Pathophysiology Of Appendicitis And Growth And Development Theories: A Case Study Of Anne

Overview of Anne’s diagnosis and treatment

Discuss about the Right Iliac Fossa Pain Of Anne.

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 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.

Pathophysiology of appendicitis

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 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).

Growth and developmental theories

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 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.

Family-centered care

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 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.

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 International, 41(1), 3-16.

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 research. American Psychologist, 69(2), 153.

Festini, F. (2014). Family-centered care. Italian journal of pediatrics, 40(1), A33.

Gordon, B.K, Miles, S., McLeod, M., El Ali, M., & Gale, P.L. (Eds.) (2012). Child, adolescent and family nursing. Sydney: Pearson.

Hahn, F., Coricelli, F., & Di Matteo, M. (Eds.). (2016). New Theories in Growth and Development. Springer.

Haley, C. (Ed.). (2016). Pillitteri’s Child and family nursing in Australia and New Zealand (2nd ed.). North Ryde, New South Wales: Lippincott Williams & Wilkins Pty Ltd.

Lehne, R. A., & Rosenthal, L. (2014). Pharmacology for Nursing Care-E-Book. Elsevier Health Sciences.

Maslow, A. H. (2013). A theory of human motivation. Simon and Schuster.

Maslow, A. H. (2013). Toward a psychology of being. Simon and Schuster.

Mischel, T. (Ed.). (2013). Cognitive development and epistemology. Academic Press.