APPENDICITIS

Presented by Group 3:
Cruz, Nicole Anne
Dimaangay, Jen Louise
Dionela, Dorothy Jane
Sison, Chelcon
Sy, Louise Kiana
Torres, William Albert Henry
Risk Factors:
● Age - children and young adults (10 - 30 years old)
● Males > Females
● Family history
● Infection
● Trauma to the appendix
● Low fiber diet
Clinical signs:
● (+) vague periumbilical RLQ pain
● Low-grade fever
● Nausea
● Abdominal
● Constipation
● (+) McBurney’s sign: Rebound Tenderness
● (+) Rovsing sign: Palpation of the LLQ
● (+) Obturator sign: Internal rotation and knee flexion
● (+) Psoas sign: Back extension of right thigh
Diagnostic Tests

Physical Examination
● McBurney’s Point Test
● Rovsing’s Sign
● Psoas Sign
● Obturator Sign

Radiologic
● Abdominal X-ray
● Abdominal Ultrasound
● Magnetic Resonance Imaging (MRI)
● Computed Tomography (CT) Scan

Laboratory
● Blood Test
● C-Reactive Protein (CRP) Blood Test
● Urinalysis
Medical Management: Surgical Management:
● Immediate NPO
● Uncomplicated: Antibiotics and IV fluids 1. Appendectomy
- Piperacillin and Tazobactam a. Preoperative:
- D5LR i. Immediate NPO
● Complicated: Surgery + 3-5 days antibiotic ii. IV infusion: D5LR
● Food is provided as desired and tolerated after iii. Antibiotics
surgery when bowel sounds are present. iv. Analgesics (seldom to give)
● (+) Abscess formation b. Post-operative:
- Delay surgery i. Position patient in high-fowler’s
- Percutaneous/surgical drainage
ii. Incentive Spirometry Q2H
- Antibiotics
iii. Give opioids: Morphine
Pharmacologic Management: iv. Monitor bowel sounds and
passage of flatus
● Uncomplicated appendicitis
1. Antibiotics: Piperacillin and Tazobactam v. Gradual diet progression
(Zosyn) vi. Early ambulation
2. IV therapy vii. Avoid lifting
viii. Incision care
Nursing Management:

● Assessing and relieving pain through medication administration as

well as nonpharmacologic interventions.
● Prevent fluid volume deficit by administering IV fluids.
● Prevent infection. Provide wound care to incision site and assess
frequently for signs of infection.
● Gradual diet progression
● Monitor for adequate bowel movements. Encourage adequate water
intake and use of a stool softener. Auscultate for the return of bowel
sounds and queries the patient for passing of flatus.
● Encourage the patient to ambulate the day of surgery to reduce risks
of atelectasis and venous thromboemboli formation.
● Instruct the patient not to lift or strain as it may increase abdominal
pressure and may lead to dehiscence.
THANK YOU!