1) Appendicitis is an inflammation of the appendix, which is a small pouch attached to the colon. It often causes pain in the lower right abdomen that starts around the belly button and shifts to the right side.
2) There is no clear cause, but obstruction of the appendix is thought to cause a buildup of bacteria leading to swelling and infection. It most commonly occurs in young adults.
3) Diagnosis involves physical exam noting tenderness at McBurney's point on the lower right side, along with blood tests and imaging tests like CT scans. Treatment involves antibiotics and surgical removal of the appendix.
Image result for ulcerative colitis
Ulcerative colitis (UL-sur-uh-tiv koe-LIE-tis) is an inflammatory bowel disease (IBD) that causes inflammation and ulcers (sores) in your digestive tract. Ulcerative colitis affects the innermost lining of your large intestine (colon) and rectum. Symptoms usually develop over time, rather than suddenly.
Appendicitis is characterized by inflammation of the appendix. it is most common abdominal emergency encountered in children. most common symptom is pain., vomiting and low - grade fever. Here, nurses play an important role in managing the problem before the doctor arrives. so read this out and it will help you in the future.
Intestinal obstruction is a significant or mechanical blockage of intestine that occurs when food or stool can not move through the intestine.
These obstruction may be complete or partial.
Ulcerative colitis (UC) is an inflammatory bowel disease. It causes irritation, inflammation, and ulcers in the lining of your large intestine (also called your colon). There's no cure, and people usually have symptoms off and on for life
Image result for ulcerative colitis
Ulcerative colitis (UL-sur-uh-tiv koe-LIE-tis) is an inflammatory bowel disease (IBD) that causes inflammation and ulcers (sores) in your digestive tract. Ulcerative colitis affects the innermost lining of your large intestine (colon) and rectum. Symptoms usually develop over time, rather than suddenly.
Appendicitis is characterized by inflammation of the appendix. it is most common abdominal emergency encountered in children. most common symptom is pain., vomiting and low - grade fever. Here, nurses play an important role in managing the problem before the doctor arrives. so read this out and it will help you in the future.
Intestinal obstruction is a significant or mechanical blockage of intestine that occurs when food or stool can not move through the intestine.
These obstruction may be complete or partial.
Ulcerative colitis (UC) is an inflammatory bowel disease. It causes irritation, inflammation, and ulcers in the lining of your large intestine (also called your colon). There's no cure, and people usually have symptoms off and on for life
An intestinal obstruction occurs when your small or large intestine is blocked. The blockage can be partial or total, and it prevents passage of fluids and digested food. If intestinal obstruction happens, food, fluids, gastric acids, and gas build up behind the site of the blockage.
Intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. Either the small bowel or large bowel may be affected. Signs and symptoms include abdominal pain, vomiting, bloating and not passing gas.
Image result for appendicitis
Appendicitis is an inflammation of the appendix, a finger-shaped pouch that projects from your colon on the lower right side of your abdomen. Appendicitis causes pain in your lower right abdomen.
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism.
An intestinal obstruction occurs when your small or large intestine is blocked. The blockage can be partial or total, and it prevents passage of fluids and digested food. If intestinal obstruction happens, food, fluids, gastric acids, and gas build up behind the site of the blockage.
Intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. Either the small bowel or large bowel may be affected. Signs and symptoms include abdominal pain, vomiting, bloating and not passing gas.
Image result for appendicitis
Appendicitis is an inflammation of the appendix, a finger-shaped pouch that projects from your colon on the lower right side of your abdomen. Appendicitis causes pain in your lower right abdomen.
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
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2.
Appendicitis is an inflammation of the appendix, a
finger-shaped pouch that projects from colon on the
lower right side of abdomen. Appendicitis causes
pain in lower right abdomen. However, in most
people, pain begins around the navel and then
moves.
DEFINITION
3.
INCIDENCE
It can occur at any age but is rare in clients younger than
2 years and reaches a peak incidence in clients between
20 and 30 years.
It is not common in older adults; however when it does
occur in such clients, rupture of the appendix is more
common.
Appendicitis affects 7% to 12% of the population.
4.
5.
6.
There is no clear cause of appendicitis.
Obstruction of the appendiceal lumen causes appendicitis.
Mucus backs up in appendiceal lumen, causing bacteria
that normally live inside the appendix to multiply.
As a result, the appendix swells and becomes infected.
CAUSES AND RISK
FACTORS
7.
Sources of obstruction include food waste, hard piece of
stool, parasites, or growths that clog the appendiceal
lumen, enlarged lymph tissue in the wall of the appendix,
caused by infection in the gastrointestinal tract or
elsewhere in the body, inflammatory bowel disease and
trauma to the abdomen.
8.
PATHOPHYSIOLOGY
Due to etiological factors
Obstruction of the appendix lumen by faecioth
Decreased flow or drainage of mucosal secretion
Increased intra luminal pressure in the appendix
10.
Necrosis and perforation of appendix; bacteria invade in
appendix
Disruption of cell membrane and at last inflammation of
appendix
11.
The classic manifestation of appendicitis begins with acute
abdominal pain that comes in waves.
At first, the pain may be perceived merely as discomfort
that makes the client feel that passing flatus or having a
bowel movement will bring relief. Taking laxative during
this period may lead to rupture of the appendix and
peritonitis.
CLINICAL
MANIFESTATION
12.
The pain typically start in the epigastrium or
periumbilical region. It then shifts to the right lower
quadrant as the inflammatory process spreads to
involve the serosal layers of the bowel.
The pain becomes steady rather than intermittent, and
the client guards or protects the area by lying still and
drawing the legs up to relieve tension on the
abdominal muscles.
13.
Local tenderness is elicited at McBurney’s point when
pressure is applied.
Vomiting that begins after the pain starts.
Loss of appetite
Low-grade fever
Coated tongue
Bad breath
15.
Blumberg's sign, also referred to
as rebound tenderness, is a clinical
sign that is elicited during physical
examination of a patient's abdomen
by a doctor or other health care
provider. It is indicative of
peritonitis. It refers to pain upon
removal of pressure rather than
application of pressure to the
abdomen.
18. The obturator sign or Cope's obturator test is an indicator of
irritation to the obturator internus muscle. The technique for
detecting the obturator sign, called the obturator test, is carried
out on each leg in succession. The patient lies on her/his back with
the hip and knee both flexed at ninety degrees.
19.
Aaron's sign is a referred pain felt in the epigastrium
upon continuous firm pressure over McBurney's point. It
is indicative of appendicitis. Aaron's sign is named for
Charles Dettie Aaron, an American gastroenterologist.
20.
Diagnosis is based on results of a complete physical
examination and on laboratory and x-ray findings.
ASSESSMENT &
DIAGNOSTIC FINDINGS
21.
The complete blood cell count demonstrates an
elevated white blood cell count.
22.
Abdominal x-ray films, ultrasound studies, and CT scans may reveal
a right lower quadrant density or localized distention of the bowel.
23.
To correct or prevent fluid and electrolyte imbalance and
dehydration, antibiotics like Inj. Augmentin or Inj.
ampiclox and intravenous fluids are administered until
surgery is performed.
Analgesics like Inj. voveron can be administered after the
diagnosis is made.
MEDICAL MANAGEMENT
24.
Surgical intervention involves removal of the appendix
(appendectomy) within 24 to 48 hours of onset of the
manifestations. The surgery can be performed through a small
open incision or a laparoscope (a lighted scope used to visualize
and remove the appendix). When the operation is performed in
time, the mortality rate is less than 0.5%. delay usually causes
rupture of the organ and resultant peritonitis.
SURGICAL
MANAGEMENT
25.
1) Peritonitis:
Observe for abdominal tenderness,
fever, vomiting, abdominal rigidity,
and tachycardia.
Employ constant nasogastric suction
Correct dehydration as prescribed
Administer antibiotic agents as
prescribed.
POTENTIAL
COMPLICATION
26. 2) Pelvic abscess:
Evaluate for anorexia, chills, fever and
diaphoresis.
Observe for diarrhea, which may
indicate pelvic abscess
Prepare patient for rectal examination.
Prepare patient for surgical drainage
procedures.
27.
3) Subphrenic abscess (abscess under diaphragm):
Assess patient for chills, fever.
Prepare for x-ray examination.
Prepare for surgical drainage of abscess.
28.
4) Ileus (paralytic and mechanical)
Assess for bowel sounds.
Employ nasogastric intubation and suction.
Replace fluids and electrolytes by intravenous route as
prescribed.
Prepare for surgery, if diagnosis of mechanical ileus is
established.
29.
Goals include relieving pain, preventing fluid volume deficit,
reducing anxiety, eliminating infection from the potential or actual
disruption of the GI tract, maintaining skin integrity, and attaining
optimal nutrition.
NURSING MANAGEMENT
30.
Acute pain
Imbalanced nutrition less than body requirements
Impaired skin integrity
Ineffective tissue perfusion
Risk for deficient fluid volume
Risk for infection
Risk for injury
Nursing diagnosis