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.
Ground Zero
Concepts Covered:
- Communication
- Fundamentals of Emergency Nursing
- Intraoperative Nursing
- Documentation and Communication
- Legal and Ethical Issues
- Emergency Care of the Cardiac Patient
- Delegation
- Perioperative Nursing Roles
- Preoperative Nursing
- Community Health Overview
- Prioritization
- Studying
- Factors Influencing Community Health
- Concepts of Population Health
- Understanding Society
- Test Taking Strategies
- Medication Administration
- Adult
- Microbiology
- Cardiac Disorders
- Anxiety Disorders
- Depressive Disorders
- Vascular Disorders
- Nervous System
- Upper GI Disorders
- Central Nervous System Disorders – Brain
- Gastrointestinal Disorders
- Immunological Disorders
- Dosage Calculations
- Circulatory System
- Concepts of Pharmacology
- Hematologic Disorders
- Newborn Care
- Adulthood Growth and Development
- Disorders of Pancreas
- Respiratory Disorders
- Postoperative Nursing
- Pregnancy Risks
- Neurological
- Postpartum Complications
- Substance Abuse Disorders
- Noninfectious Respiratory Disorder
- Bipolar Disorders
- Peripheral Nervous System Disorders
- Learning Pharmacology
- Psychotic Disorders
- Prenatal Concepts
- Tissues and Glands
- Basics of Chemistry
- Gastrointestinal
- Newborn Complications
- Labor Complications
- Fetal Development
- Terminology
- Labor and Delivery
- Postpartum Care
- EENT Disorders
- Infectious Disease Disorders
- Lower GI Disorders
- Integumentary Disorders
- Neurologic and Cognitive Disorders
- Hematologic Disorders
- Integumentary Disorders
- Cardiovascular Disorders
- Musculoskeletal Disorders
- Endocrine and Metabolic Disorders
- Renal and Urinary Disorders
- Urinary System
- Oncologic Disorders
- Renal Disorders
- Infectious Respiratory Disorder
- Urinary Disorders
- Sexually Transmitted Infections
- EENT Disorders
- Behavior
- Emotions and Motivation
- Growth & Development
- Psychological Disorders
- State of Consciousness
- Health & Stress