Podcast
Questions and Answers
What is the primary cause of primary peritonitis?
What is the primary cause of primary peritonitis?
Which symptom is universally associated with peritonitis?
Which symptom is universally associated with peritonitis?
What is a common clinical manifestation of peritonitis?
What is a common clinical manifestation of peritonitis?
What complication can develop from untreated peritonitis?
What complication can develop from untreated peritonitis?
Signup and view all the answers
Which diagnostic study is primarily used to assess for elevations in white blood cell count in peritonitis?
Which diagnostic study is primarily used to assess for elevations in white blood cell count in peritonitis?
Signup and view all the answers
Which of the following can lead to secondary peritonitis?
Which of the following can lead to secondary peritonitis?
Signup and view all the answers
What initial condition occurs following irritation to the peritoneum due to bacterial contamination?
What initial condition occurs following irritation to the peritoneum due to bacterial contamination?
Signup and view all the answers
What condition may an abdominal x-ray reveal in a patient with peritonitis?
What condition may an abdominal x-ray reveal in a patient with peritonitis?
Signup and view all the answers
Which is a sign of peritoneal irritation during an examination?
Which is a sign of peritoneal irritation during an examination?
Signup and view all the answers
Why do patients with peritonitis often take only shallow breaths?
Why do patients with peritonitis often take only shallow breaths?
Signup and view all the answers
Which of the following is NOT a common cause of secondary peritonitis?
Which of the following is NOT a common cause of secondary peritonitis?
Signup and view all the answers
What is a key diagnostic tool for peritonitis that involves examining peritoneal fluid?
What is a key diagnostic tool for peritonitis that involves examining peritoneal fluid?
Signup and view all the answers
Which of the following is NOT a component of conservative care for patients with mild peritonitis?
Which of the following is NOT a component of conservative care for patients with mild peritonitis?
Signup and view all the answers
What is the primary goal of surgery in cases of peritonitis?
What is the primary goal of surgery in cases of peritonitis?
Signup and view all the answers
Which of the following is a potential clinical problem associated with peritonitis?
Which of the following is a potential clinical problem associated with peritonitis?
Signup and view all the answers
What is the significance of monitoring intake and output in a patient with peritonitis?
What is the significance of monitoring intake and output in a patient with peritonitis?
Signup and view all the answers
What is the purpose of administering antiemetics to a patient with peritonitis?
What is the purpose of administering antiemetics to a patient with peritonitis?
Signup and view all the answers
Why are drains inserted after open surgical procedures for peritonitis?
Why are drains inserted after open surgical procedures for peritonitis?
Signup and view all the answers
Which nursing intervention is most helpful in reducing a patient’s pain associated with peritonitis?
Which nursing intervention is most helpful in reducing a patient’s pain associated with peritonitis?
Signup and view all the answers
What is the main purpose of placing a patient with peritonitis on NPO status?
What is the main purpose of placing a patient with peritonitis on NPO status?
Signup and view all the answers
Study Notes
Peritonitis: Etiology and Pathophysiology
- Peritonitis is inflammation of the peritoneum, caused by bacteria, irritating chemicals, or both.
- Primary peritonitis involves blood-borne organisms entering the peritoneal cavity, often associated with conditions like cirrhosis and ascites.
- Secondary peritonitis is more common, resulting from ruptured/perforated abdominal organs releasing contents (bile, enzymes, bacteria). Common causes include ruptured appendix, perforated ulcer, diverticulitis, and trauma.
- The initial response is chemical peritonitis, followed by bacterial peritonitis.
- The body's inflammatory response leads to fluid shifts, edema, and adhesions.
Clinical Manifestations
- Severe, continuous abdominal pain is a key symptom.
- Tenderness over the affected area is a common sign.
- Rebound tenderness, rigidity, and spasm indicate peritoneal irritation.
- Patients often lie still, breathing shallowly due to pain exacerbation.
- Other symptoms can include abdominal distention, fever, tachycardia, tachypnea, nausea, vomiting, and changes in bowel habits.
- Severity and speed of onset of underlying condition affect the symptom presentation.
- Potential complications include hypovolemic shock, sepsis, intra-abdominal abscesses, paralytic ileus, and acute respiratory distress syndrome.
- Untreated peritonitis can be fatal.
Diagnostic Studies and Interprofessional Care
- Complete Blood Count (CBC) shows elevated white blood cell count and hemoconcentration due to fluid shifts.
- Peritoneal aspiration analyzes fluid for blood, bile, pus, bacteria, fungus, and amylase levels.
- Abdominal X-rays check for dilated bowel loops (paralytic ileus), free air (perforation), or air/fluid levels (obstruction).
- Ultrasound and CT scans identify ascites and abscesses.
- Peritoneoscopy allows direct visualization of the peritoneum and biopsy for diagnosis (useful if no ascites).
- Conservative care (antibiotics, NG suction, analgesics, IV fluids) for milder cases or poor surgical candidates.
- Surgery is crucial to pinpoint the cause, drain pus, and repair damaged organs.
Common Causes of Peritonitis (Table 47.14)
- Primary: Blood-borne organisms, cirrhosis with ascites.
- Secondary: Ruptured appendix, blunt/penetrating trauma, diverticulitis, intestinal cancer, ischemic bowel, pancreatitis, perforated intestine/uterus/bladder/stomach, perforated peptic ulcer, peritoneal dialysis, postoperative complications (anastomosis breakage).
Nursing Management: Peritonitis
- Assessment: Pain evaluation (location, quality), bowel sounds, abdominal distension/guarding, nausea, fever, and hypovolemic shock signs.
- Clinical Problems: Pain, fluid imbalance, impaired GI function, risk for infection.
- Goals: Inflammation resolution, pain relief, avoidance of complications (sepsis, shock), and normal nutrition.
- Implementation: IV access for fluid/antibiotic administration, pain monitoring/analgesic response, positioning (knee flexion), sedatives for anxiety, accurate I&O monitoring, electrolyte checks, vital sign monitoring, antiemetics for nausea/vomiting, NPO status, NG tube for gastric decompression, oxygen therapy, and insertion of drains (open surgical procedures).
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
This quiz explores the causes and mechanisms of peritonitis, including both primary and secondary types. It covers the inflammation's impact on the peritoneum and the body's inflammatory response. Additionally, clinical manifestations and symptoms of peritonitis will be examined.
