Care of Clients With Ruptured Appendicitis

7/28/2019 Care of Clients With Ruptured Appendicitis

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SPECIFIC OBJECTIVES:

At the end of 2-hour discussion onthe concept on Ruptured

Appendicitis, the learners shall:

Define what Ruptured Appendicitis is

and its related terms

Enumerate its Clinical Manifestations,Complications and Diagnostic Evaluation

Determine the Treatments and the

appropriate Nursing Responsibilities


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Incorporate the Growth and

Development satisfactorily to the

patients condition

Review concepts on the Anatomy and

Physiology of the Appendix and

PeritoneumTrace the Pathophysiology of Ruptured

Appendicitis

Critique the three (3) formulatedNursing Care Plans

Relate the two (2) Research articles


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Patients Name: patient X

Civil Status: Single

Birth Date: December 12, 1993Age: 18 years old

Address: Block 3, Lot 1 Mediatrix Dipolog City

Sex: Male

Religion: Protestant

Nationality: German-Filipino

Fathers Name: Augustus KhadMothers Name: Carmelita Velasco


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Admission: September 25, 2012 8:30 am

Attending Physician: Dr. Donald Dy

Diagnosis: Peritonitis

Past History: experienced colds, cough, fever, andwas never admitted because when having anillness would just drink medications and just rest.

No known drug and food allergies. No familyhistory of diabetes, hypertension and etc.

Present History: experienced severe abdominalpain on September 24, 2012 in the evening. Alsoexperienced fever and vomiting. Loss of appetiteand could not sleep well because of the severeabdominal pain.


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Growth and Development


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SIGMUND FREUDS THEORY OF

PSYCHOSEXUAL DEVELOPMENT

Developmental

TasksExpected Behavior Actual Behavior

Latency6 to puberty

Energy is directed tophysical and

intellectual activities.

Sexual impulses tend

to be pressed.

Develop relationships

between peers of the

same sex.

Tends to engage intremendous activities;

loves to hang-out with

peers.


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ERIK ERIKSON THEORY OF

PSYCHOSOCIAL DEVELOPMENTDevelopmental Tasks Expected Behavior Actual Behavior

Adolescence

12 to 20 years

(Identity versus

Role confusion)

Young adulthood

20 to 35 years

(Intimacy versus

Isolation)

Positive Resolution

Coherent sense of self; Plans to

actualize ones abilities

Negative Resolution

Feelings of confusion,

indesciveness, and possible

antisocial behavior

Positive Resolution

Intimate relationship with

another person; commitment towork and relationships

Negative Resolution

Impersonal relationships;

avoidance of relationship, career, or

lifestyle commitments

Positive Resolution

Has positive outlook in life,

that someones above who can

help straighten ones path.

Negative Resolution

Never felt his alone as he is

guided, cared and loved by his

ever supportive family.

Positive Resolution

Committed to career and hasclose relationship with Almighty

Father.


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JEAN PIAGETS COGNITIVE THEORY

Developmental

TasksExpected Behavior Actual Behavior

Formaloperation

phase

11 to 15

years

Uses rationalthinking; reasoning is

deductive and

futuristic

Able to usedeductive reasoning,

though conditions felt

at present wasnt able

to cope up enough.


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LAWRENCE KOHLBERGS STAGES OF

MORAL DEVELOPMENT

DevelopmentalTasks

Expected Behavior Actual Behavior

Adolescence

and adulthood

(most men

are in this

stage)

Law-and-Order Orientation (STAGE)

The person wants established rules and

authorities, and the reason for decisions and

behavior is that social and sexual rules and

traditions demand the response.

Conventional (LEVEL)

Person is concerned with maintaining

expectations and rules of the family, group,

nation, or society. A sense of guilt has

developed and affects behavior. The person

values conformity, loyalty, and active

maintenance of social order and control.

Conformity means good behavior or what

pleases or helps another and is approved.

Able to follow rules and

policies preceded by as a

manner of respect to person.

Developed a sense of guilt

to everything that was

inappropriate. Loyalty and

honesty are values that he

pursued.


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ANATOMY AND PHYSIOLOGY

APPENDIX

o elongated outpouching of the cecum,

found at its posteromedial aspect about2.5 cm below the ileocecal valve


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DRUG STUDY


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METRONIDAZOLE

Drug Classification: Antibiotic; Antibacterial;

Antiprotozoal; Amebicide

Therapeutic Actions:

Bactericidal; Inhibits DNA synthesis in specific

(obligate) anaerobes, causing cell death;

antiprotozoal-trichomonacidal, amebicidal:

Bio-chemical mechanism of action is not

known


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Indications:

Acute infections with susceptible anaerobic

bacteriaAcute intestinal amebiasis

Amebic liver abscess

Bacterial vaginosis

Contraindications:

Contraindicated with hypersensitivity tometronidazole

Use cautiously with CNS disease, hepaticdisease, candidiasis (moniliasis)


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Adverse Effects:

Headache, dizziness, insomnia, seizures,

fatigue

Nausea, vomiting, diarrhea, GI upset, cramps,

anorexia

Incontinence, darkening of the urine, dysuria

Thrombophlebitis, redness, burning, dryness,

and skin irritation (topical)


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Nursing Interventions:

Administer oral doses with food if GI upset

Take full course of drug therapy

Instruct patient not to drink alcohol (beverages orpreparations containing alcohol, cough syrups) for 24-72 hour of drug use; severe reactions may occur

Tell patient that urine may be a darker color than usual;this is expected

Patient may experience these side effects: Dry mouthwith strange metallic taste (frequent mouth care,sucking sugarless candies may help)


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CEFTRIAXONE SODIUM

Drug Classification: Antibiotic;

Cephalosporin (3rd generation)

Therapeutic Actions:

Bactericidal; Inhibits synthesis of

bacterial cell wall, causing cell death


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Indications:

Lower respiratory infections caused by

Streptococcus pneumonia UTIs and intra-abdominal infections

caused by Escherichia coli

Septicemia caused by Escherichia coli

Contraindications:

Contraindicated with allergy tocephalosporins or penicillins

Use cautiously with renal failure


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Adverse Effects:

Headache, dizziness, lethargy

Nausea, vomiting, diarrhea, abdominal pain,

flatulence Nephrotoxicity

Decreased WBC count, decreased platelet count

Ranging from rash to fever to anaphylaxis

Abscesses at injection site, phlebitis,inflammation at IV site

i i


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Nursing Interventions:

Monitor ceftriaxone blood levels in patients with

severe renal impairment and in patients with

renal and hepatic impairment

Have vitamin K available in case

hypoprothrombinemia occurs

Discontinue if hypersensitivity reaction occurs

Instruct patient to avoid alcohol while taking this

drug and for 3 days after because severe

reactions often occur Report severe diarrhea, difficulty breathing,

unusual tiredness or fatigue, pain at injection site


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RELATED RESEARCH

Man collapses with ruptured appendicitis

Schistosomal peritonitis secondary to

perforated appendicitis


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Kozier, B., et. al,. (2004). Fundamentals of Nursing: Concepts,Process, and Practice. 7th ed. Jurong, Singapore: PearsonEducation South Asia Pte Ltd

Karch, A. M. (2011). 2011 Lippincotts: Nursing Drug Guide.Norriston Road: Lippincott; William and Wilkins

Tortora, G. J., & Grabowski, S. R. (2003). Principles ofAnatomy & Physiology. 10th ed. United States of America; JohnWiley & Sons, Inc.

Daniel Bates, Man collapses with ruptured appendix threeweeks after NHS doctors took it out. Article. 25 August 2009.

[http://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.html#ixzz27VBMLjEV]
http://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.htmlhttp://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.html


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Documents

Care of Clients With Ruptured Appendicitis