Peritonitis for Certified Emergency Nursing (CEN)

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