Appendicitis for Certified Emergency Nursing (CEN)
Included In This Lesson
Study Tools For Appendicitis for Certified Emergency Nursing (CEN)
Outline
Appendicitis:
Definition/Etiology:
An appendicitis is an inflammation of the appendix. It occurs when an obstruction of the appendiceal lumen (basically the inside of the appendix), results in a decreased blood supply which, if left untreated, may progress to necrosis, perforation and peritonitis.
Pathophysiology:
The patho of an appendicitis seems to stem from an obstruction of the appendiceal lumen. The cause of this can differ in different age groups. The obstruction can be caused by infections of benign or malignant tumors and a few other uncommon causes. This obstruction can cause mucus to build up which in turn causes increased pressure. This pressure causes the wall of the appendix to become ischemic and necrotic. Bacteria grows rampant and if the appendix bursts, these organisms venture off into the peritoneal cavity and cause peritonitis.
Clinical Presentation:
Classic presentation is mild fever and periumbilical pain which moves to the right lower quadrant at McBurney’s point. It is accompanied usually by fever, and nausea and vomiting.
There are several common signs we can assess for. Rebound tenderness over McBurney’s Point. Rovsing’ sign: Rt lower quadrant pain elicited by palpation of the left lower quadrant. And one you may not be familiar with: Psoas sign: to check this, we extend the right thigh of someone lying on their back or their side with the kneed extended. Now have the patient lay flat then flex her/her right thigh at the hip, If RLQ pain results, it’s a “positive” sign.
Collaborative Management:
- Line and Labs
- NPO
- Frequent abdominal assessments
- Most will resolve on their own
- If not, obtain IV access and be ready to admin fluids
- Parenteral analgesics and antiemetics PRN
- Broad spectrum antibiotics
- Possible surgery
Evaluation | Patient Monitoring | Education:
- Hemodynamic monitoring
- Pain level
- Be aware of complete resolution of pain, could be sign of perforation
- If surgical intervention is called for, prepare patient as per your hospital policy
Linchpins: (key Points)
- Know the signs
- Inflammation
- OR ready
Transcript
For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/
References:
- Emergency Nurses Association. (2022). Emergency Nursing Orientation 3.0. Cambridge, MA: Elsevier, Inc.
- Sheehy, S. B., Hammond, B. B., & Zimmerman, P. G. (2013). Sheehy’s manual of emergency care (Vol. 7th Edition). St. Louis, MO: Elsevier/Mosby.
NCLEX
Concepts Covered:
- Circulatory System
- Emergency Care of the Cardiac Patient
- Cardiac Disorders
- Cardiovascular
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Hematology
- Gastrointestinal
- Upper GI Disorders
- Liver & Gallbladder Disorders
- Newborn Complications
- Lower GI Disorders
- Multisystem
- Neurological
- Nervous System
- Central Nervous System Disorders – Brain
- Renal
- Respiratory
- Urinary System
- Respiratory System
- Noninfectious Respiratory Disorder
- Test Taking Strategies
- Note Taking
- Basics of NCLEX
- Prefixes
- Suffixes
- Medication Administration
- Gastrointestinal Disorders
- Respiratory Disorders
- Pregnancy Risks
- Labor Complications
- Hematologic Disorders
- Fundamentals of Emergency Nursing
- Factors Influencing Community Health
- Delegation
- Perioperative Nursing Roles
- EENT Disorders
- Basics of Chemistry
- Adult
- Emergency Care of the Neurological Patient
- Acute & Chronic Renal Disorders
- Emergency Care of the Respiratory Patient
- Respiratory Emergencies
- Studying
- Substance Abuse Disorders
- Disorders of the Adrenal Gland
- Behavior
- Documentation and Communication
- Preoperative Nursing
- Endocrine System
- Legal and Ethical Issues
- Communication
- Understanding Society
- Immunological Disorders
- Infectious Disease Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Fetal Development
- Terminology
- Anxiety Disorders
- Cognitive Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Tissues and Glands
- Vascular Disorders
- Renal Disorders
- Eating Disorders
- Prenatal Concepts
- Microbiology
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Depressive Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Peripheral Nervous System Disorders
- Integumentary Disorders
- Neurologic and Cognitive Disorders
- Integumentary Disorders
- Newborn Care
- Basics of Mathematics
- Statistics
- Labor and Delivery
- Proteins
- Emergency Care of the Trauma Patient
- Hematologic System
- Hematologic Disorders
- Developmental Considerations
- Skeletal System
- Digestive System
- Urinary Disorders
- Postpartum Care
- Basic
- Musculoskeletal Disorders
- Bipolar Disorders
- Metabolism
- Cardiovascular Disorders
- Concepts of Population Health
- Musculoskeletal Disorders
- EENT Disorders
- Postpartum Complications
- Basics of Human Biology
- Postoperative Nursing
- Neurological Emergencies
- Prioritization
- Disorders of Thermoregulation
- Writing
- Community Health Overview
- Dosage Calculations
- Neurological Trauma
- Concepts of Mental Health
- Health & Stress
- Endocrine and Metabolic Disorders
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Concepts of Pharmacology
- Integumentary Important Points
- Emotions and Motivation
- Renal and Urinary Disorders
- Developmental Theories
- Reproductive System
- Adulthood Growth and Development
- Psychological Emergencies
- Growth & Development
- Basics of Sociology
- Somatoform Disorders
- Reading
- Intelligence and Language
- Oncologic Disorders
- Med Term Basic
- Med Term Whole
- Central Nervous System Disorders – Spinal Cord
- Muscular System
- Neonatal
- Learning Pharmacology
- Pediatric
- Psychological Disorders
- State of Consciousness
- Sensory System