Appendicitis Pre- and Post-Operative Care Plan

Appendicitis Pre Operative Care:

• Sonde installation to decompress the stomach.
• Catheters to control urine production.
• Rehydration.
• Antibiotic with broad spectrum and is given intravenously.
• Fever-reducing medicines.
• If fever, should be reduced before anesthesia.

Appendicitis Operative Care :

• Appendectomy
• Appendix removed, if the appendix is perforated freely, then the abdomen was washed with physiological saline and antibiotics.
• Appendix abscess treated with IV antibiotics, its mass may shrink, or abscess may require drainage within a few days.
• Appendectomy done if the abscess performed elective surgery after 6 weeks to 3 months.

Appendicitis Post Operative Care:

• Observation of vital signs.
• Lift the stomach sonde when patients have realized that aspiration of gastric fluid can be prevented.
• Put the patient in a semi-Fowler position.
• Patients are said to be good when it is in 12 hours without any disturbance, during fasting.
• When the action is bigger operation, for example the perforation, fasting continued until bowel function returned to normal.
• Give drink from 15 ml / hour, for 4-5 hours, then raised it to 30 ml / hour. The next day give food strain, and the next day be given soft foods.
• One day after surgery the patient is advised to sit upright in bed for 2 × 30 min.
• On the second day the patient can stand and sit outside the room.
• Day 7 stitches can be removed and the patient allowed to go home.

In the appendix to the state of the masses who are still active inflammatory process that is characterized by:

• General state of the client it still looks sick, the body temperature is still high.
• Local examination of the right lower quadrant of the abdomen are still clear signs of peritonitis.
• Laboratory there are leukocytosis and the counts are shifting to the left.

Surgery should be performed as soon as the client is prepared, because it feared would happen appendix abscess and generalized peritonitis. Preparation and surgery should be done as well as possible given the complications of wound infection is higher than surgery in simple appendicitis without perforation.

On the state of the appendix mass with inflammatory process has subsided characterized by:

• General condition has improved with no visible pain, body temperature is not high anymore.
• Local inspection abdomen there are no signs of peritonitis and only clear and palpable mass with mild tenderness.
• Laboratory leukocyte count and differential count normal.

Actions taken should be conservative with antibiotics and bed rest. Surgery if the bleeding was more difficult and more, especially when mass appendix has formed more than a week since the attacks of abdominal pain. Surgery is carried out immediately if the treatment occurs abscess with or without generalized peritonitis.