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    Unit Ix: Nursing Management of Patients With Gi Disorders: Topic: Appendicitis

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    ayushi raina
    The document discusses appendicitis including its pathophysiology, clinical manifestations, diagnostic findings, complications, and nursing management for pre-operative, operative, and post-operative care with the goals of relieving pain, preventing fluid volume deficit, reducing anxiety, eliminating infection, maintaining skin integrity, and attaining optimal nutrition. Appendicitis is caused by a blockage in the appendix from a fecalith, tumor, or foreign body which leads to inflammation and increased intraluminal pressure.

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    Unit Ix: Nursing Management of Patients With Gi Disorders: Topic: Appendicitis

    Uploaded by

    ayushi raina
    25 views16 pages
    The document discusses appendicitis including its pathophysiology, clinical manifestations, diagnostic findings, complications, and nursing management for pre-operative, operative, and post-operative care with the goals of relieving pain, preventing fluid volume deficit, reducing anxiety, eliminating infection, maintaining skin integrity, and attaining optimal nutrition. Appendicitis is caused by a blockage in the appendix from a fecalith, tumor, or foreign body which leads to inflammation and increased intraluminal pressure.

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    Appendicitis

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    The document discusses appendicitis including its pathophysiology, clinical manifestations, diagnostic findings, complications, and nursing management for pre-operative, operative, and post-operative care with the goals of relieving pain, preventing fluid volume deficit, reducing anxiety, eliminating infection, maintaining skin integrity, and attaining optimal nutrition. Appendicitis is caused by a blockage in the appendix from a fecalith, tumor, or foreign body which leads to inflammation and increased intraluminal pressure.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    25 views16 pages

    Unit Ix: Nursing Management of Patients With Gi Disorders: Topic: Appendicitis

    Uploaded by

    ayushi raina
    The document discusses appendicitis including its pathophysiology, clinical manifestations, diagnostic findings, complications, and nursing management for pre-operative, operative, and post-operative care with the goals of relieving pain, preventing fluid volume deficit, reducing anxiety, eliminating infection, maintaining skin integrity, and attaining optimal nutrition. Appendicitis is caused by a blockage in the appendix from a fecalith, tumor, or foreign body which leads to inflammation and increased intraluminal pressure.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 16

    UNIT IX: NURSING MANAGEMENT OF PATIENTS WITH GI

    DISORDERS

    TOPIC : APPENDICITIS

    PRESENTED BY :
    AYUSHI RAINA
    CLINICAL INSTRUCTOR
    INTRODUCTION
    • The appendix is a small, fingerlike appendage about 10 cm (4 in) long that is attached to the
    cecum just below the ileocecal valve. The appendix fills with food and empties regularly into the
    cecum. Because it empties inefficiently and its lumen is small, the appendix is prone to
    obstruction and is particularly vulnerable to infection (ie, appendicitis)
    • It can occur at any age, it more commonly occurs between the ages of 10 and 30 years
    PATHOPHYSIOLOGY

    Fecalith (ie, hardened mass of stool), tumor, or foreign body

    Kinked or occluded appendix

    Appendix becomes inflamed and edematous

    Inflammatory process increases intraluminal pressure

    A progressively severe, generalized, or periumbilical pain that


    becomes localized to the right lower quadrant of the abdomen
    within a few hours
    CLINICAL MANIFESTATION
    • Vague epigastric or periumbilical pain (ie, visceral pain that is dull and
    poorly localized) progresses to right lower quadrant pain
    • a low-grade fever
    • nausea & vomiting
    • Loss of appetite
    • local tenderness is elicited at McBurney’s
    point when pressure is applied
    • Constipation
    • Rebound tenderness (ie, production or intensification of pain when
    pressure is released)

    • Rovsing’s sign
    ASSESSMENT & DIAGNOSTIC
    FINDINGS
    • History collection
    • Physical examination
    • complete blood cell count
    • Abdominal x-ray films
    • ultrasound studies
    • CT scans
    • laparoscopy
    COMPLICATIONS
    Perforation of the appendix, which can lead to:
    • Peritonitis
    • Abscess formation (collection of purulent material)
    • Portal pylephlebitis which is septic thrombosis of the portal vein
    caused by vegetative emboli that arise from septic intestines.
    Perforation generally occurs 24 hours after the onset of pain.
    Symptoms include a fever of 37.7C (100F) or greater, a toxic
    appearance, and continued abdominal pain or tenderness.
    MEDICAL/SURGICAL
    MANAGEMENT:
    • Appendectomy (ie, surgical removal of the appendix) - laparotomy) or
    by laparoscopy
    • To correct or prevent fluid and electrolyte imbalance, dehydration,
    and sepsis, antibiotics and IV fluids are administered until surgery is
    performed
    NURSING MANAGEMENT:
    GOALS:
    • Relieving pain
    • Preventing fluid volume deficit
    • Reducing anxiety
    • Eliminating infection due to the potential or actual disruption of the
    GI tract
    • Maintaining skin integrity
    • Attaining optimal nutrition.
    PREPARING THE CLIENT FOR SURGERY (PRE-OPERATIVE CARE):
    • IV infusion to replace fluid loss and promote adequate renal function
    • Antibiotic therapy to prevent infection
    • If there is evidence or likelihood of paralytic ileus, a nasogastric tube
    is inserted
    • An enema is not administered because it can lead to perforation.
    POST-OPERATIVE CARE:
    • Places the patient in a high fowler’s position- it reduces the tension
    on the incision and abdominal organs, helping to reduce pain
    • Incision and abdominal organs, helping to reduce pain
    • Oral fluids are administered
    • Food is provided as desired and tolerated on the day of surgery when
    normal bowel sounds are present
    Potential complications and nursing interventions after appendectomy:
    COMPLICATION NURSING INTERVENTIONS
    Peritonitis • Monitor for abdominal tenderness, fever, vomiting,
    abdominal rigidity, and tachycardia.
    • Employ constant nasogastric suction.
    • Correct dehydration as prescribed.
    • Administer antibiotic agents as prescribed.
    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 procedure
    Subphrenic abscess (abscess under the diaphragm) • Assess patient for chills, fever, and diaphoresis.
    • Prepare for x-ray examination.
    • Prepare for surgical drainage of abscess.

    leus (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.

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