Appendicitis Nursing Care Plan & Management


  • Appendicitis is inflammation of the appendix.
  • When the appendix becomes inflamed or infected, rupture may occur within a matter of hours, leading to peritonitis and sepsis.
Risk Factors
  • Obstruction by fecalith or foreign bodies, bacteria or toxins.
  • Low-fiber diet
  • High intake of refined carbohydrates
Signs and Symptoms/ Assessment 
  1. Pain in the periumbilical area that descends to the right lower quadrant.
  2. Abdominal pain that is most intense at McBurney’s point
  3. Rebound tenderness and abdominal rigidity
  4. Low-grade fever
  5. Elevated white blood cell count
  6. Anorexia, nausea, and vomiting
  7. Client in side-lying position, with abdominal guarding and legs flexed
  8. Constipation or diarrhea
Diagnostic Evaluation
  • Diagnosis is based on a complete physical examination and laboratory and radiologic tests.
  • Leukocyte count greater than 10,000/mm 3, neutrophil count greater than 75%; abdominal radiographs, ultrasound studies, and CT scans may reveal right lower quadrant density or localized distention of the bowel.
Primary Nursing Diagnosis
Primary Preoperative Nursing Diagnosis
  • Pain (acute) related to inflammation
Primary Postoperative Nursing Diagnosis
  • Risk for infection related to the surgical incision
Other Diagnoses that may occur in Nursing Care Plans For Appendicitis
  • Imbalanced nutrition: Less than body requirements
  • Impaired skin integrity
  • Ineffective tissue perfusion: GI
  • Risk for deficient fluid volume
  • Risk for injury
Medical Management

An appendectomy (surgical removal of the appendix) is the preferred method of management for acute appendicitis if the inflammation is localized. An open appendectomy is completed with a transverse right lower quadrant incision, usually at the McBurney point. A laparoscopic appendectomy may be used in females of childbearing age, those in whom the diagnosis is in question, and for obese patients. If the appendix has ruptured and there is evidence of peritonitis or an abscess, conservative treatment consisting of antibiotics and intravenous (IV) fluids is given 6 to 8 hours prior to an appendectomy. Generally, an appendectomy is performed within 24 to 48 hours after the onset of symptoms under either general or spinal anesthesia. Preoperative management includes IV hydration, antipyretics, antibiotics, and, after definitive diagnosis, analgesics.

Complications of Appendectomy
  • The major complication is perforation of the appendix, which can lead to peritonitis or an abscess.
  • Perforation generally occurs 24 hours after onset of pain, symptoms include fever (37.7°C [100° F] or greater), toxic appearance, and continued pain and tenderness.