Appendectomy is the surgical removal of the vermiform appendix, a small, finger-shaped projection in the lower right abdomen at the juncture of the large and small intestines. The appendix, which protrudes from a section of the large intestine(cecum), generally has been considered an unessential organ that is removable without significant loss of body function.

Surgical Removal of the appendix is the only treatment for appendicitis. Without it, appendix can rupture, spilling infectious material into the bloodstream and abdomen, which can be life-threatening.

NURSING PRIORITIES
1.Prevent complications.
2.Promote comfort.
3.Provide information about surgical procedure/prognosis, treatment needs, and potential complications.
DISCHARGE GOALS
1.Complications prevented/minimized.
2.Pain alleviated/controlled.
3.Surgical procedure/prognosis, therapeutic regimen, and possible complications understood.
4.Plan in place to meet needs after discharge.

NURSING DIAGNOSIS: Acute pain

May be related to

  • Distension of intestinal tissues by inflammation
  • Presence of surgical incision

Possibly evidenced by

  • Reports of pain
  • Facial grimacing, muscle guarding; distraction behaviors
  • Autonomic responses

Desired Outcomes

  • Report pain is relieved/controlled.
  • Appear relaxed, able to sleep/rest appropriately.

Appendectomy Nursing Care Plan (NCP)-Acute Pain

Actions/Interventions Rationale
Provide accurate, honest information to patient/SO.

 

Being informed about progress of situation provides emotional support, helping to decrease anxiety

 

Keep at rest in semi-Fowler’s position. Gravity localizes inflammatory exudate into lower abdomen or pelvis, relieving abdominal tension, which is accentuated by supine position.
Encourage early ambulation. Promotes normalization of organ function, e.g., stimulates peristalsis and passing of flatus, reducing abdominal discomfort.
Provide diversional activities. Refocuses attention, promotes relaxation, and may enhance coping abilities.

 

Keep NPO/maintain NG suction initially.

 

Decreases discomfort of early intestinal peristalsis and gastric irritation/vomiting.
Administer analgesics as indicated. Relief of pain facilitates cooperation with other therapeutic interventions, e.g., ambulation, pulmonary toilet
Place ice bag on abdomen periodically during initial 24–48 hr, as appropriate. Soothes and relieves pain through desensitization of nerve endings. Note: Do not use heat, because it may cause tissue congestion

Credits:mdguidelines.com