Chapter 47: Peritonitis Flashcards
A 32-year-old female presents with severe abdominal pain, fever, and a rigid abdomen. She is diagnosed with peritonitis following a ruptured appendix. Which of the following is the most common cause of peritonitis?
A. Trauma to the abdomen
B. Infection from a perforated organ
C. Blood-borne bacterial infection
D. Inflammatory bowel disease
B. Infection from a perforated organ
Rationale: Peritonitis often results from the contamination of the peritoneal cavity by microorganisms, typically from a perforated organ such as the appendix or bowel.
A patient with peritonitis is exhibiting symptoms of fever, tachycardia, and shallow breathing. The nurse notes that the patient’s abdomen is distended and tender to touch. What is the most appropriate nursing action?
A. Encourage deep breathing exercises
B. Obtain a stool sample for culture
C. Administer prescribed antibiotics
D. Perform a complete blood count (CBC)
C. Administer prescribed antibiotics
Rationale: Antibiotics are crucial for treating the infection causing peritonitis and preventing further complications.
A patient is diagnosed with peritonitis secondary to a ruptured appendix. Which of the following is the most common clinical manifestation of peritonitis?
A. Abdominal distension and rigidity
B. Diarrhea and dehydration
C. Painful urination and flank pain
D. Chest pain and shortness of breath
A. Abdominal distension and rigidity
Rationale: Abdominal distension and rigidity are classic signs of peritonitis due to the inflammation of the peritoneal cavity.
Which of the following diagnostic tests is most commonly used to confirm the diagnosis of peritonitis?
A. Abdominal ultrasound
B. Chest X-ray
C. CT scan of the abdomen
D. Colonoscopy
C. CT scan of the abdomen
Rationale: A CT scan is commonly used to identify the source of peritonitis, such as a perforated organ or abscess.
A 50-year-old male with a history of diverticulitis presents with fever, chills, and severe lower abdominal pain. His abdomen is distended and tender, with decreased bowel sounds. What is the priority intervention for this patient?
A. Administer pain medication as prescribed
B. Prepare the patient for a laparotomy
C. Obtain a stool sample for culture
D. Start an intravenous (IV) line and administer fluids
D. Start an intravenous (IV) line and administer fluids
Rationale: Fluid resuscitation is critical for maintaining blood pressure and supporting kidney function in a patient with peritonitis.
A nurse is caring for a patient with peritonitis. Which of the following is an expected finding on the physical examination of this patient?
A. Abdominal guarding and rebound tenderness
B. Hypoactive bowel sounds
C. Palpable mass in the right lower quadrant
D. Yellowish discoloration of the skin
A. Abdominal guarding and rebound tenderness
Rationale: Abdominal guarding and rebound tenderness are common findings in peritonitis due to peritoneal irritation.
A patient is diagnosed with peritonitis secondary to bowel perforation. The healthcare provider orders a broad-spectrum antibiotic. Which of the following is the rationale for using broad-spectrum antibiotics in peritonitis?
A. To target specific pathogens identified through culture
B. To treat both anaerobic and aerobic bacteria
C. To improve the patient’s immune response
D. To prevent gastrointestinal bleeding
B. To treat both anaerobic and aerobic bacteria
Rationale: Broad-spectrum antibiotics are used in peritonitis to cover both anaerobic and aerobic bacteria until specific pathogens are identified.
A patient with peritonitis due to a ruptured appendix has been started on antibiotics. What is the primary purpose of this treatment?
A. To reduce inflammation in the peritoneal cavity
B. To eliminate the causative microorganisms
C. To prevent the formation of adhesions
D. To relieve abdominal pain
B. To eliminate the causative microorganisms
Rationale: Antibiotics are aimed at eradicating the bacteria that cause peritonitis, preventing further infection and complications.
Which of the following complications is most likely to occur if peritonitis is left untreated?
A. Septic shock
B. Pneumonia
C. Gastrointestinal bleeding
D. Hyperkalemia
A. Septic shock
Rationale: If peritonitis is untreated, it can lead to septic shock due to widespread infection and systemic inflammation.
A 45-year-old female presents with a perforated bowel causing peritonitis. What is the priority surgical intervention for this patient?
A. Laparotomy with drainage of the peritoneal cavity
B. Removal of the gallbladder
C. Exploration of the appendix
D. Colectomy with colostomy creation
A. Laparotomy with drainage of the peritoneal cavity
Rationale: Laparotomy with drainage of the peritoneal cavity is the standard surgical treatment for peritonitis caused by a perforated bowel.
A patient with peritonitis is receiving IV fluids, antibiotics, and pain management. Which of the following actions should the nurse prioritize?
A. Monitoring for signs of fluid overload
B. Administering antidiarrheal medications
C. Encouraging early ambulation
D. Assessing vital signs and oxygen saturation
D. Assessing vital signs and oxygen saturation
Rationale: Monitoring vital signs and oxygen saturation is crucial in peritonitis management to detect any early signs of septic shock or respiratory distress.
A patient with peritonitis has undergone surgery to repair a perforated bowel. The nurse is preparing the patient for post-operative care. Which of the following should the nurse include in the plan of care?
A. Place the patient in the Trendelenburg position
B. Restrict fluid intake until bowel function resumes
C. Encourage coughing and deep breathing exercises
D. Encourage the patient to ambulate immediately post-op
C. Encourage coughing and deep breathing exercises
Rationale: Coughing and deep breathing exercises help prevent atelectasis and pneumonia in post-operative patients.
A nurse is caring for a patient with peritonitis who is receiving IV antibiotics. The patient is also on a strict I&O monitoring. Which of the following is the most important factor to monitor?
A. Urine output
B. Electrolyte levels
C. Blood pressure
D. Respiratory rate
A. Urine output
Rationale: Monitoring urine output is crucial in patients with peritonitis to ensure adequate kidney perfusion and detect early signs of sepsis or dehydration.
A 60-year-old male with peritonitis presents with hypotension, tachycardia, and fever. His laboratory results show an elevated white blood cell count. What is the nurse’s priority intervention?
A. Administer a prescribed antipyretic
B. Start IV fluids and administer antibiotics
C. Place the patient on oxygen therapy
D. Prepare for immediate surgery
B. Start IV fluids and administer antibiotics
Rationale: Starting IV fluids and antibiotics is essential for treating peritonitis, stabilizing blood pressure, and addressing the infection.
Which of the following clinical manifestations would indicate that a patient with peritonitis is progressing toward septic shock?
A. Fever and hypotension
B. Severe abdominal pain and tenderness
C. Decreased urine output and tachypnea
D. Tachycardia and restlessness
A. Fever and hypotension
Rationale: Fever and hypotension are key indicators of septic shock, a potential complication of peritonitis.
