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We are Top Nursing Assignment Writers

Top Nursing Assignment Writers

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We Assign Your Papers to the Most Qualified Writers

We remain the top nursing assignment writers because of our large pool of writers. To ensure successful delivery, we assign orders to the writers based on their areas of expertise. For example, a writer with experience in neonatal nursing would only handle orders related to it; the same goes for writers with knowledge in psychiatric mental care nursing.

Upon placing an order, we require the client to provide clear instructions and, where possible, indicate the nursing topic to be considered. Where the client fails to provide the topic, the support team uses the information provided by the client to determine the topic.

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Top Nursing Assignment Writers





NUR3503 Assessment 2: Case Study Analysis

Case Study Analysis

The appendix is a rudimentary organ in human beings. The appendix can get inflamed and, at times, rupture. A perforated appendix is a medical emergency that requires urgent attention. Patients often report excruciating pain in the right lower abdominal quadrant. According to Ferris et al. (2017 Top Nursing Assignment Writers), appendicitis contributes to a rather significant percentage of emergency department patient visits. Appendicitis’s primary treatment is a surgical incision or appendectomy. Pediatric patients after appendectomy require special attention to enhance recuperation and ensure they do not develop complications. This essay focuses on the pathophysiology of a perforated appendix and the postoperative and discharge care of Siena, a pediatric patient with a perforated appendix.

Pathophysiology of Appendix Perforation

Appendix perforation is the rupture of the appendix, often releasing contents into the peritoneum. A perforated appendix often begins with obstruction of the appendix lumen (Hinkle & Cheever, 2018). The blockage might result from fecal matter, foreign bodies, or worms, leading to distension, microorganisms’ overgrowth, and obstructed blood flow and inflammation. The appendix swells and produces excruciating right lower abdominal pain.

Patients are often admitted to the emergency departments with complaints of the ‘worst abdominal pain ever.’ The pain is often acute and associated with loss of appetite, nausea, and vomiting. With obstruction of blood flow, the tissue becomes necrotic if left untreated. Necrosis results in gangrene, and perforation follows. Appendix materials may leak into the peritoneum, irritating it and other surrounding organs (Hinkle & Cheever, 2018 Top Nursing Assignment Writers). The most apparent Appendix management is excision.

Assessments to prioritize care Discussions

A complete physical assessment is essential to know the individual’s health status, in this case, Siena. A head-to-toe physical assessment is critical. Vital signs are necessary for this patient every thirty minutes for the first two hours post-operation. A systemic assessment is also vital, paying attention to the gastrointestinal system. The patient assessment triangle is a quick assessment tool that helps assess any respiratory or cardiovascular problems (Fernandez et al., 2017 Top Nursing Assignment Writers). The tool is helpful before utilizing a focused gastrointestinal system exam. Sienna is alert and responsive, as per the assessment. The tool is divided into appearance, breathing work, and skin circulation. As He and Rangel (2021) note, the appearance item helps determine muscle tone, respiratory distress, speech, irritability, look, and controllability. The item shall help determine the child’s airway, vigor, and agility.

The second item, work of breathing, determines if the patient is in distress by observing signs such as noisy breathing, retractions, use of accessory muscles, or nasal flaring. The third item, circulation to the skin, involves observing skin color and visible bleeding (Fernandez et al., 2017 Top Nursing Assignment Writers). After the Pediatric assessment tool triangle, a focused abdominal assessment is necessary. Observation shall include examining for obvious distension, engorged blood vessels, skin discoloration, and obvious bleeding. The tube and catheter insertions are also inspected for swelling, erythema, bleeding, or any drainage. The drainage tube is inspected, and the color of the drainage is recorded. Auscultation of the bowel sounds in all quadrants to determine their frequency. Percussion and palpation may be avoided due to her condition because they might exacerbate her pain.

Siena’s Nursing Management.

Nursing care management after surgery takes a specified path but differs depending on the patient’s diagnosis. Acute pain often occurs in all patients post-surgery. Patient care after appendectomy includes ensuring adequate hydration, preventing infection, and pain management (He & Rangel, 2021). The first intervention is taking vital signs to get the baseline data for patient care. To minimize pain, nurses should continually evaluate patients’ self-reporting of pain and non-verbal cues for the presence of pain (He & Rangel, 2021). They should also report the findings appropriately. Patient education about the process is vital as it enables patients to ‘make peace’ with their condition, thus relieving anxiety and pain (Livne, Peterfreund, & Sheps, 2018 Top Nursing Assignment Writers). Educating Siena about medications and her treatment regimen shall ease her phobia and enhance treatment collaboration.

Nurses should also place the patient in a semi-fowlers position to ensure exudate drain through the tubes. Further, this will ensure that other abdominal organs do not put pressure on the incision, thus relieving pain and promoting breathing. The nurse should also maintain the patient on nil per oral and ensure the nasogastric tube is well inserted to relieve discomfort and facilitate drainage (Greer et al., 2020). Prescribed analgesics also help relieve pain. Opioids should be avoided due to the risk of constipation, which would complicate the healing process (Gee et al., 2017 Top Nursing Assignment Writers). Patients can collaborate in other care activities, such as ambulation with minimized pain, thus promoting their healing process.

The patient is at risk for fluid volume deficit due to decreased intake and increased loss. Replacing fluid using intravenous fluids is thus critical. Assess the hydration status regularly on the skin and mucous membranes to determine the adequacy of hydration (Rove, Edney, & Brockel, 2018 Top Nursing Assignment Writers). Assessing for bowel movements allows the nurse to know the right time to reinitiate oral feeding (Greer et al., 2020). Assessing urine color is also essential in determining hydration status. The nasogastric tube should be maintained at its position to prevent vomiting and decompress the bowels.

Infection prevention is integral for this patient because the infection can delay healing and exacerbate signs and symptoms. Nurses should inspect the incision and drainage insertion sites for drainage and erythema, signs of infection. Vital signs changes such as fever and high blood pressure could also indicate infection, hence the need for consistent monitoring. The nurse should administer antibiotics post-operatively to patients whose appendix had ruptured. In addition, it is essential to assess the surgical site regularly for surgical complications such as dehiscence and abscess. Patients recover quickly and resume their everyday life with proper nursing management (Rove, Edney, & Brockel, 2018 Top Nursing Assignment Writers).

Child and Family-Centered Care Model for Siena’s Care

The model focuses on the patient and family as the focus of care. According to Kokorelias et al. (2019 Top Nursing Assignment Writers), the model calls for care that relays the most benefits to the patients and involves them throughout their care. The model applies to patient care throughout the postoperative period. Seeking informed consent is one of the interventions in the family-centered care model. Often, the family is worried after the patient comes with tubes, and the nurses should explain what they are and why they are there. Patients and their families also need to understand why they should not feed the patient post-operatively until a healthcare provider instructs them. Consulting them regarding hospital stay and home care is also integral (Park et al., 2018).

After bowel sounds return, the family should be taught to begin with clear liquids and proceed to solid foods as the patient tolerates them. Allowing them to feed her under supervision ensures they collaborate and feel part of her treatment plan. Respecting family decisions is also integral in this patient’s care (Park et al., 2018 Top Nursing Assignment Writers). Making decisions with the family ensures they adhere to those decisions. After discharge, she and her family should be taught moderate exercises. She should also be allowed to rest for at least two weeks before rejoining other students at school. The family members should also understand that.

Discharge Education

After recuperation, every patient should be released to go home with health messages on enhancing quick healing and preventing readmission (Sapikowski et al., 2021 Top Nursing Assignment Writers). The most crucial information regards exercises and medications. Adherence to pain medications to minimize pain and enhance tolerance is integral. She should also be taught to start with light activities such as walking and stretching herself. In addition, do not lift weights above 10 pounds to avoid straining the abdominal muscles.

Adequate rest is also essential for her healing. Take copious amounts of water to prevent constipation, which could strain the abdominal muscles. Keeping the incision dry and infection-free is also necessary for infection prevention. Teaching Siena these signs, such as swelling, draining pus, and redness, shall ensure that any infection is detected and treated early, preventing comorbidities. According to Jukić, Antišić, and Pogorelić (2021 Top Nursing Assignment Writers), readmissions are often secondary to insufficient patient knowledge, and hence patient education during discharge is paramount.

Community Resources

Community resources are integral during patient recuperation. Community resources include schools, social groups, libraries, and other amenities in the society that can be helpful in patient recuperation (Huth et al., 2018 Top Nursing Assignment Writers). There are numerous resources for Siena, such as the gym/fitness center. Here, she can learn exercises to help regain her regular activity without hurting and straining her abdominal muscles. Available physiotherapy groups in society can be a good community resource to help Siena recover and regain regular activity. Being part of a social group promotes mental health, enhances a patient’s knowledge, and thus promotes quick healing.


A perforated appendix is a common occurrence in the emergency department. The care of a pediatric patient differs from that of an adult from assessment to discharge of health messages. Nurses and their healthcare providers should ensure they involve the patient and their families during their care. Patient education is also crucial in promoting cooperation and ensuring the delivery of the best quality care. Nurses should ensure their patients are well educated on their condition to enhance informed decision-making even after discharge. In addition, nurses should refer patients to helpful community resources to enhance recovery and reintroduction to society with the resumption of expected roles.


Fernandez, A., Benito, J., & Mintegi, S. (2017). Is this child sick? The usefulness of the Pediatric Assessment Triangle in emergency settings☆. Jornal de Pediatria, 93, 60-67.

Ferris, M., Quan, S., Kaplan, B. S., Molodecky, N., Ball, C. G., Chernoff, G. W., Bhala, N., Ghosh, S., Dixon, E., Ng, S., & Kaplan, G. G. (2017). The global incidence of appendicitis: a systematic review of population-based studies. Annals of Surgery, 266(2), 237–241. doi:10.1097/SLA.0000000000002188

Gee, K. M., Jones, R. E., Nevarez, N., McClain, L. E., Wools, G., & Beres, A. L. (2020). No pain is gain: A prospective evaluation of strict non-opioid pain control after pediatric appendectomy. Journal of Pediatric Surgery, 55(6), 1043–1047.

Greer, D., Karunaratne, Y. G., Karpelowsky, J., & Adams, S. (2020). Early enteral feeding after pediatric abdominal surgery: A systematic review of the literature. Journal of Pediatric Surgery, 55(7), 1180-1187.

He, K., & Rangel, S. J. (2021). Advances in the Diagnosis and Management of Appendicitis in Children. Advances in Surgery, 55, 9-33.

Hinkle, J. L., & Cheever, K. H. (2018). Brunner and Suddarth’s textbook of medical-surgical nursing. (15th Ed.).Wolters kluwer india Pvt Ltd.

Huth, K., Long-Gagne, S., Mader, J., & Sbrocchi, A. M. (2018). Understanding the needs of children with medical complexity. MedEdPORTAL, 14.

Jukić, M., Antišić, J., & Pogorelić, Z. (2021). Incidence and causes of 30-day readmission rate from discharge as an indicator of quality care in pediatric surgery. Acta Chirurgica Belgica, 1-5.

Kokorelias, K. M., Gignac, M. A., Naglie, G., & Cameron, J. I. (2019). Towards a universal model of family-centered care: a scoping review. BMC Health Services Research, 19(1), 1-11.

Livne, Y., Peterfreund, I., & Sheps, J. (2017). Barriers to patient education and their relationship to nurses’ perceptions of patient education climate. Clinical Nursing Studies, 5(4), 65.

Park, M., Lee, M., Jeong, H., Jeong, M., & Go, Y. (2018). Patient-and family-centered care interventions for improving the quality of health care: a review of systematic reviews. International Journal Of Nursing Studies, 87, 69-83.

Rove, K. O., Edney, J. C., & Brockel, M. A. (2018). Enhanced recovery after surgery in children: Promising, evidence‐based, multidisciplinary care. Pediatric Anesthesia, 28(6), 482–492.

Sapikowski, L., Members, T., Walsh, J., & Bullock, K. (2021). Improvement of Discharge Education for Pediatric Outpatient Surgical Patients. Journal of PeriAnesthesia Nursing, 36(4), e4.

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