Surgery

APPENDICITIS

DIAGNOSIS: Appendicitis

(LAYMANS) DESCRIPTION: Inflammation of the appendix requiring surgical removal

EXPECTED LENGTH OF STAY: 2-7 days based on severity of infection

CARE OVERVIEW: Acute appendicitis is one of the most common surgical emergencies in the world.  Laparoscopic appendectomy is the most common approach. However, in some circumstances (if the appendix has ruptured) then an open appendectomy is performed.

COMMON THERAPIES: Hospitalization is always required.  Patients will receive intravenous hydration, antibiotics, and pain control.  For a small number of patients (those with high surgical risks) then a non-operative approach may be considered.  For patients undergoing a laparoscopic appendectomy, most patients can be discharged home within 24-48 hours. For those requiring an open appendectomy, patients can be expected to be discharged home after 5-7 days.

 

CARE MILESTONES: Discharge criteria include patients having good pain control with oral agents and being able to tolerate an oral diet.

QUESTION PROMPTS FOR THE DOCTOR:

LABS: Daily complete blood count to assess for inflammation and infection, basic metabolic panel to assess hydration status and electrolytes.

RADIOLOGY EXAMS: The standard imaging for the diagnosis of acute appendicitis is a CT scan of the abdomen and pelvis with IV contrast.

MEDICATIONS: What are the risks for my antibiotics?  How long do you expect I will need an IV? How long will I need to take the pills?

QUESTION PROMPTS FOR THE NURSE:

Will you be rounding on me hourly?  

Will you do a bedside report at change of shift?

Ask them for the name of the medications, what they are for, and what the side effects are when they are brought to you.