Septic Pediatric Case Study

Postoperative Care of the Septic Pediatric
Patient Secondary to a Ruptured Appendix

PediaSIM HPS® Program for Nursing Curriculum Integration (PNCI™)

Simulated Clinical Experience (SCE™) Overview

Location: Emergency Department and General Pediatric Surgical Unit
History/Information:
The patient is an 8 year old male who lives with his parents and 2 sisters. He presents to the
Emergency Department (ED) with complaints of severe localized pain in the right lower quadrant of the abdomen, nausea, vomiting, and fever. Two days ago he began complaining of loss of appetite, cramping type pain, and his mother states that he just wasn't acting like himself. By that evening he was complaining of generalized abdominal pain. Yesterday he…show more content…
(2004). Practice alert: Family presence during CPR and invasive procedures. Retrieved May 15, 2005 from http://www.guidelines.gov 2. What assessment findings would indicate that the appendix has or is about to rupture?
Discuss how this would impact the nursing plan of care for the pediatric patient.

Emil, S., Laberge, J-M., Mikhail, P., Baican, L., Flageole, H., Nguyen, L., et al.
(2003). Appendicitis in children: A ten-year update of therapeutic recommendations. Journal of Pediatric Surgery, 38, 236-242.

4. What developmental factors need to be considered when assessing a child's self-rating of pain? Fefferman, N. R., Roche, K. J., Pinkney, L. P., Ambrosino, M. M., and Genieser,
N. B. (2001). Suspected appendicitis in children: Focused CT technique for evaluation. Radiology, 220, 691.

5. Why isn't the test for rebound tenderness consistently recommended with the pediatric patient? Joanna Briggs Institute for Evidence Based Nursing and Midwifery. (1999). Vital signs: Best Practice, 3(3), 1-6. Retrieved May 30, 2005 from http://www. joannabriggs.edu.au/best_practice/bp8.php 6. What would be the priority nursing diagnoses in the care of the family coping with…show more content…
E., and Newman, K. D. (2005). Appendicitis. In K. W. Ashcraft, G.
W. Holcomb, and J. P. Murphy (Eds.), Pediatric Surgery (pp. 577-585).
Philadelphia: Elsevier Saunders.
Samuel, M. (2003). Pediatric appendicitis score. Journal of Pediatric Surgery,
37, 877-881.

10. What strategies can the nurse use to assist the family of a child who is hospitalized?
11. Develop a discharge plan for the pediatric patient being discharged on home antibiotic therapy.
12. Discuss the importance of including other members of the healthcare team in discharge planning. Springhouse. (2003). Best practices: A guide to excellence in nursing care.
Philadelphia: Lippincott Williams and Wilkins.
Stevenson, R. J. (2003). Appendicitis. In M. Ziegler, R. Azizkhan, and T. R.
Weber (Eds.), Operative Pediatric Surgery (pp. 671-689). New York:
McGraw-Hill.
Vegunta, R. K., Ali, A., Wallace, L. J., Switzer, D. M., and Pearl, R. H. (2004).
Laparoscopic appendectomy in children: Technically feasible and safe in all stages of acute appendicitis. American Surgeon, 70, 198-201.

Postoperative Care of the Septic Pediatric
Patient Secondary to a Ruptured Appendix,

3. Describe at least 3 pain scales which can be used in pediatric pain assessment. Of the