ATI Pediatrics Study Guide – Appendicitis Version-1 2021/2022

Pediatric Case Study – Appendicitis R.O. is a 12-year-old girl who lives with her family on a farm in a rural community. R.O. has four siblings who have recently been ill with stomach pains, vomiting, diarrhea, and fever. They were seen by their primary care provider (PCP) and diagnosed with viral gastroenteritis. A week later, R.O. woke up at 0200 crying and telling her mother that her stomach “hurts really bad!” She had an elevated temperature of 37.9° C (100.2° F). R.O. began to vomit over the next few hours, so her parents took her to the local emergency department (ED). R.O.'s vital signs (VS), complete blood count (CBC), and complete metabolic panel were normal, so she was hydrated with IV fluids and discharged to home with instructions to call their PCP or to return to the ED if she did not improve or worsened. Over the next 2 days, R.O.'s abdominal pain localized to the right lower quadrant (RLQ), she refused to eat, and she had slight diarrhea. On the third day, she began to have more severe abdominal pain, increased