IMPLEMENTATION

• Maintain NPO
• Monitor vital signs
• Turn client supine <-> prone (helps passing flatus and relief abdominal pressure)
• Monitor patency of decompression tube
POSTOPERATIVE;
• Encourage coughing, turning, deep breathing
• Monitor bowel sounds (return of peristalsis)
PERITONITIS
Acute inflammation of peritoneum
BACTERIAL
• Perforated duodenal ulcer
• Ruptured appendicitis
• Volvulus (twisting of bowel , strangulation, obstruction)
• Abdominal trauma
CHEMICAL
• Pancreatitis
• Perforated gastric ulcer
Note: Mortality dramatically decreased with antibiotics!
ASSESSMENT
• Constant, intense, diffuse abdominal pain
• Nausea
• Weakness
• Abdominal rigidity
• Absent bowel sounds
• Signs and symptoms of shock
• Diagnostic paracentesis: cytology, bacterial culture
IMPLEMENTATION
• NPO to reduce peristalsis
• Monitor vital signs
• Maintain bed rest
• Semi-Fowler’s position
• IV electrolytes and antibiotics are ordered
COLORECTAL CANCER
• Second most common cancer in US
• 5 year mortality about 50%
• Early diagnosis significantly improves survival
ASSESSMENT
• Vague abdominal discomfort
• Nausea, loss of appetite
• Weakness, fatigue
• Family history of colorectal cancer
• Ribbon – or pencil – shaped stools
• Black of tarry stools
• Anemia
• Signs of intestinal obstruction
• Diagnosis: sigmoidoscopy, colonoscopy with boipsy, CEA blood test to detect recurrence after
surgery
IMPLEMENTATION
• Monitor intake and output
• Monitor consistency and color of stool
• Prepare client for surgery
COLOSTOMY CARE:
• Remove pouch when 1/3 full
• Cleanse stoma with soft cloth and water or mild soap
• Dry skin thoroughly before applying pouch
• Use skin barrier powder or paste to protect from fecal drainage
• Irrigaton of stoma – never force catheter
• Allow client to verbalize feelings about colostomy