Four-year-old Jenna has just been admitted to

Four-year-old Jenna has just been admitted to the pediatric unit following surgery for a perforated appendix. She complained of her stomach hurting last night, but this morning her condition was worse and she had a temperature of 102°F. Worried that this was not just a virus, Jenna’s mother took her to the pediatrician. On the way to the doctor’s office Jenna told her mother that her pain “just went away.” While at the pediatrician’s office she complained of feeling bad all over. On examination, her abdomen was rigid and no bowel sounds were heard. A complete blood count revealed a white blood count (WBC) of 22,000/mm3. The pediatrician diagnosed that Jenna had appendicitis and most likely had a perforated appendix. He referred Jenna to the emergency department for assessment and surgical consultation. A CT scan confirmed a diagnosis of appendicitis. During surgery, the appendix was found to have perforated. Jenna had a laparoscopic appendectomy. A dry dressing is in place. She has a peripherally inserted central catheter (PICC) line for fluids, pain medication, and intravenous antibiotics. She also has a nasogastric tube to suction and a Foley catheter. Jenna’s parents are anxious about the surgery. They feel guilty that Jenna became ill so quickly and wonder if they could have done something to prevent it. This is Jenna’s first hospitalization. They are worried that she will have a lot of pain and wonder how she will cope with the hospitalization. 1. What is the priority of nursing care for Jenna in the immediate postoperative period? 2. What should the nurse include when teaching Jenna’s parents about the postoperative course? 3. Jenna’s parents ask why she needs all of the tubes. What information should the nurse include related to the purpose of the nasogastric tube, the Foley catheter, and the central line? 4. Create a concept map for Jenna based on postoperative management of a 4-year-old with a perforated appendix. Include nursing interventions related to fluid and electrolyte balance, pain management, prevention of pulmonary complications, treatment of infection, and developmental and psychosocial care.

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