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Appendicitis Signs, symptoms, treatment & Nursing Management

Appendicitis: Signs, symptoms, treatment & Nursing Management

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What is Appendicitis?

Appendix – The appendix is a finger-like projection present at the end of the cecum. Appendicitis – Appendicitis is an acute and chronic inflammation of the vermiform appendix. Appendicitis is a medical emergency that is always required surgical treatment as soon as to remove the appendix. Appendicitis mainly occurs at 10 – 30 years of age.

Appendix
Appendix

Cause of appendicitis

  • Idiopathic
  • Faecalith ( hard stool stored in appendix )
  • Obstruction and tumor
  • Knot in appendix
  • Undigested seeds
  • Foreign bodies
  • Inflammation and fibrosis of the colon
  • Abdominal surgery
  • Infection
  • Intestinal parasites
  • Constipation
  • Diabetes mellitus and immunosuppression.

Types of appendicitis

  1. Acute simple appendicitis
  2. Acute purulent appendicitis
  3. Obstructed appendicitis
  4. Malignant appendicitis
  5. Perforation and gangrenous appendicitis

Pathophysiology of appendicitis

Cause / Etiology

Inflammation and obstruction of an appendix

Increase the intra luminal pressure

Affect the blood supply of the appendix

Edema or swelling in the appendix

Sever pain (appendicitis)

 

Appendicitis Symptoms

  • Acute abdominal pain –
  • at right lower quadrant
  • At  McBurney point
  • Between umbilicus and anterior spine of the ilium.
  • Nausea, vomiting
  • Dehydration and GI disturb
  • Anorexia
  • Abdominal tenderness and rigidity
  • Rovsing sign
  • Rebound tenderness
  • Tachycardia and tachypnea
  • Fever ( 99 – 102° )
  • Swollen belly
  • Severe cramps.

Appendix pain symptoms

Rovsing sign – Pain occurs in the right lower quadrant when palpate in the left lower quadrant.

Rebound tenderness Sign– Also know the Blumberg sign. It is a clinical sign of appendicitis in which pain or tenderness occurs when sudden release of abdominal pressure.

rovsing sign
rovsing sign

Appendicitis Tests

  • History collection and physical examination.
  • Blood test – WBC increased ESR increase.
  • Laparoscopic test.
  • Rectal examination
  • Stool examination
  • Urine analysis
  • CT scan and USG
  • Positive signs and symptoms.

Treatment of appendicitis

  • Maintain NPO
  • Provide adequate bed rest
  • Treatment of appendicitis starts with antibiotic therapy and IV fluid.
  • Antispasmodic, antiemetic, analgesics.
  • Provide comfortable position
  • Cold application apply at pain site
  • Proton pump inhibitors.

Surgical management  

  • Appendectomy (remove inflamed appendix).

Complication of appendicitis  

  • Peritonitis
  • Perforation
  • Post-operative wound infection
  • Abscess.

Nursing management of Appendicitis

Preoperative care of appendicitis

  • Nurses establish nurse patient relationships.
  • Nurses collect patient files and all diagnostic examinations.
  • Nursing informs the sector to explain surgical procedures to the patient.
  • If pain occurs before surgery, provide the right lateral position and legs are flexed.
  • Collect patient consent.
  • Instruct to patient for NPO.
  • Enema contraindicated in appendicitis, because enema rupture appendicitis.
  • Cold applications apply for relief pain.
  • Prepare the patient for surgery.

Intraoperative care of appendicitis

  • Nurses provide appropriate positions.
  • Prepare the MCBurney point with an antiseptic solution.
  • Provide prescribe IV fluid.
  • Check vital signs.
  • Prepare for anaesthesia.
  • Use all aseptic techniques during surgery.
  • Follow the instructions of surgeons.
  • After surgery, nurses transport patients to the recovery room.

Post-operative care of appendicitis

  • Nurses assess patient vital signs and general appearance.
  • Monitor operative site dressing.
  • Provide prescribed medication.
  • Provide comfortable rest and sleep.
  • After surgery, provide left lateral position and flexed legs to relieve pain.
  • Provide a high fiber diet and fresh fruits or vegetables.
  • Instruct patients about follow up care.

Read also – Pancreatitis

Key Points about Appendicitis

  1. Finger-like projection at the end of the cecum – Appendix.
  2. Most common cause of appendicitis – Faecalith.
  3. Most common site of appendicitis pain – MCBurney point.
  4. Enema is contraindicated in – Appendicitis.
  5. Rovsing and rebound tenderness is a sign of – Appendicitis.
  6. Most common nursing action in appendicitis –  Apply cold application.
  7. Right quadrant pain when palpate left lower quadrant – Rovsing sign.
  8. Suddenly abdominal pressure causes pain, as is known – the Blumberg sign.
  9. Stool appearance in appendicitis – Melena.
  10. Most common surgery in appendicitis – Appendectomy.
  11. Which site prepares for appendicitis surgery – Right lower quadrant.
  12. Most common complication of appendicitis – Peritonitis.
  13. Common symptom of appendicitis – Pain in McBurney point.
  14. Accumulation of hard stool appendix is called – Faecalith.
  15. Hot application contraindicated in – Appendicitis.

What is site of appendicitis pain?

MCBurney point.

What is contrainddicatedin appendicitis?

Enema

What is the sign of appendicitis?

Rovsing and rebound tenderness is a sign of – Appendicitis.

What is most common nursing action in appendicitis?

Apply cold application.

What is Rovsing sign?

Right quadrant pain when palpate left lower quadrant – Rovsing sign.

What is Blumberg sign?

Suddenly abdominal pressure causes pain, as is known – the Blumberg sign.

Which surgery common in appendicitis

Most common surgery in appendicitis – Appendectomy.

What is most common complication of appendicitis

Peritonitis.

Accumulation of hard stool appendix is called

Faecalith.

Hot application contraindicated which diseases?

Appendicitis.

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