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Appendicitis

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Submitted By nickngabe
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A 42 year old female arrives in the emergency room with right lower quadrant pain. I begin my assessment by asking her the onset, duration, and frequency of the pain. I would also want to know if she has nausea and vomiting, diarrhea a change in her appetite, did she take any medication to address the pain, ask about change in elimination pattern, feeling of bloating or gas, or a change in weight. I would also ask when was the last time the patient had anything to eat or drink.
While taking the history of the patient, I would want to know if they have a history of abdominal pain that could be unrelated to the current pain.
Known risk factors would include peritonitis, sepsis, or even death related to the infected appendix. If appendicitis is even suspected, doctors tend remove the appendix to avoid its rupture. If the appendix has formed an abscess, you may have two procedures: one to drain the abscess of pus and fluid, and a later one to remove the appendix.
Physical assessment of the abdomen includes inspection, auscultation, percussion, and palpation (D’Amico). Percussion and palpation should be done last to avoid disturbing bowel sounds. Normal bowel sounds should occur from 5 to 30 times per minute. I would also take her temperature to see if there she has an elevated temperature.
The following tests are usually used to make the diagnosis.

Abdominal exam to detect inflammation
Urine test to rule out a urinary tract infection
Rectal exam
Blood test to see if your body is fighting infection
CT scans and/or ultrasound.
I would tell the patient appendicitis is an inflammation of the appendix. The appendix is a part of the large intestine that normally is not used. The inflammation may be caused by bacteria or a blockage. Appendicitis may occur for several reasons, such as an infection of the appendix, but the most important factor is the obstruction of the appendiceal lumen.
Symptoms of appendicitis include right lower quadrant abdominal pain, nausea, vomiting, constipation or diarrhea. Other symptoms of an infection include increased heart and breathing rates, increased temperature, irritability, and restlessness. I would also inform her that an appendectomy is the only way to cure appendicitis and she will require emergency surgery.
Nursing notes:
42 year old female presents to emergency room with right lower quadrant pain rated 10/10 and guarding. Nausea and vomiting x 3. NPO since midnight. CT of abdomen performed and appendicitis diagnosis was made. Preparing the patient for surgery.
References:
Amico, D. D., & Barbarito, C. (2012). Health and Physical Assessment in Nursing (2nd ed.). Upper Saddle River, NJ: Pearson Education, Inc. Singh. S. (2012). Intra-abdominal and pelvic emergencies. The medical clinics of North America. Vol 96(6). Pg 1171.

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