Physiological Adaptation Q 118

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Jerry has been diagnosed with appendicitis. He develops a fever, hypotension, and tachycardia. The nurse suspects which of the following complications?

  

     A. Intestinal obstruction

     B. Peritonitis

     C. Bowel ischemia

     D. Deficient fluid volume

    

    

Correct Answer: B. Peritonitis

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Complications of acute appendicitis are peritonitis, perforation and abscess development. Diffuse peritonitis and sepsis can also develop, which may progress to significant morbidity and possible death. Postoperative abscesses, hematomas, and wound complications are all complications that can be seen after appendectomies. If the wound does get infected, one may grow Bacteroides. “Recurrent” appendicitis can occur if too much of the appendiceal stump is left after an appendectomy.

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Option A: Signs of intestinal obstruction include crampy abdominal pain, loss of appetite, constipation, vomiting, inability to have a bowel movement or pass gas, and swelling of the abdomen. Complications of appendicitis and appendectomy include surgical site infections, intra-abdominal abscess formation (3% to 4% in open appendectomy and 9% to 24% in laparoscopic appendectomy), prolonged ileus, enterocutaneous fistula, and small bowel obstruction.

Option C: Symptoms of bowel ischemia include sudden abdominal pain, an urgent need to have a bowel movement, frequent, forceful bowel movements, abdominal distention or swelling, bloody stool, and mental confusion in older adults.

Option D: Deficient fluid volume may be characterized by hypotension, concentrated urine, decreased skin turgor, decreased urine output, and dry mucous membranes. If diagnosed and treated early, within 24 to 48 hours, the recovery and prognosis should be very good. Cases that present with advanced abscesses, sepsis, and peritonitis may have a more prolonged and complicated course, possibly requiring additional surgery or other interventions.

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