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Nursing 3 Test 3
Appendix
| Question | Answer |
|---|---|
| appendicitis | inflammation of the verniform appendix |
| verniform appendix | blind sac at the end of the cecum, size of little finger, no known function |
| pathophysiology of appendicitis | caused by obstruction of the appendiceal lumen, fecalities(hardened stool), foreign bodies, tumors, swelling, fibrous diseases & adhesions, twisting or kinking |
| obstruction of outflow of mucous | swelling, infection, & ulceration, occlusion of artery, necrosis, & gangrene, abscess formation, perforation, peritonitis, ileus |
| incidence of appendicitis | most common surgical pediatric emergency, affects 7-12% of population, commonly occurs in the younger population ages 10-30(rare under 2 and most frequently in boys 10-19 yrs old) |
| high incidence of rupture(28%) in pediatric pt's due to | delayed treatment |
| delayed treatment in pediatric clients is due to | child's inability to verbalize, professional's failure to correctly interpret behavioral clues |
| clinical manifestations of appenidicitis | abdominal pain(initially periumbilical), mcburney's point(rt anterior superior iliac crest to umbilicus, midpoint to this line), pain aggravated by movement, blumberg's sign(rebound tenderness), rovsing's sign(referred pain), splinting when deep breathing |
| more manifestations of appendicitis | n/v, anorexia, constipation or diarrhea, child not himself, guarding abdomen, walks bent over, side lying with knees flexed, elevated WBC, mild fever |
| signs of rupture and perforated appendicitis | elevated temperature, sudden relief of pain then increased pain but more diffuse, increased abdominal distention, absent bowel sounds, tachycardia, shallow respirations, restlessness |
| defferential diagnosis for appendicitis | IBD, acute infectious diarrhea, PID, UTI, RLL pneumonia |
| diagnosis for appendicitis | based on history & physical, elevated WBC, urinalysis, u/s, ct scan |
| treatment for appendicitis | surgical removal(appendectomy), recovery rapid, overnight stay unless ruptured |
| treatment for ruptured appendix | medical emergency, IV fluids & electrolytes, IV antibiotics, NG tube, surgery, drain to allow transperitoneal drainage |
| nursing diagnosis appendicitis:pain | ice to abdomen(no heat), try to decrease blood flow to area and decrease inflammation, no enema or laxatives(stimulated bowel motility, may lead to rupture) |
| other nursing diagnosis for appendicitis | knowledge defecit, anxiety, fluid volume defecit, high risk infection |
| post op care for appendectomy | ambulation same day, home next day unless rupture, food & fluids after peristalsis returns, observe for complications |
| post op care for ruptured appendix | peritonitis:increased drainage & pus(penrose drains),elevated temp(antibiotics),decreased perstalsis(NG tube,bowel sounds),loss of fluids & electrolytes(hypovolemic shock,IV fluids & electrolytes), High fowlers(facilitates drainage from peritoneal cavity) |
| Discharge for appendectomy | if no complications return to school in 1-2 wks, avoid contact sports for a few weeks |
Created by:
jbittner
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