MEDICAL SURGICAL NURSING -I
B.Sc (N) II Year
LESSON PLAN
ON
APPENDICITIS
LESSON PLAN
Name of the Institution : GRT College of Nursing
Name of the subject : Medical surgical nursing - I
Unit : IV
Topic : Appendicitis
Duration : 30 mts
Venue : B.Sc (N) II Yr Classroom
Method of teaching : Lecture cum discussion
Av aids : Chalk board & PPT Presentation
Name of the presenter : Gracy. J M.Sc(N)
Assistant Professor,
GRT College of Nursing, Tiruttani.
General objectives:
The students will acquire knowledge about Definition , Incidence , Causes , Pathophysiology , Clinical manifestations ,Management and
Complications of appendicitis, which can be useful for their future reference .
Specific objectives:
At the end of the teaching the student will be able to,
explain mana define appendicitis
describe the incidence of appendicitis
enlist the causes of appendicitis
explain pathophysiology of appendicitis
enumerate clinical manifestations of appendicitis
management for appendicitis
enlist complications of appendicitis
Teaching and
Specific A.V Evaluatio
Time Contents Learning
Objective Aids n
Activity
2 define DEFINITION: Teacher Chalk What is
mins appendicitis defining board& meant by
An inflammation of the vermiform appendix, appendicitis is most typically seen appendicitis PPT appendiciti
in young adults and adolescents. An acute inflammation of the appendix is called
and students s?
appendicitis.
Appendicitis can occur at any age but is most common below 40 yrs , taking notes
especially between the ages of 8 & 14 yr &it is very rare below the age of 2.
1 describe the INCIDENCE: Teacher PPT Write the
min incidence of describing incidence
appendicitis The most prevalent acute surgical disorder affecting the abdomen is incidence of of
appendicitis. The frequency of appendicitis peaks between the ages of 10 and 30 years
appendicitis appendiciti
old, affecting about 7% of the population at some point in their lives.
and student s?
taking notes
2 CAUSES: Teacher PPT What are
Mins Infection enlisting all the
enlist the causes of causes of
causes Fecal matter buildup appendicitis appendiciti
and student s?
Malignancy asking doubts
about how it
Increased lymphoid follicles
will cause
Trauma appendicitis
Worms
Teacher Chalkb Write the
7 explaining oard& pathophysi
mins pathophysiolo PPT ology of
explain PATHOPHYSIOLOGY:
gy of appendiciti
pathophysiolog appendicitis s?
y and student
asking doubts
8 enumerate the CLINICAL MANIFESTATION: Teacher PPT What are
mins clinical enumerating all the
manifestations Bloated stomach and regurgitation clinical clinical
Appetite loss manifestations manifestati
Chills and fever and ons and
Constipation is the inability to pass stool. explaining the cardinal
Diarrhoea, or loose stool cardinal signs signs of
Problems with gas passage of appendiciti
Swollen belly appendicitis s?
Pain: severe colicky type initially felt in the umbilical region & it and student
is due to the distension of appendix. taking notes.
Vomiting
Anorexia
Fever (100 F)
Hematuria (un common)
Constipation
CARDINAL SIGNS: The 5 important cardinal signs of appendicitis are
PSOA’S SIGN
OBTURATOR’S SIGN
BLOOMBERG’S SIGN
MCBURNEY’S SIGN
ROVSING’S SIGN
PSOA’S SIGN:
Psoas sign is right lower-quadrant pain that is produced with the patient
extending the hip due to inflammation of the peritoneum. Straightening out the leg causes
the pain because it stretches the muscles.
OBTURATOR’S SIGN
the lateral side of the knee resulting in internal rotation o Pain on passive
internal rotation of the flexed thigh. Examiner moves lower leg f the f emur.laterally
while applying resistance to
BLOOMBERG’S SIGN
o It is also referred as rebound tenderness .
o Deep palpation of the viscera over the suspected inflamed appendix
followed by sudden release of the pressure causes the severe pain on the
site.
o This indicates positive Blumberg's sign & peritonitis.
MCBURNEY’S SIGN:
o Mc Burney’s Point is two third away from umbilicus to Anterior superior
iliac spine
o To elicit Mcburney’s sign patient should be in supine position with his
knees slightly flexed and his abdominal muscles relaxed.
o Palpate deeply and slowly in the right lower quadrant over McBurney’s
point, located about 2” from the Rt. Ant. Sup. Iliac Spine, On a line
between the spine and umbilicus.
o Pain and tenderness is a positive sign and indicates appendicitis.
ROVSIGN SIGN :
The Rovsing sign is positive when pressure over the patient’s left lower
quadrant causes pain in the right lower quadrant
DIAGNOSTIC EVALUATION :
8 explain MANAGEMENT: Teacher Chalkb What are
mins management for explaining the oard&P all the
appendicitis MEDICAL MANAGEMENT: management PT manageme
of nt of
Medical treatment aims to treat infections,
appendicitis appendiciti
Prevent problems from developing complication and student s?
taking notes.
Treat patients with medication therapy, which includes
anti-inflammatory and antibiotic medications. Examples of
medication therapy include cephalosporins. Metrogyl
Pain relievers
SURGICAL MANAGEMENT:
APPENDICECTOMY:
The surgical cut and removal of appendix.
LAPAROSCOPIC APPENDECTOMY:
Become more and more common these days.
Faster recovery
Less discomfort following surgery In the event that
laparoscopic appendectomy produces intraoperative
difficulties that are not manageable with laparoscopy,
conversion to an open appendectomy may be necessary.
NURSING MANAGEMENT:
• The nurse gets the patient ready for surgery by administering an
intravenous infusion to replace lost fluid and support adequate renal function, as
well as antibiotic therapy to prevent infection, and relieving pain, preventing fluid
volume deficit, lowering anxiety, and eliminating infection from the potential or
actual disruption of the GI tract.
o Administers the required analgesics strictly respecting the route and
frequency of administration as well as uses non-pharmacological measures
to reduce severe pain or discomfort .
o Monitors the patient closely for signs of perforation and peritonitis such as
if the abdomen appears to be very firm and tender to touch.
o Should alert the physician immediately if signs of perforation and
peritonitis are evident.
o Should closely monitor vital signs to determine sudden changes, such as
increased heart rate (tachycardia) or fever, as this could indicate infection
or acute inflammation.
o Should check and empty drain , and provide appropriate and adequate
care.
o Reports signs of infection.
NURSING DIAGNOSIS:
Pain (acute) related to obstructed appendix /inflammation due to
distension of intestinal tissues as evidenced by expressive behavior (e.g.,
restlessness, moaning, crying, vigilance, irritability, and sighing).
Risk for deficient fluid volume related to preoperative vomiting
evidenced by poor skin turgor.
Risk for infection related to a ruptured appendix, peritonitis, and abscess
formation evidenced by the disruption of the GI tract.
Risk for malnutrition related to anorexia and nausea evidenced by less-
than-body requirements.
2 enlist COMPLICATION: Teacher PPT What are
min complications of enlisting the all the
appendicitis Ruptured Appendix complications complicati
and student ons?
Abcess
taking notes.
Peritonitis
Life threatening conditions
EVALUATION : TIME:20 MINS (5*2 = 10 Mark)
1. Define appendicitis
2. Enumerate the cardinal signs of Appendicitis
3. List out the causes of Appendicitis
4. What is meant by Appendicectomy
5. Explain the Medical management for Appenticitis
SUMMARY :
So for we are discuss about Definition , Incidence , Causes , Clinical manifestations , Cardinal signs And Management of
Appendicitis .
CONCLUSION :
o From the above discussion everyone should learn about Definition , Incidence , Causes , Clinical manifestations ,Cardinal signs
And Management of Appendicitis
I hope that this discussion is very helpful for the audience and everyone should carry this information in your future.
BIBLIOGRAPHY :
