Apendicitis

Question 1

Risk factors of appendicitis (3 things)

Answer 1

a. Obstruction by fecalith or foreign bodies, or bacteria or toxins
b. Low-fiber diet
c. High intake of refined carbohydrates

Question 2

S/s of appendicitis

Answer 2

1. Dull p! in per-umbilical area (LRQ)
2. anorexia, nausea, vomiting
3. p! @ mcburney’s point
4. low grade fever
5. rigidity
6. elevated WBC

Question 3

Diagnostic evaluation

Answer 3

Complete PE

i. Leukocyte count greater than 10,000/mm3
ii. Neutrophil count greater than 75%
iii. Abdominal radiographs, ultrasound & CT scan

Question 4

Medical management

Answer 4

Appendectomy (open & laparoscopic-females of childbearing age or obese)

Question 5

if appendix has ruptured:

Answer 5

i. Antibiotics and IV fluids 6-8 hours prior
ii. Appendectomy performed 24-48 hours after onset of symptoms
iii. General or spinal anesthesia
iv. Preoperative IV hydration, antipyretics, antibiotics, analgesics

Question 6

Complications

Answer 6

perforation of appendix

Question 7

Perforation of appendix

Answer 7

ii. Occurs 24 hours after onset of pain

iii. Fever (100 F or greater), toxic appearance, pain, tenderness

Question 8

Pharmacologic interventions

Answer 8

IV fluids, Antibiotics, Analgesics

Question 9

Preoperative care

Answer 9

a. NPO
b. IVF
c. Assess pain
d. Right side-lying position, or low to semi-fowler’s position
e. Assess bowel sounds
f. Ice packs to abdomen (no heat!)
g. Antibiotics
h. Avoid laxatives or enema

Question 10

1. Sharp abdominal pain, fever, N/V, increased HR & RR
2. Seek medical attention immediately

Complication:

Answer 10

Peritonitis