Appendicitis is caused by blockage of the lumen of the appendix by fecalit, foreign objects, because there are previous inflammation. The obstruction causes mucus-producing mucosa, having the dam. However, the elasticity of the walls of the appendix has limitations that cause intra-luminal pressure. The increased pressure will inhibit the flow of lymph which will cause edema and ulceration of the mucosa, this occurs when the local acute appendicitis is characterized by the presence of pain.
Appendix unknown function, is part of the cecum. Inflammation of the appendix may occur by the presence of mucosal ulceration or obstruction of the lumen wall (usually by fecalit / hardened feces). Penymbatan spending mucus resulting in adhesions, and inhibition of bloodstream infections. Of hypoxia, resulting gangreng or rupture within 24-36 hours. If this process continues around the walls of organs appendix adhesions will occur that will cause an abscess (chronic). If the infection process is very fast will cause peritonitis.
Perforation signs include increased pain, muscle spasm right lower quadrant abdominal wall with a sign that generalized peritonitis or abscess localized, ileus, fever, malaise, leukocytosis increasingly clear. When perforation with generalized peritonitis or abscess formation has occurred since the increment clients outsmart come, the diagnosis can be established with certainty.
If peritonitis occurs, specific therapy is surgery performed to close the perforation origin. While the other acts as a support: Fowler position bed rest in the medium, the installation of NGT, fasting, correction fluids and electrolytes, giving tranquilizers, antibiotics with broad-spectrum antibiotics are continued in accordance with the culture, transfusion to treat anemia, and treatment of septic shock in the intensive , if any.
Preoperative Nursing Interventions for Apendicitis
1. Risk for Infection related to an inadequate immune.
Characterized by:
- body temperature above normal,
- increased respiratory frequency,
- abdominal distension,
- leukocytes> 10.000/mm3
Goal: Not an infection
Outcomes: There are no signs of postoperative infection.
Intervention:
- Clean the field operations of several organisms that may be present through the principles of shearing.
- Give laxatives 1 day before surgery.
- Encourage clients with the perfect bath.
- Do a good hand washing and aseptic wound care.
2. Acute Pain related to intestinal distension
Characterized by: respiratory tachypnea, tachycardia circulation, epigastric pain radiating to the local area Mc Burney, the client complained of feeling pain lower right area.
Goal: pain is resolved
Outcomes:
- normal breathing,
- normal circulation
- Assess the level of pain, location and characteristics.
- Encourage deep breathing.
- Give analgesics.
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