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Questions and Answers
What is the risk of fetal loss if the appendix has ruptured during appendicitis?
Older adults typically present with classical signs of appendicitis.
False
What is the primary curative measure for appendicitis?
Surgery
If the appendix is not found on an ultrasound, appendicitis should still be a ________ diagnosis.
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Match the following outcomes with their corresponding conditions regarding appendicitis:
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What is a common symptom of appendicitis in infants?
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Appendicitis is more likely to be diagnosed in children under the age of 4.
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What percentage of children diagnosed with appendicitis had been to the Emergency Department within the past 7 days?
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In pregnant women, acute appendicitis may present with new-onset ________ instead of classical signs.
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Which group of children is more likely to have a delayed diagnosis of appendicitis?
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Match the demographic with the likelihood of having a delayed diagnosis of appendicitis:
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Ultrasound imaging is used first when diagnosing appendicitis in pregnant women.
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What role should nurses advocate for in the management of appendicitis?
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Study Notes
Appendicitis in Children and Adolescents
- Children under 4 typically do not develop appendicitis.
- Appendicitis in young children often progresses to rupture because they cannot accurately communicate their pain.
- Common symptoms in infants include listlessness, inconsolability, vomiting, and a distended abdomen.
- Appendicitis is rare in infants, leading to delayed diagnosis and an increase in rupture, complications, and death.
- Older children may not exhibit typical signs, with lethargy, reduced mobility, and guarding being potential indicators.
- Cultural factors influence the progression of appendicitis in children.
- Black, Hispanic, and other children of color are more likely to have delayed diagnoses and less likely to receive diagnostic imaging.
- Black, Hispanic, and other children of color experience a significantly higher incidence of perforation compared to white children.
- Discrimination can contribute to delayed diagnosis and increased severity.
- A study found Black children are less likely to receive adequate pain medication in emergency departments.
Appendicitis in Pregnant Women
- Acute appendicitis is a common surgical presentation in pregnant women.
- Pregnant women might not present with typical appendicitis symptoms.
- Instead, they might experience heartburn, flatulence, nausea, vomiting, and right lower abdominal tenderness.
- Ultrasound imaging is the initial diagnostic tool, with MRI used for inconclusive cases.
- Surgery is the treatment, with outcomes similar to non-pregnant women if the appendix has not ruptured.
- Rupture increases the risk of fetal loss to 36%, compared to 1.5% without rupture.
Appendicitis in Older Adults
- Older adults may have a weakened immune response, resulting in a less pronounced inflammatory response and atypical appendicitis symptoms.
- Confusion and abdominal pain should prompt consideration of appendicitis in older adults.
- The lack of typical signs may lead to delayed care, resulting in a higher rate of perforation.
- Laparoscopic appendectomy, regardless of complications, offers improved outcomes in older adults, including shorter hospital stays, higher likelihood of home discharge, and fewer complications.
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Description
This quiz explores the various aspects of appendicitis as it occurs in children and adolescents. It addresses symptoms, diagnostic challenges, and cultural factors impacting disease progression and treatment. The quiz highlights disparities in healthcare access and outcomes among different racial and ethnic groups.
