APPENDICITIS.pptx- introduction, definition, causes, sign and symptoms,

Appendicitis is an inflammation of appendix that develops most common in adolescents and young adults.
Appendicitis is acute inflammation of the appendix, and is the most common cause for acute, severe abdominal pain.

1. APPENDICITIS Saumya Yadav Nursing Tutor

2. DEFINITION Appendicitis is an inflammation of appendix that develops most common in adolescents and young adults. Appendicitis is acute inflammation of the appendix, and is the most common cause for acute, severe abdominal pain. 3

3. RISK FACTORS Infection, possibly stomach infection that has traveled to the site of appendix. Obstruction such as a hard piece of stool getting trapped in the appendix leading to infection of the appendix. Extreme of age Previous abdominal surgery

4. PATHOPHYSIOLOGY

5. TYPES Acute Appendicitis : Acute appendicitis, as its name implies, develops very fast, usually in a span of several days or hours. It is easier to detect and requires prompt medical treatment, usually surgery. Acute appendicitis occurs when the vermiform appendix is completely obstructed, either because of a bacterial infection, feces or other types of blockage. Infection may also cause swelling of the lymph nodes, which then adds pressure on the appendix, cutting off its blood supply.

6. TYPES Appendicitis Can Be Chronic (But It's a Rare Condition) Chronic appendicitis is an inflammation that can last for a long time. This is rare according to a report published in Therapeutic Advances in Gastroenterology, it only occurs in only 1.5 percent of recorded acute appendicitis cases. Basically, chronic appendicitis means that the appendiceal lumen is only partially obstructed, causing inflammation. The inflammation worsens over time, causing internal pressure to buildup. 8

7. CLINICAL MANIFESTATIONS Abdominal pain Anorexia Constipation Diarrhea Fever Migration of pain to right lower quadrant Nausea Vomiting 20XX 9

8. CLINICAL MANIFESTATIONS Abdominal tenderness Right lower quadrant tenderness Rectal tenderness Cervical motion tenderness Rigidity 20XX 10

9. CLINICAL MANIFESTATIONS Rovsing's sign : Palpating in the left lower quadrant causes pain in the right lower quadrant Obturator's sign : Internal rotation of the hip causes pain, suggesting the possibility of an inflamed appendix located in the pelvis Dunphy's sign : Increased pain in the right lower quadrant with coughing. Iliopsoas sign : Extending the right hip causes pain along posterolateral back and hip, suggesting Retrocecal appendicitis. Sitkovskiy (Rosenstein)'s sign : Increased pain in the right iliac region as the person is being examined lies on his/her left side. 20XX Pitch deck title 11

10. Diagnosis History Collection Physical Examination Blood Test: Complete blood count Imaging Technique: Abdominal X-rays CT Scan: Dilated appendix with distended lumen ( >6 mm diameter); Thickened and enhancing wall; Thickening of the caecal apex (up to 80%) Ultrasonography: Aperistaltic, non- compressible, dilated appendix (>6 mm outer diameter); Distinct appendiceal wall layers; Periappendiceal fluid collection/enlargement 20XX 12

11. ALVARADO SCORE 20XX Pitch deck title 14

12. MEDICAL MANAGEMENT Analgesics : Morphine sulphate 10 mg/ml Antibiotics : Cefotaxime; Levofloxacin; Metronidazole IV fluids administration Antipyretics Antiemetics Antidiarrheal 20XX Pitch deck title 15

13. SURGICAL MANAGEMENT • Appendectomy : (ie, surgical removal of the appendix) is performed as soon as possible to decrease the risk of perforation. It may be performed under a general or spinal anesthetic with a low abdominal incision or by laparoscopy. 20XX Pitch deck title 16

14. NURSING MANAGEMENT Goals include relieving pain, preventing fluid volume deficit, reducing anxiety, eliminating infection from the potential or actual disruption of the G.l. tract, maintaining skin integrity, and attaining optimal nutrition. The nurse prepares the patient for surgery, which includes an intravenous infusion to replace fluid loss and promote adequate renal function and antibiotic therapy to prevent infection. 20XX Pitch deck title 18

15. Pre-Operative care: Assessment History taking physical examinations, Regarding pain, nausea vomiting, abdominal rebound tenderness, Anorexia Monitor vital signs B.P., Temperature for baseline data NPO and I.V. Fluids be started Naso -gastric aspiration Monitor for signs of ruptured appendix and peritonitis Position right-side lying or low to semi fowler position to promote comfort. 20XX Pitch deck title 19

16. Pre-Operative care: 20XX Pitch deck title 20 Auscultate Bowel Sounds Administer antibiotics as prescribed Preparation for surgery i.e. physically & psychologically Written consent for surgery Prepare and send the patient for surgery without delay OT clothes and pre medications to be given 45 minutes before operation

17. Post-Operative Nursing care: Clear airway Proper breathing and adequate tissue perfusion by IVF Naso-gastric suction to be done regularly to relieve tension on sutures Provide safety & effective care environment to the patient Care of all drainage tubes Care of surgical wounds. Watch for bleeding Nutritional status maintained by I.V. fluids 20XX 21

18. Post-Operative Nursing care: Intake and output maintained Monitor vital signs & fluid, electrolytes balance Encourage early ambulation to prevent post operation complications. Maintain NPO till bowel sounds return then start clear fluids orally Medication as per prescription to be given by using 6 rt of Nursing standards of medication Drugs - Antibiotics, analgesic & Anticholenergies i.e. Injection Aciloc as per prescription After surgery, the nurse places the patient in a semi-Fowler position. This position reduces the tension on the incision and abdominal organs, helping to reduce pain. 20XX 22

19. NURSING DIAGNOSIS Acute pain may be related to, distension of intestinal tissues by inflammation, presence of surgical incision Risk for fluid volume deficit , risk factors may include, preoperative vomiting, postoperative restrictions (e.g., NPO), hypermetabolic state (e.g., Fever, healing process) inflammation of peritoneum with sequestration of fluid Risk for infection , risk factors may include, inadequate primary defenses; perforation/rupture of the appendix; peritonitis; abscess formation, invasive procedures, surgical incision Deficient knowledge may be related to lack of exposure/recall; information misinterpretation, unfamiliarity with information resources 20XX Pitch deck title 23

20. COMPLICATIONS Peritonitis Pelvic abscess Subphrenic abscess (abscess under the diaphragm) 20XX Pitch deck title 24