Appendectomy (1)

8/13/2019 Appendectomy (1)

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Appendectomy(A Case Study)

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TABLE OF CONTENTS:

I. INTRODUCTION.3

a. Current trends about the disease condition..4

b. Reasons or choosin! such case or "resentation..#

II. NURSIN$ASS%SS&%NT...'

a. ersona *istory...'

b. ertinent +a,iy *eath-Iness *istory.

c. *istory o ast Iness../

d. *istory o resent Iness..../

e. hysica %0a,ination ..1

f. Dia!nostic and 2aboratory rocedures..

III.ANATO&5 and *5SIO2O$5(6ith 7isua aids)....4

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6hen the o"enin! ro, the a""endi0 into the cecu, beco,es boc?ed. The boc?a!e

,ay be due to a buid-u" o thic? ,ucus 6ithin the a""endi0 or to stoo that enters the

a""endi0 ro, the cecu,. The ,ucus or stoo hardens< beco,es roc?-i?e< and boc?s

the o"enin!. This roc? is caed a ecaith (iteray< a roc? o stoo). At other ti,es< the

y,"hatic tissue in the a""endi0 ,ay s6e and boc? the a""endi0. =acteria 6hich

nor,ay are ound 6ithin the a""endi0 then be!in to in7ade (inect) the 6a o the

a""endi0. The body res"onds to the in7asion by ,ountin! an attac? on the bacteria< an

attac? caed ina,,ation. (An aternati7e theory or the cause o a""endicitis is an initia

ru"ture o the a""endi0 oo6ed by s"read o bacteria outside the a""endi0.. The cause

o such a ru"ture is uncear< but it ,ay reate to chan!es that occur in the y,"hatic

tissue that ine the 6a o the a""endi0.)

I the ina,,ation and inections"read throu!h the 6a o the a""endi0< thea""endi0 can ru"ture. Ater ru"ture< inection can s"read throu!hout the abdo,en@

ho6e7er< it usuay is conined to a s,a area surroundin! the a""endi0 (or,in! a "eri-

a""endicea abscess).The treat,ent or a""endicitis is antibiotics and sur!ica re,o7a o the

a""endi0 (a""endecto,y). A""endecto,y is the re,o7a by sur!ery o the a""endi0< the s,a

6or,-i?e a""enda!e o the coon (the ar!e bo6e). An a""endecto,y is "eror,ed because o

"robabe a""endicitis.

Acute a""endicitis is the ,ost co,,on cause in the USA o an attac? o se7eree@ K %RR2A@ round< s,ooth border

h. 7ision abe to read ne6s"rint@ sensiti7ity to i!ht

EA(S

a. !enera ,obie@ir,@ no tenderness@ "inna recois ater it is oded@ no inection

b. e0terna ear cana "resence o hair oices@ "resence dischar!e

NOSE

a. e0terna sy,,etric and strai!ht@ not tender@ air ,o7es reey as the cient

breaths

b. interna "resence o hair

/O4T+ AN- O(O*+A(3N5

a. i"s unior, "in? coor@ dry@ abiity to "ursue i"sb. teeth ,issin! teeth due to ca7ities@ discooration o ena,e

c. ton!ue no esions@ 6ith thin 6hitish coatin!@ abe to ro the ton!ue u"6ard and

side to side

d. "aates and u7ua i!ht "in?@ "ositioned in the ,idde o sot "aate

e. tonsis "in?@ no s6ein!

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NEC

a. ,usces eua in si>e@ head centered@ eua stren!th

b. ,o7e,ent coordinated s,ooth ,o7e,ents 6ithout disco,ort

c .y,"h nodes not "a"abe

d.thyroid !and not 7isibe

C+EST

a. e0terna sy,,etric@ s"ina cou,n is strai!ht@ s?in intact@ chest 6a intact@ no

tenderness@ u sy,,etrica chest e0"ansion

b. un!s nor,a breath sounds@ absence o DO=

CA(-IOVASC4LA(

a. heart absence o heart sounds@ nor,a beatin! "attern

AB-O/INAL

a. !enera 6ith direct and rebound tenderness on the ri!ht o6er uadrant@ 6ith

indirect tenderness@

/4SC4LOSELETAL

a. !enera eua si>e on both sides o the body@ no contractures@ no tre,ors@

nor,ay ir,@ no deor,ities

C"ania$ Ne",e#

I. Oactory ha7e the sense o s,e

II. O"tic nor,a 7isua acuity

III. Ocuo,otor "ositi7e "a"iary ree0 and eye con7er!ence test

I; Trochear "ositi7e "a"iary ree0 and eye con7er!ence test

;. Tri!e,ina can sense the sensation o "ain< touch< te,"erature and nor,a ,usce

stren!th.

;I. Abducens "ositi7e "a"iary ree0 and eye con7er!ence test

;II.+acia nor,a ,usce stren!th o acia e0"ressions

;III. ;estibuocochear nor,a 7oice tones audibe@ abe to hear tic?in! on the bothears.

IG. $osso"haryn!ea (K) !a! ree0@ can s6ao6

G. ;a!us (K) !a! ree0

GI. Accessory nor,a ,usce stren!th

GII. *y"o!ossa nor,a ton!ue ,o7e,ents

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F. -ia)no#tic and Labo"ato"y *"ocedu"e#

-ia)no#i#6Labp"ocedu"e

-ate o"de"ed-ate "e#u$t

Indication o"pu"po#e

"e#u$t no"ma$ ,a$ue

Ana$y#i# 7inte"p"etation of "e#u$t

Urinaysis

O :3-:-

R :3-:-

- to deter,ineurineco,"ositionsuch asbood

R=C- *+

5eo6< cearSu!ar ( - )h acidicS". $ra7ity.::3-.:3:us cesK: *+

R=C:-3 *+

The,icrosco"icanaysissho6snor,ae7es.

Nu"#in) (e#pon#ibi$itie#:

%0"ain the "rocedure and the "ur"ose to the cient.

%0"ain to the cient the i,"ortance o the "rocedure

%0"ain to the cient that urine sa,"e is needed

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As? the cient i he9she had eaten< it can ater the resut

As? the cient 6hat are the ,edication that he9she had ta?en.

I there is inection< te the "atient that the test 6i be re"eated to ,onitor any

de7eo",ent.


-ate o"de"ed-ate "e#u$t in

Indicationo" pu"po#e "e#u$t No"ma$ ,a$ue

Ana$y#i# 7inte"p"etation of t&e"e#u$t

*e,atoo!ictest

O :3-:-

R :3-:-

-to indicateane,ia and"oycythe,ia

*!b.#:

=C4.'*ct:.4#

R=C#.#

*!b& 4:-/:!,92+ :-':!,92=C#.: 0 :92*ct& :.4:-:.#4292+ :.3-:.4292R=C& 4.#-'.3 0:92+ 4.-#.4 0:92

hite boodce is abo7ethe nor,aran!e< thereis syste,icinection.2eu?ocytosis indicatesa""endicitis.

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-ate o"de"ed-ate "e#u$t in

Indicationo" pu"po#e "e#u$t No"ma$ ,a$ue

Ana$y#i# 7inte"p"etation of t&e"e#u$t

*e,atoo!ictest

O :3-:-

R :3-:-

-to indicateane,ia and"oycythe,ia

*!b31

=C.4*ct:.4

R=C#.#

*!b& 4:-/:!,92+ :-':!,92=C#.: 0 :92*ct& :.4:-:.#4292+ :.3-:.4292

R=C& 4.#-'.3 0:92+ 4.-#.4 0:92

A decreaseinhe,o!obinindicatesane,ia.hite boodce is abo7ethe nor,aran!e< thereis syste,icinection.2eu?ocytosi

s indicatesa""endicitis.

Nu"#in) (e#pon#ibi$itie#

%0"ain the "rocedure and the "ur"ose to the "atient.

%0"ain to the "atient that it reuires bood sa,"e and it can cause "ain and

disco,ort due to the neede "uncture.

As? the "atient i he9she had eaten ood because it can ater the resut.

As? the "atient i he9she had ta?en so,e dru!s because it can ater the resut.

As? or the rei!ion and cuture o the "atient.

III. Anatomy and *&y#io$o)y

In a nor,a hu,an e,ae< the $I tract is a""ro0i,atey # eet or and a ha ,eters

on! and consists o the oo6in! co,"onents

/out& (Ora ca7ity9 =uca Ca7ity< incudes ton!ue< teeth< sai7ary !ands and

,ucosa)

The ,outh is the irst o the di!esti7e tract. It is the o"enin! throu!h

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6hich ta?es in ood. It is ined by stratiied sua,ous non-corniied

e"itheiu,< e0ce"t the hard "aate< !in!i7a and iior, "a"iae o ton!ue 6hich

are corniied.

It is bound inront by the i"s< abo7e by the hard and sot "aate< beo6 by

the oor o the ,outh incudin! the ton!ue and behind by the aucia isth,us.

*&a"yn

The "haryn0 is the "art o the di!esti7e syste, 6hich connects the ,outh

6ith eso"ha!us. It is 6here the di!esti7e tract and the res"iratory tract crossy,es reuired or the di!estion o

ceuose ro, "ant ,atter. The "artiay di!esti7e "ant ,atter "asses throu!h

each o the sto,ach8s cha,bers in seuence< bein! re!ur!itated and reche6ed

at east once in the "rocess.

Bo;e$6Inte#tine

Sma$$ Inte#tine

S,a intestine is the "ortion o the ai,entary tract bet6een the sto,ach

and the ar!e intestines 6hose ,ain unction is or absor"tion. It is about '

,eters on! and consists o 3 "arts duodenu,@ eunu, and ieu,.

-uodenum

Duodenu, is a hoo6 ointed tube that connects the sto,ach to the

eunu,< it is the shortest< the 6idest and ,ost i0ed "art o the s,a intestine

and is ar!ey retro-"eritonea cosey attached to the dorsa 6a.

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Cecu, is the "ro0i,a end o the ar!e intestine and is 6here the ar!e

and the s,a intestine ,eet at the ieoca unction. It is ocated in the ri!ht o6er

uadrant o the abdo,en near the iiac ossa. It is a sac that e0tends ineriory

about ' c,s. "ast ieoca unction. Attached to the cecu, is a tube about 1 c,s.

on! caed the A%NDIG.

Co$on

The coon is about .#-./ ,eters on! and consists o our "arts

Ascendin! coon

Trans7erse coon

Descendin! coon and si!,oid coon

A#cendin) Co$on

The ascendin! coon e0tends su"eriory ro, the cecu, to the ri!ht coic

e0ure near the i7er< 6here it turns et

T"an#,e"#e Co$on

The trans7erse coon e0tends ro, the ri!ht coic e0ure to the et coic

e0ure near the s"een< 6here the coon turns ineriory.

-e#cendin) Co$on and Si)moid Co$on

The descendin! coon e0tends ro, the et coic e0ure to the "e7is

Appendectomy (1)

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