Learning about Appendicitis
I am sure many of you can say you have heard of someone close to you or someone you know that have had appendicitis and had to have their appendix removed. When I rotated in the ER in nursing school, one of my cases was a very young teenage girl that came in with horrible RLQ pain, had a fever, and was nauseated. She had severe pain at McBurney’s point which eventually led to her having to get her appendix removed. I never got to see her after surgery, but heard she recovered very well and was soon discharged from the hospital.
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Appendicitis, a condition marked by inflammation of the appendix, is a swift and concerning health issue that demands prompt attention. The appendix, a small pouch located in the lower right abdomen, can become blocked or infected, leading to intense abdominal pain, loss of appetite, and nausea.
If left untreated, a ruptured appendix can result in a life-threatening infection. Timely diagnosis through physical examination, imaging, and laboratory tests is crucial. Surgical removal of the inflamed appendix, known as an appendectomy, is the standard treatment. Seeking medical care at the onset of symptoms is essential in preventing complications and ensuring a swift recovery
Overview for Appendicitis
An acute inflammation of the appendix, a small finger-like organ located in the lower right abdomen. It is a common medical emergency that requires immediate attention and often requires surgical intervention.
General information for Appendicitis
1. Unknown exact cause2. Major risk is rupture → pus and possibly fecal matter spill into the peritoneum causing peritonitis, and sepsis
Assessment for Appendicitis
1. Abdominal pain at McBurney’s point
2. Pain descends to RLQ
3. rebound tenderness
4. ↑ WBC, fever
5. Fever
6. Abdominal guarding
7. SUDDEN RELIEF OF PAIN SIGNIFIES A RUPTURE→ Medical emergency and requires surgical intervention immediately
Therapeutic Management for Appendicitis
1. Avoid heat application which can lead to rupture
2. Avoid stimulation of peristalsis so keep NPO
3. May require Appendectomy--? Keep NPO
a. NG tube for decompression
b. Post-Op Care → Monitor VS, assess for abdominal distention, and clear Liquids, advance diet as tolerated
Nursing Case Study for Appendicitis
Patient Profile:
Name: Sarah Adams
Age: 18 years old
Gender: Female
Medical History: None reported
- Severe abdominal pain localized in the lower right quadrant
- Loss of appetite
- Nausea and vomiting
- Low-grade fever
Medical Examination and Diagnostics:
- Physical Examination: Sarah displayed rebound tenderness and guarding in the lower right abdomen.
- Laboratory Tests: Elevated white blood cell count and C-reactive protein, indicating inflammation
- Abdominal Ultrasound: Confirmed the presence of an inflamed and enlarged appendix.
Sarah had no significant medical history, and her symptoms led to a suspicion of appendicitis
Diagnosis:
Sarah was diagnosed with acute appendicitis, an acute inflammation of the appendix.
Treatment Plan:
1. NPO Status:
Sarah was kept NPO (nothing by mouth) to avoid worsening of inflammation and potential surgical complications
2. Pain Management:
Administered analgesics to manage severe abdominal pain and improve patient comfort
3. Antibiotic Therapy:
Started intravenous antibiotics to reduce infection and inflammation
4. Surgical Consultation:
Consulted the surgical team for an appendectomy to remove the inflamed appendix
5. Preoperative Preparation:
Prepared Sarah for surgery, explaining the procedure and addressing her concerns.
Outcome:
Sarah underwent an appendectomy promptly after diagnosis, and her inflamed appendix was successfully removed. Post-surgery, she experienced a gradual improvement in her symptoms, and her pain subsided. Her vital signs stabilized, and she began tolerating a regular diet.
Conclusion and Free Download
This Appendicitis review provides essential knowledge for approaching the NCLEX with confidence. Understanding its prevention, management, and interventions empowers nurses to provide effective care and save lives.
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