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Critique of a patient case using evidence

Introduction to Nursing Care Servcies

The practice of nursing requires specialized knowledge, skill and independent decision making and this also includes several interventions to be followed. In the present research study, discussion has been included regarding a 6 year old boy who is having issues related to appendicitis and whose medical related information should be properly addressed to the family members (Well, First, it Out and Training, 2013). Furthermore, in the research study nursing care needs of the patient has been analysed and that are also related to current medical and nursing management. At the same time, discussion has also been included regarding patient problem and how nursing intervention can be used to resolve the appendicitis issues.

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Along with this, researcher has also discussed complexities, contraindications and inconsistencies that focuses on patient care; hence on that basis possible alternatives for health problem has been identified. Discussion has also been stated about perception of illness regarding of the patient suffering from appendicitis. Future risks for the patient have also been identified in the study because the risk related appendicitis could increase because of the age factor (Li and Jones, 2013). Nurses must also be aware that patient’s needs proper care and their privacy aspects should be protected as well. This means that nursing assistants should not discuss their care or other personal information with any other person expect the staff members that has an interest in the care of that patient.

Main Body

Relevant information about the patient (including physiological, psychological and sociological factors)

The present case has been discussing about a 6 year old boy who is currently hospitalized because of abdominal pain and he is also identified as appendicitis after carrying out different tests. It is also identified that the boy also has the history of bloated abdomen and his family and social history is related with this (Kangasniemi and et. al., 2013). Thus, in this respect looking towards the case scenario, health care practitioners need to emphasize on maintaining confidentiality and secrecy at the time of addressing patient’s problems. Further, it is also identified that the patient is having right lower abdomen pain, nausea and lethargy and his past history is also related to these aspects. Therefore, as per the diagnosis, the main problem that is analysed is appendicitis; hence nursing practice should be carried out accordingly.

Pain in the abdomen is one of the most common symptoms of an acute abdominal pathologic process and this symptom also brings the patient to his physician. Thus, it can be said that the symptom deserves the utmost care in evaluation. Therefore, as per the sociological factor, it has been analysed that the family condition of the patient is not suitable as a lot of economic problem exist in the family (Ciccu-Moore and et. al. , 2014). This is the major reason that the boy is unable to get prominent access as per his health problem. From previous many years, financial condition of his parents is not stable; hence various issues are occurring in the same area.

Moving on to sociological dimensions, it can be articulated that the family needs to address their child’s issues in confidential manner because they do not want to bring any other issue about his medical condition. Due to lack of support from the community, the family is experiencing financial crisis; hence they are unable to render appropriate medical treatment to the boy. Further, it is also analysed that the boy is scared of the pain; since he is 6 years old, he has much issues with the acute pain (Wong, Cummings and Ducharme, 2013). Thus, it is clear that the boy needs to get proper treatment as this problem could amend various risks and uncertainties in future.

Include an outline of key nursing problems and also if the patient is at risk of developing further problems and why

According to the case analysis, it is evident that the boy is having serious abdominal pain; hence this requires proper medical treatment. Nurses must develop suitable care plan so that right services could be delivered to the boy. However, at the time of conducing nursing practice, nurses could experience several issues because the boy is very much scared of pain that appears in his abdomen (Lewis and, 2015). The age factor could be one of the issues in nursing procedure; hence nurses would not be able to derive any sort of support from the patient at the time of delivering health care services. Therefore, these are the most common issues that may arise at the time of conducting nursing practices.

Considering the present case, nurses must emphasize on care plan so that proper medication and treatment could be provided to the boy in appropriate way. In this respect, economic condition of the family could also be considered so that accordingly, medical intervention could be selected. The most important thing that needs to be considered while giving treatment to the boy is his perception of illness regarding appendicitis (Shepard, 2013). In the practice of nursing, the boy will not be able to support the nurses since he has no idea about the problem and medication purpose as well. Further, nurses should carry out their duties in encouraging manner so that boy may not get scared of the medications and treatment.

As per medical terminologies, Appendicitis is a painful medical condition in which the appendix becomes inflamed and filled with pus (a fluid that is made up of dead cells and that often results from an infection). If not treated properly, then it may cause the appendix to burst and this can also spread infection throughout the abdomen (Reinbeck and Fitzsimons, 2013). Thus, according to the risk factors, it can be said that the patient needs to get suitable medical treatment as early as possible so that the issues of co-morbidity could be avoided.

Assigned a clear, measurable goal to each problem

Here, the problem identified with the patient is appendicitis and thus heath care home needs to take proper care of their parents in regard to identify clear, measurable goal to such problem. Proper analysis of the issue needs to be done in regard to identify the issues and then accordingly health care facilities should be provided. It is also essential for them to outline the problem from which patient is suffering (Oster and Braaten, 2017). Care providers need to assess the requirement of health care patients and thus nursing practice need to identify the past history of patient and then provide them appropriate treatment to obtain better results. Through identifying the problem of patient, care nurses needs to give proper care so that desired goals could be attained as per the issue. Here, patient is suffering from abdominal pain and after examining it has been identified as appendicitis and the patient have identified a past history of bloated abdomen (Ethridge and Lamb 2010). Therefore, care plan needs to be prepared accordingly and thus proper and clear goals needs to be identified so that best results could be attained in terms of satisfying the patient needs. Here, nursing practice requires to be effectively carried out and thus identify the areas for improvement so that best possible alternatives could be assessed.

Here, the problem faced by patient is abdominal pain and thus care providers need to critically examine and then come to any conclusion. After conducting various tests, it has been identified that patient is suffering from appendicitis and therefore he is having pain in lower abdomen. Also, health care home needs to give proper care and support to their patients in various form so that they feel satisfied with the services provided by nurses and health care workers (Christensen and Kockrow, 2013). Further, confidentiality is one of the major problem and thus it is essential for health care home to maintain it so that name and personal identity of the patient should not be leaked. However, it is one of the main concern of any patient that their name should not be disclosed as well as their disease and all this should be kept secret. Thus, it is a clear and measurable goal that helps health care home to easily accomplish it by providing right care and duty towards the patients and help them in relieving the pain suffering by them. Care delivery and nursing practice aims to be effectively measured and identified by identifying the past history of patient, family history, social history as all these are crucial in terms of giving relevant care and support to patients.

Explain how each problem has been prioritized

One of the main need of heath care home is to prioritize every problem being faced by patients and then delivering due care and support to them in relation to overcome the pain from which they are suffering. It also identifies that outlining proper care plan needs to be followed by health care workers so that best care facilities needs to be provided to patients. Here, patient is complaining about abdominal pain and thus care providers needs to properly examine and conduct different tests in order to identify the exact problem (Röing and Holmström, 2015). Thus, such health problem needs to be prioritized by care workers so that they can plan proper solution to the disease. It has been evaluated that patient is suffering from appendicitis due to pain in lower abdominal. Now the duty of health care workers start as they need to give proper instructions to their family to provide all the past history of their family as well as patients which helps them to give best care opportunity to patient. After identifying the case history it assists them to render the best care needs and thus proper care and support at the time of surgery. Appendicitis needs to be cured because then only patient will be relieved from health issue.

It is essential for health care workers to prioritize the problems of every patient because it helps them to obtain satisfaction. Nurses and care providers render the best care facilities to patients so that prioritizing care problems helps in fulfilling their needs and obtain best care and support. Here, patient is suffering from lower abdominal pain and thus doctors needs to examine the patient illness and then cure them accordingly. Care home needs to maintain proper confidentiality regarding patient's health and personal information and do not share this with anyone otherwise it would result in breaches of confidentiality act. Health care workers need to give proper care.

Health care workers need to carry out effective principle that is providing high quality safe patient care in nursing practice and thus provide the best care facilities to patients. It is essential for health care home workers to assess the past history of patient so that they can render the care accordingly. Also, they need to prioritize their care as per the problem faced by workers because it is essential for them to give treatment to patients who are in pain and thus solve their problems as soon as possible.

Consider the entire patient care period

Herein, this care period has been described for a 6 years old child who was initially suffering from a severe abdominal pain and later found to be afflicted from appendicitis. It was thus deliberated to be a medical emergency where appendicitis in children is often referred to be a dreadful state where it causes immense pain and an aggravated infection in the appendix. It is mainly due to an unsure outlook towards it actual functioning in the body, removal of this part is considered to be the most safe measure for the prevention of appendicitis. In context to which, appendectomy is the surgery named to be the most common emergency surgery for the children enduring from appendicitis. It is a surgical removal of the organ called appendix from patient's body and is usually performed at the time of emergency. Where most of the time, a prime reason behind such removal is basically due to another vital concern of the patient's and their respective surgeons to not come up with such issues again and again.

Also, this body organ is also not referred to play any such crucial role in the body and hence its removal is entirely a justified clause. It however requires the patient and their family members to take some precautionary measures with some proper care where that period is generally termed as postoperative care. It is also due to its fundamental time of recovery that takes at least 4 to 6 weeks of time followed by the below mentioned care period that is followed by a successful completion of the surgery (Fathoni, Sangchan and Songwathana, 2013). After which the patients are being taken to the post anaesthesia care unit also termed as PACU and are being kept their until their anaesthesia starts wearing off. At this time, the care staff is continually required to check the temperature of patient's body by together checking their heart rate and breathing at regular interval of time. It is after a complete wear off of instilled anaesthesia with some pivotal signs of stabilization the patient is then required to be transferred to the hospital rooms.

It is firstly in context to a non ruptured appendix with no prior harm before the surgery that further leads to a quick recovery of the patient. Wherein, the very next day the patient is then required to offer clear liquid food after whose successful toleration, they can also consume solid foods (Kahn and, 2015). It is once after the patient have started to eat and drink the normal food, this leads to the removal of intravenous so that the patient can hereby perform some sort of physical activities like getting out of the bed to perform other routine activities, etc. Some patients are however in need of medicine to get rid of the pain caused from large incision took place while performing the surgery. It is however with a prime responsibility of the nursing staff to take care of the patient with continual checks so as to detect the healing of incisions after which the patients with such uncomplicated appendectomy can leave within a care period of 1-2 days.

Now, in context to the present case script of 6 years old boy suffered from appendix and went through an appendectomy of a ruptured appendix as per his past history is required to go through some other sort of care period measures. It is where getting recovered from the surgery done for a punctured appendix is slightly longer than the above detected situation where it hereby needs a principal treatment for the infection (Lewis and, 2015). This needs a minimal stay of 4 days in the hospital and could range more longer in case the complications tends to develop. However, the drain is required to stay in place by the timer the pus completely stops exhausting with a continual check of the nursing staff to change the packed gauze bandage.

Apart from which, intravenous antibiotics are also required to be continued throughout the care period during hospitalization. Wherein, one after the discharge of patient, there exists some prescribed oral antibiotics that should be continued to intake as per the given direction of the surgeon or physician (Oster and Braaten, 2017). However, the drainage and along with the gauze bandage pack are needed to be kept in place with prompt instructions to properly care that particular area where in case of a sudden increase in the drainage, the physician is hereby required to be informed. Also, in case of any change in the colour or consistency of the drainage, it should be removed by the doctor themselves after completely resolving the infection.

Identifies areas for improvement and offer possible alternatives for each

It is with reference to identify some key areas of improvement in the above ascertained measures of appendectomy and its postoperative care. Where this surgery is itself associated with a major risk of wound infection and abscess formation onto the area of removed appendix due to a surgical site of incision along with some other relative number of complications (Röing and Holmström, 2015). It is thereby suggested to adopt some other possible alternatives for each of these complex areas where the patient is firstly required to be treated with crystal clear surgical tools. Beside this, the doctors should also possess a vigilant outlook towards maintaining other hygienic requisitions to accomplish a successful operation. Additionally, once the patient gets back to home then they must be instructed to constantly check the incision site where it must be dried but the wound should not be closed completely.

Likewise, in case the incision starts draining blood with the edges pulling apart then also the physician must be immediately notified. Wherein, symptom of fever with an increased sense of pain in the incision site should together be reported to the doctor. All these instructions if required then should be given in a written notification to the patient where here in the case of 6 years old child, his parents should rigorously follow these directions (Well, First, it Out, and Training, 2013). Also, the normal activities should be resumed in accordance to the given direction of the surgeon with a cautious approach where it is assumed to be healed within a minimal time period of 4 to 6 weeks. During which, heavy lifting of goods and other energetic activities must be completely avoided with timely intake of any prescribed antibiotics for pain medication.


Above study concludes patient care is crucial for health care home and thus they need to identify the problem faced by care users so that appropriate care needs to be given to them. It also identifies that confidentiality needs to be maintained by care home so that it does not leak the patients personal information as well as past medical history otherwise it would result in breaching of confidentiality. Also, here the problem outlined is appendicitis and patient is at risk so that appropriate care delivery needs to be planned and improve the health conditions of care user. For which, appropriate care measures have been discoursed in this report by identifying any further scope of improvement in them. Herein, it is with a leading focus on the surgical method of removing the appendix termed as appendectomy by together outlining its postoperative care measures. This has been done with a precise identification of each of the measurable goals as a way of explicating each of the prioritized problems associated with the treatment of appendix.


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