Peritonitis for Certified Emergency Nursing (CEN)

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Outline

Peritonitis

Definition/Etiology:

Inflammation of the peritoneum

  • Ruptured appendix
  • Pancreatitis
  • Penetrating trauma
  • Peritoneal dialysis
  • Pelvic inflammatory disease, post abd surgery (“knicked the bowel/bladder”), bowel perforation, diverticulitis

 

Pathophysiology:

Primary: Blood-borne organisms enter peritoneal cavity

Secondary: Abdominal organs perforate and release contents into peritoneal cavity (more common)

 

Clinical Presentation:

  • Diffuse pain exacerbated by movement, coughing; may be relieved by flexing knees
  • Tenderness upon palpation
  • Rebound tenderness
  • Guarding
  • Rigid abdomen
  • Fever, signs of sepsis
  • Diminished or absent bowel sounds
  • Dehydration
  • Respiratory difficulties

 

Collaborative Management:

  • NPO
  • Insert gastric tube (rest bowel)
  • IV fluids
  • Analgesics, Antiemetics, Antibiotics
  • Prepare for surgery

 

Linchpins: (Key Points)

  • Inflammation of the abdominal wall lining
  • Infectious and often life-threatening
  • Board like abdomen
  • Anbx and Surgery

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Transcript

For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/

References:

  • Emergency Nurses Association. (2017) Emergency Nursing Core Curriculum, 7th Edition. PA: Saunders
  • Chaput, C. (2017). Gastrointestinal Emergencies. In CEN Online Review. Emergency Nurses Association.

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