Care analysis Acute Appendicitis of a 77 year old woman - Research Paper Example

Case Study on Acute Appendicitis A. Pathophysiology of acute appendicitis 2 page) Sudden onset of inflammation of the appendix is known as acute appendicitis. The main cause for appendicitis is obstruction of the lumen of the appendix. Obstruction can occur either due to hyperplasia of the lymphoid follicles or due to fecoliths, parasites or tumors. Appendix is basically a blind pouch and any obstruction to its lumen allows accumulation of the fluid inside the lumen leading to the distension of appendix.

The distension also hampers venous and lymphatic drainage, thus facilitating invasion of bacteria into the wall of the appendix. This ultimately leads to accumulation of pus and necrotic tissue. In advanced cases, appendix can perforate and the pus can ooze into the peritoneal cavity leading to peritonitis, sepsis and other consequences (Craig, 2010). B. At least 4 symptoms of acute appendicitis. Answer the question why does the body develops each symptom? Explain the reason for the development of each symptom?

Pain is the most important symptom in appendicitis. The pain typically begins in the navel and then shifts to right lower quadrant. Pain in umbilicus is related to inflammation of the peritoneum surrounding the appendix. Later, the whole organ gets inflammed and hence the pain shifts to the right lower quadrant, at the McBurney's point, the anatomical location of appendix. Nausea and vomiting are other important symptoms and occur due to irritation of the peritoneum covering the appendix. Fever is an indication of infection of the appendix and impending rupture due to accumulation of pus (Craig, 2010). C. The medications provided to the patient were (all intravenous) Protonix, magnesium sulfate, Unasyn, and Azactam, Lasix.

Based on the symptoms written above why do you think the Dr. ordered these meds? Compared the treatment provided above with what the Medical-surgical literature of acute appendicitis says about managing this condition. (1/2 page) Protonix is prantaprazole. It is a proton pump inhibitor and thus inhibits secretion of gastric acid. This medication was prescribed to decrease secretion of gastric juice and prevent erosions and ulcerations related to the acute illness. Magnesium sulphate was prescribed as an adjuvant for propofol for surgical anesthesia.

Studies have shown that administration of magnesium sulfate as an adjuvant to propofol decreases the requirement of propofol. (Altan et al, 2005) Unasyn is a combination of ampicillin and sulbactam. it is a broad spectrum antibiotic and hence started for antibacterial therapy. Azactum is aztreonam and is effective against gram negative bacteria hence is given to cover for microbials in appendicitis (Craig, 2010). Furosemide is not recommended in appendicitis. Infact, studies have shown that it can cause complications like perforation when administered in appendicitis. D. Come up with at least 4 NURSING (not medical) interventions.

Then, Compared them with NURSING CARE literature for acute appendicitis says. This is Evidence-based Nursing management of the condition. Nursing interventions for acute appendicitis include assessment of pain using pain scale and delivering medications based on pain assessment, teaching the patient about abdominal splinting while ambulating, coughing and turning around, teaching home care of incisions and discussion of limitations in activity. According to Bristow (2004), nurses have a major role to play in both preoperative and postoperative management of appendicitis.

Nurses must intervene to allay anxiety, decrease pain and prepare the patient for surgery and care after going home. References Altan, A., Turgut, N., Yildiz, F., Turkmen, A., and Ustun, H. (2005). Effects of magnesium sulphate and clonidine on propofol consumption, haemodynamics and postoperative recovery. Br J Anaesth., 94 (4), 438-41. Bristow, N. (2004). Treatment and management of acute appendicitis. Nursing Times.net, 100(43), 34. Retrieved on 21rd Feb, 2011 from http://www.nursingtimes.

net/nursing-practice-clinical-research/treatment-and-management-of-acute-appendicitis/201482.article Craig, S. (2010). Appendicitis, Acute. Emedicine from WebMD. Retrieved on 21rd Feb, 2011 from http://emedicine.medscape.com/article/773895-overview