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Appendicitis Nursing Care Plan and Interventions
Appendicitis nursing care before surgery: keep the client NPO, start IV fluids, give pain medication and antibiotics as ordered, and never apply heat or give laxatives or enemas. Sudden relief of pain can mean rupture; watch for peritonitis.
Appendicitis nursing care plan
| Nursing problem | Goal | Key interventions |
|---|---|---|
| Acute pain | Pain controlled; analgesia does not delay diagnosis. | |
| Risk for infection (perforation and peritonitis) | No rupture before surgery; peritonitis signs reported at once. | |
| Risk for deficient fluid volume | NPO with IV fluids; stable vital signs. |
Problem wording is plain-language nursing diagnosis style. Your program may require NANDA-I labels and your own assessment data.
What it is
Appendicitis
The opening of the appendix gets blocked, so the appendix swells, loses blood flow and can perforate. 1,2
Delay is the danger: an infected appendix can rupture less than 36 hours after symptoms start.
Assessment: what you will see
Classic appendicitis pain
Pain starts around the navel with nausea and poor appetite, then moves to the right lower quadrant within hours. 2
Coughing or moving makes it worse. A low-grade fever is common.
McBurney point
RLQ tenderness and rebound tenderness about one third of the way from the front hip bone to the navel. 2,1
Rovsing sign: pressing the left lower quadrant causes pain on the right.
Appendicitis labs and imaging
WBC is often elevated, but a normal count does not rule it out. CT or ultrasound helps when the picture is unclear. 1,2
Ultrasound uses no radiation, so it is a good first choice for children.
Atypical appendicitis
Young children may have pain that is not localized. Older adults and pregnant clients often have milder pain and less tenderness. 2
In these groups, mild pain does not mean mild disease.
Complications and red flags
Sudden pain relief
If the pain suddenly eases, the appendix may have ruptured. Pain and fever then return worse as peritonitis develops. 2
Treat sudden relief as a red flag: reassess the abdomen and call the surgeon.
Peritonitis cues
Guarding, rebound tenderness and a rigid abdomen the client cannot relax, with fever, distention and vomiting. 1
Untreated peritonitis can progress to sepsis and septic shock.
Priority: what the nurse does first
Before appendectomy
Keep the client NPO, start IV fluids, and give IV antibiotics as prescribed before surgery. 1,2
Start IV antibiotics as prescribed before the appendectomy begins.
No heat on the abdomen
Heat increases blood flow to the area, which may speed inflammation and rupture of the appendix. 3,4,1
A client with RLQ pain asks for a heating pad: hold it and report the pain.
No laxatives or enemas
Laxatives are contraindicated in appendicitis, and enemas are avoided when a bowel perforation is possible. 5,1
Don't push the bowel to move when an inflamed appendix may burst.
Nursing interventions and treatment
Appendectomy
Laparoscopic or open removal. Antibiotics stop after surgery if it did not perforate; if it did, they continue for days. 1,2
Early surgery usually means a quick, full recovery. Rupture or older age makes it harder.
NCLEX traps
Pain relief is allowed
Moderate doses of IV pain medicine do not mask peritoneal signs and can make the exam easier. 2
Withholding all pain medicine until the surgeon arrives is outdated.
Keep studying appendicitis in NurseLingo Pro
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Frequently asked questions
What are the priority nursing diagnoses for appendicitis?
Common nursing problems for appendicitis include acute pain; risk for infection (perforation and peritonitis); risk for deficient fluid volume. Choose the ones your assessment supports and rank airway, breathing and circulation problems first.
What does the nurse do first for appendicitis?
Keep the client NPO, start IV fluids, and give IV antibiotics as prescribed before surgery. Heat increases blood flow to the area, which may speed inflammation and rupture of the appendix. Laxatives are contraindicated in appendicitis, and enemas are avoided when a bowel perforation is possible.
How to assess for appendicitis with a nurse?
Ask where the pain started and where it is now: classic pain begins around the belly button and moves to the right lower quadrant near McBurney point. Check for fever, nausea, rebound tenderness and guarding, and report sudden pain relief, which can mean rupture.
More gi & liver
Related cheat sheets
Sources
- OpenStax Medical-Surgical Nursing, 19.5
- merckmanuals.com
- OpenStax Medical-Surgical Nursing, 7.4
- OpenStax Clinical Nursing Skills, 8.3
- OpenStax Pharmacology for Nurses, 30.3
For study only, not medical advice. Follow your program, your facility's policies and the provider's orders.