Joy went to the ED with right-side abdominal pain. It was discovered she needed her appendix removed
Before the surgical team could get to the surgical suite, Joy's pain increased, and she started having a spiked temperature and was feeling extremely nauseous.
a. What assessment finding would be expected with appendicitis?
b. What happens when the appendix ruptures or perforates?
c. Discuss appendicitis and peritonitis.
d. What follow-up care is expected for Joy?
Students' answers should include the following:
a. Definition of appendicitis is an infection of the appendix, and peritonitis is an infection in the peritoneum
Assessment of appendicitis includes right-sided pain with localized pain at midway between umbilicus and right iliac crest
McBurney's point
Rebound tenderness on manual pressure examination
Fever, nausea, and vomiting are present.
Perforation causes more pain; diffused
WBC is elevated with moderate leukocytes.
CT shows enlarged cecum.
b. Perforation spills appendix contents with infection into the abdominal cavity; becomes infected and inflamed
c. Peritonitis same s/s pain, fever, N/V, lower B/P, can lead to shock and death
d. Antibiotics; cultures of fluid in cavity for specific organism present
IV fluids, electrolytes, NG tube, rest, and antiemetics
Prognosis is usually good if appendicitis is caught early; if peritonitis is present, it needs to be treated aggressively and closely monitored.
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