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Peritonits: - Peritonitis:Is An Inflammation (Irritation) of The Peritoneum, The
Peritonits: - Peritonitis:Is An Inflammation (Irritation) of The Peritoneum, The
ETIOLOGICAL FACTORS
• PANCREATITIS. INFLAMMATION OF YOUR PANCREAS
(PANCREATITIS) COMPLICATED BY INFECTION MAY LEAD TO
PERITONITIS IF THE BACTERIA SPREAD OUTSIDE THE PANCREAS.
• DIVERTICULITIS. INFECTION OF SMALL, BULGING POUCHES IN YOUR
DIGESTIVE TRACT (DIVERTICULITIS) MAY CAUSE PERITONITIS IF
ONE OF THE POUCHES RUPTURES, SPILLING INTESTINAL WASTE
INTO YOUR ABDOMEN.
• TRAUMA. INJURY OR TRAUMA MAY CAUSE PERITONITIS BY
ALLOWING BACTERIA OR CHEMICALS FROM OTHER PARTS OF
YOUR BODY TO ENTER THE PERITONEUM.EG:ACCIDENT.
ETIOLOGICAL FACTORS
RISK FACTORS
ABCESS OF INFECTION
-DUE TO INFLAMMATION
CLINICAL FEATURES
• MINIMAL URINE OUTPUT
• EXCESSIVE THIRST
• FATIGUE
DIAGNOSTIC EVALUATION
• BLOOD TESTS. A SAMPLE OF YOUR BLOOD MAY BE DRAWN AND SENT TO A LAB TO
CHECK FOR A HIGH WHITE BLOOD CELL COUNT. A BLOOD CULTURE ALSO MAY BE
PERFORMED TO DETERMINE IF THERE ARE BACTERIA IN YOUR BLOOD.
• IMAGING TESTS. YOUR DOCTOR MAY WANT TO USE AN X-RAY TO CHECK FOR HOLES
OR OTHER PERFORATIONS IN YOUR GASTROINTESTINAL TRACT. ULTRASOUND MAY
ALSO BE USED. IN SOME CASES, YOUR DOCTOR MAY USE A COMPUTERIZED
TOMOGRAPHY (CT) SCAN INSTEAD OF AN X-RAY.
• PERITONEAL FLUID ANALYSIS. USING A THIN NEEDLE, YOUR DOCTOR MAY TAKE A
SAMPLE OF THE FLUID IN YOUR PERITONEUM (PARACENTESIS), ESPECIALLY IF YOU
RECEIVE PERITONEAL DIALYSIS OR HAVE FLUID IN YOUR ABDOMEN FROM LIVER
DISEASE. IF YOU HAVE PERITONITIS, EXAMINATION OF THIS FLUID MAY SHOW AN
INCREASED WHITE BLOOD CELL COUNT, WHICH TYPICALLY INDICATES AN
INFECTION OR INFLAMMATION. A CULTURE OF THE FLUID MAY ALSO REVEAL THE
PRESENCE OF
DIAGNOSTIC PROCEDURE
• INCREASED WBC. THE WHITE BLOOD CELL COUNT IS ALMOST ALWAYS
ELEVATED.
• SERUM ELECTROLYTE STUDIES. SERUM ELECTROLYTE STUDIES MAY REVEAL
ALTERED LEVELS OF POTASSIUM, SODIUM, AND CHLORIDE.
BACTERIA
.
• ABDOMINAL XRAY. AN ABDOMINAL XRAY MAY SHOW AIR AND FLUID LEVELS AS
WELL AS DISTENDED BOWEL LOOPS.
• ABDOMINAL ULTRASOUND. ABDOMINAL ULTRASOUND MAY REVEAL
ABSCESSES AND FLUID COLLECTIONS.
• CT SCAN. A CT SCAN OF THE ABDOMEN MAY REVEAL ABSCESS FORMATION.
• MRI SCAN .MRI MAY BE USED FOR DIAGNOSIS OF INTRA-ABDOMINAL
ABSCESSES.
• PERITONEAL FLUID ANALYSIS. EXAMINATION OF THIS FLUID MAY SHOW AN
INCREASED WHITE BLOOD CELL COUNT, WHICH TYPICALLY INDICATES AN
INFECTION OR INFLAMMATION. A CULTURE OF THE FLUID MAY ALSO REVEAL
THE PRESENCE OF BACTERIA.
MEDICAL TREATMENT
• FLUID. THE ADMINISTRATION OF SEVERAL LITERS OF AN ISOTONIC SOLUTION IS
PRESCRIBED.
• ANALGESICS. ANALGESICS ARE PRESCRIBED FOR PAIN.
• INTUBATION AND SUCTION. INTESTINAL INTUBATION AND SUCTION ASSIST IN
RELIEVING ABDOMINAL DISTENTION AND IN PROMOTING INTESTINAL FUNCTION.
• OXYGEN THERAPY. OXYGEN THERAPY BY NASAL CANNULA OR MASK GENERALLY
PROMOTES ADEQUATE OXYGENATION.
• ANTIBIOTIC THERAPY. ANTIBIOTIC THERAPY IS INITIATED EARLY IN THE
TREATMENT OF PERITONITIS.
NURSING INTERVENTION
• NURSING ASSESSMENT:
• ASSESSMENT SHOULD BE ONGOING AND PRECISE.
• PAIN. PAIN SHOULD BE ASSESSED CONTINUOUSLY AND SHOULD BE ACTED UPON.
• GI FUNCTION. GI FUNCTION SHOULD BE MONITORED TO ASSESS RESPONSE TO
INTERVENTIONS.
CONT….
• NURSING CARE PLANNING & GOALS
• THE GOALS APPROPRIATE FOR A PATIENT WITH
PERITONITIS INCLUDE:
• REDUCE LEVEL OF PAIN.
• RESTORE FLUID AND ELECTROLYTE BALANCE.
• PREVENT COMPLICATIONS.
• RESTORE NORMAL FUNCTIONS.
CONT…..
• NURSING INTERVENTIONS
• DRAINAGE MONITORING. THE NURSE MUST MONITOR AND RECORD THE CHARACTER OF
THE DRAINAGE POSTOPERATIVELY.
CONT….
• DISCHARGE AND HOME CARE GUIDELINES
• THE NURSE’S RESPONSIBILITIES DURING DISCHARGE AND FOR HOME
CARE INCLUDE:
• EDUCATION. THE NURSE SHOULD EDUCATE THE PATIENT AND THE
FAMILY ABOUT THE CARE FOR INCISIONS AND DRAINS IF THE PATIENT
WILL BE SENT HOME WITH THE DRAINS STILL IN PLACE.
• REFERRAL. REFERRAL FOR HOME CARE MAY BE INDICATED FOR
FURTHER MONITORING AND PATIENT AND FAMILY TEACHING.
DOCUMENTATION
• CLIENT’S DESCRIPTION AND RESPONSE TO PAIN.
• ACCEPTABLE LEVEL OF PAIN.
• PRIOR MEDICATION USE.
• DEGREE OF DEFICIT.
• CURRENT SOURCES OF FLUID INTAKE.
• I&O.
• FLUID BALANCE.
• PRESENCE OF EDEMA.
• RESULTS OF DIAGNOSTIC TESTS.
CONT…..
• VITAL SIGNS.
• PLAN OF CARE.
• TEACHING PLAN.
• RESPONSE TO INTERVENTIONS, TEACHING, AND ACTIONS
PERFORMED.
• ATTAINMENT OR PROGRESS TOWARD DESIRED OUTCOME.
• MODIFICATIONS TO PLAN OF CARE.
• LONG TERM NEEDS.
• SPECIFIC REFERRALS MADE.