I. How appendectomy is an operation The appendix is an organ in the abdominal cavity of the human body (Figure 1). If for some reason the appendix becomes inflamed and infected, the appendix needs to be removed (Figure 2). Figure 1: The location of the appendix in the human body and its proximity Figure 2: Schematic diagram of the appendectomy procedure 2. The available anesthesia methods for appendectomy 1. epidural anesthesia 2. lumbar anesthesia 3. general anesthesia 3. Ask the patient if there is any discomfort in the abdomen and if the incision is painful. ② Ask the surgeon if there is any drainage tube and drainage bag in the abdomen, and find out the number of drainage tube and drainage bag. ③ See if the patient has a fever, and tell the physician if the temperature rises; ⑥Check with the physician if there is a catheter and urine collection bag, observe the color of urine, and tell the physician if the color of urine is darker; ⑦When the motor strength of both lower limbs is restored, you can move your body to both sides in a small range, but be careful not to pull various tubes; ⑧No food or water; ⑨Check the gauze dressing of the surgical area twice to see if there is bleeding or water seepage; ⑩Family members take turns to be on night duty that night. The patient should report any abnormalities to the nurse. 2, two or three days after surgery This period will also have incisional pain and a feeling of weakness. Observe: ① whether there is abdominal distension and whether the anus is exhausted; if it is exhausted, you can start to eat a semi-liquid diet; ② if you are physically fit, you can get out of bed, remove the catheter and urinate and defecate on your own; if you are old and weak, you still need to lie in bed, you can turn over or lie on your side, or you can rest in a half-leaning, half-sitting position; ③ if there is an abdominal drainage tube, observe the amount and color of the drainage; ④ observe whether you have a fever. If the temperature is high, tell the physician; ⑤ If there are other newly emerged symptoms, such as incisional pain instead of aggravation, report to the nurse. 3.After three days after the surgery, the patient’s basic condition will continue to improve during this period. The incision pain will be mild, bowel and urine will be clear, and sleep will resume its daily routine. ① Observe whether there is fever, if the temperature is high, tell the physician; ② Ask the patient about the degree of incision pain, if the pain is not reduced, it may be a precursor of incision infection; ③ Observe twice a day whether the incision dressing and the dressing at the poke hole site of the drainage tube are clean and dry, if there is more ooze, report to the nurse; ④ Report to the nurse if there are other newly appeared symptoms. ⑤ The time of stitch removal is between the 8th and 10th day after surgery. The time of stitch removal varies according to the severity of inflammation in the appendix and abdominal cavity, and some patients will take the measure of intermittent stitch removal. 4. Observation after discharge The day after the stitches are removed, the patient can be discharged from the hospital. After discharge, pay attention to the observation of the surgical incision, at this time the wound can be used without dressing. It is not advisable to do strenuous exercise to protect the incision area from external forces; you can take a bath or rinse the skin of the surgical area, but do not rub it hard. Daily physical work can be resumed after two weeks after discharge from the hospital. 4. Physical exercise arrangement for appendectomy patients 1. Generally, young and middle-aged people with good physical fitness can get out of bed one day after surgery, and the amount of activity should be such that they do not feel exhausted. 2.For elderly people, especially those over 70 years old, we need to consult the physician in charge whether to get out of bed or not, and the physician will prescribe medical advice according to the patient’s blood pressure, blood sugar, body temperature and whether to have abdominal distension. 3. For children and adolescents, physical activity should be in accordance with the child’s own reaction. Children are more sensitive to physiological changes during childhood, and when the body recovers to a certain extent, children will involuntarily increase the amount of exercise, which only needs to be guided correctly and slightly restrained. V. Dietary arrangements for appendectomy patients vary greatly according to the degree of the disease. 1, the attack time is not long, belong to simple appendicitis: generally no drainage tube, ① adults, one day after surgery can enter the liquid diet, two days later gradually transition to ordinary diet; drink enough water; ② elderly people over 60 years old, wait until the recovery of intestinal function, anal venting after the medical advice to start into the liquid semi-liquid diet, and then slowly transition to ordinary diet; such cases of anal venting time is generally (3) Children and adolescents, whose gastrointestinal function is not yet fully developed, should delay the diet arrangement for one day compared with adults. 2, the attack is longer, belong to the septic appendicitis: according to the amount of abdominal exudate, can be without drainage tube, may also need to retain a drainage tube, ① adults, the second day after surgery can enter the liquid diet, three days after the gradual transition to ordinary diet; drink enough water; ② 60 years of age or older, wait until the intestinal function recovery, anal exhaustion after the doctor’s advice to begin to enter the liquid semi-liquid diet, and then slowly transition to ordinary diet; such cases ③ Children and adolescents, the gastrointestinal tract function is not fully developed, so the dietary arrangement should be compared to that of elderly people over 60 years old. 3, appendicitis is very heavy, belonging to perforated appendicitis: this case are left drainage tubes, some will be left two drainage tubes. It is necessary to wait until the intestinal function is restored and the anus is exhausted, then follow the doctor’s advice to start a liquid and semi-liquid diet, and then slowly transition to a normal diet; the anal exhaust time in this case is usually 24 to 96 hours after surgery. 4. Diet composition: ① Drink enough water; ② Light, no spicy and sour, no irritating ingredients, no cold; ③ Easy to digest, no nuts, no frying; ④ More plant dietary fiber, but not a lot of coarse fiber; ⑤ Do not overeat, preferably in small amounts; ⑥ People with diabetes, people with renal insufficiency, or patients with malnutrition themselves, there are special arrangements for diet composition, please follow the doctor’s instructions; ⑦ The body as a whole The nourishment and tonic should wait until 10 days after the surgery. 5.Post-operative recuperation and tonic program 6.Smoking and alcohol control and work and rest schedule 1.Avoid smoking and alcohol. It should be maintained at least one month after surgery. 2.Ensure sufficient sleep, early to bed and early to rise. 3. Arrange light or heavy physical work after healing according to the physical condition. 7. Arrangements for follow-up of appendectomy patients 1. If you recover well after discharge and have no discomfort, come to the hospital for follow-up once a month after discharge; 2. If you recover slowly after discharge or have any discomfort, follow up promptly; 3. Please keep the telephone number of the nurse’s office; 4. When you are admitted to the hospital, the physician in charge will usually ask the patient to provide his telephone number, so please tell us truthfully. After discharge, the physician and nurse will differentiate the situation and make a return visit by telephone or at home.