic, collaborative approaches to enhance patient outcomes and family involvement, including a complete sharing of information, to ensure the child's well-being and recovery.

Running head: CHILD CARE
CHILD CARE
Name of Student:
Name of University:
Author’s Note:

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CNA342 Assessment 2 Template
Clinical Scenario – Written Report
Student Name and ID
Introduction
The case study highlights the story of 7 years old Syrian boy name Karam who have been
hospitalized to the pediatric unit for severe stomach pain, nausea, and vomiting. The diagnosis
reveals that he had appendicitis and requirements urgent laparoscopic appendicectomy. Karam
and his family are refugee from Syria, due to which there is no medical history of the patient. His
father worked as a laborer in Australia and her mother was a homemaker. Post surgery, Karam
was having pain and was crying in the bed. There was the need to take care of the patient
because when asked for pain care by nurse he simply shook his head. As everything was in
control, Karam was discharged and his parents needs discharge info on the post appendicectomy
care, management of pain and GP follow up in 1 week. Therefore, the main aim of the paper is to
discuss the evidence based approach to provide effective nursing care to the child and his family.
The main purpose is to make use of principle of child and family centered care and rights of
child related to heath care in the process of communication.
Nursing Care
The key nursing care required by the child is based on the child’s assessment of
abdominal pain post surgery. It is evident from the case study that Karam was still having pain
post surgery due to which he was crying. Though the nurse interrogated Karam about the need,

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he simply shook his head. From the study of Stein et al. (2019) it can be said that children of 1-8
years of age are not able to express their feeling and address their own area of concern. It is the
responsibility of the nurse to assess the patient by the mean of objective and subjective data to
provide effective care. As it is seen in the case study, the child was crying, which is a sign of
non-verbal communication, where the gesture of the child indicates that he require urgent care
and assistance for the pain. The main principle of child centered care is to involve them in the
decision making and care must be provided assessing the interest of the children (Coyne,
Hallström and Söderbäck 2016). Therefore, there is the need to provide effective care to the
patient for better health outcome.
Child being of 7 years old is at middle childhood age and stage of development.
According Kuczynski, Pitman and Twigger (2018) it can be said that children at middle
childhood stage tends to be less assertive and nurse being involved in care of the child required
to assess the child care need by mean of effective communication. Initially the child will be
approached by the mean of effective communication, where the child will be asked for his health
status and how he is feeling. The middle childhood stage children tends to communicate by the
mean of non-verbal means and use of gesture therefore, to provide nursing care for pain to
Karam, it is important to read his gesture like crying, holding stomach and way of
communication. This way of approach can have positive impact, as he would not feel scare and
afraid by the nurse, as most of the children at this stage may encounter (Mattos dos Santos et al.
2016; Bramhall 2014). When patient will be entertained with respect, which will give confidence
to him in the child care.
The underlining principle of child centered care keeps the child at the center by focusing
on their interest and including them in the care plan. The finding is supported by Lerkkanen et

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al. (2016) where he explains the importance of child centered approach. It focus on the child’s
choice and decision for the care. It is evident that child centered care bring healthy outcome of
the patient. Therefore, child center strategies will be used to provide effective nursing care. It is
seen in the case study that the child was crying and did not showed any relevant sign for pain
even after asking with the patient. Therefore, the child will be communicated with respect to
make him comfortable and develop trust in the care given. Then the child will asked do he feel
any discomfort post surgery and what kind of assistance he need. The choice and interest of the
child be asked in order to apply child centered care (Ruch et al. 2017; Bramhall 2014). He will
be given options about the intervention that nurse will provide to assist him with his pain like
medication intervention or psychological intervention. It will create sense of respect and trust
and will be able to establish successful therapeutic relationship with the child. The choice of the
child regarding the intervention will be given respect to incorporate the principle of child
centered care.
Communication
From the given scenario, there has been lack of effective exchange of information
between the health care staffs and family member of the child. It is noticed that the discharge
information regarding the care of the post appendicectomy surgery and way to manage the pain
was not provided at the time of discharge. The staffs will provide discharge plan after one week
from the date of release. Leyenaar et al. (2015) has demonstrated an evidence based nursing
practice. It is the responsibility of the nurse and health care staffs to provide all the relevant
information related to care plan and management of the illness. It is reported in his study that by
incorporating above mentioned evidence based practice, the readmission and length of stay of the

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patient is reduced. Therefore, lack of timely information due to ineffective communication, is an
issue which needs consideration.
In order to address this issue, the role of the nurse is crucial as they are responsible for
implementing the principle of family centered care. The nurse will provide adequate knowledge
to the family about the different ways, by which home care will be provided. It is crucial to
communicate about the discharge plan and information at the time of discharge of the patient.
The family of the patient will be given all the required information for pain management (Starks
et al., 2016). They will be given copy of the discharge plan and pain management in order to
avoid risk of gap in communication. Further, the family will be included in the decision making
process, so that understand the concern of their child at home. It is evident from the study of
(Bramhall 2014; Bastani, Abadi and Haghani 2015) that communication is very important for the
proper care of the child. In order to avoid any miscommunication between the nurse and the
patient it is very important the nurse makes a check list of all the items that has to be done in
order to fulfill the demands and the needs of the patients. As the child that is being admitted to
the pediatric ward for appendectomy thus, it is very important to ensure that proper information
gets relayed between the parents of the child and the nurse or the other allied healthcare
professional (Smith, Swallow and Coyne 2015; Bramhall 2014). As per the principles of the
family centered care the important concepts of care are collaboration and participation. Thus, in
order to incorporate the principles of effective communication in the family centered care the
nurse will try to encourage the parents of Kareem to take part in the care and the decision-
making process. In order to make the process family-centered the nurse should advise the parents
and family members to participate in the development of the treatment program (Meert, Clark
and Eggly 2013).

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Conclusion
Lastly, from the above discussion it can be said that child centered care and family
centered care are the most affective mean of strategy to provide effective care to the child. As
Kareem was admitted to the hospital and belonged to the middle developmental stage, thus he
needed pain management plan after being discharged from the hospital. The report thus,
highlights the importance of the patient centered approach and the effective communication
skills that can help the patient to recover faster and also gives a chance to the family members
regarding the treatment and the diagnosis process. The report also identifies that the lack of
effective and proper information is a serious issue in this case. In order to address the situation it
is mandatory that the nurse tries to exchange complete information with the family members of
Karam so that they can also have a say in the treatment process. Finally report tries to highlight
the ways in which the nurse will try to incorporate a more holistic approach that will involve the
family of Karam in order to have a collaborative approach and also to encourage the patient and
their family in the decision-making process as the patient is a minor and it is important for them
to incorporate the decision of their parent. This report also emphasizes on the fact that there
should be complete and unbiased sharing of the information.

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Reference
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