Flashcards › MS III (Peritonitis and Appendicitis)

A serous sac lining the abdominal cavity Peritoneum The peritoneum becomes inflamed Peritonitis abdomen feels rigid and boardlike as it destends with gas and intestinal contents. Bowels sounds are typically absent Peritonitis Spillage of ________ contents and bacteria inflames the peritoneum, which leads to localized abscess formation or generalized inflammation chemical Paralytic ileus intestine lacks peristalsis Cultures of peritoneal fluid and blood usually reveal bacteria E-Coli, Klebsiella, Prteus, and Pseudominas vascular fluid shifts to the abdomen , lowering blood pressure and producing hypovolemic shock or septic shock As generalized peritonitis occurs. Appendicitis inflammation of a narrow blind protrusion called located at the tip of the cecum in the right Lower Quadrant vermiform appendix Appendicitis is most common in adolescents and yound adults Hard mass of feces fecalith the appendix can become gangrenous or it ruptures spilling bacteria throughout the peritoneal cavity an area midway between the umbilicus and the right iliac crest McBurney's point pain is worse when manual pressure near the region is suddenly released rebound tenderness when an examiner does deep palpation in the left lower abdominal quadrant, and the client feels pain in the right lower abdominal quadrant positive Rovsing's sign and suggests acute appendicitis tip of appendix is against the rectum pain with defecation tip of appendix near the bladder or against a ureter pain with urination CT or abdominal ultrasound enlargement at the cecum Analgesics may be withheld initially avoid masking symptoms remove the appendix before it spontaneously ruptures appendectomy appendix perforates or ruptures peritonitis develops avoid multiple or frequent palpation cause the appendix to rupture may cause the appendix to rupture Laxatives and cathartics may result from a hard mass fecalith , a foreign body, local edema, or a tumor obstruction swelling compresses surrounding blood vessels as the appendix enlarges and distends perforation generally occurs 24 hours following the onset of abdominal pain. 100 F or higher and are very ill. MS III Chap 52