Adam's conceptual model for nursing in the care of postoperative client suffering from ruptured appendicitis with generalized peritonitis / Cyrille Y. Panimdim.

Computer print out

Thesis (Master in Nursing Major in Medical-Surgical Nursing)-- Cebu Institute of Technology- University, March 2009.

Includes bibliographical references.

TITLE: Adam?s Conceptual Model for Nursing in the care of Postoperative Client Suffering from Ruptured Appendicitis with Generalized Peritonitis
AUTHOR: Cyrille Yamid Panimdim
SCHOOL: Cebu Normal University
DEGREE: Master in Nursing
Major in Medical-Surgical Nursing
ADVISER: Dr. Marylou B. Ong
YEAR COMPLETED: 2009

Statement of the Problem:

This clinical paper is to utilize Evelyn Adam?s Conceptual model for Nursing in dealing with postoperative client suffering from ruptured appendicitis with generalized peritonitis.
This is the case of L.A., a postoperative client suffered from ruptured appendicitis with generalized peritonitis utilizing Adam?s Conceptual Model for Nursing. The following questions were asked: What is the clinical profile of the patient in terms of the three dimensions? Biological, Psychological and sociocultural. What is the psychopathophysiological background of Ruptured Appendicitis with generalized peritonitis? What are the identified sources of difficulty of the client? What are the interventions formulated based on the identified problems? What are the consequences observed after the nursing intervention?




Methodology:

The researcher used the descriptive method of research through a case study that was conducted in the Female Surgical Ward (Ward VI) of Vicente Sotto Memorial Medical Center. The researcher locale is in tertiary government hospital with 800 beds capacity.
The researcher utilizes Marjory Gordon?s Functional Health Pattern assessment framework because it is particularly useful, however in collecting health data to formulate nursing diagnoses. Gordon has defined 11 functional health patterns that provide for a holistic client database. A pattern is a sequence of related behaviors that assists the nurse in collecting and categorizing data. These 11 functional health patterns can be used for nursing assessment in any practice areas for clients of all ages and in the assessment of families and communities.
Before the researcher started the 50 hours intensive practicum a letter of approval was sent to the Dean, Graduate School through the Dean, College of Nursing and a letter was sent to the Chief Nurse, Vicente Sotto Memorial Medical Center. The researcher rendered 10 hours per day to complete the 50 hours intensive practicum.

Findings

The researcher found out that Evelyn Adam?s Conceptual Model for Nursing has been successfully implemented and was effective in the care of patient L.A., 20 years old, female, housewife married to a construction worker, with two children, a first year high school level and is residing at Upper Tunghaan Minglanilla, Cebu, who is a post-operative client suffered from ruptured appendicitis with generalized peritonitis.
In appendicitis, the appendix becomes inflamed and edematous as a result of either becoming kinked or occluded by a fecalith (ie, hardened mass of stool), tumor, or foreign body. The inflammatory process increases intraluminal pressure, initiating a progressively severe, generalized or upper abdominal pain that becomes localized in the right lower quadrant of the abdomen within a few hours. Eventually, the inflamed appendix fills with pus that causes perforation if no management initiated at an early stage.
The following sources of difficulty were identified base on the three dimensions; For biological, Acute pain, difficulty in breathing, difficulty in moving, fluid and electrolyte imbalance, self-care deficit: grooming and hygiene, risk for infection, risk for imbalance nutrition less than the body requirement, hyperthermia. In psychological only one identified, which is moderate anxiety. Socio-cultural problem is family process risk interrupted.
Goals were formulated according to each source of difficulty and planned interventions were implemented and consequences were checked if there were changes in status happen after sources of difficulty were managed. Upon evaluation, the patient was able to move safely with less discomfort and eventually able to ambulate freely in going to the bathroom with assistance for personal hygiene, which facilitated faster recovery until the patient finally went home.


Conclusion

The researcher found out that Evelyn Adam?s Conceptual Model for Nursing has been successfully implemented to the patient who are post operative and was effective and therefore was encouraged.


Recommendations

Based on the findings, the following recommendations were made:
In order to promote faster recovery from the state of being ill, Evelyn Adam?s Conceptual Model for Nursing could be utilized; it can also be applied in the hospital setting where the client confines in order to recover from a certain ailment. Adam?s conceptual model can be integrated in the nursing curriculum as basis for clinical case management; lastly, this study is recommended to be replicated by other nursing practitioners.