C. IMPLEMENTATION 1.

Drugs Name of Drug Date Administered Route of Administration, Dosage, Frequency of administration 500 mg PO 1 cap 3x a day General Action Indication/Purposes Client’s Response to medication

Generic: Cefuroxime Axetil Brand: Ceftin

02/06/10

Interferes with bacterial cell wall synthesis and division by biding to cell wall, causing cell to die. Active against gram-positive and gramnegative bacteria, with expanded activity against gram-negative bacteria.

Used in the treatment Consumed with of moderate to no adverse severe infections reactions. including septicemia.

Nursing Responsibilities: Before:  Explain the importance and action of the drug

watch for signs and symptoms of superinfection. During:  Administer with a meal. After:  Advise patient to immediately report rash or bleeding tendency.  Monitor temperature. . Assess for any allergies to medication.

also acts as potent inhibition of platelet aggregation. Dosage.Name of Drug Date Administered Generic: Ketorolac Tromethamine Brand: Toradol 02/06/10 Route of Administration. Nursing Responsibilities: Before:  Explain the importance and action of the drug  Tell the possible reaction or side effects of the drug. During:  Administer with a meal. After:  Inform the patient that drug is meant only for short-term pain management. Used in the treatment The patient of moderately severe verbalized that pain. eat small and frequent servings of healthy foods. .  If GI upset occurs. Frequency of administration 10 mg/ tab q 6 hours General Action Indication/Purposes Client’s Response to medication Interferes with prostaglandin biosynthesis by inhibiting cyclooxygenase pathway of arachidonic acid metabolism. the pain diminished.

and dizziness. Watch for bleeding and adverse CNS reaction such as drowsiness. . Dosage. treatment of active duodenal ulcer. headache. Used in the treatment Consumed with of frequent heartburn no adverse and short term reactions. Frequency of administration 40 mg PO daily General Action Indication/Purposes Client’s Response to medication Generic: Omeprazole Brand: Zegerid 02/06/10 Reduces gastric acid secretion and increases gastric mucus and bicarbonate production’’ creating protective coating on gastric mucosa and easing discomfort from excess gastric acid. Name of Drug Date Administered Route of Administration.

diarrhea or constipation.Nursing Responsibilities: Before:  Explain the purpose. . importance and action of the drug  Tell the possible reaction or drug’s side effect.  Check for abdominal pain. After:  Watch out for adverse reaction of the drug. During:  Administer the drug 30 to 60 minutes before a meal. emesis. preferably in morning.  Assess vital signs.

prophylaxis. Dosage.Name of Drug Date Administered Generic: Cefoxitin Sodium 02/06/10 Route of Administration. . Frequency of administration 1 gram IVP every 8 hours General Action Indication/Purposes Client’s Response to medication Interferes with bacterial cell wall synthesis and division by biding Used in the treatment Consumed with of septicemia and no adverse preoperative reactions.

watch for signs and symptoms of superinfection and other serious adverse reactions. Nursing Responsibilities: Before:  Explain the importance and action of the drug  Assess for any allergies to medication. with expanded activity against gram-negative bacteria. Exhibits minimal immunosuppressant activity. Active against grampositive and gramnegative bacteria. .Brand: Mefoxin to cell wall. causing cell to die. After:  Advise patient to immediately report rash or bleeding tendency.  Monitor temperature. During:  Administer with a meal.

Frequency of administration 500 mg PO 1 cap 3x a day General Action Indication/Purposes Client’s Response to medication Bind to opiate receptors in Used in the treatment Patient was of moderate to calmed and . Dosage.Name of Drug Date Administered Generic: Nalbuphine 02/06/10 Route of Administration.

Client’s response to the operation  To avoid complication  Before the procedure the like peritonitis. NSS on LRs. inhibiting severe pain and ascending pain adjunct balanced pathways. Surgical management Name of the procedure appendectomy Date performed 02/06/10 : 8:35 pm Brief description The surgical removal of the veniform appendix. During:  Administer medication slowly with compatible solution such as D5W. 2. feels less pain.  Watch for hypersensitivity reaction. Indication/ purposes .  Tell the possible reaction or drug’s side effect. After:  Instruct patient to change position slowly and carefully to avoid dizziness from sudden blood pressure decrease. Nursing Responsibilities: Before:  Explain the purpose of giving the drug.Hydrochloride Brand: Nubain CNS. its importance and action. inhibition alters perception of and response to painful stimuli. client is crying and afraid. This anesthesia.  Assess vital signs.

Maintain client in NPO 3. Give the prescribed medication 4.This procedure is normally performed when the patient is suffering from acute appendicitis. Monitor Intake and output every 4 hours 2. Secure consent 2. Remove cuticle jewelry and other accessories 5. . Place the patient in a supine position 3. client is weak in appearance. Inform the client about the procedure 6. Document  To remove the inflamed  After the procedure the appendix. Demonstrate deep breathing exercise During 1. Monitor vital signs 4. Monitor vital signs After 1. Nursing responsibilities Before the surgical procedure 1.

it was advised that she would b e compliant with the interventions being enforced to her to avoid any complication that may occur. To the significant others of the client. and postoperatively. they should know the early signs of such for it is not preventable. To those who do not yet experienced the disease and surgery. EVALUATION Since the appendix was not ruptured. The patient complains of pain grimaces. a gained knowledge of the student nurses in the management of patient with the disease. intraoperatively. The patient was confined and assessed on her first and second day of assessment. the student nurses also imparted health teachings to the patient in all phases of operation and to the significant others to gain self reliance and independence in the home care management postoperatively IV. the patient only undergoes uncomplicated appendectomy. She was also nauseated that can be associated with the induction of anesthesia. Furthermore. the group concludes that the goal and objective was met as evidenced by accomplishment of a comprehensive case report on Appendicitis. After the surgery. she verbalized that it was lessened. irritability and guarding reflex on the incision site but with proper management. CONCLUSION Based from the goal and general objectives presented. . RECOMMENDATION The following recommendations were suggested to different personnel’s: To the patient. a thorough assessment of the patient and the recognition of chief complaints and needs. The patient was asleep throughout the surgery and awakens as the operation was ended. the vital signs urine output and level of consciousness was monitored.D. Her wound dressing was also inspected and it was dry and intact. There were no discrepancies in the assessment gathered. III. thus detection of the condition is important. it was suggested that they should offer financial and emotional support to her for her to gain optimism from them that may contribute to faster healing. implementation of the planned care and a patient –centered approach of care preoperatively.

REVIEW OF RELATED LITERATURE Acute appendicitis in childhood: did mother know best? A pathological analysis of 1409 cases Roger W Byard.Authors' details Make a comment . We analysed a series of acute appendicitis in children in an attempt to validate the maternal hypothesis and to dispel the memories of years of childhood terror. Adelaide. was searched for records of all cases of surgical removal of a vermiform appendix over the period 1972-1997. In addition.Discussion . resulting in inflammation. all three of us were subjected to repeated injunctions by our respective mothers that under no circumstances should we swallow fruit pips or seeds.07%) was a fruit seed discovered. they were advised to take the responsibilities of educating the public on the clinical manifestation of the disorder. NOS [not otherwise specified]). 169: 647-648 Introduction .To the healthcare providers. Underpinning the maternal reasoning was an unshakeable belief in the inevitable impaction of such ingested material in the appendix. 0. Nicholas D Manton and Richard H Burnell MJA 2003.Current contents list More articles on Pathology Introduction As children. it is recommended that they provide quality health care to a client with any other complaint. The cases had been coded using the SNOMED1 system and were searched for under the codes T-66000 (appendix). In only one of these cases (1/1409.Subjects and methods .Register to be notified of new articles by e-mail . V. This seed enteric entrapment disease state (SEEDS) involved a three-year-old girl who had .References . distress and eventual "surgical mutilation" (referred to by surgeons as "operative cure"). M-41000 (acute inflammation) and M-30400 (foreign body. Subjects and methods The computerised database at the Department of Histopathology. Women's and Children's Hospital. Results Among 2224 consecutive cases of surgically removed appendices there were 1409 cases in which there was sufficient evidence of acute inflammation to justify a diagnosis of acute appendicitis. South Australia.Results .

expensive and time-consuming immunohistochemical techniques. date seeds and grape seeds found within the appendix are not really seeds at all. that most cases thought to be cherry stones. electron microscopic or molecular biological evaluations of the foreign body were undertaken.7 This theory has not been universally accepted. its aetiology remains "vague and indefinite".3 Originally known as perityphlitis (Greek. Expert analysis of the seed revealed it to be consistent with a cherry pip (unidentified elderly white man representing Fresh Fruit and Vegetables Inc.3 The similarity between humans and wombats certainly comes as no surprise to our group. we have previously been unable to distinguish between wombats and humans. might lodge in the appendix. as for some reason rates for the colonies were not given. the results would also have been consistent with the identification of a cherry pip. One of the earliest aetiological theories for acute appendicitis (to which our mothers still subscribe) is that a small foreign body. While no subsequent immunohistochemical. 2 (Whether it occurred in the Antipodes at that time is not known. if they had been. when an eminent text noted that it had become quite common in "highly civilized countries such as Great Britain". certain apes and the wombat.5 However. Pathological examination of the excised appendix revealed a 10 mm round fruit seed in the distal portion of the appendix (Figure) associated with a transmural acute inflammatory infiltrate. with lower occurrence rates in Denmark and Sweden.. SA. indicates that the disease has been around since ancient times. and is apparently found only in humans.presented in 1997 with a short history of right-sided lower-abdominal pain necessitating surgical intervention. peri.) A perforated appendix found in an Egyptian mummy. such as a seed. using quite elaborate. the disease was described by John Hunter in a case at autopsy in 1769.8 . Discussion Although acute appendicitis is common. thus initiating an acute inflammatory reaction. with suggestions being made. as early as 1925. Adelaide. as. we are in no doubt that. however. who used the term at the inaugural meeting of the Association of American Physicians in 1886.2 It was rarely recognised until the latter part of the 19th century. around + typhlos. we did note at the time that wombats tended to be hairier and smaller (R W B. unpublished observation).6. inflammation).4 The appendix is an unusual organ. blind + -itis. personal communication). 4 the first use of "appendicitis" is credited to Fitz. but concentrically laminated faecoliths.

the impact on the affected individual was obviously quite profound. however.14 The reader should be the final arbiter. diligently searching for such elusive treasures. We would defend this apparent defection from the truth on pragmatic grounds. a reviewer for the Journal disagreed and stated that our study demonstrated instead that our mothers were "incorrect in espousing the belief that fruit seeds or pips may cause appendicitis". sergeant-surgeon to George II. As publication was at stake.au/public/issues/xmas03/byard/byard. although seemingly rare. under the heading of "Some observations on wounds in the guts". at 0. possibility.9 Although it may be argued that the rate of SEEDS in our series was rather low. and also look to Cervantes for support in that "one swallow does not make a summer". with potentially dire consequences.14 Thus. that impaction of fruit seeds within the appendix is a very real.mja. it is clearly mandatory that pathologists insist that their registrars carefully scrutinise all faecoliths. we agreed to reverse our opinions while still using the same data. The case was reported in 1736 by Claudius Amyand. Ref: http://www.Our study has clearly demonstrated.html .10 As well as further reports of pins becoming lodged in the appendix (so-called "Halloween" appendicitis).12 snipe shot (birdshot)13 and bullets.07%.com. In searching the literature we have uncovered reports of a host of other swallowed foreign bodies retrieved from appendices.9 balls of animal hair. One of the earliest documented cases of foreign body entrapment within the appendix involved perforation by a pin in a 12-year-old boy. The case of a boy who "died of his first berry" was reported as early as 1887 by Jacobi.11 there were also reports involving needles. Although our initial conclusion was that our mothers were entirely correct in espousing the belief that fruit seeds may be potentially lethal.

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