Appendicitis

Appendicitis is inflammation of the vermiform appendix.
History taking (Questions)
1) Hospital ana ki waja kya hai

2) Kab sa yeh dard shuru huwa hai
3) Kis tarah ka dard ha
4) yeh dard Kitni dair tak rehta ha
5) Kia ya jism k dusry hissa tak phelta ha
6) Ap na is dard ko kam karna k lia kia kia hai
7) Ap na pehla kabi doctor ko dikhaya tha
8) Ap ziyadatr khana ma kia khaty ha
9) Ap din ma pani ka kitna istimal karti han
10) Ap ko constipation ka masla to nahi
11) Iss k liyeh ap koyee medicine laitii hain
12) Kia ap ko pyas ziyada lagti ha or pishaap ka bar bar ana ki
shikayat rehti ha
13) Kia ap thakawat sa mehsoos kartey han
14) Kia is drd ki wja sy roz mrha k kaam krny m frk pra hai
Pathophysiology
Become blocked/ obstructed
Swell up
Shut off/seal itself up
Sometimes the infection is sealed up in the appendix
Or it can swell up more
Sometimes it can burst and pus can leak out into the abdomen (peritonitis)
Causes
1) Appendicitis occurs when the opening of the appendix is blocked, or due to
infection. Causes include:
2) Obstruction of appendix by fecal matter, foreign body, roundworm or
threadworm infection
3) Viral infection
4) Infection by bacteria such as E.coli, Enterococci, Streptococci, Clostridium
5) Family history: 30% of appendicitis in children has a family history
Sign and symptoms

Appendicitis starts with pain around the umbilicus (navel or belly button) and
progresses to the right lower abdomen or pelvis in a few hours.
Other symptoms include:
 Nausea, vomiting, fever, tachycardia (fast heartbeats), and foul breath
 Constipation is a common feature but diarrhea might occur in some cases
 Frequent urination- inflamed appendix may come in contact with urinary
bladder and cause irritation and frequent urination
Diagnostic test
Complete blood count (CBC): The WBC count may indicate if the body is
fighting infection.
Ultrasound: Done to rule out other conditions like kidney stones, pancreatitis,
ovarian cysts, ectopic pregnancy and also to confirm appendicular mass or
abscess.
CT scan: CT scan of abdomen or pelvis helps in detecting the cause.
Magnetic resonance imaging (MRI): MRI scan of pelvis helps in diagnosis of
appendicitis during pregnancy
Special test:
Psoas sign: active flexion of the right hip while supine causes right lower-
quadrant pain. ▪
Obturator sign: flexing and internal rotation of the hip will cause pain in the
hypogastrium.
Rovsing sign: Palpation of the left iliac fossa causes right iliac fossa pain.
Hop test: Hopping or jumping causes abdominal pain.
Surgical management:
Appendectomy
Laparotomy and laparoscopy
Medical management:
Antibiotics (used to clear infection) e.g.
Ciprofloxacin, levofloxacin, metronidazole and tinidazole.
IV fluids
Drainage
Nursing assessment:
Assess the level of pain
Assess relevant laboratory findings
Assess patient vital sign in preparation for surgery
Nursing diagnosis:
 Acute pain related to inflammation of tissues.
Interventions:
1) Investigate pain reports, noting location, duration, intensity ( 0-10 scale),
and characteristics(dull, sharp, constant).
2) Maintain semi fowler’s position.
3) Move slowly and deliberately.
4) Provide comfort measure like back rub, deep breathing. Instruct in
relaxation or visualization exercise. Provide diversional activities.
5) Provide frequent oral care. Remove noxious environment stimuli.
 Fluid volume deficit related to loss of fluids secondary to nausea,

vomiting.
Interventions:
1) Record intake and output
2) Monitor skin turgor
3) Observe for dry mucous membranes
4) Give a fluid little by little but often appropriate
5) Monitor urine output per hour and shift
6) Establish IV access and replace GI losses, volume/volume.
7) Give antiemetic’s as ordered
 Risk for infection related to ruptured appendix.

Interventions:
1) Ensure that any articles used are properly disinfected or sterilized before
use.
2) Wash hands or perform hand hygiene before having contact with the
patient.
3) Instruct client not to share personal care items
4) Limit visitors
5) Monitor vital signs
Teaching plans
1) Teach patient to stop smoking and try to get weight down if the patient is
overweight.
2) Encourage to check the hospital’s advice about taking the pills or hormones
replacement therapy.( HRT)
3) Encourage the patient do not worry if he or she forget to take dose when it
is due. Do not take two doses together to make up for a forgotten dose.
4) Try to keep your regular appointments with your doctor. This is so your
doctor can check on your progress.
5) Fruit and milk diet for further 3 days. In this regimen, milk may be added to
each fruit meal.

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Appendicitis is inflammation of the vermiform appendix.

History taking (Questions)

1) Hospital ana ki waja kya hai

Become blocked/ obstructed

Sign and symptoms

 Fluid volume deficit related to loss of fluids secondary to nausea,

 Risk for infection related to ruptured appendix.

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