Nursing School Explained: Peritonitis

Introduction

• Peritonitis: Inflammation of the peritoneum
• The peritoneal cavity includes all organs of the abdomen (digestive and genitourinary organs)

Causes of Peritonitis

• Local or systemic infections
  • Systemic infections: Sepsis
  • GI or GU infections
  • Cirrhosis with ascites
• Fluid leakage: Third spacing of ascites fluid can lead to peritonitis
• Abdominal conditions
  • Appendicitis
  • Diverticulitis
  • Pancreatitis
  • Abdominal trauma (e.g., car accident, bladder rupture)
• Risk factors
  • Intestinal perforation (e.g., small bowel obstruction, Crohn's, ulcerative colitis)
  • Peritoneal dialysis
  • Post-operative leaks from abdominal surgeries

Symptoms of Peritonitis

• Severe abdominal pain
• Rebound tenderness
• Abdominal distension
• Fever
• Signs of shock: Hypotension, tachycardia, increased respiratory rate
• Nausea and vomiting
• Decreased bowel sounds

Complications

• Hypovolemic shock
• Systemic infection leading to sepsis
• Abscess formation
• Paralytic ileus
• Acute respiratory distress syndrome (ARDS)
• Potentially fatal if untreated

Diagnostic Tests

• CBC (Complete Blood Count) and CMP (Comprehensive Metabolic Panel)
• Blood cultures
• Peritoneal aspiration for cultures
• Imaging: X-ray, ultrasound, CT scan

Treatment

• Antibiotics based on culture and sensitivity
• NG tube placement: Rest digestive system, relieve stomach pressure
• Fluid and electrolyte management
• Anti-emetics for nausea and vomiting
• Possible surgery to repair leaks or perforations
• Pain management

Nursing Care

• Monitor vital signs closely
• Conduct thorough abdominal assessments
• Manage fluids and electrolytes
• Administer IV antibiotics
• Keep patient NPO (nothing by mouth)
• Consider TPN (Total Parenteral Nutrition) for prolonged NPO status

Conclusion

• Peritonitis is a serious condition with potential for severe complications
• Early detection and appropriate management are crucial

Additional Resources

• Watch related videos on GI disorders in the GI playlist on Nursing School Explained's channel.