Appendicitis is the inflammation of the vermiform appendix. It is classified as a medical emergency and often requires excision of the inflamed appendix. If left untreated, appendicitis can lead to peritonitis and shock.

Pathophysiology of Appendicitis

If an obstruction by a fecalith or by a parasite occur, inflammation of the vermiform appendix occurs. It can then increase the intraluminal pressure and cause rupture of the appendix.

Signs and Symptoms of Appendicitis

1. Anorexia
2. Epigastric pain (Periumbilical)
3. Right lower quadrant pain (McBurney’s area)
4. Nausea and vomiting
5. Diarrhea
6. Body malaise
7. Low grade fever
8. Sudden relief of pain (Signifies rupture of the appendix)

Findings on Physical Examination for Appendicitis

1. Direct tenderness
2. Rebound tenderness
3. When hyperextension of the right thigh is performed, there is positive right lower quadrant pain (Psoas’ Sign)
4. Internal examination reveal that there is positive cervical tenderness

Diagnostic Exams for Appendicitis

1. Ultrasound – confirmatory diagnostic exam for appendicitis
2. Chest X-Ray – to rule out right lobar pneumonia
3. CBC – look for increased white blood cell count

Management for Appendicitis

• Administer IV Antibiotics.
• Appendectomy.
• For ruptured appendix, an emergency explore laparotomy is performed. Peritoneal lavage is done with normal saline solution.

Nursing Diagnosis for Appendicitis

Acute Pain

Nursing Interventions:

1. Assess the severity and location of pain. If client presents with board-like rigidity and severe pain, suspect for peritonitis.
2. Administer analgesics after a diagnosis is made.
3. Assess the effectiveness of the analgesic given.
4. Position client in a supine position with thighs slightly flexed.

Risk for Infection

Nursing Interventions:

1. Administer antibiotics as ordered.
2. Practice aseptic technique.
3. Position client in right lateral semi-Fowler’s position post-operation for ruptured appendix to localize infectious process.