C TO MY

AP P E N DE

ARIAS, ARIANA J.
BSN – 4A / GROUP 27
DEMOGRAPHIC
DATA
PATIENT’S INITIALS: F. B. N.

AGE: 38 YEARS OLD

ADDRESS: LIPATA,
MINGLANILLA, CEBU
PRE OPERATIVE
DIAGNOSIS
ACUTE APPENDICITIS
- a rapidly progressing inflammation of a small
part of the large intestine called the appendix.
It is a medical emergency that generally
requires prompt removal of the appendix to
prevent life-threatening complications, such as
ruptured appendix and peritonitis.
OPERATION
PERFORMED
APPENDECTOMY (surgical
removal of the appendix)
- During an appendectomy, an incision two to three inches
in length is made through the skin and the layers of the
abdominal wall in the area of the appendix. The surgeon
enters the abdomen and looks for the appendix, usually
located in the right lower abdomen. 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 attachment to the
abdomen and to the colon, cutting the appendix from the
colon, and sewing the over the hole in the colon.
OPERATIVE
DIAGNOSIS
ACUTE RUPTURED
APPENDICITIS W/ LOCALIZED
PERITONITIS
- an inflammation of the peritoneum, the
serous membrane that lines part of the
abdominal cavity and viscera that may result
from infection often due to rupture of a
hollow organ as may occur in abdominal
trauma or appendicitis.
ANATOMY &
PHYSIOLOGY
The appendix is a narrow, muscular tube. One end is
attached to the first part of the large intestine, while
the other end is closed. The position of the appendix
in the body can vary from person to person.

An average adult appendix is about 4 inches (10cm)

long. However, it can vary in length from as less as an
inch to 8 inches. Its diameter is usually about about 6
to 7 mm.

The function of the appendix is unknown.

Foods that have not been digested tends to move

into the appendix and are forced out again by the
contractions of appendix.
PATHOPHYSIOLOGY
 ETIOLOGY: RISK FX:
-Obstruction of -Male
the appendical -Family Hx of
lumen Appendicitis

AFFECTED ORGAN:
-Appendix

Bacteria normally Pressure builds The wall of the This causes

found in the and causes appendix can break serious
intestines multiply severe pain in open. If the inflammation
and make toxins in the abdomen. appendix ruptures, in the
the lining of the The wall of the its contents can abdominal
appendix. appendix can spill into the cavity called
break open. abdominal cavity. peritonitis.

Acute Ruptured Appendicitis w/

Localized Peritonitis

SIGNS & SYMPTOMS:

-Abdominal Pain,Anorexia, N/V,
Fever,Constipation, Rebound tenderness
 TYPE OF
ANESTHESIA
SPINAL ANESTHESIA

BUPIVACAINE 0.5%
HEAVY
 SKIN
PREPARATION
 ABDOMINAL
ANTISEPTIC SKIN
PREPARATION

Patient is in supine position. Area

includes breast line to upper third of
thighs, from the table line to the table
left.
POSITION OF
PATIENT
DURING
OPERATION
 DORSAL
RECUMBENT/SUPINE
- The patient lies flat on the back with the arms
secured at the sides with the lift sheet and the
palms extend along the side of the body. The
legs are straight and parallel and are in line
with the head and spine; the hips are parallel
with the spine.
INSTRUMENT
SET USED
 AP SET II
(WITH STAINLESS
MAYO TRAY)
6 pcs. Towel clip
16 pcs. Kelly curved
16 pcs. kelly straight
4 pcs. Allis forcep 1 pc. Adson forcep w/teeth
2 pcs. Needle holder 1 pc. Tissue forcep w/
1 pc. Babcock teeth
1 pc. Sponge holder 1 pcs. Tissue forcep w/o
1 pc. Blade holder #3 teeth
1 pc. Blade holder #4 1 pc. Long tissue forcep
1 pc. Metzenbaum w/o teeth
1 pc. Mayo scissors 2 pcs. Army navy retractor
2 pcs. Small richardson
retractor
1 pc. Round basin
1 pc. Kidney basin
LINEN PACK
USED
LAP PACK
SUTURES
USED
LAYER SUTURES USED

APPENDIX CHROMIC 1

PERITONEUM SAFIL - 0

MUSCLE SAFIL - 0

FASCIA SAFIL - 0

SUBCUTANEOUS SAFIL 3 - 0

SKIN SAFIL 3 - 0
 NURSING
RESPONSIBILITIES
(POST OP NSG. CARE)
1. Measures following recovery from anesthetic.
a. Maintain fowler’s position.
b. Give analgesic every 3 or 4 hrs. as needed.
c. Give fluids and food as tolerated.
d. Monitor vital signs, intake and output.
e. Encourage to cough and deep-breathe to prevent
pulmonary complications.

2. On going care
a. Document bowel sounds and the passing of flatus or
bowel movements.
b. Watch for surgical complications such as continuing
pain or fever.
c. Stitches removed between fifth and seventh day.
 THAT’S ALL!
THANK YOU!