Appendicitis

Question 1

Inflammation of the vermiform appendix (8-10cm)

More common in males 10-30yrs of age

Familial, slightly higher

Answer 1

Appendicitis

Question 2

Etiology

Answer 2

1. Obstruction by fecal impaction, kinking of the appendix, parasites, or infection
2. Low fiber diet
3. High intake refined carbohydrates
4. Sedentary lifestyle

Question 3

Assessment

“rebound tenderness”

Answer 3

Blumberg’s sign

Question 4

Assessment

Pain upon removal of pressure rather than application of pressure to the abdomen

Indication: peritonitis/appendicitis

Answer 4

Blumberg’s Sign

Question 5

Assessment

Tenderness in the RLQ when palpating the LLQ

Answer 5

Rovsing’s Sign

Question 6

Assessment

RLQ pain that is produced with the pt extending the hip d/t inflammation of the peritoneum overlying the psoas muscle

Answer 6

Psoa’s Sign or Copes psoas or Obraztsova’s sign

Question 7

Assessment

Straightening out the leg causes the pain because it stretches the muscles and flexing the hip into the “fetal position” relieves the pain

Answer 7

Psoa’s Sign or Copes psoas or Obraztsova’s sign

Question 8

Appendicitis: Assessment

Answer 8

Vague periumbilical pain/Mcburney point
Rigid, guarded abdomen
Anorexia, N/V
Blumberg’s Sign (rebound tenderness)
Rovsing’s Sign
Psoa’s Sign
Fever (38-38.5)
Constipation
Decreased/absent bowel sound

Question 9

Diagnostic Tests

Answer 9

1. WBC count
2. Pregnancy test
3. Urinalysis
4. CT Scan
5. UTZ
6. Neuro-Spec Imaging

Question 10

Surgical Management

Answer 10

1. Laparoscopy
2. Laparotomy
3. Appendectomy

Question 11

Nursing Management

Answer 11

1. Pt NPO status for possible admission
2. Administer IVF as prescribed to prevent fluids and electrolyte imbalance (run for 8hrs)
3. Maintain pt in semi-fowler’s position to prevent upward spread of infection

Question 12

Nursing Management: what NOT TO DO

Answer 12

DO NOT
1. Administer laxatives or enema to prevent perforation of the appendix

2. Apply local heat to prevent inflammation and perforation. Instead, apply cold compress