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appendicitis nursing care plan
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Appendicitis Case Study (Peds) (30 min)

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A 4-year-old girl comes into the emergency room for nausea, vomiting, fever and abdominal pain. The mother reports that the child has been saying their tummy hurts for the past 3 days and not wanting to eat very much but that today she started to throw up. 

Critical Thinking Check
Bloom's Taxonomy: Application

What nursing assessment data and history questions would you obtain at this time?

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The emesis is yellow and the child has thrown up 4 times. Upon assessment of the child, the girl cries anytime she sees a nurse or doctor and hugs her blanket and mother. The nurse notes tears, pink dry skin and a patent airway. The nurse stays in the room and plays with the child until the nurse is finally able to get a set of vitals:

HR 122

RR 28

BP 91/52

Temp 101°F axillary


The child still will not let anyone auscultate or palpate her abdomen. The doctor orders blood work, Tylenol and an X-Ray of the abdomen. The nurse draws the blood work and sends the child to X-Ray with her mother.

Critical Thinking Check
Bloom's Taxonomy: Analysis

Which labs do you expect will be abnormal for the child?

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Critical Thinking Check
Bloom's Taxonomy: Application

Before administering the Tylenol, what should the nurse check?

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The child has returned from X-Ray and is cuddled up with her mother and blanket. The child still will not let the nurse listen with her stethoscope but isn’t crying anymore. The X-Ray has resulted and shows the child has appendicitis. The nurse knows she needs to prepare the parents and the child for being admitted to the hospital and surgery. A re-check in vital signs shows the following:

HR 110

BP 95/53

RR 22

Temp 101.2°F axillary

Critical Thinking Check
Bloom's Taxonomy: Application

Which non-pharmacological interventions should the nurse implement at this time to address the child's fever

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Critical Thinking Check
Bloom's Taxonomy: Analysis

What would be the most concerning behavior that the nurse should be watching out for in the child?

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The OR schedules the child’s surgery for tomorrow at 6 AM and the hospital room is ready for the child to be admitted to overnight. 

Critical Thinking Check
Bloom's Taxonomy: Analysis

What is the most important thing for the nurse to educate the mother on before sending them to the room?

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