Pathophysiology of Intussusception

The essay describes about the Child and Adolescent nursing and the issues related to them. The analysis has been done for an understanding regarding the development of the child, several aspects have been studied. A case study has been chosen for the analysis of the problem or issues represented and the nurse’s role in delivery the effective nursing care. Also, it describes in the later part the family centred care and the effects of medical procedures and clinical treatment in the hospital on the child as well as the family. Therefore, these aspects in relation with the case study have been stated to derive remedies to the problems.

The undertaken case study for the assessment of the disease or the issue represented includes certain symptoms such as vomiting, stoppage of bowel movements, decreased feeds, and the irregular abdominal pain. The case depicts about the child and adolescent nursing, which analyses about a 4-month old boy, Jay diagnosed with the symptoms such as vomiting, no bowel movements, and a severe abdominal pain and poor or decreased feeds. After the clinical diagnosed ultrasound test, it was analysed that the cause or reason behind these symptoms is Intussusception.

The term intussusception describes about the serious condition of a human body in which a part of the intestine slides to the near-by intestine. It is the most common problem identified with the children under the age of 2 years. When this situation occurs, the flow of food and the fluids can become blocked. Intussusception occurs in every 1 to 4 children, out of every 1000 infants (Crain, 2015). Primarily it is commonly observed generally in babies who are 5 to 9 months old. This problem often causes intense abdominal pain and drawing the legs towards chest. It makes the children and small babies cry out in pain. Pathophysiology has been studied for the assessing the issue with the Jay. It can be defined as the study of the disturbance of the balanced mechanical, biological, and the physical functions in the system of the human body; often caused by any disease or problem. It represents the altered or disordered functions in a living organism. It includes the diseases and the processes related to them. In broader and simpler terms, it disturbs the state of homeostasis of the human body (Hielkema, Winter & Reijneveld, 2017).

As the problem discusses the telescoping of one portion of the bowel into the next, thus the pathophysiology of the intussusception includes the body parts such as ileum, cecum, and jejunum. In this condition, the ileum enters the cecum; ileum is the final section of the small intestine in the organism. However the other types when the ileum or jejunum prolapses into itself is rarely observed situation. Every intussusception occurs with the intussusceptum which is close to intussuscipiens. Intussusceptum refers to the portion invaginated with another part during the intussusception, and intussuscipiens is the part of the bowel or the intestine which receives the part invaginated into it during the process of intussusception (Dunker, et. al., 2015). Due to the invagination of one part into another, the blood supply may be blocked which leads to the problem of ischemia. The sensitivity of the  mucosa is found with the ischemia and further creates a red-currant jelly stool, that often occurs in less number of cases of intussusception, therefore this should be differently diagnosed when the children represents the problem of bloody stool. Therefore, the above discussion states the pathophysiology of intussusception in the children during their infancy (Lacy et.al, 2016).

Role of Nurses in Child and Adolescent Nursing

The problem of intussusceptions underlying the pathophysiology has been studied and their impact on the infants or children, that may cause the stoppage of the blood supply to the intestine. The lack of blood may cause the tissues of the intestinal wall to die infecting the lining of abdominal cavity. Thus, the role of nurse is very effective in the development of nursing care to the child or infant intussusception. From the beginning till the diagnosis of the problem, nursing play an important role. Nurses in the healthcare identify the situation of the patient that indicates the pain and the unresponsive behaviour, handling the patient gently. Maintaining the NPO status timely and continuously assessing the condition of the patient because the increase in pain may lead to proferation (Hockenberry & Wilson, 2014).

Monitoring the change in the situation of the patient, and explaining parents about the cause of the severe pain and symptoms is essential for dealing with the child effectively. It also includes giving reassurance about the diagnostic tests and the results. Also, after the procedure followed in the treatment of the disease until the last step, continuing the follow-up care which includes providing the anticipatory guidance towards the development of the child. Therefore, it is essential to be aware about the growth and developmental theories of the infant who are dealing with the problem of intussusception (McCance & Huether, 2018). 

As the essay focuses on the child and adolescent nursing and their development, this includes studying about the expected development milestones at the age of infancy, i.e. as per the case study, the development milestones for Jay. Babies at the age of 4-7 months learn to apply their abilities to perceive things, include the ability to see, touch, and hear. As per the growth and development research undertaken for Jay, was a 4month old boy, above mentioned are the expected development milestones. It states about the motor skills, language skills, social, and other emotional skills which he might have developed at that age (Kuo et.al, 2012).

The understanding about the development of the child or adolescents, it must be considered that the child or adolescents should be involved in medical-related conversation only when they reach the age of 12-16 or 21years. It means when the children or adolescents reach legal adulthood, then they can take effective medical decisions (Koukourikos et.al, 2015). There are certain child growth and development theories, which might be helpful in gaining a better understanding of the problem and diagnosis. These theories include psychosocial, behaviourist, and the ecological in relation to the problems of the children and ensuring their state of wellbeing in the future (Betancourt et.al, 2016).

Expected Development Milestones in Infancy

In every healthcare setting it is the duty of the nurses to ensure the application of a family-centred model they may be neonatal, paediatric and the adolescent nurse. Nowadays the hospitals in the current scenario have adopted the family-centred approach, to enhance the well-being of paediatric patients. In other words, the approach focuses on the responsibility of the nurse towards both the family and the patient. This will enhance the wellbeing and development of the child with respect to the fulfilment of the needs of the family, and it will lead to positive outcomes (Gulanick & Myers, 2016).

 The family centred approach has been considered effective in the nursing of the children in their younger age. There are nine elements of this approach, which includes recognising the family and the family members as a permanent support system in the child’s life, which helps in the  parent-professional collaboration at all the different levels of healthcare (Merrell & Gimpel, 2014).

It also includes accepting the racial, economic, and cultural diversity of the families, encouraging support from the members of the family and responding to the child developmental needs in context of the healthcare practices. Family centred approach recognises that the family and the parents are vital to the health and wellbeing of infants, children, and the adolescents. With the context of the case study of Jay‘s health and wellbeing’s state can be improved by adopting the family-centred approach by the nurses and the healthcare. However, the approach is an important element in the wellbeing or nursing because it acknowledges that the emotional, social, and developmental support is an important element in the healthcare. It leads to better and positive health outcomes as it gives satisfactory experiences to both the patient and the family (King & Chiarello, 2014).

Jay has been diagnosed with severe symptoms of intussusception which made him cry out in pain and disturbed his functions and the system in the body. During the time-period of intense pain and poor health, family or the parents are the major factors bringing a positive change. The approach affects the siblings also, in a way that the development of family-centred policies includes open hours for the siblings or extended family to visit the patient. These persons have their own different role in the enhancement of the wellbeing of the child. In addition to the sibling’s role, the parent participation facilitating the child’s care to reduce or treat the diseases to the extent they decide to is another benefit of the family-centred approach (Yen et.al, 2017).

Family-Centred Approach in Nursing

In context of the case study given, it has been mentioned that due to the rotavirus vaccination given to the child Jay, the incidence of the condition has been increased amongst infants. As he was diagnosed with the problem intussusception, therefore there was an essential role of medical procedures and hospitalisation. The practice of applying medical procedures and processes or hospitalisation affects the child as well as his family in a number of ways. Clinical procedures and medical treatment of illness are stressful experiences for the child and family, as the child or infant lives in contact with number of people together. The child lives in an environment which creates difficulties as in the healthcare settings; there are multiple patients, professional and non-professional staff which exerts an influence over child. This affects the family or the parents of the child making them conscious regarding the treatment and health of their child (Yung, Chong & Thoon, 2016).

To assess and reach a conclusion on the child and adolescent nursing in context of the healthcare, it has been analysed that child and adolescent nursing is an essential phenomenon, which must be applied properly in the healthcare settings. Moreover, the role of nurses and the procedures in the clinical practices are crucial especially to the children. The essay mentioned the problem of intussusception which has been increasingly affecting infants these days, therefore new procedures and effective methods of treatment must be adopted to improve treatment. The health includes the aspects such as social and emotional wellbeing which is often relative to the family of the child also, thus hospitals must incorporate the family centred approach. This will ensure the effective and faster recovery of the children and adolescents from their illness

References

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