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:

  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

Risk for Deficient Fluid Volume: At risk for decreased intravascular, interstitial, and intracellular fluid.

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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See Also

You may also like the following posts and care plans:

Gastrointestinal Care Plans

Care plans covering the disorders of the gastrointestinal and digestive system:

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7 COMMENTS

  1. 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.

  2. 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.

  3. 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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