A nurse is caring for a school-age child who has appendicitis.
For which of the following findings should the nurse monitor as a manifestation of a perforated appendix and report to the provider?
A.
Bradycardia.
B.
Elevated temperature.
C.
Lethargy.
D.
Decreased abdominal girth.
The correct answer and Explanation is :
The correct answer is C. Lethargy.
Explanation:
In a child with appendicitis, the concern for a perforated appendix is significant because it can lead to peritonitis and sepsis, which are serious complications requiring immediate medical attention. Monitoring for signs of perforation is crucial, and lethargy is an important indicator to watch for.
Lethargy is a key sign of a potentially severe condition, such as a perforated appendix, where the infection has spread beyond the localized area of the appendix. When the appendix perforates, the infection can diffuse into the peritoneal cavity, causing widespread inflammation and leading to peritonitis. This systemic infection can significantly impact the child’s overall condition, causing a decrease in energy levels and alertness, thus resulting in lethargy. This symptom indicates that the child’s body is overwhelmed by the infection and may be progressing towards a more severe stage of illness, which requires urgent intervention.
Elevated temperature is a common response to infection, including appendicitis, but it is not as specific for perforation as lethargy. While an elevated temperature is a sign of an ongoing infection, it alone does not necessarily indicate that the appendix has perforated.
Bradycardia, or a slower-than-normal heart rate, is less commonly associated with appendicitis or its complications in children. It can occur due to various reasons but is not a classic sign of a perforated appendix.
Decreased abdominal girth is not typically a sign associated with a perforated appendix. In fact, abdominal girth may increase due to bloating and fluid accumulation in cases of severe infection or perforation.
In summary, lethargy should be closely monitored and reported immediately to the provider as it can signify a critical worsening of the child’s condition, potentially indicating a perforated appendix with systemic infection.