Medical Surgical Appendicitis #4

Question

What should the nurse include in teaching when preparing the client for discharge following a laparoscopic appendectomy?

Answers

  1. Report temperature of 99.9º F (37.7º C)
    • Rationale:

      This answer is not correct because a temperature of 99.9º F (37.7º C) is not a temperature of concern. The client should be instructed to report a fever 101º F (38.3º C) or greater.

  2. Remove the steri-strips 24-hours after the surgery
    • Rationale:

      This answer is not correct because steri-strips are placed to stay on an incision site for longer than 24-hours. Often, clients are instructed to let steri-strips come off on their own in the shower. Steri-strips will not come off on their own in the shower in 24-hours unless forcefully removed. This action can open the incision sites and increase the risk of infection.

  3. Avoid weight-bearing exercise for the first week
    • Rationale:

      This answer is correct because the client should avoid weight-bearing exercise for the first week. This will allow time for the body to heal and help reduce the chance of pulling the incisions open.

  4. Avoid laxatives the first two weeks after surgery
    • Rationale:

      This answer is not correct because laxatives do not have to be avoided after surgery and may be necessary after use of pain medications and surgery. Laxatives should absolutely be avoided prior to an appendectomy due to the risk of perforation.

Overview

Discharge teaching for a client who has had a laparoscopic appendectomy would include avoiding weight bearing activities for the first week. Lifting more than 10 pounds could put strain on the small incisions and should be avoided.

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. 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. With laparoscopic surgery, the client will have several small incisions that will easily close with surgical glue or steri-strip bandages. Even though an appendectomy is minimally invasive, the client should be instructed to avoid weight bearing exercise for the first week.

Test Taking Tip

Be sure to understand discharge teaching for an appendectomy. Know when to report a fever and how to care for steri-strips after surgery.

Video Rationale