Appendicitis
Appendicitis
- Appendix becomes inflamed or infected. Perforation may occur and lead to peritonitis and septic shock.
- Treatment: Surgical removal of the appendix.
- Tests: CT scan #1 and Ultrasound
Symptoms
- Pain near the umbilicus that moves to the lower right abdomen (RLQ pain)= Mcburney’s sign
- Loss of appetite
- Nausea and vomiting
- Low-grade Fever and chills
- Rebound tenderness and rigidity in the lower right abdomen.
- Rovsing’s sign=RLQ pain when palpation of left side of abdomen
Nursing Priorities
- Keep NPO for surgery
- IV hydration
- IV pain meds (NPO remember?)
- Position for comfort (right side-lying or low semi-fowler’s and legs drawn towards the chest)
- Monitor for rupture of the appendix (pain that suddenly goes away and subsequent pain increases with guarding of the abdomen). Why? Pain is due to the inflammation of the appendix. Once it bursts, the inflammation goes away. But then peritonitis starts and pain returns.
- Monitor for changes in pain.
- Monitor for peritonitis
- No laxatives or enemas
- Avoid heat (ruptures appendix)
- Antibiotics as prescribed
Test your Understanding
A 12-year-old female presents with sudden onset of severe abdominal pain. The pain started in the periumbilical region and migrated to the right lower quadrant over the last 12 hours. She reports nausea, vomiting, anorexia, and has not had a bowel movement for 24 hours. Physical examination reveals rebound tenderness, guarding, and positive Rovsing’s sign. Her vital signs are within normal limits.