On one Sunday evening we ate rice for dinner with my friends,few hours later Janet started to complain of Abdominal tenderness and pain. It started in the upper part of her stomach and then quickly moved to her right lower quadrant abdomen within few hours. The pain increased and became severe.
I said to myself I hope that she feels better so that we can have a peaceful sleep tonight since tomorrow is Monday and we have to be in school in the morning. Little did I know that it will be a long night. Before I could complete my sentence, she started vomiting uncontrollably. Vomiting forcing everything that she ate out of her stomach. I can see some of the undigested foods.
What is it?.
Food poison?.
Kidney stones?.
We never thought of Appendicitis.
We believed that it was food poison.Her mom gave her pain medication.(motrin 400mg po ×1)But her pain did not stop,pain persisted for more than four hours. Her mom couldn’t call their family doctor since it is already midnight. So we have to go to the Emergency room immediately.
Diagnostic studies done.
Xray,CT scan of abdomen and Pelvic done and some laboratory tests.
It was confirmed that she has Appendicitis. Appendicitis why asked her father?.
Appendicitis is a condition in which the appendix become inflamed with pus causing lots of pain. The appendix does not do any work in the body.So removal of it will not be a problem the doctor explained to Janet’s father.
Doctor orders:
Diagnosis Acute Appendicitis.
Strict NPO.
Consent signed for Appendectomy. ( Surgical removal of appendix before it ruptures)
Zosyn 3.375gm IV Q8hours.
Ancef 2gm IV Q8hours x3.
Dilaudid 1mg IV Q3hours prn severe pain. Zofran 4mg IV Q4hours prn severe pain.
Vital signs Q4hours and prn.
Tylenol 650mg po Q4hours prn temperature with sips of water.
Foley catheter placed for surgery to be removed in 48hours.
D545NS +20meqkcl at 100ml/hour left forearm 20guage clean/ Patent and dry.
Note: If the appendix has perforated a drain such as Jackson Pratt may be placed in lower incision site and dressing applied.
The dressing change will be done frequently.
Postoperative:
Monitor patient frequently, medicate as ordered for pain by the doctor.
Encourage ambulation.
Coughing and deep breathing.
Encourage the use of incentive Spirometry every hour while awake.
Ice chips initially ,advance to clear liquid for dinner.
Discontinue Foley catheter by 05am tomorrow morning.
CBC with differential, Comprehensive Metabolic panel in 05am.
Nurses You Move Me 