for nursing students

2.  it is also called epityphilitis
 It is infection or inflammation of the
appendix (the tiniest part of the bowel, a
worm like out pouching of the bowel at the
junction of the small and large intestine)

3. 
Obstruction
Swelling
Increased
intralumi
nal
pressure
Compression
of
vasculature
Bacterial
invasion

4. Due to etiological factors
Obstruction of the appendix lumen by faecolith
Decreased flow/ drainage of mucosal secretions
Increased intra luminal pressure in appendix
Vasocongestion causes decreased blood supply in the appendix
Necrosis and perforation of the appendix and bacteria invade
in appendix
Decreased supply of oxygen and nutrition in the appendiz
Disruption of cell membrane of the appendix
Inflammation of appendix

5.  Pain around belly button (Peri- umbilical
region)
 Upper central abdomen (epigastrium )
 McBurney’s point- pain tends to move into
right lower abdomen and focuses directly
above the appendix.
 Pain around belly button (Peri- umbilical
region)
 Upper central abdomen (epigastrium )
 McBurney’s point- pain tends to move into
right lower abdomen and focuses directly
above the appendix.

7.  Feel pain in passing urine
 Constipation and diarrhea
 Loss of appetite
 Nausea and vomiting
 Low grade fever

8.  Guarding- when a person subconsciously
tense the abdominal muscles during an
examination
 Rovsing’s sign – by applying hand pressure to
the lower leftside of the abdomen. Pain felt
on the lower right side of the abdomen upon
the release of pressure on the left side

9.  Rebound tenderness- by applying hand pressure to
a patient abdomen. Pain felt upon the release of
pressure indicates
 Aaron’s sign – it is pain felt in the epigastrium upon
continuous firm pressure over McBurney’s point-
chronic appendicitis

10.  Psoas sign- the right psoas muscle also runs over
the pelvis and near the appendix.
 By applying resistance to the right knee as
patient tries to lift the right thigh while lying
down.
 If flexing the muscle will cause abdominal pain

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12.  Obturator sign- right obturator muscle runs near
the appendix.
 Asking the patient to lie down with the right leg
bent at the knee.
 Moving the bent knee left and right requires
flexing the obturator muscle and will cause
abdominal pain

13.  Blumberg’s sign- here the abdominal wall is
compressed slowly and the rapidly released,
presence of pain makes the sign positive- it
indicates peritonitis

14.  History collection- medical conditions,
previous illness and surgeries and use of
medications, alcohol and smoking.
 Physical examination- palpation
 Laboratory tests-CBC, urinalysis
 Imaging test- abdominal USG scn, X ray, CT
scan

15.  Non Surgery Management:
 Antibiotics- metronidazole 500mg, cefuroxime or
augumentin 1.2 grams 8 hrly given through the
veins.
 Surgery management:
 Appendectomy
 Open surgery called laprotomy
 Laparoscopic surgery

16. Open surgery called laprotomy

17. Laparoscopic surgery

18.  PALPATION- slight muscular rigidity and diffuse
tenderness around the umbilicus and
midepigastrium.
 McBurney’s point
 All signs should be assessed.
Nursing diagnosis:
 Acute pain r/t distension of intestinal tissues
 Risk for deficient fluid volume
 Risk for infection
 Knowledge deficit
 Imbalance nutrition
 Impaired skin integrity
 Imbalance nutrition less than body requirements
 Risk for injury

19.  Informed consent
 Administer iv fluids
 NPO
 Antibiotics
 Painkillers
 Abdomen and genitalia are may be shaved

20.  Monitor vital signs
 Monitor I/O chart
 Encourage patient to cough, breath and
turning to prevent pulmonary complications
 Document bowel sounds, passing of flatus
and bowel movements
 Bed rest- semi fowlers position(relieving the
abdominal tension)
 Inspect incision and dressings
 Encourage early ambulation next day
 If need NG tube insertion for feeding and
prevent the internal bleeding

21.  100ml of cucumber juice, 100 ml beet juice
and 300 ml carrot juice- take two times a
day
 Buttermilk, ginger
 1 lt of cold water add 1 tsp fenugreek seeds
and let it boil
 Coriander juice, radish juice
 Ginger and turmeric powder