Diseas
e
Risk Subjective Finding Objective Findings Diagnostics Treatment Education
GI DISORDERS
Appendicitis -Most common
between 10-30yrs;
but can
... [Show More] occur at any
age; rare in infants
and older adults
-men more at risk
- Diets low in fiber,
high in fat, refined
sugars, & other carbs
at increased risk.
- Obstruction of
appendix is cause of
majority of
appendicitis
- contributing
factors: Intra-
abdominal tumors,
positive family hx
- Recent
roundworm
infection or viral
GI infection
-Dx made
clinically, based
primarily on H&P
exam
- Classic
presentation
includes acute onset
of mild to severe
colicky, epigastric,
or periumbilical pain
- Pain is vague at
first then localizes
within 24hrs to
RLQ
- Pain exacerbated
by
walking\coughing
- Men may feel
radiated pain in
testes
- Abd muscle
rigidity, N\V,
anorexia
- Mildly elevated
temp 99-100F
common
- If RLQ
accompanied by
shaking chills,
perforation should
be suspected
- Older adults may
-May have
HTN\tachy
proportional to
pain\symptoms
-When lying flat,
may flex R knee to
relieve tension in
abd muscle
-Pain with palpation
in abd, diffuse in
early stages.
Localized to RLQ
later
-Positive for
rebound pain; ask
pt to cough to
localize pain
location
-Sudden cessation
of pain means
perforation and is
ER
-Labs are not
diagnostic
and
nonspecific
-Women should
have urine human
chorionic
gonadotrophin to
r\o ectopic
pregnancy
- +Rovsing’s Sign-
deep palpation &
release in LLQ
causes rebound
pain in RLQ
- +Psoas Sign- lift
R leg against
gentle pressure
causes pain
- +Obturator Sign-
flex R hip & knee
and slowly rotate
internally causes
pain
- +McBurney’s
Sign- pain with
pressure applied
to point between
umbilicus & ilium
- x-ray\CT helpful
when paired with
positive H&P
-Surgical;
preoperative care,
NPO, correction of
fluid\electrolyte
imbalances
-Avoid narcotics
-Atb with 3rd gen
cephalosporin; Ex:
ampicillin,
gentamycin, flagyl
-F\U with surgeon
-Ambulation
after surgery
-Adv diet
when bowel
sounds
return
-Return to hosp
with s\s of
infection
-Avoid heavy
lifting for at le [Show Less]