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AMS Appendicitis RN

Appendicitis is the acute inflammation of the vermiform appendix, typically caused by blockage leading to infection, with the average client age being 10 years. It commonly presents with right lower quadrant abdominal pain, fever, and other symptoms, and is most prevalent in individuals aged 10 to 30, especially adolescent males. Treatment includes IV fluids, antibiotics, and surgical management through appendectomy, with specific preoperative and postoperative care instructions to prevent complications such as peritonitis.

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Somie Jr. Sanchez
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29 views13 pages

AMS Appendicitis RN

Appendicitis is the acute inflammation of the vermiform appendix, typically caused by blockage leading to infection, with the average client age being 10 years. It commonly presents with right lower quadrant abdominal pain, fever, and other symptoms, and is most prevalent in individuals aged 10 to 30, especially adolescent males. Treatment includes IV fluids, antibiotics, and surgical management through appendectomy, with specific preoperative and postoperative care instructions to prevent complications such as peritonitis.

Uploaded by

Somie Jr. Sanchez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Appendicitis

Learning Activity
1
© 2019 Assessment Technologies Institute®, LLC
Pathophysiology

• Appendicitis is acute inflammation of the vermiform appendix (a small


projection of the cecum).
• Inflammation occurs when the appendix becomes blocked with hard
material (usually feces) that leads to a bacterial infection.
• The lumen of the appendix becomes blocked and edematous, leading to
the characteristic abdominal pain.
• Average client age is 10 years.

2
3
Prevalence

• Most often between ages of 10 to 30 years


• Peak incidence among adolescent males
• Rare in older adult clients

4
Manifestations

• Abdominal pain in the right lower quadrant


• Rigid abdomen
• Decreased or absent bowel sounds
• Fever
• Diarrhea or constipation
• Lethargy
• Tachycardia
• Rapid, shallow breathing
• Anorexia
• Possible vomiting

5
Laboratory and Diagnostic Tests

• CBC: White blood cell (WBC) count Mild to moderate elevation


• Urinalysis
• Ultrasound of the abdomen may show an enlarged appendix.
• Computed tomography (CT) scan shows an enlarged diameter of
appendix, as well as thickening of the appendiceal wall

6
Treatment

• IV fluids and antibiotics as prescribed


• Surgical management – appendectomy
• Laparoscopic (using several small incisions and an endoscope)
• Open approach (requires a larger abdominal incision).

7
Preoperative

• Maintain nothing by mouth (NPO) status in anticipation of surgery and to


prevent GI stimulation
• Administer IV fluids and antibiotics as prescribed.
• Encourage semi-Fowler’s position to contain abdominal drainage in
lower abdomen.
• Avoid laxatives/enemas or application of heat to the abdomen (can
predispose client to perforation).

8
Postoperative

• Administer analgesia as prescribed.


• Administer IV antibiotics as prescribed (surgical
prophylaxis, perforation).
• Offer food as tolerated with return of bowel
sounds.
• If peritonitis occurred, monitor nasogastric (NG)
tube drainage.
• If perforation or abscess occur, monitor surgical
drains.

9
Discharge Instructions

• If no complications, client discharge 12 to 24 hr after surgery


• Discharge instructions similar to other types of abdominal surgery
• Care of surgical incision
• Recognition of indications of wound infection
• Use of postoperative medications (purpose, guidelines, adverse effects)
• Activity restrictions (lifting, driving, returning to work)

10
Complications

• Peritonitis (inflammation in the peritoneal cavity)


– Nursing Actions
• Assess for peritonitis.
• Provide pain management.
• Assess for pain using a developmentally appropriate tool.
• Administer analgesics as prescribed.
• Manage IV fluid therapy.
• Administer IV antibiotics for infection.
• Manage NG tube suction.
• Provide preoperative and postoperative nursing care.
• Provide surgical wound care with wound irrigation and/or
dressings if delayed wound closure is necessary.
• Provide psychosocial support for the child and family.

11
Learning Activity Review Questions

1. What assessment findings are noted with appendicitis?


2. What are nursing care measures for the client with appendicitis (pre- and
postoperative)?
3. What are potential complications of appendicitis?

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