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Disorders of the intestines Peritonitis (Diagnostic findings (Increased…
Disorders of the intestines
Peritonitis
Definition
Peritonitis is the inflammation of the peritoneum
Usually, it is a result of bacterial infection the organisms come from diseases of the GI tract or in women from the internal reproductive organs.
Pathophysiology
Peritonitis is caused by leakage of contents from abdominal organs into the abdominal cavity,which leads to bacterial proliferation, edema tissues occurs, fluid in the peritoneal cavity becomes turbid with increasing amount of protein,WBC and blood, immediate response of the intestinal tract is hyper motility soon to be followed by paralytic ilues with an accumulation of air and fluid in the bowel
Causes
Injury (trauma like gunshot wound)
Inflammation
Bacteria. The most common bacteria implicated are Escherichia coli, Klebsiella, Proteus, Pseudomonas, and Streptococcus.
Clinical Manifestations
Pain (Constant and localised)
Tenderness (on the affected area)
Altered vital signs
Diagnostic findings
Increased WBC
Serum electrolyte studies( may reveal altered levels of potassium, sodium, and chloride)
Abdominal X-ray, an abdominal x-ray may show air and fluid collections
Abdominal ultrasound, abdominal ultrasound may reveal abscesses
CT scan
MRI
Medication
Administration of fluids, Dr may prescribe isotonic solution
Analgesics for pain management
Intubation and suction
Oxygen therapy to promote adequate oxygenation
Administration of antibiotics
Nursing Assessment
The nurse should assess pain continuously and should be acted upon.
The nurse should monitor GI function to assess response to interventions.
Fluid and electrolyte should be balanced.
Nursing intervention
The nurse should monitor patient’s blood pressure by arterial line if shock is present.
The nurse should administer analgesic medication and anti emetics as per Dr's prescription
Analgesics for pain management and a high-fowlers position to help in decreasing pain.
The nurse should record all intake and output to help in the assessment of fluid replacement.
The nurse administers and closely monitors IV fluids.
The nurse must monitor and record the character of the drainage postoperatively.
Evaluation of nursing care
Level of pain should be reduced
Restored fluid and electrolyte balance.
Complications should be prevented
Restored normal GI functions.
Health 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