INTRODUCTION

Appendicitis means inflammation of the appendix. It is thought that appendicitis begins when the opening from the appendix into the cecum
becomes blocked. The blockage may be due to a build-up of thick mucus within the appendix or to stool that enters the appendix from the
cecum. The mucus or stool hardens, becomes rock-like, and blocks the opening. This rock is called a fecalith (literally, a rock of stool). At
other times, the lymphatic tissue in the appendix may swell and block the appendix. After the blockage occurs, bacteria which normally are
found within the appendix begin to invade (infect) the wall of the appendix. The body responds to the invasion by mounting an attack on the
bacteria, an attack called inflammation. An alternative theory for the cause of appendicitis is an initial rupture of the appendix followed by
spread of bacteria outside the appendix.. The cause of such a rupture is unclear, but it may relate to changes that occur in the lymphatic tissue,
for example, inflammation, that line the wall of the appendix.)

If the inflammation and infection spread through the wall of the appendix, the appendix can rupture. After rupture, infection can spread
throughout the abdomen; however, it usually is confined to a small area surrounding the appendix (forming a peri-appendiceal abscess).

Sometimes, the body is successful in containing ("healing") the appendicitis without surgical treatment if the infection and accompanying
inflammation do not spread throughout the abdomen. The inflammation, pain and symptoms may disappear. This is particularly true in elderly
patients and when antibiotics are used. The patients then may come to the doctor long after the episode of appendicitis with a lump or a mass
in the right lower abdomen that is due to the scarring that occurs during healing. This lump might raise the suspicion of cancer.
What are the complications of appendicitis?

The most frequent complication of appendicitis is perforation. Perforation of the appendix can lead to a periappendiceal abscess (a collection
of infected pus) or diffuse peritonitis (infection of the entire lining of the abdomen and the pelvis). The major reason for appendiceal
perforation is delay in diagnosis and treatment. In general, the longer the delay between diagnosis and surgery, the more likely is perforation.
The risk of perforation 36 hours after the onset of symptoms is at least 15%. Therefore, once appendicitis is diagnosed, surgery should be
done without unnecessary delay.

A less common complication of appendicitis is blockage of the intestine. Blockage occurs when the inflammation surrounding the appendix
causes the intestinal muscle to stop working, and this prevents the intestinal contents from passing. If the intestine above the blockage begins
to fill with liquid and gas, the abdomen distends and nausea and vomiting may occur. It then may be necessary to drain the contents of the
intestine through a tube passed through the nose and esophagus and into the stomach and intestine.

A feared complication of appendicitis is sepsis, a condition in which infecting bacteria enter the blood and travel to other parts of the body.
This is a very serious, even life-threatening complication. Fortunately, it occurs infrequently.

A. Current trends
B. Reasons for choosing such case

►Hospital setting offers variety of experiences that can enhance our ability as health care providers. I have chosen this case for the
purpose of being familiar with this disease and its complication, management, and adequate medication. By doing so, our exposure to surgery ward will
give us meaningful experience that will broaden our passion in providing quality care to patients.

C. Objectives

Student-Centered

1. To be able to identify risk factors that may cause appendicitis

2. To familiarize the pathophysiology of the disease.

3. To be able to give proper health teachings to the patient

4. To develop and enhance skills in using nursing process

 Client-Centered

1.

II. Nursing Assessment

A. Personal History

DEMOGRAPHIC DATA
NAME: Ading
AGE: 6 y/o
GENDER: female
DATE OF BIRTH: July 16, 2003
PLACE OF BIRTH: Tarlac Provincial Hospital
RELIGION: Catholic
DATE OF OPERATION: Nov. 11, 2009
DIAGNOSIS: Acute appendicitis (generalized peritonitis r/t ruptured appendix
FINAL DIAGNOSIS: Appendicitis

HISTORY OF PAST ILLNESS

According to the medical history of the client, ading had no other diagnosed illness.

HISTORY OF PRESENT ILLNES

5 days prior to admission, adding experienced vomiting and decrease appetite.

PHYSICAL ASSESSMENT
DIAGNOSTIC AND LAB PROCEDURES
DIAGNOSTIC & DATE INDICATIONS OR RESULTS NORMAL ANALYSIS AND
LABORATORY ORDERED PURPOSES VALUES INTERPRETTATION
PROCEDURE
Hemoglobin November 15, Hemoglobin is a 97. g/l 120. – 180 g/l Decreased:
2009 protein inside red low nutrition intake
blood cells that carries leading to depletion in
oxygen. A hemoglobin immunity level causes
test reveals how much decrease hemoglobin
hemoglobin is in a count in general
person's blood.

Hematocrit November 15, The hematocrit is a test .306 .370 - .510 Decreased:
2009 that measures the a decrease in oxygen
percentage of blood will result with an
that is comprised of increase of red blood
red blood cells. cell production

RBC November 15, Red blood cell indices
2009 are measurements that
describe the size and
oxygen-carrying
protein (hemoglobin)
3.70 T/L 4.20 – 6.30 T/L Increased:
more carriers for
hemoglobin to
compensate for the
lower levels of oxygen
 content of red blood
cells.
WBC November 15, Formed elements 12.9 g/l 4.1 – 10.9 Increased:
2009 which fight bacteria An increase and
decrease of WBC
usually indicates
infection
Platelets November 15, Smallest formed 299. g/l 140. -440. NORMAL RANGE.
2009 elements in blood
which promotes
coagulation.