Appendicitis

Question 1

Where is the appendix located?

Answer 1

Right where the small and large intestine meet.

Question 2

What is a definition of appendicitis and why is it called that?

Answer 2

Inflammation of vermiform appendix. Because it looks like a worm.

Question 3

What percent of the population does this effect and when does it most commonly occur?

Answer 3

5% of the population. Most common in adolescents and young adults.

Question 4

Where is McBurneys point located?

Answer 4

2/3 of the way from umbilicus to Anterior Superior Iliac Spine.

Question 5

Why is McBurney’s point a classic sign?

Answer 5

When you push on it and release it quickly the patient experiences rebound tenderness.

Question 6

What can happen within 24-36 hours to an acutely inflamed appendix?

Answer 6

It can perforate from tissue necrosis and gangrene

Question 7

If perforation occurs what symptom will disappear from the patient?

Answer 7

Sudden disappearance of pain at McBurney’s point.

Question 8

What has occurred if the patient has a sudden disappearance of pain at McBurney’s point?

Answer 8

The appendix has perforated. Immediate surgery is required.

Question 9

What symptoms does a patient exhibit if t hey has appendicitis?

Answer 9

not wanting to eat, mild temperature increase, increased white blood cell count, nausea, vomiting.

Question 10

What diet is most susceptible for an individual to have appendicitis?

Answer 10

Low fiber high carbs

Question 11

Who is at the greatest risk for appendicitis?

Answer 11

adolescent males

Question 12

What is the main sign in older adults that they may have appendicitis?

Answer 12

Confusing! Often misdiagnosed.

Question 13

What are the symptoms in infants that they have appendicitis?

Answer 13

Listlessness, inconsolability, vomiting, distended abdomen.

Question 14

What diagnostic tests needs to be done to show appendicitis?

Answer 14

Abdominal ultrasound, intravenous pyelogram, urinalysis, pelvic exam, WBC with differential, pregnancy test.

Question 15

Why is it important to do a pregnancy test on a female you think may have appendicitis?

Answer 15

To rule out ectopic pregnancy.

Question 16

What kind of antibiotic are generally prescribed for appendicitis?

Answer 16

3rd generation cephalosporins.

Question 17

Why is it important to assess the patients most recent food and fluid intake?

Answer 17

They probably need to head to surgery.

Question 18

What are the three main diagnosis for a patient with appendicitis?

Answer 18

• Risk for impaired gas exchange
• Risk for deficient fluid volume
• Risk for infection

Question 19

Why is it important for a patient who underwent surgery to use a incentive spirometer?

Answer 19

To blow the anesthesia out of the lungs

Question 20

Why is it important to encourage ambulation after surgery?

Answer 20

Gets peristalsis going.

Question 21

If a patient underwent laparoscopic surgery do they need to splint their incision when coughing?

Answer 21

No- the incision should be small enough

Question 22

What vital sign is important to note for potential infection?

Answer 22

Fever

Question 23

If a patients appendix ruptured what do you need to assess after surgery?

Answer 23

Wound and abdominal girth

Question 24

In order to not overwhelm the belly after surgery what do you need to educate the patients and parents on?

Answer 24

Reestablishing the diet slowly

Question 25

Who are you most likely educating when preparing the patient for surgery and discharge?

Answer 25

A child and their parent.

Question 26

The nurse caring for a client admitted with suspected appendicitis appropriately plans which of the following?
A. Initiate bowel preparation for a barium enema.
B. Restrict intake to clear fluids.
C. Prepare for a possible appendectomy.
D. Insert a saline lock for antibiotic therapy.

Answer 26

C. Prepare for possible appendectomy.

Question 27

The parent of a child undergoing an emergency appendectomy tell the nurse, “If I had brought my child in yesterday at the first complaint of an upset stomach, this wouldn’t have happened.” Which of the following is the best response by the nurse?

1. “It’s okay; you got here just in time before it ruptured.”
2. “It can be difficult to predict when a simple complaint will become more serious.”
3. “Next time your child seems sick, come in right away.”
4. “Sometimes parents can make a mistake without meaning to do so.”

Answer 27

2. “It can be difficult to predict when a simply complaint will become more serious.”

This can help calm the parent.