Pathophysiology Of Laceration

Adolescence is a growing stage of life, and adolescents need proper information, support and knowledge along with opportunities to inculcate life skills. They should be provided with services of healthcare that are acceptable, equitable and profitable in environments that are safe and supportive (Vijayakumar et al., 2018). In the chosen case study, Jess Dutch was admitted to the emergency ward of a hospital with a diagnosis of Laceration, which is self-harm. The self-inflicted Laceration has made her tendon on the left wrist become protrude. Jess has a medical history of anxiety and depression, which has made her resort to some episodes of self-harm. On admission, their vital signs of Jess are found to be normal, and it is being recorded every 30 minutes. Their treatment plan for Jess involves surgical washout of the Laceration along with the repair of the same. In this essay, the pathophysiology of their underlying medical condition of Jess, along with the roles and responsibilities to be undertaken by RNs for her care, will be discussed in detail.

The clinical diagnosis in the case study is Laceration which has led to visibility of the tendon from the left wrist. A laceration is a wound that is caused by a tear in the tissue due to a shearing or a crushing force. Hence, it is the outcome of a blunt-trauma mechanism. After a laceration takes place abruptly, hemostasis begins, which involves the smooth contraction of muscles along tissues compressing small vessels (Turner & Tran, 2019). This is followed by inflammation where neutrophils become activated through a complementing cascade which initiates phagocytosis for the time of inflammation of the wound. Then begins the proliferation of the wound, which starts seven days after the occurrence of the wound. In this phase, angiogenesis takes place that makes the visibility of erythema at the wound site. In this stage, fibroblasts replace the mass of inflammation, and collagen replaces the clot of fibrin. After proliferation, maturation of the wound takes place where remodeling of collagen takes place, the scar flattens, and visible erythema gets resolved (Karri, Chien & Abd-Elsayed, 2019). This entire process takes a duration of approximately 30 days.

Lacerations are wounds that make themselves visible symptomatically. One is easily able to see the end result of a laceration (Regal & Tang, 2019). The signs and symptoms include mild to severe pain, depending on the intensity of the wound, bright and red blood oozing out of the wound, revealing of structures below the skin such as tendons, ligaments as well as bones, bruising, draining of pus, swelling of the area, rupture of the tissues along with discoloration of the skin and redness in the area of bruises (Mustafa & Negm, 2017).Adolescence And Laceration: RN Roles And Responsibilities Discussion Paper    When the Laceration is severe, prompt and urgent attention is necessary under the supervision of a doctor to avoid the occurrence of further complications. The Laceration which has been detected in the patient was due to her past history of depression, anxiety and tendencies toward self-harm. She was bullied at school for her structure and problem with acne. The severe injury which has occurred must be thus treated with care, and hence Jess has been kept under strict observation.

Signs And Symptoms Of Laceration In Adolescents

The age group of 14 to 17 years is a time when teenagers learn to think, feel and interact with other people around them to create a perception of things themselves. There is also notable growth and development seen in their bodies as well. Girls of this age grow physically mature and develop by the age of 16 years. It is seen that a 16-year-old teenager becomes conscious of her external appearance and eating disorders are usually common among these individuals (Balasundaram & darshini Avulakunta, 2021). Teenager develops their own opinions and personality while they try to be unique from others in their age group. Some of the emotional changes or developments that take place among children of this age are going through lesser conflicts with parents and remaining independent of them highly they acquire a deeper capacity for sharing and caring for others through the development of intimate relationships (Sawyer et al., 2018). However, kids of this age group spend less time with parents and more time with friends. Sometimes, adolescents of this age start suffering from depression and thus indulge in abusing substances such as drugs and alcohol. The age of 16 years is a period of rapid growth which calls for proper intake of essential nutrients as well (Norris et al., 2021). The requirement increases for the building of muscles and bones along with smooth maintenance of metabolic activities.

For rendering quality care and effective treatment to girls of the age group Jess, a nurse must assess the patient to check for all important parameters such as height, weight, eating habits, regularity of exercising and also detect the behavioral attributes of the patient. The treatment plan that is prepared should consist of goals that are both long-term as well as short-term. There should be criteria for checking the effectiveness of the process of intervention that is being undertaken. After properly formulating all the parameters, the nurse may decide upon the intervention plan along with providing the proper rationale for each intervention (Sawyer et al., 2018). The nurse has to foster a friendly relationship with the concerned patient, who is of the same age as that Jess, so that they can easily open up and cooperate in the treatment procedure.

Gillick Competence is a term that is used in the medical law, and it basically describes the whether a child who is under 16 years of age shall be able to consent or make an informed decision about the medical treatment being provided to him or her without the permission or knowledge of parents (Zimmermann, 2019). In the case study, it has been found that Jess is of 16 years and 7 months. Hence, she is capable of making independent decisions and providing medical consent regarding the treatment being provided to her according to the Gillick competence for the clinical diagnosis of Laceration. Moreover, the patient was fully conscious and did not suffer from any kind of pain and hence could completely provide informed consent to the medical treatment which she was being provided.

Emotional Developments In Adolescents

In a multidisciplinary team of health workers, apart from the RN, there will be a clinician, a social worker, an attending doctor and a few other health professionals whose collaborative effort along with expertise would render a safe environment for the patient to be taken care of in a hospital setting. The nurses play a vital role in rendering child protection responsibilities to manage the children and adolescent patients, making a transition to foster proper care. One of the responsibilities of the RN toward Jess is to provide comprehensive knowledge of Jess’ condition to the rest of the team (Woodman et al., 2018). This helps in creating better partnerships with the social worker who is appointed to rehabilitate Jess from the condition of anxiety and depression. The nurse is responsible for screening and assessing the medical needs of Jess and conveying the same to other members of the multidisciplinary team. The RN is responsible for safeguarding the patient from any kind of maltreatment or impairment which might impact their recovery. As and when required, the nurse shall make arrangements for referrals when Jess needs any special care (Lines, Hutton & Grant, 2017). Also, when Jess remains in hospital, Jess has to be protected from getting access to any kind of sharp-edge objects such as blades, glasses, or knives so that she cannot repeat any kind of self-harm again.

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To become a socially and mentally healthy individual, an adolescent girl craves four psychosocial needs such as body image, independence, peer relations and identity (Carballo et al., 2019). As Jess is suffering from depression due to being bullied by her friends because of her structure, she is in need of acknowledgment of her body image, peer relations and identity.

Adolescents of the middle age group want to make out the most of their bodies. They want to follow the trends of fashion. They lay emphasis on maintaining body weight and dieting (Wartberg, Kriston & Thomasius, 2018). Jess must be given validation for her body structure and shape, which shall make her gain confidence in herself. This will make her feel happy about her existence, and eventually, she will be able to love herself. Secondly, peer relations are an important psychosocial need for Jess. Middle-aged adolescents crave intense relationships with their friends. When Jess becomes comfortable with peers around her, she will eventually start feeling less demeaned and depressed. Thirdly, inculcating the development of identity will foster the emergence of abstract reasoning along with the development of personal values and morals (Carballo et al., 2019). This will help Jess become concrete about her existence and resolve the conditions of her depression eventually.

Firstly, The Patient Must Be Made To Feel It Is Sometimes Okay To Make Mistakes Jess Should Not Be Made Feel She Has Committed Any Kind Of Crime By Trying To Harm Herself. The patient should be approached with a positive attitude and listen to the things she has to say (Turner & Harder, 2018). Reacting with a lack of interest and irritation with whatever she has to say might have a negative impact and create frustration in her mind of Jess. Appropriate and healthy boundaries must be set for the patient with the minimum amount of resistance. By praising and supporting the patient emotionally, the confidence and self-esteem of the patient must be built. It is only then that the patient will be able to trust the nursing care and treatment provided to her.

RN’s Roles In Rendering Quality Care To Adolescent Patients

It is the responsibility of the nurse to administer proper medication to ensure appropriate treatment, which shall be drawn up the incorrect dosage. It must be administered at the right time and on the correct route to the right patient. Also, RNs play a very critical role in avoiding errors in medication (Dirik et al., 2019). Before administration of the medications to the patient, the nurse must check the validity of the medication and its order. She should apply skills of critical thinking to the application of the medication along with the condition and status of the patient. The nurse’s role is also to assess the contraindications of the medications which are administered to the patient (Wheeler et al., 2018). It is also the role of the nurse to make communication about the administration of medications to the patient and the patient party, along with the usefulness of the medications.

Conclusion

From the above essay, it can be concluded that nursing care for an adolescent has to be very careful and integrated as the individuals are in a delicate stage of development. The treatment plan for Jess shall be made by considering the signs and symptoms of Laceration. The pathophysiology has been discussed well, along with the milestones of development. It was understood that Jess could make informed decisions about her treatment procedure. The protection responsibilities suggested for Jess are sound enough to take care of her in the hospital setting. The psychosocial needs of Jess are discussed, which must be met to render an improvement in her depressive conditions. The promotion of an emotionally safe care environment will help the patient be open about her problems. The role of the Registered Nurse in the administration of medication will ensure the safe medicinal treatment for Jess.

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