Pathophysiology of Appendicitis

Predisposing factors Precipitating Factors

- Age: 10 - 30 years old - Obstructions
- Gender: Male - Infection
- Genetics - Trauma
- Prior Abdominal Surgery - Enlarge lymph nodes
- Inflammatory bowel disease - Parasites

Disease Process

Obstruction of
appendiceal
lumen
Intervention
Stretching of - Monitor intake and output (I&O) and
Build up of Appendix visceral S/SX Diagnostics/ Laboratory Nursing Diagnosis compare periodic
peritoneum, - diarrhea Urinalysis: Urine specific Fluid volume deficit r/t weights. Note enteric losses, such as
mucus in the distension and - nausea & vomiting excessive losses through
stimulation of gravity >1.020 vomiting and diarrhea.
appendix spasms autonomic nerves - constipation normal routes - Provide intravenous (IV) fluids (usually
T9-T10 glucose) and electrolytes, as ordered.

Increased
lumen pressure

Decreased
blood flow to the
appendix

Hypoxia in
the appendix

Loss of appendix
structural
integrity
Intervention
- Monitor client temperature? degree and
Diagnostics/ Laboratory pattern. Note shaking chills or profuse
Promotes Nursing Diagnosis
S/SX CBC: Increased WBC: diaphoresis.
microbial >11,000 is abnormal
Hyperthermia r/t - Administer antipyretics, such as
- Fever
invasion Leukocytes: >10,000/mm illness acetylsalicylic acid (ASA) (aspirin) or
acetaminophen (Tylenol).

Start of
inflammatory
process

S/SX
Assessment Nursing Diagnosis Intervention
Irritation & lesion of - RLQ Pain (McBurney's
Percussion: Resonance in all
the appendix Point) Acute pain r/t - Assess and manage level of pain.
quadrants
mucosal lining - Abdominal guarding Palpation: Rovsing's Sign inflammation - Monitor for signs of infection
- Rebound tenderness

Distruption of
cell membrane

Diagnostics
CT: Gold standard test
dilated appendix with a
S/SX diameter of more than 6 Nursing Diagnosis
Necrosis of mm, wall thickening
Intervention
- Inflammation of the - Risk for infection r/t
the appendix more than 2 mm, Appendectomy
appendix adjacent mesenteric
ruptured appendix
fatty stranding,
If appendix is not
surigically removed mesenteric lymph
nodes, appendicolith,
and periintestinal fluid.
Perforation of Nursing Diagnosis
colon wall, causing Ultrasound: an outer - Risk for infection r/t Intervention
peritonitis appendiceal diameter of appendectomy - Administer analgesics as ordered.
- Acute pain r/t surgical incision
6 mm or greater on - Promote diversional activities.
cross-section.

4NU08 Group 3: Simbajon, Tan, Kurt, Verano, Vergara, Uy