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inflammatory bowel disorder (Diverticular Disease (Causes (Increased…

- - - - blockage to the appendix, by stool, foreign body or cancer.
      - infection
      - assessment and common findings
        
        objective data
        
        slow grade fever
        
        local tenderness at the right lower guardant of the abdomen
        
        diagnostic tests, blood investigation including full blood count, which reveals an elevated white cells count above 11000 with the neutrophil above 75%.
        
        X-ray shows a dilated loops of bowel indicating paralytic ileus, air or fluid levels in case of obstruction and free air consistent with perforation.
        
        medical management
        
        it involves immediate surgical removal of the appendix through a laparotomy or laparoscopy.Drainage of the abscess may be indicated if this complication has developed.
        Before surgery, however intravenous therapy should b given to correct fluid and electrolyte imbalance and to administer prescribed antibiotics for infection.
        Ifthe appendix has not perforated at the time of surgery, the patient's recovery is usually smooth and he or she is discharged within 5-7 days or even more.
        
        nursing management
        
        the goals for nursing management are to allay anxiety, relief pain, prevent systemic infection, correct fluid and electrolyte balance, restore and to maintain optimal nutrition and prepare the patient for surgery
        
        administer analgesia and antibiotics for pain and infection respectively.
        
        assess the patient for the effect of these drugs by observing the and asking the patient the extent of of pain.
        
        monitor and record vital signs to detect infection early
        
        withhold oral feeds and if the paralytic ileus has developed, or peritonitis has developed, a nasogastric tube should be inserted and the patient should be kept on continuous drainage while awaiting surgery.
        
        ensure adequate fluid replacement as the patient may be vomiting.
        
        explain all procedures and activities to the patient allay anxiety.
        
        health education
        
        advise a patient not to self-medicate in case of abdominal pain as most would take laxatives, which would speed up the process of perforation, while analgesic would make the progression of the disease.
        therefore patients should be advised Advised to visit the doctors as soon as they feel abdominal pain.
    - - dull pain near the naval or the upper abdomen that becomes sharp as it moves to the lower right abdomen. and this is usually the first sign
      - loss of appetite
      - neusea
      - abdominal swelling
      - in ability to pass gas
      - fever of 99-102 degrees fahrenheit
      - painful urination, severe cramps, and constipation or diarrhea with gas
      - pathophysiology
        
        obstruction of the appendix resulting in an inflammatory reaction which leads to oedema and distention.
        pressure is applied on the intramural blood vessel, which lead to vascular engorgement, resulting in gangrene of the appendix. in addition the mucosal wall ulcerates, becomes infected and raptures, which spreads the infection to the peritoneum, hence the associated peritonitis or abcess formation
- - - - Diverticulum is a sac-like dilatation or an outpouching of the mucus layer of the bowel that extends through a defect in the muscle layer.
      - Deverticulum that occurs without inflammation is known as Deverticulosis
      - When diverticular get infected they are called Diverticulitis
  - - - Patients must be kept nil per mouth and parenteral fluids given
      - Nasogastric Drainage
      - Antibiotics
      - Analgesics
      - Antispasmodics
      - Stool softners
    - - Keep patient on bed rest and exercise once acute phase subsides
      - Administer analgesics for pain
- - - - haematological studies a full blood count reveals leukocytesis related to inflammatory reaction, anemia, elevated erythrocyte sedimentation rate, and low haematocrit and albaminuria
      - the stool should be examined for ova and parasites
      - endoscopic studies. A proctosigmoidoscopy can be done to determine the location of the lesion and obtain a biopsy specimen of the affected tissue.
      - radiological studies.
  - - - Promoting comfort and healing
      - Maintaining adequate nutrition and fluid
      - Arresting the inflammatory process
      - Preventing of complications