This document discusses appendicitis, including the anatomy of the appendix, causes of appendicitis, clinical manifestations, complications, and management. The appendix is a small sac attached to the cecum. Appendicitis is inflammation of the appendix, which is the most common reason for emergency abdominal surgery. It can occur at any age but is more common in ages 10-30. Acute appendicitis causes sudden severe symptoms within 48 hours, while chronic appendicitis goes undiagnosed for weeks to years. Symptoms include right lower quadrant pain, fever, nausea, and tenderness. Management involves appendectomy, antibiotics, and postoperative care including monitoring for complications like perforation.

1. Medical Surgical Nursing
Appendicitis
‫الصحة‬ ‫معهد‬
‫العالي‬
‫المادة‬ ‫مدرس‬
‫م‬
.
‫إختصاص‬ ‫جامعي‬
‫الوهاب‬ ‫عبد‬ ‫نزار‬ ‫صـالح‬
‫تمـريض‬ ‫علــوم‬ ‫ماجـستير‬
Salah Nazar Abdulwahhab M.Sc. Nursing
www.slideshare.net
1

2. Anatomy of Digestive System
2

3. Appendix
Appendix: is a small, fingerlike tubal sac, about 10 cm in long, attached
to the cecum just below the ileocecal junction
3

4. Appendicitis
Appendicitis: inflammation of the appendix
most common reason for emergency abdominal surgery, can occur at any age
(more commonly between age10 - 30 years)
The obstructed appendix becomes inflamed, edematous and fill with pus
Types of Appendicitis
- Acute appendicitis: severe symptoms appear suddenly within 24 to 48 hours
- Chronic appendicitis: undiagnosed for several weeks, months, or years
4

5. Clinical Manifestations of Appendicitis
- Acute pain: Right Lower quadrant.
- Low grade fever.
- Muscle spasm.
- Nausea and Vomiting.
- Loss of appetite.
- Constipation or diarrhea.
- At McBurney’s point positive: local tenderness with pressure and some rigidity of the
lower portion of the right rectus muscle.( 2/3distance from navel and Anterior Superior
Iliac Spine [ASIS])
- Rebound tenderness positive: location of appendix dictates amount of tenderness.
- Rovsing’s sign positive: palpating left lower quadrant ,causes pain in right lower
quadrant.
If appendix ruptures, pain becomes more diffuse; abdominal distention develops from
paralytic ileus, and condition worsens.
5

6. 6

7. Complications of Appendicitis
- Perforation of the appendix, which can lead to
(peritonitis, abscess formation, septic thrombosis arise from septic intestines)
- Perforation generally occurs 24 hours after the onset of pain.
Manifestations
- Fever (37.7C) or greater
- Continued abdominal pain or tenderness
- Toxic appearance (High grade fever, Lethargy, Poor perfusion, Cyanosis
Hypoventilation or Hyperventilation and Tachycardia
- Septicemia: blood poisoning by bacteria
7

8. Management
Medical Management
- Appendectomy: is the surgical removal of the appendix
(conventional or laparoscopic).
- Administer antibiotics and IV fluids until surgery is performed.
- Analgesic can be given after diagnosis is made (not given before a
suspected case of appendicitis to determine whether the patient has a
ruptured appendix or not).
8

9. 9

10. Preoperative Nursing Care
1- Stop drinking and eating 8 – 12 hours before the time of surgery
2- Bathe or clean, and possibly shave the area to be operated on
3- Preparing various blood tests, X-rays, electrocardiograms, or other procedures necessary for
surgery.
4- Removing all makeup at the day of surgery
5- Removing nail polish
6- Do not wear eye contacts
7- Take off jewelry, rings, and bracelets
8- Take off dentures
9- Loose-fitting clothes
10- Preparing Social Security, card number, Insurance information in patient medical file
11- IV infusion, to replace fluid loss and promote renal function
12- Antibiotic therapy (as described), to prevent infection.
13- nasogastric tube is inserted, if there is evidence of paralytic ileus.
14- Psychological Support
(An enema is not administered because it can lead to perforation)
10

11. Management
Postoperative Nursing Care
1- Places the patient in a high-Fowler’s position.
(to reduces the tension on the incision and abdominal organs)
2- Analgesic to reduce pain (as prescribed)
3- IV fluids if patient dehydrated before surgery
4- Oral fluids are administered, when patient tolerated
5- Monitor and Change dressing as prescribed
6- Food is provided as desired and tolerated when normal bowel sounds are present
7- The patient may be discharged on the day of surgery if there is no complication
11

12. Management
Discharge Nursing Plan
1- Make an appointment with the surgeon to remove the sutures between
the 5th and 7th days after surgery
2- Care for the incision and perform dressing changes as prescribed
3- Avoided heavy lifting postoperatively
4- Return to normal activity within 2 to 4 weeks
5- If drain is place at the area of the incision patient may be kept in the
hospital for several days and monitored carefully for signs of intestinal
obstruction or secondary hemorrhage
6- A home care nurse may be needed if necessary (assist and to monitor)
12

13. Thank You
13