GRCC PN132 Peritonitis
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| INFLAMMATION OF THE PERITONEUM CAUSED BY BACTERIAL OR CHEMICAL CONTAMINATION OF THE PERITONEAL CAVITY | Peritonitis
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| TRAUMA, RUPTURED APPENDIX. PERFPRATED I;CER. SEVERELY INFLAMED GALLBLADDER | Peritonitis causes
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| If patient has kidney failure | At risk for peritonitis due to dialysis; unknown cause of massive inflammation response, fluid shifts; look for adhesions, bacteria via exploratory lab.
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| PAIN OVER AFFECTED AREA REBOUND TENDERNESS ABDOMINAL RIGIDITY OR GUARDING OF AB MUSCLES | Peritonitis manifestations
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| DISTENTION FEVER TACHYCARDIA NAUSEA & VOMITING | Peritonitis manifestations
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| FEVER, MALAISE, TACHYCARDIA, TACHYPNEA, RESTLESSNESS, CONFUSION, OLIGURIA | PERITONITIS SYSTEMIC MANIFESTATIONS
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| When assessing a patient with peritonitis, what is most predominant? | Pain
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| What steps do you to in assessing a patient whose been diagnosed with peritonitis? | Inspect the abdomen
Ausculate for bowel sounds
Assess for dehydration
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| When assessing an elderly person for skin turgor, where is the best place to check? | The chest would be the best place to check dehydration. The elderly are harder to dgx.
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| Patient with peritonitis often presents with evidence of an acute abdomen. Define acute abdomen. | It is characterized by an abrupt onset of sever pain, often accompanied by abdominal muscle rigidity.
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| How does peritonitis come about? | The peritoneum is normally sterile, and the potential space between the layers of the peritoneum is contaminated- caused by perforated appendix, gastric ulcer, traumatic injury, gun shot wound, or contamination during ab surgery.
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| What happens to peristalsis if patient has peritonitis? | It slows or stops (paralytic ileus) due to the inflammation.
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| The elderly pt can be difficult to diagnose on whether or not they have peritonitis because they may be chronically debilitated or immunosuppressed. What signs and symptoms would help you identify if they have this problem? | Increased confusion and restlessness
Decreased urinary output
Vague abdominal complaints
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| What is the most common complication of peritonitis? | Formation of an abscess is the most common complication.
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| If pt with peritonitis has an abscess, then what might develop as a result? | Septicemia, the presence of pathogens in the blood, may develop.
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| Without prompt treatment, what will happen if an abscess forms & the patient develops septicemia? | Shock may result from hypovolemia or sepsis.
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| What is a complication of peritonitis? | Adhesions or bands of scar tissue may develop after peritonitis and subsequently cause a bowel obstruction.
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| Which diagnostic test confirms peritonitis? | WBC- it will be elevated.
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| What is the first thing done to relieve ab distention? | Intestinal decompression.
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| In managing peritonitis, what is part of the care plan to help with nausea and allow the bowel to rest? | An Ng tube is placed and client is put on NPO until bowel sounds are heard and they are passing gas.
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| While pt is NPO, what measures should be done to prevent dehydration and malnutrition? | IV fluid and electrolytes are given along with a TPN until oral intake resumes.
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| Patient with peritonitis is placed on bed rest. What is the best position for them to lay to relieve pain? | Fowlers position to help localize the infection and to make breathing easier (they are usually given oxygen as well).
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| What medications are given to fight off infection, as well as provide comfort and care? | Pt will recieve broad-spectrum antibiotics, until the specific organism is ID'd and then will be given antibiotic specific to that organism.
The client will also receive narcotic analgesics and sedatives for rest.
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| Clients who return from the surgery laparotomy for peritonitis often have this? | Jackson pratt drain and the incision may be left unsutured to allow repeated exploration of the ab and drainage of infection.
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| The priority if nursing care for treating a pt with peritonitis. | Supporting the client and managing responses to the acute inflamation.
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| Acute pain | Nursing dgx for peritonitis
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| Decreased cardiac output | Nursing dgx for peritonitis
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| Imbalanced nutrition (less than) | Nursing dgx for peritonitis
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| anxiety | Nursing dgx for peritonitis
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| Deficient fluid volume | Nursing dgx for peritonitis
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| Ineffective protection | Nursing dgx for peritonitis
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| Monitor signs for infection, fever, tachycardia, redness, swelling around incision and drainage sites, increased purulent drainage, etc | Nursing care Nanda dgx: Ineffective protection
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| Maintain fluid and nutritional balance and obtain cultures of purulent discharge | Nursing care Nanda dgx: Ineffective protection
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| Hypovolemia shock | Excessive loss of fluids
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| To avoid hypovolemia, monitor vs, I & O (including wound drainage), skin turgor, mucus membranes, and fluid loss through ab drains. | Nanda DGX for peritonitis: Deficient fluid volume. Fluid loss occur through third spacing gastrointestinal suction and drainage from surgical wounds -
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| Administer opioid analgesics | Nursing interventions for treating peritonitis
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| Monitor intake and output (including wound drainage) | Nursing interventions for treating peritonitis
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| Monitor vital signs | Nursing interventions for treating peritonitis
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| Monitor patency of NG | Nursing interventions for treating peritonitis
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| Administer anti emetics IF ordered | Nursing interventions for treating peritonitis
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| Peritonitis can be life threatening. What would happen if left untreated? | Septicemia can occur, and more likely pt will be in ICU.
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| Laparotomy | surgery to close a perforation, remove damaged and inflamed tissue, or remove an abscess.
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| Peritoneal lavage | washing of the peritoneal cavity with warm isotonic fluid and may be done during surgery.
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