Critical Analysis of a Case Study in Adolescent Care - CCA206

This assignment presents a critical appraisal of a case study involving a 16-year-old adolescent, William Giovanni, diagnosed with acute appendicitis. The analysis delves into the ethical standards of nursing, emphasizing respect for human dignity, patient relationships, and self-determination. It examines the adolescent's growth and development milestones, considering their influence on nursing care and planning. The assignment explores the concept of informed consent, considering Gillick competence, and addresses child protection responsibilities within a hospital setting. Furthermore, it outlines psychosocial and cultural needs, while also exploring how a nurse can establish a safe and supportive environment for the patient. The analysis concludes with an overview of the discussed topics and relevant references.

Critical Appraisal of a Case
Study

INTRODUCTION...........................................................................................................................3
MAIN BODY..................................................................................................................................3
ETHICAL SATNDRADS OF NURSING..................................................................................4
Consider the growth and development milestones for the age of the case study character and
how this will influence nursing and the planning of care...........................................................6
Discuss whether the adolescent in the scenario can provide informed consent, and make
independent medical decisions based on your knowledge of Gillick competence, considering
the clinical diagnosis....................................................................................................................6
Identify the child protection responsibilities of the case study character whilst in the hospital
setting and collaborative processes with a multidisciplinary team..............................................6
Outline any psychosocial and/or cultural needs which should be factored into nursing care and
care planning................................................................................................................................6
Explain how the nurse can create and sustain a safe and emotionally supportive environment
for the adolescent in the case study.............................................................................................6
CONCLUSION................................................................................................................................6
REFRENCES...................................................................................................................................7

INTRODUCTION
Adolescence is the time period which is between young and adulthood. This is one of the
most important parts of once life. During this time individuals develops themselves into mature
human beings. This makes them vulnerable to various kinds of medical conditions and chronic
diseases. It increases responsibility of nurses in dealing over various kinds of medical condition
since at times parents of an individual are not there. Such conditions may violate basic ethical
principles of health care. Ethical principles in health care and nursing plays important role in
making treatment possible with more efficiency and as per patience demand. Scope of these
ethics in healthcare is wider which makes various kinds of patience to achieve satisfaction within
the services provided to them. In this file a case study is given which has to be solved in relation
over knowledge of different pathologies and ole of the Registered Nurse.
MAIN BODY
Clinical Scenario 1: In this case William Giovanni who is 16 years and 11 months
within his brother Owen Giovanni who is 20 years old. They suffers form allergies like lactose,
fructose. Further in past they have been suffering form asthma, lactose intolerance, fructose
intolerance and was smoker. The medications they were given are salbutamol prn. They were
brought to hospital for 1/7 of mild bilateral lower abdominal pain, localised to the R) side in the
last 2 hours with associated rebound tenderness, nausea, hot flushes and diaphoresis. Diagnosis:
Acute appendicitis. Also other basic information is as HR: 90, BP: 109/65, RR: 22, Spo02: 99%
RA, Temp: 38.5 Glasgow Coma Scale (GCS), 15 Investigations: Abdominal U/S: Positive for
appendicitis, Bloods: FBE (WBC = elevated), U&E and Blood cross match, Urinalysis: NAD.
Treatment Plan: Admission: requires surgical removal of appendix, Diet: Fasting for theatre ad
Vital signs: 30/60. Medication that is been given to them are IV Morphine 2mg PRNo, IV
Maxalon 10mg PRNoIV Metronidazole 500mg in 100ml N/Saline stato, IV Amoxicillin 500mg
IV stato IVT N/saline 0.9% 8/24, ani-emboli stockings. It was advice to take over nursing care
of Bill in the ED, until a bed is ready in theatre. Bill requires pharmacological management of
his pain, intravenous antibiotics to remain fasting and be prepared for theatre.
While approaching to the cubical it was observed that Bill lying in bed, knees bent,
guarding his abdomen, and grimacing in discomfort. His brother is with him who looks stressed.
Owen (the patient’s brother and next of kin (NOK)) talks about Bill’s condition and pain that is

been faced by him. Also tells that Bill cannot tolerate pain and freaks out due to their father
passed away in a hospital when they were children. Owen explain about the condition of Bill as
estranged form mother since she took IV drug which makes Bill afraid of having IV medications.
The Owen ask to stay with bill till he goes to theater because he is the only one looking out for
his brother, and thinks he can help keep him calm (Rauch, Dallasega and Unterhofer, 2019).
ETHICAL SATNDRADS OF NURSING
These are those kinds of standard which is required to be followed in order make sure
that nurses does their duty with effectiveness. Since I have been given responsibility to take care
of nurse and I am required to follow certain principles which are as follows:
Respect for Human Dignity
This is of one of the most important principle which is based over underlying nursing
practices. Under it nurses should respect dignity and worth of life of an individual which stops
violation of fundamental right of patient. Under it need over health care makes various kinds of
right which is of fundamental nature is protected. Being an Senior Nurse I am required to respect
my patience and value them while giving them services. Also dignity of patience shall not be
harm at any cost.
Relationships with Patients and Nurses
It makes establishment of relationships over trust and provides nursing services according
to need, setting aside any bias or prejudice. In this planning is required to be done by family and
patient who help in centering about factors those impacts over all lifestyle of an person. In these
factors such as lifestyle, culture, value system, religious or spiritual beliefs, social support system
and primary language shall be considered. Since I am senior Nurse as requires over promoting of
healthcare positive practice with respecting decision of patient. This makes trust developed
within patient and nurses( Meng and et. al., 2018).
The Nature of Health Nurses respect
The dignity and rights of all human beings regardless of the factors contributing to the
health status. The worth of a person is not affected by disease, disability, functional status, or
proximity to death. Nurses assess, diagnose, plan, intervene, and evaluate patient care in accord
with individual patient needs and values. Respect is extended to all who require and receive

nursing care whether in the promotion of health, prevention of illness, restoration of health,
alleviation of suffering, and provision of supportive care to those who are dying. Being and
senior nurse I am required over understanding patience on the basis of much physical, emotional,
social, and religious or spiritual well-being. This make patience loose panic and attain calmness
within its health recovery process.
The Right to Self-Determination
Respect for human dignity requires to be done by nurse within hospital which makes self-
determination formed within them. Different rights of patience is required to be determined when
they are been treated. It is the responsibility of senior nurse to take care that proper consent of
patience is been taken before treating him. So, being senior most nurse it is required by me to
make sure that patient is been treated well and all his rights is been determined. This makes
necessary support to be achieved in order to make valid decision to be taken within treatment of
patient.
Primacy of the Patient’s Interests
This is another important commitment which is been made in relation to ethical code of
conduct in relation to whether individuals, families, groups, communities, or populations which
is related with patient. Under it an nurse of required over making patient friends and family
member informed about condition of patience. Being senior nurse I am required over recognizing
of patient interests and make it disclose to family and friends in order to make transparency
maintained within it. Also it helps in dealing over conflict in more effective manner related to
health care facility (Kumar, Samalia and Verma, 2017).
These principles of ethical conduct are very important which makes proper framework
developed in relation to smooth running of treatment process within hospital. In this case
scenario Bill is required to be provided with proper medical facilities and in order to give him
these facilities I am being Seiner nurse should take initiative and talk to management to give him
relief as soon as possible.

Consider the growth and development milestones for the age of the case study character
and how this will influence nursing and the planning of care.
The above case scenario deals with adolescent which is one of the most important things
of healthcare facility. In this case scenario Bill is required to be given immediate medication and
for this purpose planning for care is required over making sure that nursing ethics is been
followed in proper manner by Senior nurse which makes health ethics creditability increased.
Discuss whether the adolescent in the scenario can provide informed consent, and make
independent medical decisions based on your knowledge of Gillick competence,
considering the clinical diagnosis.
Yes, informed consent can be provided with the brother of Bill since he is the care taker
of him. Since Bills brother Owen is 20 years old and can be given consent over based on Gillick
competence.
Identify the child protection responsibilities of the case study character whilst in the
hospital setting and collaborative processes with a multidisciplinary team.
Childe protection is required to be done on the basis that adolescent is the ager where
child has not attained full maturity and can be risked to various danger. So, being senior nurse it
is the responsibility to take care that proper responsibility is required to be followed while
maintaining discipline while treating Bill (Karadag, 2017).
Outline any psychosocial and/or cultural needs which should be factored into nursing
care and care planning.
Duty of care this should be followed which can be achieved by making patient attain
mental peace (Hernández and et. al. 2020). Also the nurse should perform physiological consent
in relation to care of Bill.
Explain how the nurse can create and sustain a safe and emotionally supportive
environment for the adolescent in the case study.
Safety and emotional support can be gained only when basic medical aid is been provided
to Bill which stops his intense pain. This is to be taken care by nurse and make Bill get better
fast.
CONCLUSION
From the above discussion it can be concluded that health care practices is one of the
most important practices which makes health facility to be enhanced in more effective manner.
Also these laws is required to be followed by nurses in more strict manner when it comes to

adolescent. Further the file covers about ethical practices required to be followed by senior
nurses and also about various other basics related to it.

REFRENCES
Books and journal
Hernández, J.P.S.I and et. al. 2020. Moderating effect of firm size on the influence of corporate
social responsibility in the economic performance of micro-, small-and medium-sized
enterprises. Technological Forecasting and Social Change, 151, p.119774.
Karadag, H., 2017. The impact of industry, firm age and education level on financial
management performance in small and medium-sized enterprises (SMEs). Journal of
Entrepreneurship in emerging economies.
Kumar, D., Samalia, H.V. and Verma, P., 2017. Exploring suitability of cloud computing for
small and medium-sized enterprises in India. Journal of Small Business and Enterprise
Development.
Meng, B and et. al., 2018. More than half of China’s CO2 emissions are from micro, small and
medium-sized enterprises. Applied energy, 230, pp.712-725.
Rauch, E., Dallasega, P. and Unterhofer, M., 2019. Requirements and barriers for introducing
smart manufacturing in small and medium-sized enterprises. IEEE Engineering
Management Review, 47(3), pp.87-94.
Viesi, D and et. al., 2017. Energy efficiency and sustainability assessment of about 500 small and
medium-sized enterprises in Central Europe region. Energy Policy, 105, pp.363-374.