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Group 1
PERITONITIS
and other GIT complications ..
PREPARED BY;
1.Nur Syafiqah Bt Kamaruzaman(08DIN0050)
2.Haryani Jakarsi (08DIN0086)
3.Nabilah Bt Abu Samah (08DIN0021)
4.Nur Izzati Bt Ismail (08DIN0028)
5.Warsana A/P Bonsi (08DIN0412)
A &E DEPT
Mr. Tan
m/60yrs
C/O
You’ve been
diagnosed with..
PERITONIT
IS
FINALLY..
DEFINITION OF PERITONITIS
•
PERITONEUM
TYPES OF PERITONITIS
• Primary peritonitis
• usually caused by liver disease. Fluid builds
up in the abdomen, creating a prime
environment for the growth of bacteria.
•
• Secondary peritonitis
• caused by other conditions that allow
bacteria, enzymes, or bile into the peritoneum
from a hole or tear in the gastrointestinal or
biliary tracts. Such tear can be caused by
pancreatitis, a ruptured appendix, stomach
ulcer, Crohn's disease, or diverticulitis.
Peritoneal dialysis, which uses the blood
vessels in the peritoneum to filter waste from
your blood when your kidneys are not able to
CAUSES OF PERITONITIS
1. Infected peritonitis
vPerforation of a hollow viscus is the most common cause of
peritonitis.
E.g perforation of the distal oesophagus, of the stomach of the
duodenum of the remaining intestine (e.g. appendicitis, diverticulitis,
inflammatory bowel disease (IBD), intestinal infarction,colorectal
carcinoma, meconium peritonitis).
1.X-RAYS
2.
3. BLOOD TESTS
To check for which
bacteria are responsible.
4. LAPAROSCOPY
A slender tube is inserted through an abdominal incision and
the insides examined.
5. PERITONEAL LAVAGE
If reasonable doubt still persists, an exploratory peritoneal
lavage may be performed (e.g. in cases of trauma, in order
to look for white blood cells, red blood cells, or bacteria).
6. PARACENTASIS
hyperemia
Fluid shift
Decrease circulatory volume
Peristalsis slow
PERITONITIS
Bacteremia Septicemia
NURSING CARE PLAN 1
Alteration in comfort : pain
related to abdominal
distension
Date:25.10.2009
Time:8.15 am
Nursing Problem : Alteration in comfort : pain related to
abdominal distension .
Supporting Data:1)Patient verbalized that he in pain at
the abdomen .
2)Patient face looked pale
3)Patient blood pressure 140/80mmHg,
pulse 70
4) Patient choose number 6 out of 10
from pain scale which is
consider as moderate pain.
Goal : Patient’s pain will be reduced 1-2 hours after
nursing interventions carried out and during
hospitalization .
Nursing interventions:
•
1.
• Assess patient’s level of pain by asking patient
whether the pain is mild , moderate or severe using
pain scale and site of pain.
•® As a baseline data and to plan proper nursing
•
•
•2)Monitor vital signs especially blood pressure and pulse
rate .
•®Elevated blood pressure and pulse indicate patient’s
in pain
•I-I had monitored my patient’s vital signs especially blood
reduced .
•
vomiting .
•I-I administer hydroxyzineto my patient and explain
•Date:25.10.09
•Time:10.15 am
intervention.
•I I assess patient condition such as vital
signs and patient look pale, poor skin
turgor, and dry mucous skin membrane.
•
IBS
GASTRIT
IS
•Severe, steady
•Localized to epigastrium and
RUQ of abdomen
•May radiate to back, right
Complications •Cholecystitis
•Common bile duct obstruction with possible
* Constipation
* various genetic
* abdominal discomfort
* environmental factor
GASTROENTERITIS
DEFINITION OF
GASTROENTERITIS
Is an inflammation of the stomach and small
intestine. Enteritis may be caused by a
bacteria, viruses, parasites, or toxins.
•
Vomiting
Diarrhea
Mild fever
Borborygmi
diarrhea
GENERAL EFFECTS
Malaise, weakness, and muscle aches.
Headache.
Fever.
COLORECTAL CANCER
EFINITION OF COLORECTAL CANCE
Colorectal cancer, also called colon cancer or
large bowel cancer, includes cancerous growths
in the colon, rectum and appendix.
CONSTITUTIONAL METASTASIS
SYMPTOMS SYMPTOMS
•iron deficiency anaemia ~ca colon most
•fatigue, commonly spreads to
•palpitations liver and cause:
•pallor Jaundice
•weight loss, Abdominal pain
•a decreased appetite
GASTRO - ESOPHAGEAL
REFLUX DISEASE
( GERD )
DEFINITION OF
Gastroesophageal refluxGERD
disease (GERD), gastric reflux
disease, or acid reflux disease is defined as chronic
symptoms or mucosal damage produced by the abnormal
reflux in the esophagus.
Medications
•Proton pump inhibitors
•Gastric H2 receptor blockers
•Antacids
Surgical treatments for GERD
•The standard surgical treatment is the Nissen
fundoplication . In this procedure the upper
part of the stomach is wrapped around the LES to
strengthen the sphincter and prevent acid reflux
and to repair a hiatal hernia. The procedure is
often done laparoscopically. When compared to
medical management laparoscopic fundoplication
had better results at 1 year.
An obsolete treatment is vagotomy ("highly
selective vagotomy"), the surgical removal of
vagus nerve branches that innervate the stomach
lining.
PEPTIC ULCER DISEASE
DEFINITION
•peptic ulcer, also known as ulcus pepticum, PUD or
peptic ulcer disease, is an ulcer (defined as mucosal
erosions equal to or greater than 0.5 cm) of an area of the
gastrointestinal tract that is usually acidic and thus
extremely painful.
CLASSIFICATIONS
1.Stomach
(called gastric ulcer)
2. Duodenum
(called duodenal ulcer)
3. Oesophagus
(called Oesophageal ulcer)
4. Meckel's Diverticulum
(called Meckel's Diverticulum
ulcer)
Symptoms of a peptic ulcer can be;
1. abdominal pain,
2. waterbrash (rush of saliva after an
episode of regurgitation to dilute the
acid in esophagus)
3. nausea,
4. vomiting
5. loss of appetite and weight loss
6. hematemesis (vomiting of blood);
7.melena (tarry, foul-smelling feces
due to oxidized iron from hemoglobin);
WEIGHT
LOSS
Types of peptic ulcers:
•Type I: Ulcer along the lesser curve of stomach
•
•Type II: Two ulcers present - one gastric, one
duodenal
•
•Type III: Prepyloric ulcer
a. Drug a. Alcohol
b. Acid or alkalis b. Drug – Digitalis
c. Reserpine
d. Anti inflammatory agents, •Endogenous agent
aspirin a. Reflux of bile
e. Cytotoxics agents b. Pancreatic enzyme
f. Corticosteroids c. Radiation
d. Peptic ulcer disease
•Bacterial Endotoxins e. Renal disease
•
Life style
•
haryaniThanks izzati
syafiqah nabilah
warsana