Acute Pain NCP for Appendicitis

Appendicitis is a condition characterized by inflammation of the appendix. The appendix is a small pouch attached to the beginning of your large intestine. It is classified as a medical emergency and many cases require removal of the inflamed appendix, either by laparotomy or laparoscopy.

The main symptom of appendicitis is abdominal pain. Symptoms of appendicitis may take 4-48 hours to develop. Other symptoms include:
  • loss of appetite,
  • nausea,
  • vomiting,
  • lack of appetite, and
  • fever.

Diagnosis is based on patient history (symptoms) and physical examination backed by an elevation of neutrophilic white blood cells. Histories fall into two categories, typical and atypical. Typical appendicitis usually includes abdominal pain beginning in the region of the umbilicus for several hours, associated with anorexia, nausea or vomiting. The pain then "settles" into the right lower quadrant (or the left lower quadrant in patients with situs inversus totalis), where tenderness develops. The combination of pain, anorexia, leukocytosis, and fever is classic. Atypical histories lack this typical progression and may include pain in the right lower quadrant as an initial symptom. Atypical histories often require imaging with ultrasound and/or CT scanning.

Nursing Diagnosis for Appendicitis: Acute Pain related to distention of the intestinal tissue.

Goal: Pain will be solved
Expected outcomes: normal breathing. normal circulation.


1) Assess the level of pain, location and characteristics of pain.
Rationale: To determine the extent of pain and is an indicator of early to be able to give further action.

2) Encourage deep breathing.
Rationale: deep breathing, can breathe oxygen adequately, so that the muscles into relaxation so as to reduce pain.

3) Perform gate control.
Rationale: The gate control large diameter nerve stimulating small-diameter nerve so that pain stimuli are not forwarded to the hypothalamus.

4) Give analgesics.
Rationale: As a prophylactic in order to relieve pain (if already know the symptoms for sure).

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