Appendectomy 2
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Transcript of Appendectomy 2
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AppendectomyReported by:
Reblando, Henna R.
Cruz, John Rouke
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Appendix A small, fingerlike appendage about 10cm(4in)
long that is attached to the cecum just below the
ileocecal valve.
Fills with food and empties regularly into the
cecum.
Because it empties inefficiently and its lumen is
small, the appendix is prone to obstruction and
particularly vulnerable to infection
(Apppendicitis).
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The Appendix
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Appendicitis The most common cause of acute surgical
abdomen in US., is the most common reason for
emergency surgery.
Although it can occurs between the ages of 10
and 30 years. (NIH, 2007).
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Pathophysiology
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Clinical manifestation Vague epigastric or periumbilical pain
Low-grade fever
Nausea and vomiting Loss of appetite
Local tenderness
Constipation or diarrhea Pain on defecation
Pain in urination
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Rovsings sign Palpation of left iliac region Displacement of
colonic gas and small bowel towards inflamed
appendix Pain on right iliac region
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Blumberg sign: Rebound tenderness at Mc Burneyspoint
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Psoas (Copes psoas) sign Pain in attempt to extend the hip flexed
due to irritation of psoas major in retrocecal
appendicitis)
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Obturator (Copes obturator) sign: Flexion and medial rotation at hip produces
pain due to irritation of obturator muscle in
pelvic appendicitis.
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Aarons sign: Pain or pressure inepigastrium or anterior chest with persistentfirm pressure applied to McBurneys point.
Cough tenderness: Differentiates from rightsided ureteric colic.
Rigidity and Guarding in Right Iliac Fossa(RIF)
Rectal examination: Tenderness in rightrectal wall
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Assessment and diagnostic findings CBC
Abdominal X-ray films
Ultrasound studies
CT scans
Laparoscopy
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Appendectomy Surgical removal of the appendix.
Is performed as soon as possible to decrease the risk of
perforation.
It may be performed using general or spinal anesthesia
with a low abdominal incision (Laparotomy) or bylaparoscopy.
Both Laparotomy and laparoscopy are safe and effective
in the treatment of appendicitis with perforation. Recovery after laparoscopic surgery is generally quicker.
Consequently, laparoscopic appendectomy is more
common.
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When perforation of the appendix occurs, anabscess may be formed. If this occurs, the patient
may be initially treated with antibiotics, and the
surgeon may place a drain in the abscess. After abscess is drained and there is no further
evidence of infection, an appendectomy is then
typically performed.
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Preoperative Management All diagnostic tests and procedures are explained to
promote cooperation and relaxation.
The patient is prepared for the type of surgical
procedures as well as the post operative care.
Measures to prevent postoperative complication are
taught, including coughing, turning, and deep
breathing using splint at the incision site.
I.V fluids or total parenteral nutrition beforesurgery maybe ordered to improved fluid and
electrolyte balance and nutritional status.
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Post Operative Management And NursingManagement And Nursing Care Monitor vital signs for sign of infection and shock
such as fever, hypotension and tachycardia.
Monitor I and O for sign of imbalance, dehydration,
and shock.
Assess abdomen for increased pain, distention,
rigidity, and rebound tenderness because these may
indicate postoperative complications.
Evaluate dressing and incision.
Evaluate the passing of flatus or feces.
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Monitor for nausea and vomiting.
Laboratory values are monitored and patient isevaluated for sign and symptoms of electrolyte
imbalances.
Wound drains, I.V, and all other catheter aremonitored and evaluated for signs of infections.
Turning , coughing, deep breathing, and incentive
spirometry are performed every 2hours.
Diet is advanced as ordered.
Administration of medications as ordered
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Patient Education and Health Maintenance Instruct patient to avoid heavy lifting for 4
to6 weeks after surgery.
Instruct patient to report symptoms
of anorexia, nausea, vomiting, fever,
abdominal pain, incisional redness anddrainage postoperatively
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