Physical Examination
- General state of the client really looks sick
- Mild rise in body temperature on mild appendicitis. Body temperature rises and settled around 30oC or more if perforation has occurred.
- Dehydration mild to severe depending on the degree of pain. Severe dehydration on the client perforated appendicitis with generalized peritonitis. This is due to shortage of inputs, vomiting, rise in body temperature and fluid collection in the viscus tissues (edema) and peritoneal cavity.
- Abdomen: The signs of the right lower quadrant peritoneal stimulation. Perforated appendicitis is more obvious, such as muscular defans, word of pain and tenderness.
- Not rare signs of paralytic intestinal obstruction due to the local or general peritonitis
Radiological Examination
- Perselubungan picture is more clear and not confined to the lower right quadrant
- Bowel wall thickening around the location of the appendix, such as the cecum and ileum
- Pre-peritoneal fat lines disappear
- Scoliosis to kenana
- Signs of intestinal obstruction such as lines of liquid-liquid surface due to local paralysis of the intestines in the process of interaction.
Laboratory
Blood tests: Leukocytes are generally mild in simple appendicitis over 13000/mm3 generally in perforated appendicitis. Lekositosis absence does not rule out appendicitis. Counts: there is a shift to the left. Urine examination: normal or sediment can be contained leucocytes and erythrocytes more than normal when the inflamed appendix attached to the ureter or vesicles.
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