PERITONITIS - PERITONITIS Inflammation of the peritoneal...

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PERITONITIS Inflammation of the peritoneal cavity, caused by either bacteria or chemicals, can be primary or secondary, and acute or chronic. Primary peritonitis is a rare condition in which the peritoneum is infected via the blood/lymphatic circulation. Secondary sources of inflammation are the GI tract, ovaries/uterus, urinary system, traumatic injuries, or surgical contaminants. Surgical intervention may be curative in localized peritonitis, as occurs with appendicitis/appendectomy, ulcer plication, and bowel resection. If peritonitis is diffuse, medical management is necessary before or in place of surgical treatment. CARE SETTING Inpatient acute medical or surgical unit RELATED CONCERNS Appendectomy, see Nursing Care Plan CD-ROM Inflammatory bowel disease: ulcerative colitis, regional enteritis (Crohn’s disease, ileocolitis) Pancreatitis Psychosocial aspects of care Renal dialysis: peritoneal Sepsis/speticemia Surgical intervention Total nutritional support: parenteral/enteral feeding Upper gastrointestinal/esophageal bleeding Patient Assessment Database ACTIVITY/REST May report: Weakness May exhibit: Difficulty ambulating CIRCULATION May exhibit: Tachycardia, diaphoresis, pallor, hypotension (signs of shock) Tissue edema ELIMINATION May report: Inability to pass stool or flatus Diarrhea (occasionally) May exhibit: Hiccups; abdominal distension; quiet abdomen Decreased urinary output, dark color Decreased/absent bowel sounds (ileus); intermittent loud, rushing bowel sounds (obstruction); abdominal rigidity, distension, rebound tenderness; hyperresonance/tympany (ileus); loss of dullness over liver (free air in abdomen) FOOD/FLUID May report: Anorexia, nausea/vomiting, thirst May exhibit: Projectile vomiting Dry mucous membranes, swollen tongue, poor skin turgor PAIN/DISCOMFORT May report: Sudden, severe abdominal pain, generalized or localized, referred to shoulder, intensified by movement May exhibit: Distention, rigidity, rebound tenderness; distraction behaviors; restlessness; self-focus Muscle guarding (abdomen); flexion of knees
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RESPIRATION May exhibit: Shallow respirations, tachypnea SAFETY May report: Fever, chills SEXUALITY May report: History of pelvic organ inflammation (salpingitis), puerperal infection, septic abortion, retroperitoneal abscess TEACHING/LEARNING May report: History of recent trauma with abdominal penetration, e.g., gunshot/stab wound or blunt trauma to the abdomen; bladder perforation/ruptured gallbladder, perforated carcinoma of the stomach, perforated gastric/duodenal ulcer, gangrenous obstruction of the bowel, perforation of diverticulum, UC, regional ileitis; strangulated hernia Discharge plan DRG projected length of inpatient stay: 4.9 days considerations: Assistance with homemaker/maintenance tasks Refer to section at end of plan for postdischarge considerations.
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This note was uploaded on 02/01/2011 for the course PNR 182 taught by Professor Toole during the Spring '10 term at Orangeburg-Calhoun Technical College.

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PERITONITIS - PERITONITIS Inflammation of the peritoneal...

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