Nursing intervention Potential complication Priority Rationale

Nursing intervention Potential complication Priority Rationale

1. Examination of the
   patient (Erica):
   a. Note down the entire
   condition of the patient.
   b. Find out the patient’s
   temperature, blood
   pressure, and the rate of
   pulse
   c. The nurse would also
   examine the patient by
   finding out her past
   medical condition. For
   instance, the nurse may
   ask the patient when she
   began experiencing the
   pain, whether the pain is
   continuous or just

Paralytic ileus
After the Appendectomy procedure, there is
likelihood that the patient, in this case Erica will
develop some post operative complication. One of
the most common conditions that she will likely
develop is the Paralytic ileus. This is a condition that
normally occurs as a result of the obstruction of the
intestine because of the intestinal muscles. It is
important to note that the paralysis must not be
complete to develop ileus, however, the inactivity of
the intestinal muscles would block the passage of
foods and therefore causing the functional blockage
of the intestine. There are various interventions that
the medical practitioners can apply to rectify the
condition. One of those possible interventions
includes a process called computed topography for
the abdomen. There is also pelvis which is

The nurse will have to
intervene almost
immediately considering
the excruciating pain that
the patient has
complained about. In
other words, the patient
should be given high
priority. In the general
ward, Erica should be
given high priority
because of the
complications that she
might develop and
worsen her situation
further, and might even
lead to the loss of life.

It is advisable for the medical
practitioners especially the nurse to
monitor and report any signs of
presence of the paralytic ileus the
moment Erica is taken to the
general ward after the
appendectomy, and its possible
complications. The nurse should
ensure that the patient is as
comfortable as possible and allow
him or her to get enough rest. The
nurse should also explain to the
patient the purpose of the intestinal
tube, moving around with the
patient, and at the same time
encouraging ambulation. The nurse
should advice the patient to avoid

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NUR2226 Erica’s Appendix (Handover) Student Response
intermittent, ask the
patient to describe the
kind of pain that she is
experiencing, and finally
the nurse should find out
if there are some either
relieving or aggravating
factors like medication,
position and/or food.

conducted by the IV contrast and PO to eliminate the
blockage of the anatomical. During this process, the
patient should be given anything through the mouth,
and he or she will be kept in a low Fowler’s place.
Some of the symptoms of the Paralytic ileus include
tenderness of the abdomen, lack of sounds from the
bowel, absence of flatus, and frequent nausea and
vomiting. There are also instances of reduction of
the urinary outputs.

consuming anything through the
mouth and also breathing due to
the fact that inhaled air can cause
enhanced distension.

1. Providing Post-
   Colostomy:
   Giving the patient anti-biotic

Wound Infection
The other possible condition that is common after
the appendectomy has been conducted is the

Due to the excruciating
pain that Erica has
complained about, it

To prevent the peristomal skin
against contacting the faeces that
might irritate the patient. This can

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NUR2226 Erica’s Appendix (Handover) Student Response
called pectin, which has
methylcellulose, can do the
process. The nurse may as well
intervene by giving the system a
pouch, which is two pouches, or a
bag that has an access cover.
Finally, the nurse may intervene
by emptying when it is one-third
full.
The nurse should also take an
urgent action to ensure that the
wound is well taken care of.
The other mode of intervention
by the nurse is to ensure that the
patient is getting enough nutrition
and hydration as much as

infection to the wound. More often than note, after
the affected appendix is removed, there is a chance
that wound that has been left to be affected. The
infection to the wound will make the skin to become
reddish and inflamed, and there will also be leakage
of the pus from the incision point. Before Erica was
admitted to the general ward, she has shown some of
the signs of infected wound. It is important to
remember that in case of the infection to the wound,
the patient is administered to the antibiotics and the
discharge from the hospital may be delayed based on
the severity of the condition.

would be prudent for the
nurses to prioritize her.
She should be given high
priority.

be done so that the stoma can be
inspected to find out its contents
within a period of 12 to 24 hours.
To ensure that the sealed bag is
kept safe.

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NUR2226 Erica’s Appendix (Handover) Student Response
possible.

References

Ball, C. G., Kortbeek, J. B., Kirkpatrick, A. W., & Mitchell, P. (2004). Laparoscopic appendectomy for complicated appendicitis: an evaluation
of postoperative factors. Surgical Endoscopy and Other Interventional Techniques, 18(6), 969-973.
Behdad, A., Hosseinpour, M., & Khorasani, P. (2011). Preemptive use of ketamine on post operative pain of appendectomy. The Korean journal
of pain, 24(3), 137-140.
Moore, C. B., Smith, R. S., Herbertson, R., & Toevs, C. (2011). Does use of intraoperative irrigation with open or laparoscopic appendectomy
reduce post-operative intra-abdominal abscess?. The American Surgeon, 77(1), 78-80.
Van Bree, S. H., Nemethova, A., Cailotto, C., Gomez-Pinilla, P. J., Matteoli, G., & Boeckxstaens, G. E. (2012). New therapeutic strategies for
postoperative ileus. Nature Reviews Gastroenterology and Hepatology, 9(11), 675.