Unveiling appendicitis
Alexandra C Morgan
University of Newcastle, NSW
PP: 114 - 117
Abstract
The most common reason for performing abdominal surgery is appendicitis, which affects up to 12% of the population (Lemone & Burke, 2000). Appendicitis is acute inflammation of the vermiform appendix that is typically manifested by localised pain in the right lower quadrant of the abdomen (Holmes, 2001; Lemone & Burke, 2000; McCance & Huether, 2002; Wagner, McKinney & Carpenter, 1996). Abdominal pain is a very common complaint. However, pain in the lower right quadrant cannot be used as the gold standard in a nursing assessment as an indication of appendicitis. Approximately one third of patients with appendicitis will have pain that is spread across the abdomen similar to gastritis (Mattice, 1999). Therefore a more in depth nursing assessment is required. This paper looks at accurately assessing the other signs and symptoms of appendicitis. These may include changes in vital signs, behaviour and body positioning and a history of anorexia, nausea and vomiting.
Unveiling appendicitis requires the performance of an accurate and thorough abdominal pain assessment. This competent assessment will assist in preventing complications such as perforation and peritonitis and ensure a better patient outcome (Wagner, et al., 1996; Wright, 1997).
Keywords
appendicitis; nursing assessment; pain assessment
References
Australian Institute of Health and Welfare. (1999-2000). Separation, patient day and average length of stay statistics by principal diagnosis in Australia. Australian Institute of Health and Welfare National Hospital Morbidity Database, [Online]. Available: http://www.aihw.gov.au/cognos/cgi-bin/ppdcgi (2002, September 25).
Bergeron, E., Richer, B., Gharib, R., & Giard, A. (1999). Appendicitis is a place for clinical judgement. The American Journal of Surgery 177(6): 460-462
Crisp, J. & Taylor, C. (Eds). (2001). Potter and Perry's fundamentals of nursing. Mosby, Sydney.
Holmes, N. (Ed.). (2001). Handbook of pathophysiology, Springhouse, Pennsylvania.
Lemone, P., & Burke, K. M. (2000): Medical surgical nursing: Critical thinking in client care (2nd ed.). Prentice Hall, New Jersey.
Massoni M & Walter M. R (2002): Gastrointestinal care. In Holmes, N. (ed.) Illustrated manual of nursing practice, pp.680-801 (3rd ed.). Lippincott, Williams & Wilkins, Springhouse , Philadelphia.
Mattice, C.(1999). Pain varies in patients with appendicitis. RN 62(4): 78.
McCance, K. L., & Huether, S.E. (2002). Pathophysiology: The biologic basis for disease in adults and children (4th. ed.) Mosby, St Louis.
McConnell, E (2001): Appendicitis: What a pain. Nursing 31(8): HN1-HN3.
O'Hanlon-Nichols, T. (1998): Basic assessment series: Gastrointestinal system. American Journal of Nursing 98(4): 48-53.
Pisarra, V. (2001): Recognizing the various presentations of appendicitis. Dimensions of Critical Care Nursing, 20(3): 24-27.
Stone, R. (1996): Primary care diagnosis of acute abdominal pain. The Nurse Practitioner 21(12): 19-32.
Town, J. (1997): Bringing acute abdomen into focus. Nursing 27(5): 52-57.
Wagner, J., McKinney, W., & Carpenter, J. (1996): Does this patient have appendicitis? Journal of the American Medical Association. 276(19): 1589-1594.
Wright, J. (1997): Seven abdominal assessment signs every emergency nurse should know. Journal of Emergency Nursing, 23(5): 446-450.
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