Causes of Appendicitis
Appendicitis is inflammation of the appendix. This organ can be described as the three and half inch long tube like tissue that is seen to be an extending part from the large intestine. Appendicitis can be described as the medical emergency that requires almost prompt surgery for the removal of the swollen appendix. When it is left untreated, the inflamed appendix has the chance of bursting or getting perforated (Dangleban & Madbak, 2017). This results in the spilling of the infectious materials present inside the appendix into the abdominal cavity. This results in the occurrence of the peritonitis situation. Researchers describe this situation as the serious inflammation of the peritoneum which is the abdominal cavity lining (Drake et al., 2014). This can become fatal if not treated immediately. The assignment would show how nursing professionals would be caring for a child affected by the disorder and will help the family to cope up with the situation.
The main cause of acute appendicitis is the obstruction of the lumen of the appendix. Fecalith (which is actually a hard mass of faecal matter) as well as normal stool and that of lymphoid hyperplasia are some of the main causes that result in obstruction of the lumen of the appendix. The lumen, which is distal to the obstruction site, starts getting filled up with mucus. Thereby it starts acting as a closed loop obstruction (Alvarado, 2018). This obstruction starts developing distension as well as increase in the intraluminal and intramural pressure and as the situation becomes progressive, the bacterium that resides here in the appendix starts multiplying rapidly. The most common bacteria that start multiplication in the appendix are the Bacteroides fragilis as well as Escherichia coli. It is then found that distension of the lumen of the appendix results in reflex anorexia as well as vomiting and nausea and visiting.
The pressure continues to increase and when the pressure of the lumen exceeds the venous pressure, the small venules as well as capillaries become thrombosed. However arterioles remain open and this this results in engorgement and congestion of the appendix. the inflammatory procedure soon starts involving the serosa of the appendix. Therefore, in the parietal peritoneum in this region, there results in classical right lower quadrant pain. Once the small arterioles are seen to get thrombosed, division at the antimesenteric border also start becoming ischemic (Kothadia, Katz & Ginzburg, 2015). Farther infection and perforation occurs in the appendix. Therefore the bacteria is seen to leak out through the dying walls and results in formation of pus within the organ and also surrounding the appendix. Perforation is usually seen just beyond the obstructions rather than at the tip vision of the appendix.
In the case study as well, right iliac fossa pain was found to be present in the patient because the appendix have already become perforated and resulted a gangrenous condition due to the spilling of infectious fluid in the abdominal cavity. It required immediate surgery so that appendix can be removed and the spreading of infection can be controlled (Rentea & Peter, 2017).
Symptoms of Appendicitis
Erikson’s eight-stage theory of psycho-social development mainly describes that growth as well as the change that every individuals go throughout life. This theory mainly focuses on the impact of different types of social interaction as well as the conflicts that might arise at the different stages of the development. Researchers are of the opinion that better the individuals balance this conflicts, they will be able to handle each of the stages successfully and this will in turn help them to be live a successful life in harmony (Light, 2017). A lifelong psychological virtue can only be developed when the individuals can successfully overcome the challenges and face the developmental crisis properly. The theorists propose eight important ages and the important stage that can be applied to the case study of Anne is the industry versus inferiority stage. This stage is mainly seen to take place in children during the early years from approximately 5 to 11. In this stage, children are seen to develop a sense of pride in their accomplishments as well as their abilities. Studies have shown that children who are constantly encouraged and commended by their parents would develop a feeling of competence and would start believing their skills and feeling empowered. Those individuals who are seen to receive little or no encouragement at all from the parents, peers as well as the teachers would start developing fear, would suffer from lack of confidence, and will start doubting their abilities of being successful (Osherson, 2017).
It is extremely important for every individual to correctly develop a balance at this stage of the psychosocial development so that they can effectively develop competence and starts believing on their abilities. Anne is in this stage and hence the nursing professionals have to be very careful while interacting with her. The patient might be going through a strenuous stage as she has to live being separated from her parents and siblings and she might not be able to cope with the situation of separation (Berk, 2017). If not handled properly, this inability to cope with the strenuous situation would never develop and she might go into expressive state. Therefore, the nurses should constantly encourage her and communicate with her to develop strength and resilience building. This would help her feel empowered and help her to learn to handle such situation in the future effectively.
Another theory that can be also developed is the Piaget’s theory that remains mainly concerned with the development of the thought procedure of the children as they grow up. This theory mainly explains how the through procedures can influence the ways by which individuals understand and thereby interact with the world (Syed & Mclean, 2017). He has put forward 4 important theories out of which the stage that is applicable for this case is the concrete operational stage. This stage is mainly applicable for children between the age 7 and 11. During this time, the children are seen to gain better understanding of the mental operations. Here, the children are seen to start thinking logically about the different types of concrete events. They cannot understand abstract as well as hypothetical concepts. They tend to understand that not all people will mainly have similar viewpoints to them and that others might have different thinking patterns that do not match with them (Degges & White, 2017). Therefore, as the children are seen to have crossed the stage of egocentrism, the nurses would get the scope of making Anne understand the reasons why she had developed the disorder as Anne might have this inquiry in her head. However, they need to be very careful to ensure that they describe the disorder in ways by which they do not make her scared as this would have negative impact. They should discuss every aspects of Anne’s concern logically as she would have developed the capability of understanding logics.
Nursing Care for Children with Appendicitis
Family centered care can be defined as the partnership that takes place between families and health care professionals. It can be defined as a collaborative relationship that ultimately helps families in setting effective goals for their children and their treatment and recovery. One of the most important principles of family centered care is that the Healthcare professionals need to effectively communicate and share complete as well as unbiased information with the parents and the families in ways that are useful to them (Smith, Swallow & Coyne, 2015). Researchers are of the opinion that parents are always found to be in a confused and stressful state during the hospitalizations of their children because they do not get proper information about what is happening to their child. They also do not know what the doctors are doing with their child. They also remain tensed about the fate of the interventions that the professionals are applying on the child. Therefore more clear and transparent the information, the lessee will be anxiety and fear of the parents (Brosco et al., 2018). This will have better effect on the child and on his health outcomes.
Another important principle of family-centered care that needs to be encouraged by the healthcare professionals is the strength building among the family members. The latter are encouraged for building on the strengths by effective participation in the different experiences that help in enhancing their control and Independence. Researchers are of the opinion that to achieve this, the family members and the patients are to be given proper information, variety of resources are to be shared and others that make it easier for the parents to participate in their care of the children (King & Chiarello, 2014). Another important principle is that the Healthcare professionals should co-operate with families, the community caregivers as well as other Healthcare provider in order to ensure that the care given to the children not only aligns with the requirements and their care priorities of the children but also ensures the coping power of the children and the family members. the Healthcare professionals taking care of Anne should ensure that they involve her parents and the family members in the decision making, communicate with them the necessary information regarding the Health and Care plan with parents, maintain and dignity and autonomy, and respect their cultural preferences and health literacy. The parents are the primary caregiver of the children and therefore involving them in the care of the children not only strengthen them and empower the parents but also help the children to gain strength and enjoy a sense of security and bonding within the foreign hospital environment.
Hospitalization often results in the creation of stress not only on the child who is admitted but also on the parents of the child. Some of the major stresses for hospitalization are the separation, loss of control as well as fear, anxiety, nervousness and many others. Anxiety is often seen to occur of pediatric patients of this age mainly because of the sudden onset of the disorder and being admitted to the foreign environment where they had not been present before. The limited experience of the child is indeed one of the main reasons that make them anxious. Fear occurring due to the cause of separation from their parents as well as the family members is another contributor for higher suffering of the patients (Labrose et al., 2017). The children of this age start to live and think independently but they still need the support and acre of their parents whenever they face difficulty in life. They also need care in different of their activities and even in times of fear and stress, not getting the parents in such strenuous, moments of ill health might make Anne more nervous and scared.
Erikson’s Theory of Psychosocial Development and Appendicitis
On the other hand, parents are also seen to suffer from a sense of guilt and disappointment thinking that their carelessness might have resulted their ward to go through the phase of suffering and this makes them depressed (Homaira et al., 2016). Moreover, these feelings also results in development of anger where they cannot forgive themselves, they feel anxious thinking how their children would be able to cope with the painful days and all these result in the development of helplessness in them (Weaver & Weaver, 2014). Moreover, they cannot understand the disorders completely, are properly informed by the professionals and many others that give them a hard time. Therefore, family centered care would help the healthcare professionals to help both Anne and her parents and siblings to fight with the different forms of challengers that occur and help them lead better quality lives.
From the above discussion, it is clearly understood that appendicitis is medical emergency that requires surgery when identified in the pediatric patient. However, for handling such patients, nurses need to develop ideas about developmental theories like Erikson’s theory as well as Piaget’s theory successfully so that they can give proper holistic care to patients. They also need to ensure providing family centered care as effects of hospitalization have both negative outcomes on parents and the child as well. These would help in ensuring better quality lives for all.
References:
Alvarado, A. (2018). Clinical Approach in the Diagnosis of Acute Appendicitis.
Berk, L. (2017). Development through the lifespan. Pearson Education India.
Brosco, J. P., Pulgaron, E., Vanderbilt, D. L., Macias, M., Mathew, M. S., & Blum, N. J. (2018). The Interprofessional/Family-Centered-Care Observation Rubric (I-FOR): Results of a Multicenter Study of a New Measure of Educational Outcomes. Maternal and child health journal, 1-9.
Dangleben, D. A., & Madbak, F. G. (2017). Acute Care General Surgery. Springer.
Degges-White, S. (2017). Erikson’s Theory Of Psychosocial Development. College Student Development: Applying Theory to Practice on the Diverse Campus, 35.
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.
Homaira, N., Mallitt, K. A., Oei, J. L., Hilder, L., Bajuk, B., Lui, K., … & Jaffe, A. (2016). Risk factors associated with RSV hospitalisation in the first 2 years of life, among different subgroups of children in NSW: a whole-of-population-based cohort study. BMJ open, 6(6), e011398.
King, G., & Chiarello, L. (2014). Family-centered care for children with cerebral palsy: conceptual and practical considerations to advance care and practice. Journal of Child Neurology, 29(8), 1046-1054.
Kothadia, J. P., Katz, S., & Ginzburg, L. (2015). Chronic appendicitis: uncommon cause of chronic abdominal pain. Therapeutic advances in gastroenterology, 8(3), 160-162.
Labrosse, R., Vincent, M., Nguyen, U. P., Chartrand, C., Di Liddo, L., & Pastore, Y. (2017). Using a standardised protocol was effective in reducing hospitalisation and treatment use in children with newly diagnosed immune thrombocytopenia. Acta Paediatrica, 106(10), 1617-1623.
Light, P. (2017). Social interaction and cognitive development: a review of post-Piagetian research. In Developing thinking(pp. 67-88). Routledge.
Osherson, D. N. (2017). Logical Abilities in Children: Volume 1: Organization of Length and Class Concepts: Empirical Consequences of a Piagetian Formalism. Routledge.
Rentea, R. M., & Peter, S. D. S. (2017). Contemporary management of appendicitis in children. Advances in pediatrics, 64(1), 225-251.
Smith, J., Swallow, V., & Coyne, I. (2015). Involving parents in managing their child’s long-term condition—A concept synthesis of family-centered care and partnership-in-care. Journal of pediatric nursing, 30(1), 143-159.
Syed, M., & McLean, K. C. (2017). Erikson’s Theory of Psychosocial Development.
Weaver, F. M., & Weaver, B. A. (2014). Does availability of informal care within the household impact hospitalisation?. Health Economics, Policy and Law, 9(1), 71-93.
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