2- Appendicitis

Question 0

Symptoms and manifestations

Answer 0

RLQ pain
Light Fever
Nausea & sometimes vomiting
Loss of appetite
  *Possibly rebound tenderness or Rovsing's Sign

Question 1

Risk factors for appendicitis

Answer 1

Age 10-30
Winter months
Family history esp with Males
Cystic fibrosis

Question 2

Locations of pain other than RLQ

Answer 2

Lumbar Region - the appendix curled behind the cecum.
Pain during defection- tip is against rectum
Pain on urination- tip is near the bladder or urethra

Question 3

Ruptured appendix

Answer 3

Abdominal distention
Pain becomes diffuse
Pt’s condition worsens.

Question 4

Elderly and appendicitis

Answer 4

Uncommon
Absent or minimal pain
Symptoms may indicate bowel obstruction
Poss. no fever

Incidence of ruptured appendix is higher because they may wait to seek healthcare or may be misdiagnosed.

Question 5

Medical and nursing management

Answer 5

Immediate surgery laparoscopy or laparotomy.
Antibiotics and IV fluids.
Nasogastric tube for paralytic ileus (obstruction
caused by lack of peristalsis)
AFTER surgery place patient in high fowlers to reduce tension on incision, analgesics, oral fluids, food once bowel sounds appear.

Question 6

Peritonitis

Answer 6

Inflammation of the abdominal cavity lining, usually from from bacterial infection in gastrointestinal tract.
Sx: abd tenderness, fever, vomiting, abd rigidity, tachycardia

Question 7

Peritonitis management

Answer 7

If the appendix has ruptured and there is a poss of peritonitis a drain may be left in place at the incision. Kept in the hospital and monitored for secondary abscesses- elevated temp, pulse rate, and WBC count

Question 8

Complications of appendicitis

Answer 8

Perforated/ruptured appendix leading to :

• peritonitis
• abscess formation (collection of Purulent material)
• portal Pylephlebitis caused by septic intestines

Perforation occurs 24 hrs after onset of pain, symptoms incl fever, toxic appearance, continued abdominal pain or tenderness