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cdunbar4's version from 2016-10-22 19:25

Appendicitis

Question Answer
Main goal pre-op of appendectomyCool and calm down the "hot" inflamed appendix
S/Speri-umbilical pain, n/v, anorexia
McBurney's Point anatomical locationanterior superior iliac crest, halfway between umblicus
If there is evidence of peritonitis or abscess...conservative treatment consists of antibiotic therapy & parenteral fluids for 6-8 hrs. b4 surgery to prevent sepsis & dehydration
Nursing Management encourage pt with abd pain to seek health care
patient teaching-what to avoidself-treatment, esp. laxatives & enemas bc the resulting ↑ peristalsis may cause perforation of appendix
postop care & pt. teachingwatch for peritonitis; ambulation starts day of surgery; diet advanced as tolerated; usually discharged on 1st or 2nd post op day; normal activities resumed 2-3 wks. after.
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Peritonitis

Question Answer
Secondary causesappnedicitis with rupture; blunt trauma; diverticulitis w rupture; ischemic bowel disorders; pancreatitis; perforations
Primary causesblood-borne organisms; genital tract organisms; cirrhosis with ascites
Surgery is usually always necessary, but if not, what is the treatment?NG, IV fluids, ABs, analgesics
s/spain, rebound, board-like abdomen
**CC: DiagnosticsH&P; CBC with WBC differential, serum electrolytes, abdominal xray, CT scan or ultrasound; peritonoscopy; paracentesis & culture
**CC: Preop or NonopNPO; IV fluids; ABs; NG suction; analgesics (morphine); oxygen PRN; prep for surgery
**CC: Post opNPO; NG intermittent low-suction; Semi-Fowlers; IV fluids w. electrolytes; parenteral nutrition pRN; ABs; Blood transfusions; sedatives/opioids
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Gastroenteritis

Question Answer
Usually less serious-what is usually the problem?stomach/small bowel inflammation-mostly viral, can be food borne
s/sdiarrhea, pain, n/v, cramps
Treatmentusually self-limiting
If older or chronically ill...dehydration may become dangerous→ treat same as acute diarrhea
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