key of Clinical Nursing Assignments


Choose one (1) of the case studies below. Your Assessment will be written in academic essay format with an introduction, body and conclusion according to APA Guidelines.?Using evidence specific to your chosen case study, address the following two (2) points: 

1. Describe the pathophysiology of the presenting complaint in the case study. (300-500 words)
2. Evaluation of the nurse’s role to deliver developmentally appropriate nursing care in relation to your 
chosen case study.

•    growth and developmental theories, 
•    family centred care and, 
•    the effects of hospitalisation of the child, on the child and family. (1100-1300 words) 

Case Study 1 
Anne is a 10 year old girl who has presented to the emergency department in the local hospital with right iliac fossa pain. On further assessment by the emergency registrar, appendicitis is suspected.The surgical team agree that the signs and symptoms are associated with appendicitis and take Anne to theatre for an appendectomy. 
The handover on return to the ward is that the surgical team found a gangrenous perforated appendix with peritonitis. Anne has returned to the ward with a nasogastric tube in situ on free drainage, morphine PCA, IV therapy and triple IV antibiotics.Due to the severity of the infection and the potential complications, Anne will need to remain in hospital for 10 days of IV antibiotics and pain management. Anne is the oldest of five children and her parents own and run an Indian restaurant in the city. 





The essay presents the illustration of pathophysiology and key clinical presentation of acute appendicitis by the case study presentation where it has been observed that Anne a 10 years old girl has been admitted to hospital where she has been suspected to be suffering from appendicitis. She has been taken for an appendectomy where the surgical team diagnosed gangrenous perforated appendix with peritonitis. Appendicitis is one of the most common abdominal emergency conditions which need surgery and it shows very less lifetime risk of almost 7% (Petroianu, Vinicius, & Barroso, 2016).  It is very common between the age of 10 and 20 years (Occhionorelli, Zese, Cappellari, Stano, & Vasquez, 2016). In the essay the role of the nurse in delivering care to the adolescent, Anne in this case and her family based on the nursing practices of Australia has been given. 


Acute appendicitis can be further classified into simple case where there is no perforation or gangrene or even peritoneal abscess but it can be severe with these manifestations are diagnosed to present in the patients which is found in case of Anne who is only 10 years old girl. In this case the girl needs immediate surgical treatments. It has been seen from several researches that the appendicitis with perforation is time-dependent and if not taken the surgical measures it can cause death to the patients. From other research findings it has been seen that there can be spontaneous resolution where the first attacks can be cured with the help of the treatments with antibiotic. But in case of severe appendicitis with secondary peritonitis can be fatal if not diagnosed and treated medically on time. The risk to life of the patients below the age 5 years and above 50 years is higher. The severity of the infection compels the doctors and medical practitioners to provide with surgical treatments as this type of severe appendicitis has been proved to be fatal in many of the cases. The medical science has undergone several advance changes but if the disease is not treated with care then the chances of mortality is there even for 2% (MIOLO, MIOLO, & BIANCHIN, 2011). In this case the patient can be provided ample preoperative treatments, systematically done operative treatments of peritoneal toileting, use of combinations of antibiotics and ambulation after the operative treatments are over (Evbuomwan & Onwanyin, 1994). The researchers have found that in case of gangrenous perforated appendix with peritonitis the treatments with Ceftizoxime and cefoxitin can be cured or improved (Bennion, Thompson, Baron, & Finegold, 1990). In the case it has been seen that Anne after being diagnosed with perforated gangrenous perforated appendix with peritonitis has been returned to the ward with nasogatric tube in situ on free drainage. In case of Anne to control her pain morphine PCA has been given and to control the infection IV therapy and Triple IV antibiotic has been recommended. Her case is much severe because of the infection and there have been some potential complications and hence Anne has been asked to remain in the hospital for 10 days with IV antibiotic treatment along with pain management. 

The role of nurse in managing the symptoms of the adolescent patient in alleviating the complication of the disease is very crucial. The nurses are required to understand the pathophysiology of the disease of the adolescents. The development of the stages, age of the patient and relevant factors has to be understood by the nurses. The nurses could provide individualized or patient-centred care depending on the case of the patients. The patient in the case study is a 10 years old girl who is the older sister with 4 siblings and she helps her parents in running an Indian restaurant. She is an adolescent and she undergoes several physiological and hormonal changes during her transition from a child to adolescence. The physical maturity and overall stages of development of Anne will impact the healing process. The nurse has to be responsive to the hormonal changes and the mindset of the girl while delivering care services. She needs to be taken well care of when she is in the hospital where the responsibilities of the nurse are higher. There are certain changes in her behaviour as she is getting older. She must be busy in building her personality and personal identify at this stage. She needs some privacy and the nurse has to take care of her needs while offering medical and healthcare to her. The ethical identity of the girl has also to be taken care of by the nurse (Mould, 2012). 

The case study shows Anne is an adolescent and hence the treatment and nursing care services will be focused on the growth and development stage of a female adolescent. As per the Erik Erikson’s Theory of Psychosocial Development it is believed that each individual has his or her own unique identity which is composed of several personality traits and behaviours. These traits can either be positive or negative. It is said in the theory that the individuals at every stage of life face some crisis. For an adolescent like Anne who is 10years old there can be conflicts between initiative and guilt. The adolescents at this age try to explore many new things based on their own abilities and they try to apply the lessons they acquire on their life. They realise that they are capable of doings things on their own and if they cannot accomplish them they have to ask for others help and that gives rise to the conflict between initiatives taken sense of guilt for their failure and taking others help. So the nurse has to understand these traits of an adolescents while offering care and help to the patients so as to keep their personality and identity unaffected (PSYCHOLOGY NOTES HQ , 2017). 

As per Piaget Stages of Development theory Anne falls under the Concrete Operational Stage where the thought process becomes logical accompanied by concrete reasoning. The through process is less ego-centric and the adolescents know what is going around them. They are well aware of the external events. They initiate to develop their own feelings and thoughts which they find to be unique and might share with others or even their thoughts are not real. They could think hypothetically (Shroff, 2017). The role of nurse in this case is very important as the nurse has to explain Anne what has exactly happened to her and how she could be cured with proper medical support. She must be explained her case and consequences by a well-educated nurse who has knowledge about the growth and development stages of the adolescents. By educating Anne the nurse could promote health and understanding could get her rid of any kind of fear with the medical treatments. 

Family-centred care is also an essential part for the care giving process for an adolescent patient like Anne. For an adolescent the primary point of contact is his or her parents and family. It is expected that the family of the adolescent patients have ample knowledge and understanding of their children at adolescence. The professional healthcare givers, nurse and the family of the patients should cooperate to each other for better medical treatment and cure of the patients. The nurse has to be clear in communication and there should be ample transparency in the interactions. The nurse is supposed to develop good cordial relationship with the family members of the patients along with a good rapport with them. The family members should be able to trust the nurse. The nurse must have the socio-cultural backgrounds of the family of the patients. The presence of the family members during the treatments of the adolescents can improve the cure procedures and can reduce the anxiety of the adolescents and that of the family members if there is ample transparency. In the process it is very important that the nurse takes care of both the adolescent patients and their family members. In case of Anne, the concerned nurse must be able to attend her and her family needs to enhance her outcomes (Saleeba, 2008). 

Hospitalization of patients impacts the patients and their family members both positively and negatively. It promotes better healthcare and medication along with proper medical monitoring and supervision. It also increases the anxiety and stress to the patients and their families. The hospitalization situations affect the mindset of the patients and their families. So it is very important for the professional care givers and nurses to guide the patients and their families to reduce their stress and anxiety. The ambience of the hospitals also impacts the patients and their families (Sturrock, Masterson, & Steinbeck, 2006).  The adolescents and their families have to get introduced to other patients of similar ages and their families so that they could get a cordial ambience and also the confidence in staying in the hospitals. Here the role of the nurse is also very crucial and important. The children or adolescents also need the care and support of their parents and nurses during their stay in the hospitals (cyh, 2017).


Place Order For A Top Grade Assignment Now

We have some amazing discount offers running for the students

Place Your Order

It can be concluded that acute appendicitis with gangrenous perforated appendix with peritonitis in an adolescent. The healthcare givers are required to be much responsive and supportive to different aspects of the patient care like the growth and development stages of the adolescents and family-centred care. The impacts of hospitalization on the children and their families have also been discussed. It is the duty of the professional care givers to provide ample support to the patients and their families. The nurse should promote health understanding the development stages of the adolescents as described by Erik Erikson’s Theory of Psychosocial Development and Piaget Stages of Development theory. 


Bennion, R. S., Thompson, J. E., Baron, E. J., & Finegold, S. M. (1990). Gangrenous and perforated appendicitis with peritonitis: Treatment and bacteriology. Clinical Therapeutics 12 Suppl C:31-44 .
cyh. (2017). Children in hospital. Retrieved from cyh:
Evbuomwan, & Onwanyin. (1994). Management of peritonitis in perforated appendicitis in children. East Afr Med J. 71(5), 279-281.
Mould, J. M. (2012). Paediatric nursing : an investigation of the effect of specialist paediatric nurse education on the quality of children. Theses: Doctorates and Masters, 1-235.
Occhionorelli, S., Zese, M., Cappellari, L., Stano, R., & Vasquez, G. (2016). A Life Threatening Case of Perforated Gangrenous Appendicitis: When the Open Abdomen Technique Can be Safe and Effective In Acute Peritonitis. A Case Report. Case Report JSM Gastroenterol Hepatol 4(3), 1-5.
Petroianu, A., Vinicius, T., & Barroso, V. (2016). Pathophysiology of Acute Appendicitis. Review Article JSM Gastroe, 1-4.
PSYCHOLOGY NOTES HQ . (2017, May 19). Erik Erikson’s Theory of Psychosocial Development. Retrieved from psychologynoteshq:
Saleeba, A. (2008). The Importance of Family-Centered Care in Pediatric Nursing. School of Nursing Scholarly Works , 1-7.
Shroff, A. (2017, October 26). Piaget Stages of Development. Retrieved from webmd:


Get Quality Assignment Without Paying Upfront

Hire World's #1 Assignment Help Company

Place Your Order