Nursing Study Guide for Appendicitis

Appendicitis, the most common major surgical disease, is an inflammation of the vermiform appendix, a small, fingerlike projection attached to the cecum just below the ileocecal valve. Although the appendix has no known function, it does regularly fill and empty itself of food. Appendicitis occurs when the appendix becomes inflamed from ulceration of the mucosa or obstruction of the lumen.


Pathophysiology

Appendicitis begins when the appendix becomes obstructed or inflamed. Irritation and inflammation lead to engorged veins, stasis, and arterial occlusion. Eventually bacteria accumulate, and the appendix can develop gangrene. Appendicitis is the most common cause of acute inflammation in the right lower quadrant of the abdominal cavity and is the most common surgical emergency.

Causes

Appendicitis probably results from an obstruction of the appendiceal lumen, caused by a fecal mass, stricture, barium ingestion, or viral infection. This obstruction sets off an inflammatory process that can lead to infection, thrombosis, necrosis, and perforation.

Complications

• peritonitis
• appendiceal abscess
• pyelophlebitis

Assessment Nursing Care Plans For Appendicitis

Patients often complain of anorexia, nausea, vomiting, abdominal distension, and temporary constipation. Temperature elevations may also be reported (usually 100°F to 101°F).
Palpation of the abdomen reveals slight muscular rigidity and diffuse tenderness around the umbilicus and midepigastrium. Later, as the pain shifts to the right lower quadrant, palpation generally elicits tenderness at McBurney’s point. Right lower quadrant rebound tenderness is typical. Also, a positive Rovsing’s sign may be elicited by palpating the left lower quadrant, which results in pain in the right lower quadrant.

Diagnoses Nursing Care Plans For Appendicitis

• Acute pain
• Imbalanced nutrition: Less than body requirements
• Impaired skin integrity
• Ineffective tissue perfusion: GI
• Risk for deficient fluid volume
• Risk for infection
• Risk for injury

Key outcomes

• Patient will express feelings of comfort.
• Patient will maintain adequate caloric intake.
• Patient’s skin integrity will remain intact.
• Patient will maintain adequate GI perfusion.
• Patient’s fluid volume will remain within normal parameters.
• Patient will remain free from signs and symptoms of infection.
• Patient will avoid or minimize complications.