Disease Risk Subjective Finding Objective Findings Diagnostics Treatment Education GI DISORDERS Appendicitis -Most common between 10-30yrs; but can occur at any age; rare in infants and olderadults -men more at risk - Diets low in fiber, high in fat, refined sugars, & other carbs at increasedrisk. - Obstruction of appendix is cause of majority of appendicitis - contributing factors: Intraabdominal tumors, positive familyhx - Recent roundworm infection or viral GI infection -Dx made clinically, based primarily onH&P exam - Classic presentation includes acute onset ofmild to severe colicky, epigastric, or periumbilical pain - Pain is vague at firstthen localizes within 24hrs to RLQ - Pain exacerbated by walking\coughing - Men may feel radiated pain in testes - Abd muscle rigidity,N\V, anorexia - Mildly elevated temp99-100F common - If RLQ accompaniedby shaking chills, perforation should besuspected - Older adults may present with weakness, anorexia, -May have HTN\tachy proportional to pain\symptoms -When lying flat, may flex R knee to relieve tension in abd muscle -Pain with palpation inabd, diffuse in early stages. Localized to RLQ later -Positive for reboundpain; ask pt to coughto localize pain location -Sudden cessation ofpain means perforation and is ER -Labs are not diagnostic and nonspecific -Women should haveurine human chorionic gonadotrophin to r\oectopic pregnancy - +Rovsing’s Signdeep palpation & release in LLQ causesrebound pain in RLQ - +Psoas Sign- lift R leg against gentle pressure causes pain - +Obturator Signflex R hip & knee andslowly rotate internally causes pain - +McBurney’s Sign- pain with pressure applied to point between umbilicus &ilium - x-ray\CT helpful when paired with positive H&P findings -Surgical; preoperative care, NPO, correction of fluid\electrolyte imbalances -Avoid narcotics -Atb with 3rd gen cephalosporin; Ex: ampicillin, gentamycin,flagyl -F\U with surgeon -Ambulation aftersurgery -Adv diet whenbowel sounds return -Return to hosp with s\s of infection -Avoid heavy liftingfor at least 2 wks