Assessment Overview

Purpose

This assessment task gives you the opportunity to demonstrate critical thinking and clinical reasoning within the paediatric nursing context. You will show how evidence-based information can be applied to contemporary Australian nursing practice when caring for children, adolescents and their families. By working through a realistic clinical scenario, you will develop the analytical skills required for safe and developmentally appropriate nursing care across varied hospital settings.

Instructions

Select one (1) of the three case studies provided below. Your assessment must be written in academic essay format with a clear introduction, a well-structured body and a conclusion, in accordance with APA 7th Edition guidelines. The essay must be submitted through Turnitin in the LEO Assessment Task 1 tile relevant to your campus. Email is not an acceptable submission channel for this assessment.

Allow at least one full day after submission to review your Turnitin similarity report. You may re-submit before the deadline if required; however, only the most recent version will be marked.

Essay Requirements

Using evidence specific to your chosen case study, address both of the following points:

1. Pathophysiology of the Presenting Complaint (300–500 words)
   Describe, at a cellular and systems level, the pathophysiology underpinning the primary presenting complaint in your chosen case study. Your discussion should demonstrate an understanding of the relevant scientific and physiological principles that explain how and why the condition develops, progresses and produces the signs and symptoms evident in the scenario.
2. Evaluation of the Nurse’s Role in Developmentally Appropriate Care (1,100–1,300 words)
   Critically evaluate the nursing role in delivering care that is appropriate to the developmental stage of the child or adolescent in your scenario. Your response must specifically address all three of the following sub-areas:
   • Growth and developmental theories relevant to the patient’s age and stage;
   • Principles and application of family-centred care within a paediatric setting; and
   • The effects of hospitalisation on the child and the family unit.

Case Studies

Choose one (1) case study from the following three options.

Case Study 1 – Anne: Perforated Appendicitis with Peritonitis (Age 10)

Anne is a 10-year-old girl who presents to the emergency department of a local hospital with right iliac fossa pain. Following assessment by the emergency registrar, appendicitis is suspected and the surgical team agree that her signs and symptoms are consistent with this diagnosis. Anne is taken to theatre for an appendectomy, where the surgical team discover a gangrenous, perforated appendix with peritonitis.

On return to the ward, Anne is receiving nasogastric tube drainage (free drainage), morphine via PCA, intravenous fluid therapy, and triple IV antibiotics. Given the severity of the infection and potential post-operative complications, Anne is expected to remain in hospital for ten (10) days of IV antibiotics and pain management.

Anne is the eldest of five children. Her parents own and operate an Indian restaurant in the city, placing significant additional pressure on the family during her admission.

Case Study 2 – Jay: Intussusception with Vaccine Hesitancy (Age 4 months)

Jay is a four-month-old boy admitted to the paediatric unit via the emergency department presenting with vomiting, decreased feeds, no bowel actions and intermittent spasmodic abdominal pain. During painful episodes, Jay draws his legs up to his abdomen and produces a high-pitched cry.

Following diagnostic ultrasound, intussusception is identified as the likely cause of Jay’s presentation. His management plan includes observation, electrolyte monitoring and IV therapy while preparations are made for a contrast enema to correct the intussusception. The anticipated length of stay is approximately two (2) days.

During the admission, Jay’s mother is informed that the rotavirus vaccine Jay received at four months is associated with a slightly increased incidence of intussusception among infants. This information has generated significant anxiety, and Jay’s mother is now expressing serious doubts about proceeding with future scheduled vaccinations.

Case Study 3 – Sue: Acute Rheumatic Fever in a Remote Indigenous Community (Age 14)

Sue is a 14-year-old Aboriginal girl living in a remote community in rural Australia. Over the past two years she has been treated for repeated episodes of streptococcal pharyngitis and impetigo. She is registered with a secondary prophylaxis program through the local health clinic, which prescribes routine intramuscular Benzathine Penicillin G to reduce her risk of developing acute rheumatic fever (ARF) or rheumatic heart disease (RHD). Sue has, however, failed to attend the clinic on multiple occasions to receive her scheduled injections.

Sue presents to the remote area health clinic with a four-day history of acute migratory joint pain affecting her knees, ankles, elbows and shoulders. Her health history reveals a sore throat approximately 2–3 weeks prior and a current temperature of 38°C. The remote clinic medical officer suspects a diagnosis of acute rheumatic fever and advises that Sue requires transfer to a tertiary hospital for cardiology review and echocardiogram. The nearest hospital providing those services is 800 km away.

Sue lives with her mother and six younger siblings. Access to transport, culturally safe care, and family separation are significant considerations in her management.

Referencing and Academic Integrity

All sources must be cited in-text and listed in full using APA 7th Edition format. References should be contemporary (published within the last ten years unless a seminal work), credible and directly relevant to the case study topic. Peer-reviewed journal articles, evidence-based clinical guidelines, and reputable Australian health authorities are appropriate sources. Wikipedia and non-peer-reviewed websites are not acceptable.

Academic integrity is expected throughout. All work submitted must be your own. Turnitin will be used to detect similarity. Any concerns about academic integrity must be addressed with the Lecturer in Charge before submission.

Marking Rubric – Assessment Task 1 (Total: 100 marks = 40% of Unit Grade)

1. Sequencing and Essay Structure (GA9) — 5%

2. Sentence and Paragraph Structure / Intelligibility (GA9) — 5%

3. Pathophysiology Content (LO3, GA8) — 15%

4. Growth and Development Content (LO2, GA6) — 15%

5. Family-Centred Care Content (LO1, GA6) — 15%

6. Hospitalised Child and Family Content (LO1, LO7, GA6) — 15%

7. Critical Thinking, Analysis and Synthesis of Evidence (LO1, LO2, LO3, GA8, GA9) — 20%

8. Sources and Referencing (GA8) — 10%

TOTAL: /100 marks (= 40% of unit grade)

If more detailed feedback is required, students should book an appointment with the relevant marker or the Lecturer in Charge.

Submission Checklist

• One case study selected and clearly identified in the essay introduction
• Pathophysiology section within 300–500 words
• Nursing role section within 1,100–1,300 words addressing all three sub-areas
• Total essay within 1,600 words (±10%), excluding the reference list
• Academic essay format: introduction, body, conclusion
• APA 7th Edition in-text citations and reference list
• Submitted via Turnitin in LEO – Assessment Task 1 tile (campus tile)
• Turnitin similarity report reviewed prior to final submission

Sample Answer Guidance – Assessment Task 1

Perforated appendicitis in a school-aged child like Anne involves a cascade of inflammatory events that begins when the appendiceal lumen becomes obstructed, most commonly by a faecolith or lymphoid hyperplasia following infection, resulting in rising intraluminal pressure, mucosal ischaemia, bacterial translocation and, ultimately, wall necrosis and perforation into the peritoneal cavity. The resulting peritonitis triggers a systemic inflammatory response that demands urgent surgical and pharmacological intervention, alongside vigilant nursing assessment of pain, fluid balance and infection markers across the post-operative period.

Applying Erikson’s psychosocial stage of Industry versus Inferiority to a 10-year-old helps the nurse recognise that Anne’s sense of competence and self-worth may be significantly disrupted by an unplanned, prolonged hospital admission, and that involving her meaningfully in care decisions — such as selecting preferred timing for observations or being kept informed of her treatment plan in age-appropriate language — can preserve her developing sense of autonomy and reduce hospitalisation-related distress.

Family-centred care, a model widely endorsed across Australian paediatric health policy and reinforced by the Australian Charter of Healthcare Rights, positions the family as a fundamental partner in the child’s care rather than a passive bystander, and for Anne’s parents this means the nursing team must proactively communicate care updates, negotiate flexible visiting arrangements that account for their restaurant commitments, and provide practical guidance on how to support Anne’s pain management and wound care at home post-discharge (Institute for Patient- and Family-Centered Care, 2024; Coyne et al., 2021).

Hospitalisation can produce well-documented psychological sequelae in children, including separation anxiety, regression to earlier developmental behaviours, sleep disruption, and post-hospitalisation syndrome, all of which are amplified when the admission is sudden and prolonged, as is the case for Anne, and the paediatric nurse plays a central role in mitigating these effects through consistent nurse-patient relationships, therapeutic play, clear and honest pre-procedural explanation, and ensuring parental presence is maximised throughout the stay.

For remote Indigenous adolescents like Sue, acute rheumatic fever reflects broader social determinants of health — including overcrowded housing, limited access to primary care, and the complex interplay of cultural, geographical and systemic barriers — and culturally safe nursing requires the nurse to engage in genuine partnership with Sue and her family, involve Aboriginal health workers in all stages of care, and ensure that discharge planning explicitly addresses the 800 km travel barrier and the family’s capacity to support ongoing secondary prophylaxis adherence.

Vaccine hesitancy, as experienced by Jay’s mother following the association between the rotavirus vaccine and intussusception, demands a nursing response grounded in evidence-based communication rather than dismissal; the nurse should acknowledge the mother’s concern with empathy, provide clear and accurate information about absolute versus relative risk, and refer to the current Australian Immunisation Handbook, since maintaining trust in the immunisation schedule has population-level consequences that extend well beyond the individual infant’s care episode.

 References

1. Coyne, I., Holmström, I., & Söderbäck, M. (2021). Family-centred care in paediatric nursing: A concept analysis. Journal of Pediatric Nursing, 57, e51–e57. https://doi.org/10.1016/j.pedn.2020.10.002
2. Brennan, F., & Caldwell, P. H. (2019). Reducing psychological distress in hospitalised children: A qualitative study. Journal of Child Health Care, 23(4), 558–571. https://doi.org/10.1177/1367493518817143
3. Roberts, K. V., Maguire, G. P., & Brown, A. (2020). Rheumatic heart disease in Indigenous populations: Strategies to improve secondary prophylaxis adherence. Heart, Lung and Circulation, 29(5), 639–646. https://doi.org/10.1016/j.hlc.2019.04.009
4. Australian Technical Advisory Group on Immunisation (ATAGI). (2023). Australian immunisation handbook. Australian Government Department of Health and Aged Care. https://immunisationhandbook.health.gov.au/
5. Erikson, E. H. (1963). Childhood and society (2nd ed.). Norton. [Seminal work — widely cited in paediatric nursing literature; no DOI; consult your library catalogue for contemporary applications: see Google Scholar]
6. Shields, L., Zhou, H., Pratt, J., Taylor, M., Hunter, J., & Pascoe, E. (2019). Family-centred care for hospitalised children aged 0–12 years. Cochrane Database of Systematic Reviews, 2019(10), CD004811. https://doi.org/10.1002/14651858.CD004811.pub3