The Nursing Process In A Patient Present With Appendicitis Case Study
In the middle of September, a forty-five year-old male was presented to the emergency department at Oak Hill Hospital. The patient was experiencing symptoms of abdominal pain and vomiting. Initially the nurse obtained a complete health history, physical assessment, and current vital signs. The patient’s health history demonstrated male, forty-five years old in Erikson stage generativity vs. stagnation, no known drug allergies, asthma, coronary artery disease, gastritis, gastroesophageal reflux disease, kidney disease, hypertension, diabetes mellitus type two, former smoker for thirteen plus years, and diverticulosis with episodes of diverticulitis. Had a past surgical history of a hernia …show more content…
This precipitates by the appendix becoming kinked or obstructed by a fecalith, tumor, foreign object, or lymphoid hyperplasia (Hinkle & Cheever 2014). The inflammation causes abdominal pain that induces localized pain to the right lower quadrant. Symptoms may appear in just a few, short hours. When severe, the appendix fills with pus and may rupture. If the appendix ruptures it may lead to sepsis and eventually death if not treated.
As reflected by Hinkle and Cheever (2014),
The major complication of appendicitis is perforation of the appendix, which can lead to peritonitis, abscess formation, or portal pyleplebitis. Perforation generally occurs twenty four hours after onset of pain. Symptoms include a fever of 37.7 degrees Celsius or greater, a toxic appearance, and continued abdominal pain or tenderness. Patients with peritonitis are often found to be supine and motionless” (pp.1296).
Appendicitis occurs across all ages and ethnicity. Although is it is not gender specific is does occur more so in younger ages. “although it can occur at any age, it more commonly occurs between ages ten and thirty years” (Hinkle & Cheever …show more content…
Congruently the two symptoms are manifested in the early stages of appendicitis. Over the course of progression the symptoms may start as abdominal pain, nausea, and vomiting. Precipitating abdominal pain becomes sharp and localized in the right lower quadrant. The patient may also exhibit loss of appetite and elevated body temperature. “In up to 50 percent of presenting cases, local tenderness is elicited at McBurney’s point when pressure is applied” (Hinkle & Cheever 2014). Rebound tenderness is pain when releasing pressure to the area in which will be symptomatic to the right lower quadrant. Diarrhea and constipation may be noted. When applying pressure to the left lower quadrant eliciting pain to the right lower quadrant, the Rovsing’s sign is a presented symptom. The patient when lying on the left side, slowly extending the right thigh and precipitating pain occurs, a positive psoas sign is manifested. An additional symptom that may occur is the obturator sign. The obturator sign is when the patient lying flat has pain with passive internal rotation (Hinkle & Cheever 2014). When the appendix ruptures, pain expands to other areas and abdominal distension may be