Appendicitis
-Inflammation of the appendix, a narrow blind tube that extends from the inferior part of the
cecum.
-**Most common reason for emergency abdominal surgery
-When the appendix becomes inflamed or infected, rupture may occur within a matter of hours,
leading to peritonitis and sepsis.
Etiology & Patho
-Most common in individuals 10-30 years of age
-Common cause of appendicitis is
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Appendicitis
-Inflammation of the appendix, a narrow blind tube that extends from the inferior part of the
cecum.
-**Most common reason for emergency abdominal surgery
-When the appendix becomes inflamed or infected, rupture may occur within a matter of hours,
leading to peritonitis and sepsis.
Etiology & Patho
-Most common in individuals 10-30 years of age
-Common cause of appendicitis is obstruction of the lumen by a fecalith (accumulated
feces).
-Obstruction results in distention; venous engorgement; & the accumulation of mucous
& bacteria, which can lead to gangrene, perforation, & peritonitis.
-Low fiber diet & high intake of refined carbs are risk factors
Clinical Manifestations
-Typically begins with dull periumbilical pain, followed by anorexia, nausea & vomiting
-Pain is persistent & continuous, eventually shifting to the RLQ & localizing at
McBurney’s point (halfway between the umbilicus & right iliac crest)
-Low grade fever may develop
-Further assessment reveals localized tenderness, rigidity, rebound tenderness,
& muscle guarding
-Coughing, sneezing, & deep inhalation worsen pain
-Elevated WBC count
-Pt in side lying position with abdominal guarding & legs flexed
-Constipation or diarrhea
-Older adults may report less severe pain, slight fever, & discomfort in the right iliac
fossa
Diagnostic Studies & Interprofessional Care
-Pt examination includes complete history, physical exam, & a differential WBC count
-Most pt’s have a mildly to moderately elevated WBC count
-Urinalysis is done to rule out genitourinary conditions that mimic appendicitis
-CT scan is the preferred diagnostic procedure
-Ultrasound & MRI are also used
-Leukocyte count greater than 10,000/mm 3, neutrophil count greater than 75%;
abdominal radiographs, ultrasound studies, and CT scans may reveal right lower quadrant
density or localized distention of the bowel.
-If there is a delay in the diagnosis & treatment, the appendix can rupture & the resulting
peritonitis can be fatal
-Treatment of appendicitis is an immediate appendectomy (removal of appendix)
-If inflammation is localized, surgery should be done as soon as diagnosis is made
-Antibiotics & fluid resuscitation are started before surgery
-If appendix has ruptured & there is evidence of peritonitis or an abscess, giving
parenteral fluids & antibiotic therapy for 6-8 hours before the appendectomy helps
prevent dehydration & sepsis
Nursing Management: Appendicitis
-Management focuses on preventing fluid volume deficit, relieving pain, & preventing
complications
-Keep the pt NPO until the HCP evaluates the pt
-Monitor vitals & perform ongoing assessment to detect any deterioration
-Administer IV fluids, analgesics, & antiemetics as ordered
-Provide comfort measures
Primary Nursing Diagnosis
-Primary Preoperative Nursing Diagnosis
-Pain (acute) related to inflammation
-Primary Postoperative Nursing Diagnosis
-Risk for infection related to the surgical incision
Other Diagnoses that may occur in Nursing Care Plans For Appendicitis
-Imbalanced nutrition: Less than body requirements
-Impaired skin integrity
-Ineffective tissue perfusion: GI
-Risk for deficient fluid volume
-Risk for injury
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