PERITONITIS P 1021 1022 Definition Localized or generalized inflammatory process of the peritoneum Primary peritonitis when blood borne organisms enter peritoneal cavity Secondary peritonitis when abdominal organs perforate or rupture and release their contents into peritoneal cavity Ascites with cirrhosis of liver o o Caused by ruptured appendix perforated gastric or duodenal ulcer severely inflamed gallbladder trauma from gun shot or knife wounds Abdominal pain Tenderness over involved area Rebound tenderness Muscular rigidity Spasm Lie very still and take shallow respirations r t pain from movement Abdominal distention ascites Fever Tachycardia Tachypnea Nausea or vomiting Altered bowel habits Clinical Manifestations Complications Diagnostic Studies Hypovolemic shock Sepsis Intraabdominal abscess formation Paralytic ileus Acute respiratory distress syndrome Fatal if treatment is delayed CBC determine elevations in WBC Peritoneal aspiration analyzed for blood bile pus bacteria fungus amylase X ray of abdomen dilated loops of bowel consistent with o o o paralytic ileus free air if perforation occurred air and fluid levels ultrasound and CT scans ascites and abscess peritoneoscopy patient without ascites direct exam of peritoneum Collaborative Care surgery to locate the cause of inflammation drain fluid and repair damage antibiotics NG suction Analgesics IV fluid administration Preoperative preparation Nursing Management Assessment o Assess pain PQRST Bowel sounds Presence Quality o o Increasing abdominal distention Abdominal guarding Nausea Fever Hypovolemic shock S S Low BP o Body temp o Rapid and thready oulse o Anxiety o Cool clammy skin o Confusion o Decreased UOP o Pallor o Tachypnea o o Diaphoresis Acute pain r t inflammation of peritoneum and abdominal distention Risk for deficient fluid volume r t fluids shifts into the peritoneal cavity secondary to trauma infection or ischemia Imbalanced nutrition less than body requirements r t anorexia nausea and vomiting Anxiety r t uncertainty of cause or outcome of condition and pain Diagnoses Implementation GASTROENTERITIS P 1021 1022 Symptoms IV line inserted for fluids and antibiotics Monitor pain and response to medication Position patient with knees flexed to increase comfort Sedatives for anxiety Accurate I O and electrolyte status for replacement therapy determination VS frequently Antiemetics NPO status NG tube to decrease distention and leakage of bowel contents to peritoneum Low flow O2 Post op care as usual Inflammation of the mucosa of the stomach and small intestine Viral or bacterial infection Nausea and vomiting Diarrhea Abdominal cramps and distention Fever Increased WBC Blood or mucus in stool Causative Agents Treatment Nursing Management Mostly self limiting Does not require hospitalization usually NPO status IV fluid replacement for dehydration Fluids with glucose and electrolytes Pedialyte given Accurate I O Strict medical asepsis and infection control precautions Stress proper food handling and prep to prevent infections Symptomatic nursing care for N V and diarrhea previously stated Assess pain vomiting and diarrhea and differentiate vs appendicitis Explain that gastroenteritis usually runs acute course with no sequelae
View Full Document
Unlocking...