Question

   1.           Derek, a seven-year-old, is being admitted to the pediatric unit for a hernia repair surgery. You are collecting data by interviewing Derek and his parents.

a.     What is the purpose of interviewing Derek as well as the caregivers?

b.     Describe how you would explain the procedure based on Derek's developmental stage.

c.       What are some of the important aspects the nurse should keep in mind when interviewing Derek and his parents?

      

Answer 1

Derek, seven years old, admitted in hospital for hernia repair surgery.

* Purpose of interview -

- The patient's and care takers' interview is the primary way of obtaining comprehensive information about the patient in order to provide effective patient centered care and medication.

- The clinical adage that about two-thirds of diagnoses can be made on the basis of the history alone has retained its validity despite the technological advances of the modern hospital.

- An accurate history also provides focus to the physical examination, making it more productive and time efficient.

- Clinical hypotheses generated during the interview provide the basis for a cost-effective utilization of the clinical laboratory and other diagnostic modalities.

- Interview is important to assess the patient's condition and for making care plan for patient illness.

- The following information is obtained during interview - Chief complaint, history of present illness, past medical history, past surgical history, family history, social history and general and systemic examination.

** Procedure based on Derek's developmental stage -

The choice surgery for hernia repair may include -

• Herniotomy - It is the removal of the hernial sac only.

• Hernioraphy -

• Hernioplasty

During surgery to repair the hernia, the bulging tissue is pushed back in. The abdominal wall is strengthened and supported with sutures (stitches), and sometimes mesh. This repair can be done with open or laparoscopic surgery.

* Herniotomy without sac ligation in children be the procedure of choice to save time and also to prevent any other possible complications such as nerve damage, spermatic cord injury, or peritoneal tearing.

* A hernioraphy refers to the surgical repair of a hernia, in which a surgeon repairs the weakness in the abdominal wall. A hernia occurs when a weak area in the muscles of the abdominal wall allows an internal part of the body to push through.

** Important aspects the nurse should keep in mind when interviewing -

The nurse should take the history of the patient which may includes -
• General information like age, sex, name, city, date of admission etc.

• History of past illness

• History of present illness

• Anthropometry

• Surgical history

• Family history

• Allergies, medications

• And systemic examination.

Nurse should take these information from the caretaker and patient because it actually help in diagnosis and treatment.

During interview -

• Establish report.

• Respect patient privacy.

• Recognize face value.

• Move to the patient's field of vision.

• Consider how you look.

• Ask open-ended questions.

• One thing at a time.

• Leave the medical terminology alone.