Episodes of Constipation ↓

Low Fiber Diet ↓

↓ Occlusion of Appendix by Fecalith ↓ Decreased flow/drainage of mucosal secetions ↓ Increased ILP in the appendix ↓ Vasocongestion ↓ Decreased blood supply in the appendix ↓ Decreased O2 supply in the appendix ↓ Appendix starts to be necrotic; Bacteria invade the appendix ↓ Disruption of Cell Membrane of Appendix ↓ Start of Inflammatory Process ↓ ↓ ↓ ↓ Release of Chemical Mediators Activation of the Vomiting Neutrophils to area Center in the Medulla ↓ ↓ ---> Histamine, Prostaglandin, Stimulation of Vagus Suppression of Pus Formation Leukotrienes, Bradykinin Nerve Sympathetic (phagocytized bacteria ↓ GI Function and dead cells) Swelling of Appendix ---> Prostaglandin, Bradykinin ↓ Pain in the RLQ of Abdomen ↓ Acute Pain ---> Interleukin-1 ↓ Increased WBC Nausea & Vomiting Risk for Deficient Fluid Volume Anorexia Risk for Infection (if appendix ruptures) Risk for Imbalanced Nutrition less than body requirements

Inflammation of Appendix (Appendicitis) ↓ Appendectomy ↓ Tissue Trauma Open Wound ↓ Impaired Tissue Integrity ↓ Risk for Infection Disruption of Cell Membrane ↓ Start of Inflammatory Process Release of Prostaglandin/ Bradykinin

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↓ Nociceptors on the Dermis ↓ Send Impulse to CNS Pain on Surgical Site Activity Intolerance

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