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Appendicitis/Peritonitis/Intestinal obstruction Exam Questions with Correct Answers
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Appendicitis/Peritonitis/Intestinal obstruction Exam Questions with Correct Answers
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Appendicitis/Peritonitis/Intestinalobstruction Exam Questions with
Correct Answers
Appendicitis is - Answer-1. inflammation of the appendix, a narrow blind tube that
extends from the inferior part of the cecum.
2. It is the most common reason for emergency abdominal surgery
3. Fills with food and empties into the cecum
4. Prone to infection or obstruction due to small size
5. 4 in long.
Appendicitis typically begins with - Answer-1. RLQ-dull periumbilical pain, followed by -
anorexia,
-nausea, and
-vomiting.
2. The pain is persistent and continuous,
-eventually shifting to the right lower quadrant and
-localizing at McBurney's point (halfway between the umbilicus and right iliac crest).
3. A low-grade fever may develop.
4. Further assessment reveals
-localized tenderness,
-rigidity,
-rebound tenderness, and
-muscle guarding.
5. Coughing,
-sneezing, and
-deep inhalation worsen pain.
6. The patient usually prefers to lie still, often with the right leg flexed.
7. The older adult may report
-less severe pain,
-slight fever, and
-discomfort in the right iliac fossa.
8. Rupture
-Paralytic ileus,
-diffuse pain,
-abdominal distention
the people that will develop appendicitis is most likely in those - Answer-1. 10 to 30
years of age.
2. A common cause of appendicitis is obstruction of the lumen by a fecalith
(accumulated feces).
3. Obstruction results in
-distention;
,-venous engorgement; and the
-accumulation of mucus and
-bacteria,
which can lead to
-gangrene,
-perforation, and
-peritonitis.
Patient examination includes a complete - Answer-1. history,
2. physical examination, and a
3. differential WBC count.
4. Most patients have a mildly to moderately high WBC count.
5. A urinalysis is done to rule out genitourinary conditions that mimic appendicitis.
-Pregnancy test (rule out ectopic pregnancy
6. CT scan is the preferred diagnostic procedure.
-However, ultrasound and MRI are options.
7. If there is a delay in diagnosis and treatment,
-the appendix can rupture and the resulting peritonitis can be fatal.
8. The standard treatment of appendicitis is an immediate appendectomy (surgical
removal of appendix).
9. If the inflammation is localized, surgery should be done as soon as the diagnosis is
made.
10. Antibiotics and fluid resuscitation are started before surgery.
11. If the appendix has ruptured and there is evidence of
-peritonitis or
-an abscess,
-giving parenteral fluids and antibiotic therapy for 6 to 8 hours before the appendectomy
helps prevent dehydration and sepsis.
Managing the patient who has manifestations of appendicitis focuses on - Answer-1.
preventing fluid volume deficit,
-relieving pain, and
-preventing complications.
2. To ensure the stomach is empty in case surgery is needed,
-keep the patient NPO until the HCP evaluates the patient.
3. Monitor vital signs and perform ongoing assessment to detect any deterioration in
condition.
4. Give IV fluids,
-analgesics, and
-antiemetics as ordered.
5. Provide comfort measures.
-Avoid laxatives and enemas
6. Patients are usually discharged within 24 hours after an uncomplicated laparoscopic
appendectomy.
7. Ambulation begins a few hours after surgery, and
-the diet is advanced as tolerated.
, 8. Those who had a perforation usually have a longer length of stay and need IV
antibiotic therapy.
9. Most patients resume normal activities 2 to 3 weeks after surgery.
Peritonitis results from a - Answer-1. localized or generalized inflammatory process of
the peritoneum
2. occurs when blood-borne organisms enter the peritoneal cavity.
-For example, the ascites that occurs with cirrhosis of the liver provides an excellent
liquid environment for bacteria to flourish.
-Organisms can enter the peritoneum during peritoneal dialysis.
3. Secondary peritonitis is much more common.
4. It occurs when abdominal organs perforate or rupture and release their contents
-bile,
-enzymes, and
-bacteria into the peritoneal cavity. 5. Common causes include a
-ruptured appendix,
-perforated gastric or
-duodenal ulcer,
-severely inflamed gallbladder, and
-trauma from gunshot or
-knife wounds.
6. Intestinal contents and bacteria irritate the normally sterile peritoneum and produce
an initial chemical peritonitis.
-Bacterial peritonitis develops a few hours later.
7. The resulting inflammatory response leads to massive fluid shifts (peritoneal edema)
and
-adhesions as the body tries to wall off the infection.
8. Peritoneum is normally sterile
the most common symptom of peritonitis - Answer-1. Abdominal pain
2. A universal sign is tenderness over the involved area.
3. Rebound tenderness,
-muscular rigidity, and
-spasm are other signs of peritoneal irritation.
4. Patients may lie still and
-take only shallow breaths because movement worsens the pain.
5. Abdominal distention,
-fever,
-tachycardia,
-tachypnea,
-nausea,
-vomiting, and
-altered bowel habits may be present.
6. These manifestations vary, depending on the severity and acuteness of the
underlying condition.
7. Complications include
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