4 Appendectomy Nursing Care Plans

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Appendectomy is the surgical removal of the appendix. An inflamed appendix may be removed using a laparoscopic approach with laser. However, the presence of multiple adhesions, retroperitoneal positioning of the appendix, or the likelihood of rupture necessitates an open (traditional) procedure.

Studies indicate that laparoscopic appendectomy results in significantly less postoperative pain, earlier resumption of solid foods, a shorter hospital stay, lower wound infection rate, and a faster return to normal activities than open appendectomy.

Nursing Care Plans

Nursing care planning and management for patients who underwent appendectomy includes: preventing complications, promoting comfort, and providing information.

Here are four (4) nursing care plans (NCP) and nursing diagnosis for patients who underwent appendectomy:

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  1. Acute Pain
  2. Risk for Deficient Fluid Volume
  3. Risk for Infection
  4. Deficient Knowledge
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Risk for Deficient Fluid Volume

Nursing Diagnosis

Risk factors may include

  • Preoperative vomiting, postoperative restrictions (e.g., NPO)
  • Hypermetabolic state (e.g., fever, healing process)
  • Inflammation of peritoneum with sequestration of fluid

Desired Outcomes

  • Hydration (NOC)
  • Maintain adequate fluid balance as evidenced by moist mucous membranes, good skin turgor, stable vital signs, and individually adequate urinary output.
Nursing InterventionsRationale
Monitor BP and pulse. Variations help identify fluctuating intravascular volumes
Inspect mucous membranes; assess skin turgor and capillary refill. Indicators of adequacy of peripheral circulation and cellular hydration.
Monitor I&O; note urine color and concentration, specific gravity.Decreasing output of concentrated urine with increasing specific gravity suggests dehydration and need for increased fluids.
Auscultate and document bowel sounds. Note passing of flatus, bowel movement.Indicators of return of peristalsis, readiness to begin oral intake. Note: This may not occur in the hospital if patient has had a laparoscopic procedure and been discharged in less than 24 hr.
Provide clear liquids in small amounts when oral intake is resumed, and progress diet as tolerated. Reduces risk of gastric irritation and vomiting to minimize fluid loss.
Give frequent mouth care with special attention to protection of the lips. Dehydration results in drying and painful cracking of the lips and mouth.
Maintain gastric and intestinal suction, as indicated. An NG tube may be inserted preoperatively and maintained in immediate postoperative phase to decompress the bowel, promote intestinal rest, prevent vomiting.
Administer IV fluids and electrolytes.The peritoneum reacts to irritation and infection by producing large amounts of intestinal fluid, possibly reducing the circulating blood volume, resulting in dehydration and relative electrolyte imbalances.
Never administer cathartics or enemas.Cathartics and enemas may rupture the appendix.
Give the patient nothing by mouth, and administer analgesics judiciously.This may mask symptoms.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

More nursing care plans related to gastrointestinal disorders:

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Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.
  • I am following this.there are no any class or courses to train for NCELEX in my country. But I trying it via internet.thanks for helping us.

  • thank you Matt, I am in the same position now, doing nursing care plans is a challenge. thank you for your ability to present it clearly.

  • are the diagnosis for post operative care or its combined pre and post op. for example interventions of acute pain i read somewhere talking for not to apply hot compress for fear of rupture?

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