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PERITONITIS (1)

self make this notes on peritonitis msn bsc nursing

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PERITONITIS (1)

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  1. PERITONITIS SUBJECT : MSN

  2. INTRODUCTION : * Peritonitis is the acute or chronic inflammation of the peritoneum, the membrane that lines the abdominal cavity and covers the visceral organs. Inflammation may extend throughout the peritoneum or may be localized as an abscess. * * Peritonitis commonly decreases intestinal motility and causes intestinal distention with gas. mortality is 10% with death usually a result of bowel obstruction. * Causative organism is pyogenic bacteria * E-COLI * Aerobic and anaerobic streptococcus and staphylococcus.

  3. DEFINITION :  * Peritonitis is the inflammation of the peritoneum, the serous membrane lining the abdominal cavity and covering the viscera.

  4. COMPLICATION : Complications from peritonitis can be serious and life threatening, and occur if infection extends beyond the peritoneum. They include:  1.Bloodstream infection, namely bacteremia. 2. Infection throughout the body, namely sepsis. 3. Hepatic encephalopathy (occurrence of confusion, altered level of consciousness and coma as a result of liver failure) 4.Hepatorenal syndrome, which is progressive kidney failure.  5.Intra-abdominal abscess, which is a collection of pus gangrenous bowel. 6.Intraperitoneal adhesions caused by bands of fibrous tissue leading to bowel blockage. 7.If peritonitis is suspected, immediate hospitalization and treatment are necessary to prevent complications

  5. CAUSES :

  6. OTHER CAUSES :

  7. PATHOPHYSIOLOGY : Leakage:- peritonitis is caused by leakage of contents from abdominal cavity Proliferation :- Bacterial proliferation occur Edema :- occurs and exudation of fluid develops in a short time Invasion :- Fluid in the peritoneal cavity becomes turbid with increasing amounts of protein, WBC, cellular debris and blood. Response:- the immediate response of the intestinal tract is hypermotality. Soon followed by paralytic ilius with an accumulation of air and fluid in the bowel.

  8. CLINICAL MENIFESTATION : * Swelling & tenderness in the abdomen * Fever & Chills * Loss of Appetite * Nausea & Vomiting * Pain

  9. DIAGNOSTIC EVALUATION: doctor will inquire about the medical history and conduct a thorough physical examination. This will include touching or pressing on the abdomen, which will almost certainly cause pain. A clinician can use a variety of additional tests to diagnose peritonitis, including: Blood Tests: A Complete Blood Count (CBC) is a blood test that can determine the White Blood Cell (WBC) and Red Blood Cell (RBC) counts. Inflammation or infection is frequently indicated by a high WBC count. Intra-abdominal haemorrhage can be indicated by a low RBC count. A blood culture can aid in the identification of the microorganisms responsible for the infection or inflammation.

  10. 2. Imaging Tests: Perforations or holes in the peritoneum can be detected with imaging tests such as CT scans and X-rays. abdominal X – rays 3. Fluid Analysis: If a person has an accumulation of fluid in the abdomen, the doctor can extract it with a needle and send it to a laboratory for analysis. They can also identify microorganisms by culturing the fluid

  11. MEDICAL MANAGEMENT: Fluid colloid and electrolyte replacement is the major focus of medical management. 1.Fluid:- the administration of several liters of an isotonic solution is prescribed. 2.Analgesics :- are prescribed for pain 3. Intubation and suction :- to relieving abdominal distention and in promoting intestinal function. 4. Oxygen therapy:- generally promotes adequate oxygenation. 5. Antibiotic therapy :- is initiated early in the treatment of peritonitis.

  12. SURGICAL MANAGEMENT :

  13. EXPLORATORY LAPROTOMY : An exploratory laparotomy is a surgical procedure that involves making an incision in the abdomen to examine the organs inside. It's a major surgery that can be performed as an emergency or as a planned procedure. EXCISION : Excision is a surgical procedure that may be performed to treat peritonitis, depending on the type of peritonitis and the cause of the infection. RESECTION : Resection is a surgical procedure that removes part or all of an organ or tissue. It can also refer to the process of cutting away the 5′ side of a blunt end of DNA.

  14. FECAL DIVERSION : Fecal diversion in peritonitis refers to a surgical procedure where a temporary ostomy (stoma) is created to redirect fecal matter away from a potentially infected or inflamed area in the abdomen, often used when treating severe peritonitis to reduce the risk of further contamination and allow the affected area to heal properly; essentially, it diverts stool away from the inflamed site, minimizing the chance of sepsis and complications from the infection.

  15. NURSING MANAGEMENT : Intensive care is often needed for patients with peritonitis. Nursing Assessment   Assessment should be ongoing and precise. o Pain. Pain should be assessed continuously and should be acted upon. * GI function. GI function should be monitored to assess response to interventions. o Fluid and electrolyte. F&E should be balanced.

  16. NURSING DIAGNOSIS : 1. Acute pain related to peritoneal irritation. Goal To reduce the level of pain 2. Deficient fluid volume related to massive shifting of fluids towards the intestinal lumen and depletion in the vascular space. Goal Restore fluid and electrolyte balance.

  17. 3. Risk for shock related to septicemia or hypovolemia. Goal Prevent complications.

  18. NURSING CARE PLAN : * Nursing diagnosis: * Deficient Fluid Volume related to Fluid shifts from extracellular, intravascular, and interstitial compartments into intestines or peritoneal space. * Expected Outcome: * Client will get enough fluid balance.

  19. Nursing intervention with rationale: * 1. Monitor vital signs, noting presence of hypotension (including postural changes), tachycardia, tachypnea, and fever. Measure central venous pressure (CVP) if available. * Rationale: Aids in evaluating degree of fluid deficit, effectiveness of fluid replacement therapy, and response to medications.

  20. * 3.Change position frequently, provide frequent skin care, and maintain dry, wrinkle-free bedding. * Rationale: Edematous tissue with compromised circulation is prone to breakdown. * 4.Maintain NPO status with NG or intestinal aspiration. * Rationale: Reduces vomiting caused by hyperactivity of bowel; manages stomach and intestinal fluids.

  21. BIBLIOGRAPHY : For successful completion my power point presentation I have taken help from the following websites are given:- 1. www.Google.com 2. www. Slideshare.com Different different slides use 3. www.Google image.com 4. www.Learn nursing easy website

  22. THANK YOU

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