2. Hospital: Al-amiri
Ward:5
Room: 14
Bed:23
Client name: Zhen fda
Diagnosis: appendicitis
Development
Age: 43 years
Sex: male Marital status : M
Children: 4 Significant others: Husain- his brother
4. Family history: NO
Client history : No
Allergic: No
Diet: normal diet.
Dose client wear
Dentures: No
glasses: Yes
contact lenses: No
Dose client required help in ADL?
Eating: no
bathing: no
dressing: no
walking: no
toilet: no
5. Psychological
Dose client worry about any thing?
Anxiety about his disease.
How client does cope with the worry?
Follow of doctor order.
Physiological
Why did the client come to hospital?
Sever abdominal pain.
6. Sleep pattern: 6- 8 hours comfortable
Elimination pattern: -urine: 5 time per day /yellow
-stool: 1 time per day/ brown
List medications presently taking: -flgyl 250ml,IV
-zantac 150 mg po.
-rocephin 1g,IV
Observation and comments: pale skin, tired,
7. Extra personalInterpersonalIntrapersonalvariables
- Iv lock
-Abdominal pain
Physiological
- Lack of
support from his
worker group
- Anxiety about
his disease .Psychological
- Not
comfortable
from his job
-
Socio-culture
9. The appendix is a closed-
ended, narrow tube up to
several inches in length that
attaches to the cecum (the
first part of the colon) like a
worm.
The inner lining of the
appendix produces a small
amount of mucus that flows
through the open center of
the appendix and into the
cecum
10. The wall of the appendix
contains lymphatic tissue that
is part of the immune system
for making antibodies.
11. Appendicitis means inflammation of the appendix.
Opening from the appendix into the cecum
becomes blocked.
The blockage may be due to a build-up of thick
mucus within the appendix or to stool that enters
the appendix from the cecum.
The mucus or stool hardens, becomes rock-like,
and blocks the opening.
12.
13. After the blockage occurs, bacteria which
normally are found within the appendix begin to
invade (infect) the wall of the appendix.
Body responds to the invasion by mounting an
attack on the bacteria, an attack called
inflammation.
14. If the inflammation and infection spread through
the wall of the appendix, the appendix can
rupture.
After rupture, infection can spread throughout
the abdomen.
rupture may happen as soon as 48 to 72 hours
after symptoms begin.
15.
16. A less common complication of appendicitis is
blockage of the intestine.
Blockage occurs when the inflammation
surrounding the appendix causes the intestinal
muscle to stop working, and this prevents the
intestinal contents from passing.
Nausea and vomiting may occur.
17. Pain
Nausea and sometimes vomiting
Loss of appetite
Appendix inflammation increase
Fever will be present
Consitipation
Inability to pass gas
Diarrhea
Abdominal swelling
18. In addition to a complete medical history and
physical examination, diagnostic procedures for
appendicitis may include the following:
Blood tests.
Urine tests (to rule out a urinary tract infection).
19. Imaging procedures (to determine if the appendix is
inflamed), including the following:
1. Computer tomography scan
2. Ultrasound
3. Abdominal X-Ray
20. (medication) Antibiotics .
surgical removal of the appendix (appendectomy).
People can live a normal life without their
appendix and specific changes in diet, exercise, or
other lifestyle factors may not be necessary
21. As inflammation spreads pain is localized and is noted with palpation of the right lower
quadrant. This is referred to as McBurney’s Point.
22. During an appendectomy,
an incision two to three
inches in length is made
through the skin and the
layers of the abdominal
wall over the area of the
appendix.
Surgeon enters the
abdomen and looks for
the appendix which
usually is in the right
lower abdomen.
23. After examining the area
around the appendix to be
certain that no additional
problem is present, the
appendix is removed. This is
done by freeing the appendix
from its mesenteric
attachment to the abdomen
and colon, cutting the
appendix from the colon, and
sewing over the hole in the
colon. If an abscess is
present, the pus can be
drained with drains that pass
from the abscess and out
through the skin.
25. Newer techniques for removing the appendix
involve the use of the laparoscope. The
laparoscope is a thin telescope attached to a video
camera that allows the surgeon to inspect the
inside of the abdomen through a small puncture
wound (instead of a larger incision).
26. It is not clear if the appendix has an important
role in the body in older children and adults.
There are no major, long-term health problems
resulting from removing the appendix although a
slight increase in some diseases has been noted
27. Assessment
Subjective data..
Client said: "I feel pain in my abdomen"
"I'm tired"
" I'm feeling nausea "
''I'm worry from the surgery '‘
Objective data..
Vomiting
Tired
Fever 38.6c
Abdominal swelling
28. Nursing diagnosis
Anxiety related to outcome of surgery
Nursing goal
The client will verbalize knowledge of
routines and care during and after surgery
30. Interventions
3)Identify cause that leading to anxiety
Rationales
3)To dissolve the problem that leading to
anxiety and give the client some suggest to
reduce the anxiety
33. Nursing diagnosis
Risk for infection related to invasion of
organism in the site of surgery
Nursing goal
Client will be free from infection during and
after intervention
34. Interventions
2) assess and monitor swelling redness near of
the site of surgery
Rationales
2)That make easy treatment and prevent to
develop the infection
40. Contraindications
- with patient who have allergic with this drug.
Side effects.
- diarrhea or constipation
- headache, dizziness
- blurred vision
- jaundice
41. Nursing responsibilities
- assess for abdominal pain
- teach client what the side effect of drug
- teach client to avoid smoking
- given zantac one hour before antacid
43. Nursing responsibilities
-watch and observe if the client have allergic or no
-teach client about what the side effect of drug
-if drug IM inject in deep and large muscle
44. Contraindications
- with patient who have allergic with this drug .
Side effects.
-diarrhea
- skin rash
-fever, headache
-phlebitis
47. Nursing responsibilities
- teach client to avoid alcohol
- teach client what the side effect
- check if any allergic
48. 1) INFORMED CONSENT
Obtain a written permission from client or
relatives.
2) NURSING ASSESSMENT
Vital signs
Physical assessment
drug history
Weight and height
49. 3) LEARNING NEEDS
leg exercises
Positioning
deep breathing
4)LABORATORY TESTS
nurses’ responsibility ensure that the doctors
orders are completed
50. Regulation of I/V fluids
Monitor dressings
Monitor vital signs
If vomiting occurs hold client’s head or turn to
one side to prevent aspiration
