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.
Care plan
Concepts Covered:
- Basics of NCLEX
- Test Taking Strategies
- Integumentary Disorders
- Postoperative Nursing
- Musculoskeletal Disorders
- Musculoskeletal Trauma
- Emergency Care of the Trauma Patient
- Shock
- Acute & Chronic Renal Disorders
- Vascular Disorders
- Communication
- Perioperative Nursing Roles
- Hematologic Disorders
- Disorders of the Thyroid & Parathyroid Glands
- Cardiac Disorders
- Emergency Care of the Cardiac Patient
- Disorders of the Posterior Pituitary Gland
- Male Reproductive Disorders
- Infectious Disease Disorders
- Infectious Respiratory Disorder
- Intraoperative Nursing
- Medication Administration
- Urinary Disorders
- Urinary System
- Upper GI Disorders
- Preoperative Nursing
- Lower GI Disorders
- Neurological Trauma
- Neurological Emergencies
- Noninfectious Respiratory Disorder
- Respiratory System
- Oncology Disorders
- Respiratory Emergencies
- Immunological Disorders
- Central Nervous System Disorders – Brain
- Renal Disorders
- EENT Disorders
- Emergency Care of the Neurological Patient
- EENT Disorders
- Liver & Gallbladder Disorders
- Shock
- Studying
- Disorders of Pancreas
- Respiratory
- Emergency Care of the Respiratory Patient
- Legal and Ethical Issues
- Documentation and Communication
- Fundamentals of Emergency Nursing
- Female Reproductive Disorders
- Sexually Transmitted Infections
- Peripheral Nervous System Disorders
- Microbiology
- Central Nervous System Disorders – Spinal Cord
- Integumentary Disorders
- Disorders of Thermoregulation
- Neurologic and Cognitive Disorders
- Renal and Urinary Disorders
- Disorders of the Adrenal Gland
- Respiratory Disorders
- Nervous System
- Integumentary Important Points
- Tissues and Glands
- Delegation
- Factors Influencing Community Health
- Multisystem
- Cardiovascular
- Circulatory System
- Newborn Complications
- Gastrointestinal Disorders
- Cognitive Disorders
- Neurological
- Gastrointestinal
- Endocrine