Keep the patient NPO until symptoms subside and/or surgery is ruled
(3) Position the patient in Fowler's or semi-Fowler's position. This position
relaxes the abdominal muscles and reduces pain.
Never apply heat to the abdomen, as this may cause the appendix to
Analgesics are normally withheld since they mask symptoms.
d. Treatment. Treatment of choice is surgical removal of the appendix,
especially if rupture is suspected or imminent.
(1) If the appendix can be removed before it ruptures, the post-op course is
generally uncomplicated. The wound is closed and the patient is usually discharged
within a week.
(2) If rupture has occurred, the wound is often left open to drain. The
patient must be observed for signs and symptoms of obstruction, peritonitis,
hemorrhage, or abscess.
a. The peritoneum is the serous membrane that lines the abdominal cavity and
covers the visceral organs. Peritonitis is inflammation of the peritoneum. Inflammation
may be generalized throughout the peritoneum, affecting the visceral and parietal
surfaces of the abdominal cavity, or may be localized in one area as an abscess.
b. Peritonitis occurs as a result of leakage of contents from an abdominal organ
into the abdominal cavity. Generally, this disorder results from perforation of the GI
tract, allowing bacterial contamination of the peritoneum. Peritonitis may also occur as
a result of chemical irritation, and subsequent infection, caused by rupture of an organ.
(For example, the ovaries, spleen, or urinary bladder.)
c. Signs and symptoms.
Diffuse pain that eventually localizes in the area of the underlying
Nausea and vomiting.