DEFINITION CAUSE RISK FACTORS DIAGNOSTIC EVALUATION TYPES MANAGEMENT

1. APPENDICITES
PRESENTED BY,
Mr.Hiteshkumar P. Jadav
1st Year M.Sc. Nursing
Sumandeep Nursing College

3. APPENDICITIS :
 Appendicitis is an inflammation of appendix
that develops most common in adolescents and
young adults.
 Appendicitis is acute inflammation of the
appendix, and is the most common cause for
acute, severe abdominal pain.
 The abdomen is most tender at McBurney’s
point – one third of the distance from the right
anterior superior iliac spine to the umbilicus.
This corresponds to the location of the base of
the appendix.

4. MCBURNEY’S POINT

5. RISK FACTORS :
 Infection, possibly stomach infection
that has traveled to the site of
appendix.
 Extreme of age
 Previous abdominal surgery.
Obstruction such as a hard piece of
stool getting trapped in the appendix
leading to infection of the appendix.

6. CAUSES :
Obstruction (accumulated feces in lumen)
Tumor
Foreign bodies
Swelling of the bowel wall
Parasites
 Examples: Schistosomes species,
pinworms, Strongyloides, stercoralis.
Trauma, Intestinal Worms, Lymphadenitis.

7. PATHOPHYSIOLOGY:-
 Due to etiological factors
 Inflammatory process
 Increase intra-luminal pressure
 Severe pain
 Appendicites

8. TYPES :
 Acute Appendicitis:
 Develops very fast, usually in a span of several days or
hours.
 Acute appendicitis occurs when the vermiform appendix
is completely obstructed, either because of a bacterial
infection, feces or other types of blockage.

9. APPENDICITIS CAN BE CHRONIC
(BUT IT'S A RARE CONDITION) :
o Chronic appendicitis is an inflammation
that can last for a long time. This is rare
according to a report published in
Therapeutic Advances in
Gastroenterology, it only occurs in only
1.5 percent of recorded acute appendicitis
cases

10. Stump Appendicitis: A Rare
Appendectomy Side Effect :
 If the appendix has already ruptured,
additional treatment measures are
performed during an appendectomy,
as the infection needs to be prevented
from spreading.

11. CLINICAL MANIFESTATIONS :
Subjective sign & symptoms:
 Malaise
 Anorexia
 Vomiting
 Moderate leukocytosis ( leukocyte in
blood)
 Rebound tenderness
 Constipation
 Diarrhea

12. OBJECTIVE SIGN & SYMPTOMS-
Pain at McBurney’s point.(between
umbilical & iliac crest)
Tachycardia
Tachypnoea
 Low grad fever
 Abdominal pain
 Anorexia
Constipation

13. Diagnostic evaluation:
History
Physical examination
WBC count
Urinalysis
 Abdominal x-ray
 CT Scan
 USG

14.  MANAGEMENT :
 Surgery is indicated if appendicitis is
diagnosed.
 To correct or prevent fluid and
electrolyte imbalance and dehydration,
antibiotics and intravenous fluids are
administered until surgery is performed.
 Analgesics can be administered after the
diagnosis is made. (Morphine sulphate 10
mg/ml)

15.  Antibiotics
 Cefotaxime 250mg, 500mg
 Levofloxacin 500 mg
 Metronidazole 500mg/100ml,
400 mg tablet.
Appendectomy
 Open Appendectomy
 Laparoscopic Appendectomy

17. NURSING MANAGEMENT :
Goals include relieving pain,
preventing fluid volume deficit,
reducing anxiety, eliminating
infection from the potential or actual
disruption of the GI tract, maintaining
skin integrity, and attaining optimal
nutrition.

18. Pre-Operative care:

19. POST-OPERATIVE NURSING CARE:
 Clear airway.
 Naso-gastric suction to be done regularly to
relieve tension on sutures.
 Provide safety & effective care environment to
the patient.
 Care of all drainage tubes.
 Care of surgical wounds. Watch for bleeding.
 Daily Anti-septic dressing and watch for signs
of infections.
 Intake and output maintained
 Monitor vital signs & fluid, electrolytes balance

20. Drugs – Antibiotics, analgesic &
Anticholenergies i.e. Injection Aciloc
as per prescription.
 After surgery, the nurse places the
patient in a semi-Fowler position.
This position reduces the tension on
the incision and abdominal organs,
helping to reduce pain.

21. NURSING DIAGNOSIS :
 Acute Pain May be related to, Distension
of intestinal tissues by inflammation,
Presence of surgical incision.
 Risk for Fluid Volume Deficit, Risk
factors may include, Preoperative
vomiting, postoperative restrictions ,
Hypermetabolic state (e.g., fever, healing
process) Inflammation of peritoneum with
sequestration of fluid.


22. Risk for Infection, Risk factors may
include, Inadequate primary defenses;
perforation/rupture of the appendix;
peritonitis; abscess formation,
Invasive procedures, surgical
incision.

23.  DISCHARGE AND HOME
HEALTHCARE GUIDELINES :
MEDICATIONS.
INCISION.
COMPLICATIONS.
NUTRITION.

24.  ASSIGNMENT:
Write the nursing management
according to symptoms.