Post appendectomy ncp

1st Post op NCP Should be continuation of Pre op nursing care plan
Purpose of using care plan is to individualize and improve care provided to client
Appendectomy is the surgical removal of the appendix
Pre op preparations for patient under go surgery are patient history, lab investigation, allergies, NPO, I.V. fluids, preoperative medication, teaching, consent, ……..
Post op monitoring include Vital signs, Intake & output, Pain relief, Bowel sounds, Wound healing.
continuous patient health education from admission to discharge

1. How can I put this lightly?  The sooner you come to love nursing care plans, the easier your career as a nurse will be. The relationship that most nurses have with care plans goes something like this: What the hell is a care plan? This seems easy! Agh ! Why do they keep telling me my diagnosis is wrong? Screw it! I’ll just Google and copy some random care plan. I’ll never do these again once a graduate. Finally! I graduated . . . goodbye care plans.

2. Please take a minute and think positively What does it mean to you to be accredited by JCI, CABHI? What do you think which accreditation should come next ? Are you ready for next challenge? How it can benefit you? What do you think you need ?

3. Long way Challenges and difficulties Some confusions Beginning The first step The end of successful journey About to arrive Start

4. Nursing care plan post appendectomy Jamilah Saad Alqahtani MSN,BSN,RGN EDUCATION DEPARTMENT

5. OUTLINES

6. Process of nursing care plan

7. Introduction Acute appendicitis (AA) is considered as one of the most common causes of surgical emergencies worldwide (1). The gold standard treatment for AA is Appendectomy (2). About 6% of the population during their lifetime, will suffer from acute appendicitis (3,4). Males suffer from acute appendicitis more than females (8.6% and 6.7% respectively) (5,6). Acute appendicitis rarely causing death; with a mortality rate ranges from zero up to 2.4% (8). However, more attention has been directed for early diagnosis and intervention. 1. Douglas, Charles D., et al. " Randomised controlled trial of ultrasonography in diagnosis of acute appendicitis, incorporating the Alvarado score." Bmj321.7266 (2000): 919. 2. Schwartz SI, Brunicardi FC. Schwartz’s Principles of Surgery. 9thed. New York: McGraw-Hill, Medical Pub. Division; 2010. pp. 1073–1082. 3. Cuschieri , A. "The small intestine and vermiform appendix." Essential surgical practice 3 (1995): 1325-8. 4. Kanumba , Emmanuel S., et al. "Modified Alvarado scoring system as a diagnostic tool for acute appendicitis at Bugando Medical Centre, Mwanza, Tanzania." BMC surgery 11.1 (2011): 1. 5. Von Titte , Sigmond N., Charles J. McCabe, and Leslie W. Ottinger . "Delayed appendectomy for appendicitis: causes and consequences." The American journal of emergency medicine 14.7 (1996): 620-622. 6. England, R. J., and D. C. G. Crabbe. "Delayed diagnosis of appendicitis in children treated with antibiotics." Pediatric surgery international 22.6 (2006): 541-545. 7. Shawana, et al. "CAUSES OF DELAYED PRESENTATION OF ACUTE APPENDICITIS AND ITS IMPACT ON MORBIDITY AND MORTALITY." Journal of Ayub Medical College Abbottabad 27.3 (2015): 620-623. 8. Ohmann,37. Hussain MI, Al- Akeely MH, Alam MK, Al- Qahatani HH, Al- Salamah SM, Al- Ghamdi OA (2012): Management of appendiceal abscess. A 10-year experience in Central Saudi Arabia. Saudi medical journal., 33(7):745-

8. Brief View Of Appendectomy Appendectomy is the surgical removal of the appendix. An inflamed appendix may be removed using a laparoscopic approach with laser. However, the presence of multiple adhesions, retroperitoneal positioning of the appendix, or the likelihood of rupture necessitates an open (traditional) procedure. Studies indicate that laparoscopic appendectomy results in significantly less postoperative pain, earlier resumption of solid foods, a shorter hospital stay, lower wound infection rate, and a faster return to normal activities than open appendectomy.

9. Appendectomy Brief Review Surgical management

10. Post appendectomy nursing care plan Nursing care planning and management for patients who underwent appendectomy includes: preventing complications, promoting comfort, and providing information .

11. Post appendectomy nursing care plan

12. Nursing Assessment Reminder ‘’Purpose of using care plan is to individualize and improve care provided to client’’

13. Nursing Diagnosis Acute pain Imbalance nutrition: less than body requirements Impaired skin integrity Ineffective tissue perfusion: GI Risk for deficient fluid volume Risk for infection

14. Key outcomes The patient will: Express feeling of comfort and decrease pain Maintain calorie requirement Maintain skin integrity Maintain adequate GI tissue perfusion Maintain normal fluid volume Remain free from signs and symptoms of infection

15. Nursing Interventions Maintain NPO status until surgery is performed Administer I.V. fluids Avoid administering analgesic until the diagnosis is confirmed Avoid administering enemas that may rupture appendix Place the patient in fowler’s position to decrease pain NURSING ALERT Never apply heat to the right lower abdomen; this can cause the appendix to rupture Administer prescribed preoperative medication

16. Monitoring After Surgery Vital signs Intake & output Pain relief Bowel sounds, passing of flatus or bowel movements Wound healing

17. Assistant Tools & Forms Used in AFHSR Initial assessment Adult Reassessment evaluation Care of plan Pain assessment Fluid balance Risk fall assessment

18. Health Education For Post Appendectomy Be sure to cover: Disorder, diagnosis and treatment Pre op teaching Possible complications Appropriate wound care Medication administration and possible adverse effects Postop limitations

19. Conclusion 1 st Should be continuation of pre op nursing care plan Purpose of using care plan is to individualize and improve care provided to client Appendectomy is the surgical removal of the appendix Pre op preparations for patient under go surgery are patient history, lab investigation, allergies, NPO, I.V. fluids, preoperative medication, teaching, consent, …….. Post op monitoring include Vital signs, Intake & output, Pain relief, Bowel sounds, Wound healing. continuous patient health education from admission to discharge

20. References 1. Douglas, Charles D., et al. " Randomised controlled trial of ultrasonography in diagnosis of acute appendicitis, incorporating the Alvarado score." Bmj321.7266 (2000): 919. 2. Schwartz SI, Brunicardi FC. Schwartz’s Principles of Surgery. 9thed. New York: McGraw-Hill, Medical Pub. Division; 2010. pp. 1073–1082. 3. Cuschieri , A. "The small intestine and vermiform appendix." Essential surgical practice 3 (1995): 1325-8. 4. Kanumba , Emmanuel S., et al. "Modified Alvarado scoring system as a diagnostic tool for acute appendicitis at Bugando Medical Centre, Mwanza, Tanzania." BMC surgery 11.1 (2011): 1. 5. Von Titte , Sigmond N., Charles J. McCabe, and Leslie W. Ottinger . "Delayed appendectomy for appendicitis: causes and consequences." The American journal of emergency medicine 14.7 (1996): 620-622. 6. England, R. J., and D. C. G. Crabbe. "Delayed diagnosis of appendicitis in children treated with antibiotics." Pediatric surgery international 22.6 (2006): 541-545. 7. Shawana, et al. "CAUSES OF DELAYED PRESENTATION OF ACUTE APPENDICITIS AND ITS IMPACT ON MORBIDITY AND MORTALITY." Journal of Ayub Medical College Abbottabad 27.3 (2015): 620-623. 8. Ohmann,37. Hussain MI, Al- Akeely MH, Alam MK, Al- Qahatani HH, Al- Salamah SM, Al- Ghamdi OA (2012): Management of appendiceal abscess. A 10-year experience in Central Saudi Arabia. Saudi medical journal., 33(7):745-9. https://nurseslabs.com/4-appendectomy-nursing-care-plans/4/ http://www.rncentral.com/nursing-library/careplans/ https://doc-0s-7c-apps-viewer.googleusercontent.com/viewer/secure/pdf/ofkvilh5a7fbgg4k8hmhn0gcum46fuf9/elg9m6m1adqhjrej1sm0ihv25hf7c8ob/1521198075000/gmail/05492739580097384208/ACFrOgD7-4pf3jGWqn1ya6LH9rsY0YouITN0Y4ZuegFbcGAHpJcwh7SrZJtb8OwhiQJQyB-GvJ2eraGzx7frEt7wZ0k8gFRq9etJ68fQW9LNJN-XkyQ0BQUQ-DzYlD4=?print=true&nonce=cf5nf7r32n9fu&user=05492739580097384208&hash=of8qlbb5r4rn7sn7aegvm23377cbm2lm

21. Charles Heber McBurney , MD Harvard alumni Published first paper on appendicitis in 1889 Introduced the use of rubber gloves during operations to improve aseptic technique Pre dates antibiotics E. Patchen Dellinger, MD Harvard alumni (trained under McBurney ) Published his first paper circa 1900 Also uses rubber gloves in the OR (and rubber duckies in the bathtub) Never met an antibiotic he ever liked