Question

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can you please follow this rubric and create a power point the title is "Peritonitis "

Answer 1

Peritonitis • Peritonitis is inflammation of the peritoneum, the serous membrane lining the abdominal cavity and covering the viscera. • It results from bacterial infection; the organisms come from diseases of the GI tract or, in women, from the internal reproductive organs. • Peritonitis can also result from injury or trauma (eg, gunshot wound, stab wound). The most common bacteria implicated are Escherichia coli, Klebsiella, Proteus, and Pseudomonas. • Peritonitis may also be associated with abdominal surgical procedures and peritoneal dialysis.

Pathophysiology Peritonitis is caused by leakage of contents from abdominal organs into the abdominal cavity due to inflammation, infection, ischemia, trauma, or tumor perforation. Edema of the tissues results, and exudation of fluid develops in a short time. Fluid in the peritoneal cavity becomes turbid with increasing amounts of protein, white blood cells, cellular debris, and blood. The immediate response of the intestinal tract is hypermotility, followed by paralytic ileus with an accumulation of air and fluid in the bowel.

Clinical Manifestations • Diffuse abdominal pain is felt. The pain tends to become constant, localized, and more intense near the site of the inflammation. • Movement usually aggravates pain. • The affected area becomes extremely tender and distended, and the muscles become rigid. Usually, nausea and vomiting occur and peristalsis is diminished. Fever, tachycardia, and leukocytosis.

Assessment and Diagnostic Findings • Leukocytosis. • The hemoglobin and hematocrit levels may be low if blood loss has occurred. • An abdominal x-ray shows air, fluid levels, and distended bowel loops. • An abdominal Computerised Tomography (CT) scan may show abscess formation. • Peritoneal aspiration and culture and sensitivity studies of the aspirated.

Complications Generalized sepsis, frequently, affects the whole abdominal cavity. Sepsis is the major cause of death from peritonitis. • Shock may result from septicemia or hypovolemia. • The inflammatory process may cause intestinal obstruction, primarily from the development of bowel adhesions. The two most common postoperative complications are wound evisceration (next slide) and abscess formation. Any suggestion from the patient that an area of the abdomen is tender or painful must be reported.

Medical Management • Fluid, colloid (blood, plasma), and electrolyte replacement. Hypovolemia occurs because of massive loss of fluid and electrolytes. Analgesics for pain; antiemetics for nausea and vomiting. Intestinal intubation and suction to relieve abdominal distention. Fluids in the abdominal cavity can affect lung expansion and causes respiratory distress. Oxygen therapy is indicated with or without airway intubation and ventilatory assistance. Massive antibiotic therapy. Surgical objectives include removing the infected material and correcting the cause. Surgical treatment is directed toward excision (ie, appendix), resection with or without anastomosis (ie, intestine), repair (ie, perforation), and drainage (ie, abscess).

Nursing Management • Ongoing assessment of pain, vital signs, Gl function. • The nurse reports the nature of the pain, its location in the abdomen, and any shifts in location. Administering analgesic medication and positioning the patient for comfort. The patient is placed on the side with knees flexed; this position decreases tension on the abdominal organs. Accurate recording of all intake and output and central venous pressure assists in calculating fluid replacement. • The nurse administers and monitors closely intravenous fluids.