Appendicitis

Appendicitis
Is the medical condition in which the appendix

become inflamed. Appendix is a worm-like
appendage of the caecum; about the thickness of a
pencil and may be from 2 to 6 inches long, ending in
a blind extremity.
Objectives
• AT THE END OF THIS PRESENTATION,THE
LEARNERS SHULD BE ABLE TO :
• Define appendicitis
• Give cause and predisposing factors
• Signs and symptoms
• Diagnostic test (endoscopy, x-ray and barium
swallow)
• Basic nursing management
Objective cont...
• Pharmacological treatment(name of drug,
mechanism of action, indication,
contraindication and side effects)
• Promotive and preventive management
• complications
Signs and symptoms of appendicitis
1.It commonly starts with a persistent,

continuous, periumbilical pain. Initially the
pain feels like an intermittent discomfort but
then shift to the right lower quadrant of the
abdomen where it becomes localised.
2.Fever
3.Loss of appetite/anorexia
4.Nausea and vomiting
Cause and predisposing factor
Cause Predisposing factor(risk)
The initial cause of inflammation is not People who have family history of
always clear. appendicitis
However the appendix fills with food and
empties inefficiently because its lumen is
very small and therefore is prone to
obstruction.
The common causes of obstruction of the
lumen of the appendix are faecal mass,
kinking of the appendix, foreign body,
intramural conditions of the bowel wall,
tumours of the caecum or the appendix
and external occlusion of the bowel by
adhesions.
It is common in males and people aged
between 15 to 30 years
Diagnostic test
• Blood test include a full blood count which
reveals an elevated white cell count above
11,000mm3 with the neutrophil count above
75%.
• Abdominal x-ray show dilated loops of bowel
indicating paralytic ileus, air or fluid levels in
case of obstruction and free air consistent
with perforation.
Basic nursing management
• Administer prescribed analgesics and antibiotics relieve pain and
destroy bacteria. Assess the patient for the effect of these drugs by
observing and asking the patient the extent of pain.
• Withhold oral feeds and if paralytic ileus or peritonitis has
developed, a nasogastric tube should be inserted and the patient
kept on continuous drainage while awaiting for surgery.
• Encourage patient to walk as able /permitted to maintain circulation.
If the patient is immobile, the use of serial compression devices
(SCD) and TED hose should be implemented to avoid DVT/clots.
• Monitor and record vital signs to detect infection early.
• Ensure adequate fluid replacement as the patient may be vomiting.
• Explain all procedures and activities to the patient to allay anxiety.
Pharmacological treatment
• It usually involves an immediate surgical removal of
the appendix through a laparotomy or laparoscopy .
• Laparotomy; term used to describe any opening into
the abdominal wall.
• Laparoscopy; is the insertion of the laparoscope
through a small abdominal incision for diagnostic
purposes, lysis of adhesions or tubal division .
• Laparoscope; a lighted instrument used for viewing
the interior of the abdomen and for performing
certain surgical procedure.
Promotive and preventive management
• Consume a little of butter and milk daily
Complications
1. Peritonitis: The peritoneum becomes acutely
inflamed, the blood vessels dilate and excess
serious fluid is secreted. It occurs as a complication
of appendicitis when:
a)Microbes spread through the wall of the appendix
and infect the peritoneum
b)An appendix abscess ruptures and pus enters the
peritoneal cavity
c)The appendix becomes gangrenous and ruptures,
discharging its contents into the peritoneal cavity
2.Abscess formation. The most common are :
a) Subphrenic abscess, between the liver and
diaphgram, pleura, pericardium and
mediastinal structures.
b) Pelvic abscess from which infection may
spread to adjacent structures.
3. adhesions. When healing takes place bands of
fibrous scar tissue (adhesions) form and later
shrinkage may cause:
a)Stricture of obstruction of the bowel.
b)Limitation of the movement of a loop of
bowel, which may twist around the adhesion
causing a type of bowel, obstruction called
volvulus

Appendicitis

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Appendicitis

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Appendicitis

Is the medical condition in which the appendix

1.It commonly starts with a persistent,

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