Acute Appendicitis

NAME OF
DRUG
GENERIC
NAME:
cefoxitin
BRAND
NAME:
Mefoxin
PATIENT
DOSE:

CLASSIFICATION
Antibiotic
Cephalosporin(2nd
Generation)

INDICATION

CONTRAINDICATION

Intra-abdominal Hypersensitivity to
infections, lower
cephalosporins;
respiratory
serious
infections,
hypersensitivity to
perioperative
penicillin.
prophylaxis
Use cautiously with
hepatic or renal
failure.

ADVERSE
EFFECTS
Headache,
dizziness

TIV

CNS: Seizure (High

Doses).
GI:
Pseudomembranou
s Colitis, diarrhea,
nausea, vomiting.
DERM: rashes,
urticaria.

1 g q8hrs
ROUTE:

NURSING
RESPONSIBILITY

HEMATt: bleeding,
eosinophilia,
hemolytic anemia,
leukopenia,
thrombocytopenia.

LOCAL: pain at IM
site, phlebitis at IV
site.
MISC: Allergic

reaction including
Anaphylaxis,
superinfection.
JRRMMC |ER

Inspect injection
sites regularly.
Report
evidence of
inflammation
and patient's
complaint of
pain.
Check for
Doctors order
Observe 10Rs
of the patient in
medicine
administration
Assess for
infection (vital
signs;
appearance of
wound, sputum,
urine, and stool;
WBC) at
beginning of
and throughout
therapy.
Before initiating
therapy, obtain

DRUG
RATIONALE
To inhibit
bacterial
growth.

Acute Appendicitis

JRRMMC |ER

a history to
determine
previous use of
and reactions to
penicillins or
cephalosporins.
Persons with a
negative history
of penicillin
sensitivity may
still have an
allergic
response.
Obtain
specimens for
culture and
sensitivity
before initiating
therapy. First
dose may be
given before
receiving
results.
Observe patient
for signs and
symptoms of
anaphylaxis

Acute Appendicitis
NAME OF
DRUG
GENERIC
NAME:

CLASSIFICATION

INDICATION

CONTRAINDICATION

Symptomatic
relief of pain
and fever.

Analgesic
Antipyretic

paracetamol
BRAND
NAME:
Aekmil
PATIENT
DOSE:

Contraindicated in
patients
hypersensitive to
drug.
Use cautiously in
patients with long
term alcohol use
because
therapeutic doses
cause
hepatotoxicity in
these patients.

ADVERSE
EFFECTS

Hematologic:
hemolytic
anemia,neutrop
enia,
leucopenia,
pancytopenia.
Hepatic:
Jaundice
Metabolic:
Hypoglycemia
Skin: rash,
urticaria

NURSING
RESPONSIBILITY

300mg PRN
ROUTE:
TIV

JRRMMC |ER

Use liquid form for

children and
patients who have
difficulty
swallowing.
In children, dont
exceed five doses
in 24 hours.
Advise patient that
drug is only for
short term use and
to consult the
physician if giving
to children for
longer than 5 days
or adults for longer
than 10 days.
Advise patient or
caregiver that
many over the
counter products
contain
acetaminophen;
be aware of this
when calculating
total daily dose.
Warn patient that
high doses or
unsupervised long

DRUG
RATIONALE
To relieve pain.

Acute Appendicitis
term use can
cause liver
damage.

JRRMMC |ER

Acute Appendicitis
NAME OF
DRUG
GENERIC
NAME:
omeprazole
BRAND
NAME:
Prilosec
PATIENT
DOSE:
40mg q24hrs
ROUTE:
TIV

CLASSIFICATION
Proton Pump
Inhibitor(PPI)

INDICATION
Short-term
treatment of
active duodenal
ulcer; First-line
therapy in
treatment of
heartburn or
symptoms of
gastroesophageal
reflux
disease(GERD);
Short-term
treatment of
active benign
gastric ulcer;
GERD, severe
erosive
esophagitis,
poorly responsive
symptomatic
GERD;
Long-term
therapy:
Treatment of
pathologic
hypersecretory
conditions
(Zollinger-

ADVERSE
EFFECTS

CONTRAINDICATION
Contraindicated with
hypersensitivity to
omeprazole or its
component.
Use cautiously with
pregnancy, lactation.

CNS:
headache,
malaise,
dizziness,
somnolence,
insomnia,
vertigo
CV:
tachycardia,
bradycardia
Dermatologic
: rash,
alopecia
GI:
constipation,
diarrhea,
nausea and
vomiting,
abdominal
pain,
hepatitis

JRRMMC |ER

NURSING
RESPONSIBILITY

History: allergy
to ranitidine,
impaired renal
or hepatic
function,
lactation,
pregnancy.
Physical: skin
lesions,
orientation,
affect, liver
evaluation,
abdominal
examination,
normal output,
renal function
tests, CBC
Interventions:
o Administer
oral drug
with meals
and at
bedtime.
o Decrease
doses in
renal and
liver failure.
o Provide

DRUG
RATIONALE
To suppress
gastric acid.

Acute Appendicitis
Ellisonsyndrome,
multipleadenoma
s, systemic
mastocytosis);Era
dication of H.
pylori With
amoxicillin or
metronidazole

concurrent
antacid
therapy to
relieve pain

JRRMMC |ER

Acute Appendicitis

ASSESSMENT
Subjective:
Masaki ang tiyan ko as
verbalized by the patient.
Objective:

Facial grimace
Facial mask
Guarding behavior
Weakness
Pain Scale = 7/10

Vital signs taken as follows:

BP = 110/70mmHg
T = 37.1C
PR = 75bpm
RR = 25cpm
O2 = 99%

DIAGNOSIS
Acute pain related to
inflammation as
manifested by
Guarding behavior,
Facial grimace and
Pain Scale of 7/10.

PLANNING

INTERVENTION

EVALUATION

After 4 hours of appropriate

nursing intervention, the
patients will demonstrate
use of relaxation skills,
other methods to promote
comfort.

Independent:
Investigate pain reports,
noting location,
duration, intensity (0-10
scale), and
characteristics (dull,
sharp, constant).

After 4 hours of
appropriate nursing
intervention, the patients
was able to demonstrate
use of relaxation skills,
other methods to promote
comfort.

Maintain semi-fowlers
position.

Move patient slowly and

deliberately.

Provide comfort
measures like back rubs
and deep breathing.
Provide diversional
activities.

Remove noxious
Environmental stimuli.

Dependent:
Provide analgesics as
prescribed.

JRRMMC |ER

Acute Appendicitis

ASSESSMENT

DIAGNOSIS

PLANNING

JRRMMC |ER

INTERVENTION

EVALUATION

Acute Appendicitis
Subjective:
Naka tatlong suka na siya
sa bahay as verbalized by
the mother.
Objective:

(+) 3x Vomiting
Sudden weight loss
(+) Decrease Fluid
intake
(+) Dry lips
(+) Poor skin turgor

Risk for Deficient Fluid

Volume related to
vomiting as evidence
by dry mucus
membrane and poor
skin turgor.

After 6 hours of appropriate

nursing interventions, the
patients will be able to:

Exhibit moist mucus

membrane and good
skin turgor.
Retain feedings without
experiencing vomiting.

Assess skin turgor,

mucous membrane.

Monitor Vital signs.

Weight patient daily.

Encourage to eat foods

with high fluid content,
such as watermelon,
grapes.

Encourage to avoid
foods that cause
dehydration such as
coffee, tea.

Ensure accurate intake

and output monitoring.

CHEMISTRY
JRRMMC |ER

Goals partially met. After

6 hours of appropriate
nursing interventions, the
patient was able to exhibit
moist mucous membrane
but still has a poor skin
turgor. He was able to
retain feedings without
experiencing vomiting.

Acute Appendicitis

SI UNIT
TEST NAME
Createnin

Sodium

Potassium

CONVENTIONAL UNIT

RESULT

REFERENCE RANGES

RESULT

REFERENCE RANGES

76.52umol/L

53-115umol/L

0.87mg/dL

0.6-1.3mg/dL

148.60mmol/L

139-149mmol/L

148.60mEq/L

139-149mEq/L

3.58mmol/L

3.5-5.5mmol/L

3.58mEq/L

3.5-5.5mEq/L

REMARKS: Increase Potassium Level

JRRMMC |ER