PEDIATRIC

PEDIATRIC 1
 DEFINITION
Appendicitis is an irritation, inflammation, and
infection of the appendix (a narrow, hollow tube that
branches off the large intestine).
 Appendicitis is the most common cause of
emergency surgery in childhood.

PEDIATRIC 2
PEDIATRIC 3
 SIGN AND SYMPTOM
Pain in the abdomen which:
may start in the area around the belly button, and
move over to the lower right-hand side of the
abdomen, but may also start in the lower right-
hand side of the abdomen.
usually increases in severity as time passes.
may be worse with moving, taking deep breaths,
being touched, and coughing or sneezing.
may spread throughout the abdomen if the
appendix ruptures.

PEDIATRIC 4
nausea and vomiting
loss of appetite
fever and chills
changes in behavior
diarrhea or constipation

PEDIATRIC 5
CAUSES
 Appendicitis occurs when the interior of the
appendix becomes filled with something that causes it
to swell, such as mucus, stool, or parasites.
 The appendix then becomes irritated and inflamed.
The blood supply to the appendix is cut off as the
swelling and irritation increase.
Adequate blood flow is necessary for a body part to
remain healthy.

PEDIATRIC 6
When the blood flow is reduced, the appendix starts
to die.
 Rupture (or perforation) occurs as holes develop in
the walls of the appendix, allowing stool, mucus, and
other substances to leak through and get inside the
abdomen.
An infection inside the abdomen known
as peritonitis occurs when the
appendix perforates.

PEDIATRIC 7
TREATMENT
The appendix may be removed in two ways:

•Appendectomy- is the surgical removal of the vermiform

appendix.
•Under anesthesia, an incision is made in the lower right-hand
side of the abdomen.
• The surgeon finds the appendix and removes it.

PEDIATRIC 8
Appendectomy.

PEDIATRIC 9
PEDIATRIC 10
•Laparoscopic Method- This procedure uses several small
incisions and a camera called a laparoscope to look inside the
abdomen during the operation. Under anesthesia, the
instruments the surgeon uses to remove the appendix are
placed through several small incisions, and the laparoscope is
placed through another incision. This method is not usually
performed if the appendix has ruptured.

PEDIATRIC 11
Raptured appendix:
When the appendix has ruptured, patients undergoing a
laparoscopic appendectomy may have to be switched to the
open appendectomy procedure for the successful
management of the rupture. If a ruptured appendix is left
untreated, the condition is fatal.

Preoperative
1. IV administration of fluid and electrolyte.
2. Systemic antibiotic.
3. NG suction.

PEDIATRIC 12
Postoperative
1. IV fluid.
2. Continued administration of antibiotic.
3. Continued NG suction for abdominal
decompression until intestinal activity returns.

PEDIATRIC 13
NURSING RESPONSIBILITY
 Access pain score-Because abdominal pain is the
most common childhood complaint with
appendicitis.
Access changes in behavior-The younger, nonverbal
child will assume a rigid, motionless, side lying
posture with the knees flexed on the abdomen, and
there is decreased range of motion of the right hip.

PEDIATRIC 14
Postoperative Care:

1. The course of recovery is longer (usually 7-10 days of

hospitalization).
2. The child is maintained on IV fluid, NPO and NG tube is kept
on low continuous gastric decompression until there is
evidence of intestinal activity.
3. Listening for bowel sound and observing of other signs of
bowel activity.(eg: passage of stool).

PEDIATRIC 15
4. A drain is placed in wound during surgery and
frequent dressing changes with meticulous skin
care are essential to prevent excoriation of the
surgical site.
5. Wound care includes irrigation with
antibacterial solution.
6. Parents is needed to express their feeling and
concern regarding the event surrounding the
hospitalization.
7. The nurse can provide education and
psychosocial support to promote adequate
cooping and alleviate anxiety of children.
PEDIATRIC 16
 THE END
PREPARED BY

STUDENT NURSES:

AYU AZUREEN FAZI ILAH

PEDIATRIC 17