Question

1. Describe the clinical manifestations of appendicitis with their underlying pathophysiology and associated lab findings. Include information about the typical timeframe for progression of symptoms. 2. What assessment findings would indicate that the appendix has or is about to rupture? Discuss how this would impact the nursing plan of care for the pediatric patient. 3. Describe at least three pain scales which can be used in pediatric pain assessment. Of the three, which would be most appropriate to use with the early school-aged child (six to eight years of age)? 4. What developmental factors need to be considered when assessing a child's self-rating of pain? 5. Why isn't the test for rebound tenderness consistently recommended with the pediatric patient? 6. What would be the priority nursing diagnoses in the care of the family coping with emergency surgery for appendicitis in a child? 7. Discuss the postoperative nursing management of the child with appendicitis. Include both the traditional open appendectomy as well as the laparoscopic approach. What are the early signs and symptoms that will be present in the pediatric patient who is developing sepsis? 9. What are the priority nursing interventions in the patient experiencing early sepsis? 10. What strategies can the nurse use to assist the family of a child who is hospitalized? 11. Develop a discharge plan for the pediatric patient being discharged on home antibiotic therapy. 12. Discuss the importance of including other members of the healthcare team in discharge planning.

Answer 1

1).

Appendix or the vermiform (vermis = worm) appendix is a narrow worm like tubular structure that projects downward from the cecum. Appendix does not have profound function, but contains lymphoid tissue. Rupture of appendix causes appendicitis, which is an inflammatory condition that requires removal of appendix. Symptoms of appendicitis:

• Severe pain in the right lower abdominal region
• Discomfort around the naval region
• Nausea, vomiting, fever,
• diarrhoea, or constipation

Rupture of appendix causes appendicitis, which is an inflammatory condition that requires removal of appendix. Pain in the right quadrant of abdominal region occurs during appendicitis. However, most of the elderly individuals does not exhibit the generalized abdominal pain and initial elevation of white blood cell count though they have appendicitis. So, an elderly individual with “generalized abdominal pain” unlikely to have appendicitis.

The symptoms of acute appendicitis occur within 24-48 hours, which is a medical emergency. In chronic appendicitis, the symptoms disappear and reappear over a period of time.