note med surg test 2.pdf - Inflammatory diseases Peritonitis ​➔Acute inflammation of the peritoneum endothelial lining of the abd cavity ➔Cause by

note med surg test 2.pdf - Inflammatory diseases...

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Inflammatory diseases Peritonitis: Acute inflammation of the peritoneum & endothelial lining of the abd cavity Cause by; contamination of bacteria Appendicitis, PUD, diverticulitis, peritoneal dialysis, liver disease, SXS; cardinal signs of peritonitis are abdominal pain, tenderness, and distention Rigid, board-like abdomen (classic) Abdominal pain (localized, poorly localized, or referred to the shoulder or chest) Distended abdomen, rebound tenderness in the abdomen Tachypnea & SOB can lead to resp distress Nausea, anorexia, vomiting Diminishing bowel sounds &/ or Inability to pass flatus or feces High/low fever, tachycardia Dehydration from high fever (poor skin turgor) Decreased urine output Hiccups The peritoneal cavity contains; ~50 ml of fluid which lubricates & prevent friction in the abdominal Cavity during peristalsis. Complications; Sepsis Respiratory distress Slow peristalsis Lab assessment —> WBC 20000+, renal assessments BUN, Creat, H &H Nursing interventions Prevent complications Fluids, hydration & abx Peritoneal dialysis fluid with abx NG, oxygen, pain management Fever management Surgery for complications; Perforation Irrigating with abx solution, abx therapy after admitted ICU —> Maintain the patient in a semi- Fowler's position to promote drainage of peritoneal contents into the lower region of the abdominal cavity. This position also helps increase lung expansion. Post op home care instructions/ follow up and resources Ability to care at home Sign & symptoms to watch and report
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• Unusual or foul-smelling drainage, • Swelling, redness, or warmth or bleeding from the incision site • A temperature higher than 101° F (38.3° C), • Abdominal pain, • Signs of wound dehiscence or ileus PT ON oral opioids —> docusate sodium/ senna for constipation Gastroenteritis: causes diarrhea and/or vomiting as a result of inflammation of the mucous membranes of the stomach and intestinal tract, bacterial or viral infections —> It affects mainly the small bowel and can be caused by either viral or bacterial infection. Viral gastroenteritis is the most common. Usually transmitted by the fecal-oral route, food/water Prevention; Norovirus; common in nursing homes/dorms/ jails E-coli; usually infants, good handwashing & clean environment those who are immunosuppressed or in older adults, dehydration and hypovolemia Older adult considerations; Assess for dehydration—> -Dry mucous membranes/skin turgor, -Orthostatic BP, -Hypotension -Low or no urine output, -Acute confusion, -May lead to Renal failure Treatment; Fluid, fluid fluid, oral Vs IV. many solutions available or NS or LR Drugs for nausea; zofran or other antiemetics Drugs for diarrhea; imodium and or LOMOTIL Antibiotics for bacterial only; Cipro, Septra or Levaquin Skin care from diarrhea for elderly
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