Pomes

Complications
Aanendiitis
INTRODUCTION

Normal
Appendix ofoccurs
appendicitisblocked
when
and
appendix
are
bacteria
rupture,
pendicitis.
7.10:
Fig. (Small,
APPENDICITIS
invade
abscess worm
Inflammation
Appendix of and
andinfect like,
tubular
peritonitis.
wall
appendage
of
appendix.
attached

Most
to
commoncecum

of
 100 Medical Surglcal Nursng

DEFINITION
It is an acute inflammation of vermiform appendix (a small, finger like appendage attached to
cecum just below the ileocaecal valve).
CAUSES
Most common in emergency abdominal
Infections
Obstruction of faecal matter. Lymphoid hyperplagia. surgery.
Inflammation and fibrosis of colon.

CLINICALMANIFESTATIONS
area.
Acute abdominal pain (6-12 hr.) in right lower quadrant
Anorexia YNausea/vomiting
Pain at most common Burney's point (located half way between the umbilicus and the
anterior spine of ilium).
Fever (101°F) VConstipation
> Rovsing's sign (palpating the left lower-quadrant which paradoxically causes páin in
right lower quadrant).
Abdominal distension Local tenderness with pressure.

PATHOPHYSIOLOGY
Due to infection or faecal stone and obstruction

Obstruction in appendix lumen

Increase intra-luminal pressure

Disturb blood supply

Edema or swelling in appendix

Rupture of appendix
DIAGNOSTICEVALUATIONS
> Blood
studies-WBC increases Urinalysis
Laparoscopy > By positive sign and
symptoms.
COMPLICATIONS
Perforation
y Peritonitis. Abscess

MANAGEMENT
>
>
Administer antibiotics and 1V luids until surgery is
Analgesics agents can be given after diagnosis is performed.
made.
 therapy.
GastrolntestinalDisorders and Its Management 101
Ie bag
>> Comfortableposition.

SurgicalManagement
Appendectomy (Removal of. Appendix).
>
IntraoperativeCare during Surgery
preparation to patient of appendicitis
includes
antiseptic solution,under
Physical
e.g., intraoperative care also.
Paintthe area of surgery with
> If
> small hair is present then clean or remove hairs.
preparation
Povidone-iodine.
> Gastric tract
Restrict fluid and food to patient
Maintain IV line as prescribed.
> Prepare for anaesthesia, check all cardiovascular, respiratory and neurological function.
> Provide comfortatble rest and sleep.
> Put ice bag on right lower quadrant.
> Remove the nail polish and hair pins, rings etc.
> Check and notify the hearing capacity of patient.
> Help during wearing hospitalclothes to patient.
> Togive preoperative medicines as prescribed by doctors.
> Covered the patient with blanket.
All records should be send with patient to
operation theatre.
Specific Care during Procedure
> Provide proper position to patient
according to site of operation (Right iliac fossa).
> Allaseptic technique should be used during
> Follow all instructions of
surgery.
surgeons.
> Transport patient to recovery room.
> Covers with blanket
> Shift patient on
carefully.
stretche.
Mursing Management (for Appendicitis)
a Preoperative care
a
(before surgery).
a
ntraoperative care (during procedure or surgery).
Post-operative
We also
care (after surgery).
discussed previously about preoperative and post-operative care during surgery.
(See ulcerative colitis
management)
Nursing Diagnosis
Pain related to
appendicitis and after surgery.
Knowledge deficit related to procedure
Anxiety related to fear of death during of surgery.
Risk for
infection related to operation.
Risk for deficient perforation rupture or appendix.
or
fluidvolume related to excessive vomiting and restricted intake.
Note: for Nursing Intervention of above Nursing Diagnosis refer page nos. 128-133.