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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.
The peritoneum is sterile, despite the GI tract normally contains bacteria. When bacteria invade the peritoneum due to an inflammation or perforation of the GI tract peritonitis usually occurs. Bacterial invasion usually results from appendicitis, diverticulitis, peptic ulcer, ulcerative colitis, volvulus, abdominal neoplasms, or a stab wound. It may also be associated with peritoneal dialysis.
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Nursing Care Plans
Early treatment of GI inflammation conditions and preoperative and postoperative therapy help prevent peritonitis. Patient care includes monitoring and measures to prevent complications and the spread of infection.
Here are six (6) nursing care plans (NCP) and nursing diagnosis for patients with peritonitis:
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- Risk for Infection
- Deficient Fluid Volume
- Acute Pain
- Risk for Imbalanced Nutrition: Less Than Body Requirements
- Anxiety/Fear
- Deficient Knowledge
- Other Possible Nursing Care Plans
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Deficient Fluid Volume
Nursing Diagnosis
May be related to
- Fluid shifts from extracellular, intravascular, and interstitial compartments into intestines and/or peritoneal space
- Vomiting; medically restricted intake; NG/intestinal aspiration
- Fever/hypermetabolic state
Possibly evidenced by
- Dry mucous membranes, poor skin turgor, delayed capillary refill, weak peripheral pulses
- Diminished urinary output, dark/concentrated urine
- Hypotension, tachycardia
Desired Outcomes
- Demonstrate improved fluid balance as evidenced by adequate urinary output with normal specific gravity, stable vital signs, moist mucous membranes, good skin turgor, prompt capillary refill, and weight within acceptable range.
| Nursing Interventions | Rationale |
|---|---|
| Monitor vital signs, noting presence of hypotension (including postural changes), tachycardia, tachypnea, fever. Measure central venous pressure (CVP) if available. | Aids in evaluating degree of fluid deficit or effectiveness of fluid replacement therapy and response to medications. |
| Maintain accurate I&O and correlate with daily weights. Include measured losses. Include measurements from gastric suction, drains, dressings, Hemovacs, diaphoresis, and abdominal girth for third spacing of fluid. | Reflects overall hydration status. Urine output may be diminished because of hypovolemia and decreased renal perfusion, but weight may still increase, reflecting tissue edema or ascites accumulation. Gastric suction losses may be large, and a great deal of fluid can be sequestered in the bowel and peritoneal space (ascites). |
| Measure urine specific gravity. | Reflects hydration status and changes in renal function, which may warn of developing acute renal failure in response to hypovolemia and effect of toxins. Many antibiotics also have nephrotoxic effects that may further affect kidney function and urine output. |
| Observe skin or mucous membrane dryness, turgor. Note peripheral and sacral edema. | Hypovolemia, fluid shifts, and nutritional deficits contribute to poor skin turgor, taut edematous tissues. |
| Eliminate noxious sights and smells from environment. Limit intake of ice chips. | Reduces gastric stimulation and vomiting response. Excessive use of ice chips during gastric aspiration can increase gastric washout of electrolytes. |
| Change position frequently, provide frequent skin care, and maintain dry or wrinkle-free bedding. | Edematous tissue with compromised circulation is prone to breakdown. |
| Monitor laboratory studies: Hb/ Hct, electrolytes, protein, albumin, BUN, Cr. | Provides information about hydration, organ function. Varied alterations with significant consequences to systemic function are possible as a result of fluid shifts, hypovolemia, hypoxemia, circulating toxins, and necrotic tissue products. |
| Administer plasma or blood, fluids, electrolytes, diuretics as indicated. | Replenishes circulating volume and electrolyte balance. Colloids (plasma, blood) help move water back into intravascular compartment by increasing osmotic pressure gradient. Diuretics may be used to assist in excretion of toxins and to enhance renal function. |
| Maintain NPO with nasogastric or intestinal aspiration. | Reduces hyperactivity of bowel and diarrhea losses. |
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Recommended Resources
Recommended nursing diagnosis and nursing care plan books and resources.
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- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use. - Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively. - NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales. - Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates. - Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing. - Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans. - Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you. - Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023. - All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
See also
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch. - Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
More nursing care plans related to gastrointestinal disorders:
- Appendectomy | 4 Care Plans
- Cholecystectomy | 12 Care Plans
- Cholecystitis and Cholelithiasis | 4 Care Plans
- Gastroenteritis | 4 Care Plans
- Hemorrhoids | 3 Care Plans
- Hepatitis | 7 Care Plans
- Ileostomy & Colostomy | 10 Care Plans
- Inflammatory Bowel Disease | 7 Care Plans
- Intussusception | 3 Care Plans
- Liver Cirrhosis | 8 Care Plans
- Pancreatitis | 8+ Care Plans
- Peritonitis | 6 Care Plans
- Peptic Ulcer Disease | 5 Care Plans
- Subtotal Gastrectomy | 2 Care Plans
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Thanks Matt Vera for the good work may you continue helping me with such good information since I’m also a nursing student who is almost graduating.