Indroduction: ‡ The appendix is a small fingerlike appendage about 10 cm (4 in) long. attached to the cecum just below the ileocecal valve. . ‡ The appendix fills with food and empties as regularly as does the cecum. ‡ It is prone to become obstructed and is particularly vulnerable to infection (appendicitis) because it is small. ‡ No definite functions can be assigned to it in humans.

Facts about Appendicitis: ‡ Appendicitis is the most common cause of acute inflammation in the right lower quadrant of the abdominal cavity. ‡ It is more prevalent in countries in which people consume a diet low in fiber and high in refined carbohydrates. . ‡ It occurs most frequently between the age of 10 and 30. ‡ Males are affected more than females and teenagers more than adults. ‡ About 7% of the population will have appendicitis at some time in their lives.

or tumor. fecal mass. foreign body. structure.Definition: Appendicitis is inflammation of the vermiform appendix caused by an obstruction attributable to infection. .

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generalized abdominal rigidity. involuntary guarding. 3.Clinical Manifestations: 1. Usually constipation occurs . Generalized or localized abdominal pain in the epigastric or periumbilical areas and upper right abdomen. moderate malaise. occasionally diarrhea. Anorexia. The pain localizes in the right lower quadrant and intensity increases with 2 to 12 hours. nausea and vomiting. 5. mild fever. 2. 4. Rebound tenderness. .

Pathophysiology of Appendicitis: .

.Diagnostic Evaluation: Physical examination consistent with clinical manifestations.000 to 16.000/mm3). WBC count reveal moderate leukocytosis (10. Focused appendiceal CT can quickly evaluate for appendicitis. perforation will reveal free air. Abdominal x-ray may visualize shadow consistent with fecal in appendix. Urinalysis rule out urinary disorders. Abdominal ultrasound or CT scan can visualize appendix and rule out other conditions. such as diverticulitis and crohn s disease.

. Parenteral replacement. 2. 3. Surgery. Medication.Treatment and Management: 1.

It is the effective treatment.Continue Surgery: Appendectomy: It is a surgery to remove of the appendix. . Appendectomy may be performed under a general or spinal anesthetics with a low abdominal incisions or by laparoscopy which is recently highly effective method. It is performed if appendicitis is diagnosed as soon as possible to decrease the risk of perforation.

Continue . Treatment  Intravenous fluids replacements and electrolytes.  Analgesics can be administered after the diagnosed is made..  Administration of Antibiotics. .

If left untreated. perforation.Complications: Perforation of the appendix: Peritonitis. subsequent peritonitis. appendicitis may progress to abscess. Abscess formation. Portal pylephlebitis. and death .

malaise. this indicates perforation. Notify health care provider immediately if pain suddenly ceases. fever. or peritonitis (increasing severity of pain. rigidity. . absent bowel sounds. and tachycardia). which is a medical emergency. abscess. tenderness. indicating perforation. distention. Assist patient to position of comfort such as semifowlers with knees are flexed.Nursing Interventions: Monitor frequently for signs and symptoms of worsening condition.

Promptly prepare patient for surgery once diagnosis is established.Nursing Interventions Apply ice bag to abdomen for comfort. . or abdominal distention. nausea and vomiting. Explain signs and symptoms of postoperative complications to report-elevated temperature..Continue . Avoid indiscriminate palpation of the abdomen to avoid increasing the patients discomfort. these may indicate infection.

coughing. Teach incisional care and avoidance of heavy lifting or driving until advised by the surgeon.Nursing Interventions Restrict activity that may aggravate pain.Continue . Advise avoidance of enemas or harsh laxatives. . Instruct patient on turning. Discuss purpose and continued importance of these maneuvers during recovery period. use of incentive spirometer. increased fluids and stool softeners may be used for postoperative constipation. such as coughing and ambulation. and ambulation.. or deep breathing.

Within 12 hrs of surgery you may get up and move around.Discharge Planning: Antibiotics for infection and analgesic agent can be given for pain after the surgery. Within 2-3 week usually can return to normal activities s after laparoscopic surgery. . To care wound perform dressing changes and irrigations as prescribe avoid taking laxative or applying heat to abdomen when abdominal pain of unknown cause is experienced. Reinforce need for follow-up appointment with the surgeon and to call the physician if the pain increase at the incision site .

Liquid or soft diet until the infection subsides Soft diet is low in fiber and easily breaks down in the gastrointestinal tract. Stitches removed between fifth and seventh day. which indicate an abscess . Watch for surgical complications such as continuing pain or fever.Continue Discharge Planning Document bowel sounds and the passing of flatus or bowel movements (these are signs of the return of peristalsis. .

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