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NIM. P07120214026



Appendix is part of the large intestine that appears like a funnel from secum end, has a narrow
exit but still allows it can be passed by a couple of intestinal contents. Because of their small size
and close to the intestine, the appendix becomes vulnerable to infection. Infections that occur in
the appendix is called appendicitis. Appendicitis is the obstructed appendix becomes inflamed
and edematous and eventually fills with pus which is most common cause of acute inflammation

in the right lower quadrant of the abdominal cavity and the most common cause of emergency
abdominal surgery. Appendicitis more commonly occurs between the ages of 10 to 30 years, but
it can occur at any age.
1. Clinical Manifestations
Typical symptoms are felt by patients with appendicitis is Rovsings sign (can be
identified by palpation techniques on left lower quadrant, causes pain in right lower
quadrant). This symptom is usually accompanied by low-grade fever, nausea, vomiting,
loss of appetite, muscle spasm, diarrhea and constipation . In addition, patients also
experience local tenderness with pressure and some rigidity of the lower portion of the
right rectus muscle at McBurneys point. A few moments later, pain becomes more
diffuse; abdominal distention develops from paralytic ileus and condition worsens.
2. Assessment and Diagnostic Findings
Diagnosis is based on a complete physical examination, laboratory and imaging tests.
Test results that indicate a person is diagnosed appendicitis are elevated WBC count with
an elevation of the neutrophils; abdominal radiographs, ultrasound studies and CT scans
can show a local distension of the bowel.
3. Gerontologic Considerations
In the elderly, signs and symptoms of appendicitis may vary greatly. Some patients may
experience no symptoms until the appendix ruptures. Appendicitis occurs in the elderly
due to many of these people do not taking care of themselves and maintain health as early
as possible.
4. Medical Management
Medical management can be used to treat patients with a diagnosis of appendicitis is
surgery that is should be done as soon as possible to decrease the risk of perforation,
administer antibiotics and IV fluids and give analgesic agent.
5. Complications of Appendectomy
The major complication is perforation of the appendix that is generally occurs 24 hours
after the onset of pain , which can lead to peritonitis, abscess formation, or portal
6. Nursing Management
Nursing goals include relieving pain, preventing fluid volume deficit, reducing anxiety,
eliminating infection due to the potential or actual disruption of the GI tract, maintaining
skin integrity and attaining optimal nutrition. Before surgery nurse have to prepare patient
for surgery, start IV line, administer antibiotic and insert nasogastric tube and do not
administer an enema or laxative. When the operation is complete, instruct the patient to

rest with high Fowlers position, give analgesic as ordered, administer oral fluids or IV
fluids and food when tolerated. In addition, nurse have to monitor carefully for signs of
intestinal obstruction, secondary hemorrhage, or secondary abscesses.
7. Promoting Home and Community-Based Care
Teach patient and family to care for the wound and perform dressing changes and
irrigations as prescribed. Suggestion to immediately give a follow-up to the surgeon if
necessary and continue to monitor complications and wound healing.