OSCE Peritonist

Question 1

What is peritonist?

Answer 1

The infammation and infection of the peritoneum
>often caused by introduction of ineffective material into e peritoneal environment

Question 2

What is the cause of peritonitis?

Answer 2

-Perforation of the bowel, such as a ruptured appendix
-Perforated ulcer
-Perforated gall bladder

Question 3

Where does peritonitis mostly occur in a female?

Answer 3

-The pelvis secondary to the pelvic inflammatory diseases
>Bacteria such as E.coli, pneumococci, klebsiella, pseudomonas

Question 4

What is the pathophysiology of peritonitis?

Answer 4

-The flow of blood to the inflamed area increases, resulting in congestion and increased permeability of the membrane
-This facilitates the production of a large amount of fluid containing protein and electrolytes that flow into the potential space, leading to electrolyte imbalance, dehydration, hypovolemia, and shock.
In cases of perforation, the fluid mixes with the gastric or intestinal contents and becomes infected.
-Initially the bowel becomes irritated, and there is hypermotility soon followed by paralysis irritated, whereupon the bowel is distended with no bowel sounds.

Question 5

What are the assessments and common findings in peritonitis?

Answer 5

-Abdominal pain with rebound tenderness
-Abdominal distention, guarding and ascites
-Fever, nausea, tachypnea, oliguria, pallor
-Restlessness
-Weakness and pallor

Question 6

What are the diagnostic studies of peritonitis?

Answer 6

-Abdominal x-ray
-Peritoneoscopy can be done in patients without ascites
-Blood test U+E

Question 7

What is the nursing management of peritonitists?

Answer 7

-Nurse patient in semi fowler position to support ventilation and increase comfort
-Administer analgesics and monitor the response
-Strict monitoring of input and output
Postoperatively, drains will be inserted- observe and record the drainage, amount and odour
-Care of nasogastric tube that is inserted to relieve distension from gastro intestinal contents
-Administer antiemetic’s as perscribed
-Increase fluids and food intake gradually as ordered
-Provide mouth care
-Providing patient and family with the information about the condition and ongoing care

Question 8

What health education will you give the patient with peritonitis?

Answer 8

-Provide ongoing support and encouragement
-Encourage early ambulation to minimize complications
-Teach normal coping mechanisms
-Teach importance wound management and dressings
-Completion of antibiotics
Follow-up dates