Rebound tenderness
(Mosby's Medical Dictionary, 9th edition, 2009) Iliopsoas muscle test
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Diagnostic tests - Labs:1. CBC count: White blood cell (WBC) count values range from 10,000 to 16,000 cells/mm3 when patient's suffer from appendicitis. As well there is a decrease in approximately 75% of a patients Neutrophil count. Normal neutrophil levels range between 1,500 to 8,000 cells/mm3[2].
2. C-reactive protein (CRP): Is an acute phase reactant that is synthesized by the liver in response to infection or inflammation. It's values rapidly increase within the first 12 hours and then shortly after it will normalize once symptoms of appendicitis appear. CRP levels greater then 1 mg/dL are found in appendicitis. The use of this method alone to diagnose appendicitis is not advised as CRP lacks specificity and does not distinguish between sites of infection[2]. 3. Other possible diagnostic lab tests include: Liver and pancreatic function test (to rule out possible damage to other organs); urinalysis (to rule out a possible UTI); urinary beta-hCG (to rule out possible early ectopic pregnancy in women)[2]. Unfortunately there is no outright test that can be performed to diagnose appendicitis. Although with the combination of physical assessments, lab testing an diagnostic imaging cases of appendicitis can be hypothesized to exist[2]. |
CT scan of the abdomen, looking at the appendix
(retrieved from: http://health-fts.blogspot.ca/2012/01/appendicitis.html) Ultrasound of an inflamed appendix
(retrieved from: http://emoryeus.blogspot.ca/2012/02/ultrasound-for-appendicitis.html) |
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Nursing assessments for appendicitis:
1. Abdominal assessments: An abdominal assessment would be performed on a patient who is thought to have appendicitis. There are two tests that can be done, the rebound tenderness test and the iliopsoas muscle test (which are both mentioned above). These tests help a nurse to determine if the patients abdominal pain is caused by appendicitis or any other organ/area within the abdomen[1].
2. Assess for pain: The nurse will assess the patients pain level by using verbal, non-verbal or facial scales. This assessment is preformed in order to determine the baseline of a patients pain and eventually the effectiveness of pain management. Generally with appendicitis there is a lot of lower right quadrant pain within the abdomen. In order to promote patient comfort, effective pain scoring and management is required. With these assessments and interventions performed the patient can start their return to recovery[1].
1. Abdominal assessments: An abdominal assessment would be performed on a patient who is thought to have appendicitis. There are two tests that can be done, the rebound tenderness test and the iliopsoas muscle test (which are both mentioned above). These tests help a nurse to determine if the patients abdominal pain is caused by appendicitis or any other organ/area within the abdomen[1].
2. Assess for pain: The nurse will assess the patients pain level by using verbal, non-verbal or facial scales. This assessment is preformed in order to determine the baseline of a patients pain and eventually the effectiveness of pain management. Generally with appendicitis there is a lot of lower right quadrant pain within the abdomen. In order to promote patient comfort, effective pain scoring and management is required. With these assessments and interventions performed the patient can start their return to recovery[1].
References:
1. Jarvis, C., Browne, A., MacDonald-Jenkins, J. & Luctkar-Flude, M. (Eds.). (2014). Physical examination and health assessment. (2nd Can ed). Toronto, ON: Elsevier Saunders. ISBN: 978-1-926648-72-9
2. Craig, S. (2015). Appendicitis. Retrieved from http://emedicine.medscape.com/article/773895-overview
1. Jarvis, C., Browne, A., MacDonald-Jenkins, J. & Luctkar-Flude, M. (Eds.). (2014). Physical examination and health assessment. (2nd Can ed). Toronto, ON: Elsevier Saunders. ISBN: 978-1-926648-72-9
2. Craig, S. (2015). Appendicitis. Retrieved from http://emedicine.medscape.com/article/773895-overview