1.

Study of the Illness Condition

ANATOMY PHYSIOLOGY PATHOHYSIOLOG ANALYSIS

ASSESSMENT Y
Signs and Appendicitis:
Symptoms: See picture below Appendix: Acute appendicitis is a sudden
- Abdomina For many years, the appendix was and severe inflammation of the
l pain in considered a vestigial organ with appendix, caused by an obstruction
the RLQ very limited physiological function, of the appendiceal lumen that if left
- Loss of and it was frequently overlooked. untreated, spreads to the other
appetite The appendix is a lymphoid organ part of the body.
- Nausea that aids in the maturation of B
- Vomiting lymphocytes (a kind of white blood Abdominal Pain in the RLQ:
- Mild cell) and the generation of The most primary presenting complaint of
discomfort antibodies known as immunoglobin patients with acute appendicitis. The
around the A. It is a member of the primary sharp pain can also start near the belly
umbilicus immune system. The appendix also button then move lower right. Along with
Vital Signs aids in the migration of “classical” signs of peritoneal irritation
(before lymphocytes to other regions of the such as rebound tenderness, guarding,
surgery): body. The appendix also appears to rigidity may be present due to the
Temperature: 39C expose white blood cells to a wide inflamed appendix.
(After Surgery) range of antigens found in the GI
BP: 110/70 tract. It promotes local immunity Loss of appetite, Nausea, Vomiting:
mmHg while suppressing potentially Loss of appetite is a predominant feature
RR: 20bpm harmful humoral antibody followed by nausea and vomiting, that
PR: 89 bpm responses. It was previously suggest intestinal obstruction. Vomiting
Temp: 35.9 thought to be non - functional. It indicates the development of generalized
O2 Sat: 96% was once thought to be a peritonitis after perforation (since the
nonfunctional tissue, but it is now client’s S&S showed an early sign of
Lab Values: thought to be a "back-up" that can peritonitis).
WBC: 25.2 x be used in several reconstructive
1000/mm3 surgical techniques. 39C temperature:
 The fever indicates that the appendix
Urine color: Dark Large Intestine: ruptured, the infection has already spread
Yellow and our immune system is fighting and
Sp. Gravity: The large intestine is much broader killing the bacteria present in the body.
1.040 than the small intestine and takes a
Stool much straighter path through your WBC-HIGH:
Consistency: belly, or abdomen. The purpose of High level of white blood cells indicates
Watery the large intestine is to absorb water the bacterial infection caused by the
and salts from the material that has ruptured appendix.
Diagnostic not been digested as food and get
Procedures: rid of any waste products left over. Dark Yellow urine color:
- Abdomina In the large intestine, bacteria feed The presence of dark yellow urine
l on this mixture. These helpful indicates dehydration and a urinary tract
ultrasound bacteria produce valuable vitamins infection in the patient. Because the
- Complete that are absorbed into your blood, patient is vomiting and losing appetite,
Blood and they also help digest fiber. The he is not getting enough water or food,
Count large intestine is made up of the which can lead to dehydration. Because
- Urinalysis following parts: Cecum, Colon, there are early signs of peritonitis, the
- Stool Rectum. infection may cause the urine to appear
Analysis dark in color.

SP Gravity- Elevated:
Slightly elevated sp gravity in the urine
indicates dehydration and UTI that is
caused by the ruptured appendix.

Watery stool:
A watery stool implies dehydration and a
bowel obstruction.

Abdominal Ultrasound:
Ultras Ultrasound is inexpensive safe and
diagnosing appendicitis accuracy ranges
 from 71-97%. It visualizes the abdominal
cavity specifically the in the McBurney’s
point and other signs that may help in
diagnosing appendicitis such as the
hyperechoic appendicolith and an
increased vascularity of the appendiceal
wall and fluid accumulations in the RLQ.

Complete Blood Count:

Blood tests role in decision-making
process. WBC and neutrophils are higher
with patients that has acute appendicitis
because of the inflamed and ruptured
appendix that may lead to infection.

Urinalysis:
Urinalysis may help to make sure that
there is no UTI or a kidney stone causing
the pain. Mainly because of the proximity
of the appendix to the right ureter, UTI
may occur that can cause urinary
obstructions.

Stool Analysis:
Stool buildup is the most common cause
of appendicitis. Stool analysis may help to
see if there are infections and might cause
bowel obstructions.
References: References: References: Al-gaithy, Z.K. Clinical value of total
Guo., Richard, L. A. Martin, L. (n.d.). Yu, Rosen, Y. W. white blood cells and neutrophil counts in
(n.d.). McBurney’s Point. What is the function of the human (2019, July 27).  patients with suspected appendicitis:
Osmosis. Retrieved appendix? Did it once have a Appendicitis: retrospective study. World J Emerg
October 12, 2021, from purpose that has since been lost? Pathogenesis Surg 7, 32 (2012).
https://www.osmosis.org/a Scientific American. and Clinical https://doi.org/10.1186/1749-7922-7-32
nswers/mcburneys-point Retrieved October 8, 2021, from Findingas.
https://www.scientificamerican.co Calgaryguide. Martin RF. Acute appendicitis in adults:
m http://calgaryguide.uc Clinical manifestations and differential
/article/what-is-the-function-of-the- algary.ca/wp- diagnosis.
human-appendix-did-it-once-have- content/uploads/2015/ https://www.uptodate.com/contents/searc
a-purpose-that-has-since-been-lost/ 05/Appendicitis-1.jpg h. Accessed May 4, 2021.

Animated Medical Elikashvili I, Tay ET, Tsung JW. The

Differences in Small & Large Videos, & Prakash, effect of point-of-care ultrasonography on
Intestines | Children's Pittsburgh D. G. B. (2020, emergency department length of stay and
Do you know the main differences December 16).  computed tomography utilization in
between the small and large Acute Appendicitis children with suspected
intestines? Learn exactly how your USMLE appendicitis. Acad Emerg Med.
body absorbs . . . Step 1: Etiology, 2014;21(2):163–170.
https://www.chp.edu/our- Pathopysiology,
services/transplant/intestine/educa .  Clinical Features,
. . Diagnosis,
Treatment. Dr. G
Bhanu Prakash
Animated
Medical
Videos.
https://www.youtube.
com/watch?
v=12PBBbWLpKM

Life threatening
pathway:
MD, Khatri, M.
(2019, September 28).
Appendicitis.
WebMD.
 https://www.webmd.c
om/digestive-
disorders/digestive-
diseases-appendicitis

Pathophysiology: Appendicitis

(Fecalith, Fibrosis, neoplasia, foreign

bodies, lymph nodes (kids)

Obstruction of the appendiceal lumen

 MECHANISM: Signs and Symptoms:

Stretching of the visceral Dull ,Crampy periumbilical pain

peritoneum

Distention and Spasms of the Appendix

Fever, Diarrhea, Constipation

Vomiting, Anorexia
Progression of inflammation

+ lumen pressure, - blood flow to

Focal, Intense, Persistent RLQ pain,
appendix
abdominal guarding and peritoneal
signs (percussion and rebound
tenderness)

Loss of structural integrity of the

appendix
Irritation of parietal peritoneum

Resolved through Surgery:

Appendectomy
Bacterial invasion of the appendix wall
(Inflammation)
B: Life Threatening Pathways (Patient’s refusal/ non-compliance with treatment)

Signs and symptoms of over 48 hours

RLQ pain Abdominal swelling

Nausea Fatigue
 Ruptured Appendix

Leak of bacterial (infected) content into the

abdomen cavity

Complications

Peritonitis Abscess Death