6 Peritonitis Nursing Care Plans

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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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  1. Risk for Infection
  2. Deficient Fluid Volume
  3. Acute Pain
  4. Risk for Imbalanced Nutrition: Less Than Body Requirements
  5. Anxiety/Fear
  6. Deficient Knowledge
  7. 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 InterventionsRationale
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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See also

Other recommended site resources for this nursing care plan:

More nursing care plans related to gastrointestinal disorders:

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Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.
  • 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.

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