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7/28/2019 Care of Clients With Ruptured Appendicitis
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7/28/2019 Care of Clients With Ruptured Appendicitis
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SPECIFIC OBJECTIVES:
At the end of 2-hour discussion onthe concept on Ruptured
Appendicitis, the learners shall:
Define what Ruptured Appendicitis is
and its related terms
Enumerate its Clinical Manifestations,Complications and Diagnostic Evaluation
Determine the Treatments and the
appropriate Nursing Responsibilities
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Incorporate the Growth and
Development satisfactorily to the
patients condition
Review concepts on the Anatomy and
Physiology of the Appendix and
PeritoneumTrace the Pathophysiology of Ruptured
Appendicitis
Critique the three (3) formulatedNursing Care Plans
Relate the two (2) Research articles
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Patients Name: patient X
Civil Status: Single
Birth Date: December 12, 1993Age: 18 years old
Address: Block 3, Lot 1 Mediatrix Dipolog City
Sex: Male
Religion: Protestant
Nationality: German-Filipino
Fathers Name: Augustus KhadMothers Name: Carmelita Velasco
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Admission: September 25, 2012 8:30 am
Attending Physician: Dr. Donald Dy
Diagnosis: Peritonitis
Past History: experienced colds, cough, fever, andwas never admitted because when having anillness would just drink medications and just rest.
No known drug and food allergies. No familyhistory of diabetes, hypertension and etc.
Present History: experienced severe abdominalpain on September 24, 2012 in the evening. Alsoexperienced fever and vomiting. Loss of appetiteand could not sleep well because of the severeabdominal pain.
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Growth and Development
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SIGMUND FREUDS THEORY OF
PSYCHOSEXUAL DEVELOPMENT
Developmental
TasksExpected Behavior Actual Behavior
Latency6 to puberty
Energy is directed tophysical and
intellectual activities.
Sexual impulses tend
to be pressed.
Develop relationships
between peers of the
same sex.
Tends to engage intremendous activities;
loves to hang-out with
peers.
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ERIK ERIKSON THEORY OF
PSYCHOSOCIAL DEVELOPMENTDevelopmental Tasks Expected Behavior Actual Behavior
Adolescence
12 to 20 years
(Identity versus
Role confusion)
Young adulthood
20 to 35 years
(Intimacy versus
Isolation)
Positive Resolution
Coherent sense of self; Plans to
actualize ones abilities
Negative Resolution
Feelings of confusion,
indesciveness, and possible
antisocial behavior
Positive Resolution
Intimate relationship with
another person; commitment towork and relationships
Negative Resolution
Impersonal relationships;
avoidance of relationship, career, or
lifestyle commitments
Positive Resolution
Has positive outlook in life,
that someones above who can
help straighten ones path.
Negative Resolution
Never felt his alone as he is
guided, cared and loved by his
ever supportive family.
Positive Resolution
Committed to career and hasclose relationship with Almighty
Father.
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JEAN PIAGETS COGNITIVE THEORY
Developmental
TasksExpected Behavior Actual Behavior
Formaloperation
phase
11 to 15
years
Uses rationalthinking; reasoning is
deductive and
futuristic
Able to usedeductive reasoning,
though conditions felt
at present wasnt able
to cope up enough.
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LAWRENCE KOHLBERGS STAGES OF
MORAL DEVELOPMENT
DevelopmentalTasks
Expected Behavior Actual Behavior
Adolescence
and adulthood
(most men
are in this
stage)
Law-and-Order Orientation (STAGE)
The person wants established rules and
authorities, and the reason for decisions and
behavior is that social and sexual rules and
traditions demand the response.
Conventional (LEVEL)
Person is concerned with maintaining
expectations and rules of the family, group,
nation, or society. A sense of guilt has
developed and affects behavior. The person
values conformity, loyalty, and active
maintenance of social order and control.
Conformity means good behavior or what
pleases or helps another and is approved.
Able to follow rules and
policies preceded by as a
manner of respect to person.
Developed a sense of guilt
to everything that was
inappropriate. Loyalty and
honesty are values that he
pursued.
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ANATOMY AND PHYSIOLOGY
APPENDIX
o elongated outpouching of the cecum,
found at its posteromedial aspect about2.5 cm below the ileocecal valve
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DRUG STUDY
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METRONIDAZOLE
Drug Classification: Antibiotic; Antibacterial;
Antiprotozoal; Amebicide
Therapeutic Actions:
Bactericidal; Inhibits DNA synthesis in specific
(obligate) anaerobes, causing cell death;
antiprotozoal-trichomonacidal, amebicidal:
Bio-chemical mechanism of action is not
known
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Indications:
Acute infections with susceptible anaerobic
bacteriaAcute intestinal amebiasis
Amebic liver abscess
Bacterial vaginosis
Contraindications:
Contraindicated with hypersensitivity tometronidazole
Use cautiously with CNS disease, hepaticdisease, candidiasis (moniliasis)
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Adverse Effects:
Headache, dizziness, insomnia, seizures,
fatigue
Nausea, vomiting, diarrhea, GI upset, cramps,
anorexia
Incontinence, darkening of the urine, dysuria
Thrombophlebitis, redness, burning, dryness,
and skin irritation (topical)
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Nursing Interventions:
Administer oral doses with food if GI upset
Take full course of drug therapy
Instruct patient not to drink alcohol (beverages orpreparations containing alcohol, cough syrups) for 24-72 hour of drug use; severe reactions may occur
Tell patient that urine may be a darker color than usual;this is expected
Patient may experience these side effects: Dry mouthwith strange metallic taste (frequent mouth care,sucking sugarless candies may help)
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CEFTRIAXONE SODIUM
Drug Classification: Antibiotic;
Cephalosporin (3rd generation)
Therapeutic Actions:
Bactericidal; Inhibits synthesis of
bacterial cell wall, causing cell death
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Indications:
Lower respiratory infections caused by
Streptococcus pneumonia UTIs and intra-abdominal infections
caused by Escherichia coli
Septicemia caused by Escherichia coli
Contraindications:
Contraindicated with allergy tocephalosporins or penicillins
Use cautiously with renal failure
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Adverse Effects:
Headache, dizziness, lethargy
Nausea, vomiting, diarrhea, abdominal pain,
flatulence Nephrotoxicity
Decreased WBC count, decreased platelet count
Ranging from rash to fever to anaphylaxis
Abscesses at injection site, phlebitis,inflammation at IV site
i i
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Nursing Interventions:
Monitor ceftriaxone blood levels in patients with
severe renal impairment and in patients with
renal and hepatic impairment
Have vitamin K available in case
hypoprothrombinemia occurs
Discontinue if hypersensitivity reaction occurs
Instruct patient to avoid alcohol while taking this
drug and for 3 days after because severe
reactions often occur Report severe diarrhea, difficulty breathing,
unusual tiredness or fatigue, pain at injection site
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RELATED RESEARCH
Man collapses with ruptured appendicitis
Schistosomal peritonitis secondary to
perforated appendicitis
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Kozier, B., et. al,. (2004). Fundamentals of Nursing: Concepts,Process, and Practice. 7th ed. Jurong, Singapore: PearsonEducation South Asia Pte Ltd
Karch, A. M. (2011). 2011 Lippincotts: Nursing Drug Guide.Norriston Road: Lippincott; William and Wilkins
Tortora, G. J., & Grabowski, S. R. (2003). Principles ofAnatomy & Physiology. 10th ed. United States of America; JohnWiley & Sons, Inc.
Daniel Bates, Man collapses with ruptured appendix threeweeks after NHS doctors took it out. Article. 25 August 2009.
[http://www.dailymail.co.uk/news/article-1208970/Man-collapses-ruptured-appendix--weeks-NHS-doctors-took-out.html#ixzz27VBMLjEV]
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