Appendicitis
Appendicitis
Appendicitis
Initial Management:
Suspected appendicitis in children
needs immediate hospital admission as it is
a medical emergency. There is a low threshold
for admitting children and infants with
suspected appendicitis. Research shows that
young children with appendicitis have increased
mortality due to delayed presentation and
often have atypical signs and symptoms.
Medical Management/Surgical
Acute management of patients with suspected
appendicitis:
• IV access
• Fluid resuscitation
• Contact surgical team to discuss IV antibiotics, whether
to make the child NBM and if surgical intervention is
needed*.
Diagnosis:
• Based on the assessment data, the most
appropriate diagnoses for a patient with
appendicitis are:
• Acute pain related to obstructed appendix.
• Risk for deficient fluid volume related to
preoperative vomiting, postoperative
restrictions.
• Risk for infection related to ruptured
appendix.
Nursing Management
Evaluation:
• Relieved pain.
• Prevented fluid volume deficit.
• Reduced anxiety.
• Eliminated infection due to the potential or
actual disruption of the GI tract.
• Maintained skin integrity.
• Attained optimal nutrition.
Nursing Management
Discharge and Home Care Guidelines:
• Discharge teaching for patient and family is imperative.
• Removal of sutures. The nurse instructs the patient to
make an appointment with the surgeon to remove the
sutures between the 5th and 7th days after surgery.
• Activities. Heavy lifting is to be avoided
postoperatively; however, normal activity can be
resumed within 2 to 4 weeks.
• Home care. A home care nurse may be needed to
assist with incision care and to monitor the patient for
complications and wound healing.