Medical Surgical Appendicitis #3

Question

The nurse prepares the teenager for a laparoscopic appendectomy. Which should be included in the teaching?

Answers

  1. “The incision will be large but be at the bikini line.”
    • Rationale:

      This answer is not correct because the laparoscopic appendectomy is done by a few small incisions. The incisions will not be large (unless the appendix is severely inflamed), nor will be at the bikini line.

  2. “There will likely be drains coming from the incision.”
    • Rationale:

      This answer is not correct because there would not be more than one drain coming from the surgical site. If the appendix has ruptured or badly inflamed, the healthcare provider may insert a drain.

  3. “There will be 2-3 long sutured incisions with redness and swelling.”
    • Rationale:

      This answer is not correct because during an uncomplicated appendectomy, long suture lines are not used to close the incisions. Rather, surgical glue or steri-strip bandages are used to close the small incisions made during that procedure.

  4. “The small incisions will have glue or steri-strip bandages on them.”
    • Rationale:

      This answer is correct because the laparoscopic surgery will have small incisions that will easily close with surgical glue or steri-strip bandages. A laparoscopic appendectomy is done by making several small incisions in the abdomen and umbilicus.

Overview

A laparoscopic appendectomy is done by making a few small incisions in the abdomen and umbilicus. The incisions will be closed through a special surgical glue and/or steri-strip bandages.

Explanation

Learning Outcomes

Appendicitis is inflammation of the appendix. It presents as pain in the lower right abdomen, nausea, vomiting, decreased appetite, fever, constipation/diarrhea and/or abdominal bloating. To diagnosis, a physical assessment of pain, blood test, and CT scan is used. Once confirmed by CT, an appendectomy is the next step. It is important to visually see the appendix before performing surgery. This will also confirm the appendix has not perforated or ruptured, requiring emergent surgery. An appendectomy is a surgical procedure to remove the appendix and will be performed soon after confirmation of appendicitis since there is a high risk of perforation or rupture in appendicitis. A laparoscopic surgery is often the only surgery necessary, unless perforation has occurred. The laparoscopic surgery will have a few small incisions that will easily close with surgical glue or steri-strip bandages.

Test Taking Tip

Be sure to know the difference between an open surgical procedure and a laparoscopic procedure. Be knowledgeable of what to teach your client with either procedure.

Video Rationale