APPENDICITIS EXAM 2 QUESTIONS
AND ANSWERS
Complications with appedix - Answer--Perforation
-Peritonitis
-Abscess
-Chronic appendicitis
Acutely inflamed appendix can perforate within - Answer-24 hours
Admission to hospital with a possible appendicitis - Answer--IV fluids initiated
-Oral food and fluids withheld until diagnosis is confirmed
Tests to be done to determine a appendicitis - Answer-•Abdominal ultrasound
•Abdominal x-rays
•Intravenous pyelogram
•Urinalysis
•Pelvic examination
•WBC with differential
What diagnostic test is the most effective? - Answer-Abdominal ultrasound
Treatment of choice is appendectomy which can be done by - Answer--Laparoscopic
approach
-Open appendectomy by laparotomy
Pharmacologic therapy prior to therapy - Answer--IV fluids and antibiotic therapy: third-
generation cephalosporin
Antibiotic therapy needs to be repeated during surgery and continued for at least ____
hours postoperatively - Answer-48 hours
Strong analgesics withheld preoperatively to avoid masking sudden disappearance of -
Answer-pain → perforation
Children and adolescents - Answer--Uncommon in children aged <4
-Often progresses to rupture
Common symptoms is children and adolescents - Answer-▪Listlessness
▪Inconsolability
▪Vomiting
▪Distended abdomen
, Perforation rates - Answer-Latino children > African American children > Caucasian
children
Pregnant women - Answer--One of most common surgical procedures
-Managed jointly by surgical, obstetric teams
-Can lead to discrepant pathways → detrimental to patient
-MRI useful in diagnosis
Can be managed successfully without danger to fetus
Older adults - Answer--<30% present with classic symptoms
-Half are afebrile
-Half have no rebound or involuntary guarding
-One fourth have no RLQ tenderness or pain
-Likely to present with confusion
-25-30% do not seek medical care right away
-New scoring tool has improved diagnosis
Nursing Process - Answer-•Collaborative assessment
•Provide preoperative, postoperative care
•Prevent complications
Assessment Observations and patient interview - Answer--Current manifestations
▪Onset, duration, progression, aggravating/relieving factors
-Most recent food or fluid intake
-Known medication or other allergies
-Current medications
History of chronic diseases
assessment physical exam - Answer--Vital signs
-Apparent general health
-Abdominal shape, contour
-Bowel sounds
-Tenderness to light palpation
Nursing Diagnosis may include - Answer--Gas Exchange, Impaired
-Deficient Fluid Volume, Risk for
-Infection, Risk for
-Pain, Acute
-Anxiety
-Fear
Planning
•Goals are developed with patient and family and may include - Answer--Patient will
articulate
▪Concerns about, understanding of procedure
▪Reasons for surgery
AND ANSWERS
Complications with appedix - Answer--Perforation
-Peritonitis
-Abscess
-Chronic appendicitis
Acutely inflamed appendix can perforate within - Answer-24 hours
Admission to hospital with a possible appendicitis - Answer--IV fluids initiated
-Oral food and fluids withheld until diagnosis is confirmed
Tests to be done to determine a appendicitis - Answer-•Abdominal ultrasound
•Abdominal x-rays
•Intravenous pyelogram
•Urinalysis
•Pelvic examination
•WBC with differential
What diagnostic test is the most effective? - Answer-Abdominal ultrasound
Treatment of choice is appendectomy which can be done by - Answer--Laparoscopic
approach
-Open appendectomy by laparotomy
Pharmacologic therapy prior to therapy - Answer--IV fluids and antibiotic therapy: third-
generation cephalosporin
Antibiotic therapy needs to be repeated during surgery and continued for at least ____
hours postoperatively - Answer-48 hours
Strong analgesics withheld preoperatively to avoid masking sudden disappearance of -
Answer-pain → perforation
Children and adolescents - Answer--Uncommon in children aged <4
-Often progresses to rupture
Common symptoms is children and adolescents - Answer-▪Listlessness
▪Inconsolability
▪Vomiting
▪Distended abdomen
, Perforation rates - Answer-Latino children > African American children > Caucasian
children
Pregnant women - Answer--One of most common surgical procedures
-Managed jointly by surgical, obstetric teams
-Can lead to discrepant pathways → detrimental to patient
-MRI useful in diagnosis
Can be managed successfully without danger to fetus
Older adults - Answer--<30% present with classic symptoms
-Half are afebrile
-Half have no rebound or involuntary guarding
-One fourth have no RLQ tenderness or pain
-Likely to present with confusion
-25-30% do not seek medical care right away
-New scoring tool has improved diagnosis
Nursing Process - Answer-•Collaborative assessment
•Provide preoperative, postoperative care
•Prevent complications
Assessment Observations and patient interview - Answer--Current manifestations
▪Onset, duration, progression, aggravating/relieving factors
-Most recent food or fluid intake
-Known medication or other allergies
-Current medications
History of chronic diseases
assessment physical exam - Answer--Vital signs
-Apparent general health
-Abdominal shape, contour
-Bowel sounds
-Tenderness to light palpation
Nursing Diagnosis may include - Answer--Gas Exchange, Impaired
-Deficient Fluid Volume, Risk for
-Infection, Risk for
-Pain, Acute
-Anxiety
-Fear
Planning
•Goals are developed with patient and family and may include - Answer--Patient will
articulate
▪Concerns about, understanding of procedure
▪Reasons for surgery
