Jay

Discuss about the Hospitalization And Intervention To Jay.

In this essay, case of Jay is discussed. He is diagnosed with intussusception. Pathophysiology of intussusception is discussed. Multiple factors need to be considered for providing nursing intervention to Jay. These factors include role of growth and development theories, developmentally appropriate care, family centered care and hospitalization of Jay. Importance of family centered care and factors which need to be considered for providing nursing intervention to Jay are discussed. Points to be considered for hospitalization and provisions to be made during Jay’s hospitalization are discussed. Along with medical intervention, nurse need to work on the factors which can improve well-being of Jay.

It mainly occurs due to the inequality in the longitudinal forces across the intestinal walls. Mass in the form of lead point and disturbed pattern of peristaltic movement are mainly responsible for imbalance in the longitudinal forces. Due to these imbalanced forces, intestine enters the lumen of the adjutant bowel. Intussusception is a pathological condition of GI tract in which there is part of intestine folds into the next section. It is mainly associated with the small bowel and in few cases with the large bowel. It results in the small bowel destruction and bowel perforation. In most common intusssception, ileum enters the cecum. In other few of the cases, ileum or jejunum enters inside itself. Most of the cases, intussusceptions can occur due to location of intussusceptum proximal to the intussuscipiens. This proximal location is mainly due to the peristaltic action of intestine which brings proximal end towards distal end. If progression is rapid, intussusceptum can enter distal colon, sigmoid colon and even prolapse out of the anus. Lead point mainly occurs due to projection of intestinal tissue into the bowel lumen. Lead point occurs in approximately 10 % of the cases of intussusceptions. Due to blockage of bowel, there is prevention of blood supply, which causes ischemia (Aybay et al., 2016).

Gut mucosa in sensitive to the ischemia and it leads to inactivity of mucosa in the gut. It results in the occurrence of red currant jelly stool. This stool is combination of mucosa, blood, and mucus. However, this red currant jelly stool occurs in few of the children with intussusception. Hence, it can be used as a differential diagnostic tool for children with bloody stool. Due to this pathological condition of gut, there can be abdominal pain, nausea, vomiting, leg pulling towards chest and moderate to severe cramping of the abdomen can occur in patients with intussusceptions (Loeffler, 2014).   Jay is also exhibiting all these symptoms. Intermittent pain can occur in children with intussusception because intussuscepted bowel segment transiently stops contracting. Loop of the bowel become necrotic due to ischemia which occurs due to compression of arteries. Barium or water-soluble contrast enema or an air-contrast enema can be used as treatment of intussusception (Patcharatrakul and Rao, 2017). Earlier rotavirus was linked to the occurrence of pathology of intussusceptions, however recent studies are not indicating link between rotavirus and intussusception (Otero et al., 2017). 

Growth and developmental theories

Nurse should incorporate various growth and developmental theories for providing  nursing care to Jay. Various theories include Pigets’s theory of intellectual development and Erickson trust/mistrust stage.

According to Pigets’s theory of intellectual development, sensory organ and muscles become more functional. Infants produces reflexes to the alterations in the body. Nurse need to identify these reflexes. In this case nurse need to recognize drawing legs up and high-pitched crying in response to pain. It can be helpful in the early assessment and early intervention to be planned for Jay. There is no place for emotions of nurse in evaluating cognitive developmental theory in Jay. By avoiding this emotional factor, nurse can perform objective assessment in Jay. According to Erickson trust/mistrust stage children relied completely on their caregiver for fulfilling their basic need for growth and development. Children trust their parents more as compared to the nurses, hence his parents need to administer drugs to Jay. These children are completely dependent on their caregivers for food, shelter, and protection. In this stage Jay can seek help from caregivers for his diseased condition (Reimann et al., 2017). Evaluation and execution of these growth and developmental theories in Jay can provide him with effective nursing intervention and improve his disease condition.    

Diseased state of Jay can impact his future growth and development. It can negatively impact his physical and psychological development. Nurse should make realize his family members about its negative impact on his future development. Hence, his family members can take appropriate measures to tackle this issue. Nurse should convince his parents to improve their moral because it can be helpful in augmenting their attention towards his care. Special efforts need to be taken to provide treatment in the form of enema on regular basis. Children of his age would not be cooperating to take enema and might be afraid to take it. Hence, family members need to give more attention for using enema. This age appropriate care for Jay can improve his disease condition (Lowry-Lehnen, 2015).

Family centered care is important aspect for providing care to children of Jay’s age. This is important for Jay because children like Jay can not manage their symptoms and disease condition on their own. Jay’s family should stand firmly behind him and take part in every aspect of his care. Nurse should consider this aspect and involve his family members in his care. Nurse should collect information related to Jay form his family members. Nurse should collect information related to health issues, eating habits and psychological behavior. Nurse should analyze collected information and prepare effective care plan for him. It can help nurse to provide nursing care in smooth manner. Family members confidence about the Jay condition can be improved by giving them assurance that proper treatment can improve his condition (Law, 2012). 

Developmentally appropriate care

There should be involvement of family members of Jay in planning and delivering care to Jay. Nurse should educate Jay’s family members to manage pain due to intussusception. Nurse should understand his mother’s feelings and should give respect to her feelings. Jay’s mother is worried about rotavirus vaccine because she was informed that his condition was exaggerated due to rotavirus vaccine Nurse should educate that rotavirus vaccine would not affect his condition significantly because in recent studies it is evident that rotavirus vaccine is not linked to his intussusception. Nurse should maintain their dignity and use respectful words with them. Nurse should understand strengths and weaknesses of his mother and plan nursing intervention with respect to her strengths and weaknesses. Socioeconomic and cultural aspects of his family should be considered while providing nursing intervention to Jay. Jay’s actual status of health should be informed to his family members and inform them about the anticipated effects after the completion of nursing intervention for intussusception (Barnsteiner et al., 2014).

Children at the age of Jay can feel comfortable, if nursing intervention is provided in the presence of their family members. Considering this, nurse should provide nursing intervention to Jay in the presence of his family members. It is well established that effective communication with the family members can be helpful in providing complete nursing intervention to the children. Hence, nurse should establish effective communication with his family members because few of the aspects of the nursing intervention cannot be communicated to Jay due to his age factor. Family members need to be educated about application of enema in Jay. Through this communication, nurse can improve knowledge of family members about his disease condition and treatment to be provided. Through communication, nurse can improve participation of family members in decision making of his care and inform them about the care to be taken at home. Jay’s hospitalization can be reduced by providing him with family centered care. Family centered can be helpful in improving satisfaction of Jay and his mother about the care provided (Shaul, 2014; Watson and Rodwell, 2014). Family centered care can be helpful in relieving stress of Jay and his mother.

Hospitalization is the significant part of children care. However, long duration hospitalizations of children can negatively affect children both physically and mentally. Comfortable environment need to be provided for Jay in the hospital. There should not be separation of Jay and his family members during his stay in the hospital. All sorts of interventions need to be provided for Jay in the presence of his family members. Children with age of Jay might feel fear of pain and become anxious during their hospitalization stay. Hence nurse need to ensure that all the care to be provided to Jay should be with minimal pain. Family members of Jay might be more worried about his hospitalization. Nurse should give them assurance that hospital is going to give freedom from his painful condition and improve his wellbeing. Nurse should assure them that he is going to be discharged from hospital immediately after his recovery (Thurston, 2014).

Family-centered care

Family members of Jay should be informed about the nursing and medical procedures and nurse should demonstrate them all the procedures. It would be helpful in reducing hospitalization stress on his family members. Nurse need to counsel his family members for his hospital admission. Nurse should provide flexibility to his family members to stay with him in hospital. Nurse should give counseling to his mother about financial issues due to hospitalization. Nurse should maintain confidentiality of Jay’s hospitalization. Nurse should provide suitable environment for Jay in the hospital with respect to his medical history, behavior, cultural background and socioeconomic status (Tehrani et al., 2012; Brykczynska and Simons, 2011). Nurse should consider all these aspects during hospitalization of Jay.  

Conclusion:

Intussusception in the pathological condition of the GI tract associated with pain, vomiting and bloody stool. Disease condition can worsen due to ischemia. In this case Jay is diagnosed with intussusception. Implementation growth and development theories for nursing care of Jay can be helpful in providing holistic care to Jay. Person centered care for Jay can be helpful in improving  morale his mother and relieve stress about his diseased condition. Provision of suitable hospital environment for the Jay can be helpful in his speedy recovery.    

References:

Aybay, M.N., Erol, S., Kaya, H.E., and Guler, I. (2016). Appendix Invagination Mimicking Ileocecal Intussusception in a Pediatric Patient: A Case Report. Journal of Emergency Medicine, 51(5), 589-591.

Barnsteiner, J., Disch, J., and Walton, M.  (2014). Person and Family Centered Care. Sigma Theta Tau. 

Brykczynska, G.M., and Simons, J. (2011). Ethical and Philosophical Aspects of Nursing Children and Young People. John Wiley & Sons.

Law, M. (2012). Family-Centred Assessment and Intervention in Pediatric Rehabilitation. Routledge.

Loeffler, A.G. (2014). Introduction to Human Disease: Pathophysiology for Health Professionals. Jones & Bartlett Publishers.

Lowry-Lehnen, T. (2015). Theories of Human Growth and Development: Developmental Psychology. Create Space Independent Publishing Platform.

Otero, J., Posa, M.R., and Kelly, M.N. (2017). Rectal Bleeding and Abdominal Pain Following Vaccination in a 4-Month-Old Infant. Case Reports in Pediatrics, 9461315. doi: 10.1155/2017/9461315.

Patcharatrakul, T., and Rao, SSC. (2017). Update on the Pathophysiology and Management of Anorectal Disorders. Gut Liver. 23. doi: 10.5009/gnl17172.

Reimann, M., Schilke, O., and Cook, K.S. (2017). Trust Is Heritable, Whereas Distrust Is Not. Proceedings of the National Academy of Sciences in the United States of America, 114(27), 7007-7012.

Shaul, R. Z. (2014). Paediatric Patient and Family-Centred Care: Ethical and Legal Issues. Springer Science & Business.

Tehrani, T. H., Haghighi, M., and Bazmamoun, H. (2012). Effects of Stress on Mothers of Hospitalized Children in a Hospital in Iran.  Iranian Journal of Child Neurology, 6(4), 39–45.

Thurston, C.  (2014). Essential Nursing Care for Children and Young People: heory, Policy and Practice. Routledge.

Watson, G. and Rodwell, S. (2014).  Safeguarding and Protecting Children, Young People and Families: A Guide for Nurses and Midwives. SAGE.