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Disclaimer <ul><li>All information and pictures presented in this slideshow were meant for EDUCATIONAL purposes only.  1Nu...
<ul><li>Appendicitis </li></ul><ul><ul><li>Inflammation of the vermiform appendix that prevents mucus from passing into th...
PATHOPHYSIOLOGY Obstruction of the appendix lumen Mucosal inflammation and bacterial proliferation  Increased intra-lumina...
<ul><li>Assessment findings </li></ul><ul><ul><li>Acute abdominal pain that usually starts in the epigastric or umbilical ...
<ul><ul><li>Initially periumbilical pain then radiates to the RLQ </li></ul></ul><ul><ul><li>Nausea/ vomiting and ANOREXIA...
 
<ul><li>Nursing Interventions </li></ul><ul><ul><li>Administer antibiotics/ antipyretics as ordered </li></ul></ul><ul><ul...
<ul><li>Surgical procedure= APPENDECTOMY </li></ul><ul><ul><ul><ul><li>Spinal anesthesia is usually used </li></ul></ul></...
<ul><li>More Free Nursing Lectures, Nursing Care Plans, Nursing News </li></ul><ul><li>http://1nurses.com </li></ul>
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Appendicitis Lecture on 1 nurses

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Appendicitis Lecture on 1 nurses

  1. 1. Brought to you by http://1nurses.com
  2. 2. Disclaimer <ul><li>All information and pictures presented in this slideshow were meant for EDUCATIONAL purposes only. 1Nurses.com does not claim any liability from the use of this slide and does not guarantee any action that might result from the use of this material. 1Nurses.com does not claim any ownership for the images and articles presented in this report. All articles and Images are the Copyright property of the respective owners. </li></ul>
  3. 3. <ul><li>Appendicitis </li></ul><ul><ul><li>Inflammation of the vermiform appendix that prevents mucus from passing into the cecum; if untreated, ischemia, gangrene, rupture and peritonitis occur. </li></ul></ul><ul><ul><li>It occurs in about 70% of the population and affects males more often than females. Most common in school-age children. </li></ul></ul><ul><li>Causes: </li></ul><ul><ul><li>May be caused by mechanical obstruction (fecaliths, intestinal parasites. Kinking of appendix, tumor or inflammation) or anatomic defect; may be related to decreased fiber in the diet and high intake of refined carbohydrates </li></ul></ul>
  4. 4. PATHOPHYSIOLOGY Obstruction of the appendix lumen Mucosal inflammation and bacterial proliferation Increased intra-luminal Pressure Lymphoid swelling Decreased venous drainage Thrombosis Bacterial invasion Abscess Gangrene Perforation (24 to 36 hours) Peritonitis
  5. 5. <ul><li>Assessment findings </li></ul><ul><ul><li>Acute abdominal pain that usually starts in the epigastric or umbilical region </li></ul></ul><ul><ul><ul><li>Pain gradually becomes localized in RLQ/ Mc Burney’s Point (halfway between the umbilicus and the anterior spine of the ileum) </li></ul></ul></ul><ul><ul><ul><li>Pain is initially intermittent then become steady and severe over a short period. </li></ul></ul></ul><ul><ul><li>Appendicitis “signs” </li></ul></ul><ul><ul><ul><li>Rebound tenderness (Blumberg sign) </li></ul></ul></ul><ul><ul><ul><li>Psoas sign (lateral position with right hip is palpated) </li></ul></ul></ul><ul><ul><ul><li>Rovsing’s sign (right quadrant pain when the left is palpated) </li></ul></ul></ul><ul><ul><ul><li>Obturator sign (pain on external rotation of the right thigh) </li></ul></ul></ul>
  6. 6. <ul><ul><li>Initially periumbilical pain then radiates to the RLQ </li></ul></ul><ul><ul><li>Nausea/ vomiting and ANOREXIA </li></ul></ul><ul><ul><li>Guarding of abdomen, rebound tenderness, walks stooped over </li></ul></ul><ul><ul><li>Decreased bowel sounds </li></ul></ul><ul><ul><li>Fever, low grade (temperature= 38-38.5 ºC). If high grade fever, suspect ruptured appendicitis. </li></ul></ul><ul><ul><li>Diagnostic tests </li></ul></ul><ul><ul><ul><li>WBC increased Elevated WBC (above 10,000/cu.mm.) </li></ul></ul></ul><ul><ul><ul><li>Ultrasound and abdominal x-ray to detect the fecalith </li></ul></ul></ul>
  7. 8. <ul><li>Nursing Interventions </li></ul><ul><ul><li>Administer antibiotics/ antipyretics as ordered </li></ul></ul><ul><ul><li>prevent perforation of the appendix; don’t give enemas or cathartics or use heating pad </li></ul></ul><ul><ul><li>In addition to routine pre-op care for appendectomy </li></ul></ul><ul><ul><ul><li>Give support to parents if seeking treatment was delayed </li></ul></ul></ul><ul><ul><ul><li>Explain necessity of obtaining lab work prior to surgery </li></ul></ul></ul><ul><li>COLLABORATIVE MANAGEMENT </li></ul><ul><ul><ul><ul><li>Bed rest </li></ul></ul></ul></ul><ul><ul><ul><ul><li>NPO </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Relieve pain (cold application over the abdomen, NEVER heat!) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Avoid factors that increase peristalsis, thereby rupture: </li></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Heat application over the abdomen </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Laxative </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Enema </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><li>IVF therapy to maintain fluid-electrolyte balance </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Antibiotic therapy </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Surgery: Appendectomy </li></ul></ul></ul></ul>
  8. 9. <ul><li>Surgical procedure= APPENDECTOMY </li></ul><ul><ul><ul><ul><li>Spinal anesthesia is usually used </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Post-operatively, flat on bed for 6-8 hours </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Monitor for return of sensation in the lower extremities </li></ul></ul></ul></ul><ul><ul><ul><ul><li>NPO until peristalsis returns </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Ambulation after 24 hours </li></ul></ul></ul></ul><ul><ul><ul><ul><li>If appendicitis ruptured (peritonitis): with penrose drains; Position: semi-fowler’s position to localize inflammation within the pelvic area </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Resume all normal activities within 2 to 4 weeks </li></ul></ul></ul></ul><ul><ul><li>In addition to routine post-op care </li></ul></ul><ul><ul><ul><li>Monitor NG tube (usually with low suction) </li></ul></ul></ul><ul><ul><ul><li>Monitor penrose drains </li></ul></ul></ul><ul><ul><ul><li>Position in semi-fowler’s or lying on right side to facilitate drainage </li></ul></ul></ul><ul><ul><ul><li>Administer antibiotics as ordered </li></ul></ul></ul>
  9. 10. <ul><li>More Free Nursing Lectures, Nursing Care Plans, Nursing News </li></ul><ul><li>http://1nurses.com </li></ul>

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