APPENDICITIS/PERITONITIS/INTESTINAL
OBSTRUCTION EXAM QUESTIONS WITH
CORRECT ANSWERS
the most common symptom of peritonitis - Answer-1. Abdominal pain
2. A universal sign is tenderness over the involved area.
3. Rebound tenderness,
-muscular rigidity, and
-spasm are other signs of peritoneal irritation.
4. Patients may lie still and
-take only shallow breaths because movement worsens the pain.
5. Abdominal distention,
-fever,
-tachycardia,
-tachypnea,
-nausea,
-vomiting, and
-altered bowel habits may be present.
6. These manifestations vary, depending on the severity and acuteness of the underlying
condition.
7. Complications include
-hypovolemic shock,
-sepsis,
-intraabdominal abscess formation,
-paralytic ileus, and
-acute respiratory distress syndrome. 8. Peritonitis can be fatal if treatment is delayed.
Causes of Peritonitis - Answer-1. Primary
-Blood-borne organisms
-Cirrhosis with ascites
-Genital tract organisms
2. Secondary
-Appendicitis with rupture
-Blunt or penetrating trauma to abdominal organs
-Diverticulitis with rupture
-Ischemic bowel disorders
-Pancreatitis
-Perforated intestine
-Perforated peptic ulcer
-Peritoneal dialysis
-Postoperative (breakage of anastomosis)
Interprofessional Care: Peritonitis - Answer-1. Diagnostic Assessment
,-History and physical examination
-CBC, including WBC differential
-Serum electrolytes
-Abdominal x-ray
- Abdominal paracentesis and culture of fluid
- CT scan or ultrasound
-Peritoneoscopy
2. Management Preoperative or Nonoperative
-NPO status
-IV fluid replacement
-NG to low-intermittent suction
-O2 PRN
-Parenteral nutrition as needed
3. Drug Therapy
-Antibiotic therapy
-Analgesics (morphine)
-Antiemetics as needed
4. Postoperative
-NPO status
-NG to low-intermittent suction
-Semi-Fowler's position
-IV fluids with electrolyte replacement
-PN as needed
-Blood transfusions as needed
5. Drug Therapy
-Antibiotic therapy
-Sedatives and opioids
-Antiemetics as needed
Diagnostic Studies: Peritonitis - Answer-1. A CBC is done to determine elevations in
WBC count and
-hemoconcentration from fluid shifts. 2. Peritoneal aspiration may be done with the fluid
analyzed for
-blood,
-bile,
-pus,
-bacteria,
-fungus, and
-amylase content.
3. An abdominal x-ray may show dilated loops of bowel consistent with
-paralytic ileus,
-free air if perforation has occurred,or
-air and fluid levels if an obstruction is present.
4. Ultrasound and
-CT scans may be useful in identifying
-ascites and
, -abscesses.
5. Peritoneoscopy may be helpful in the patient without ascites.
-It allows for direct examination of the peritoneum and
-the ability to obtain biopsy specimens for diagnosis.
6. Patients with milder cases of peritonitis or those who are poor surgical risks receive
conservative care.
7. Treatment consists of
-antibiotics,
-NG suction,
-analgesics, and
-IV fluid administration.
8. Surgery is indicated to locate the cause of the inflammation,
-drain purulent fluid, and
-repair any damage ( perforated organs).
The patient with peritonitis is extremely ill and needs skilled supportive care: - Answer-1.
Establish IV access so that you can give replacement fluids lost to the peritoneal cavity
and
-have access for antibiotic therapy.
2. Monitor the patient for pain and
-response to analgesics.
3. You may position the patient with knees flexed to increase comfort.
4. Sedatives may relieve anxiety and promote rest.
5. Accurate monitoring of intake and output and electrolyte status is essential to
determine replacement therapy.
6. Frequently monitor vital signs.
7. Give antiemetics to decrease nausea and vomiting and
-prevent further fluid and electrolyte losses.
8. Place the patient on NPO status.
9. The patient may need an NG tube to decrease gastric distention and
-further leakage of bowel contents into the peritoneum.
10. Give low-flow oxygen therapy as needed.
11. If the patient had an open surgical procedure,
-drains are inserted to remove purulent drainage and
-excess fluid.
12. Postoperative care is similar to that for the patient who had a laparotomy
Intestinal obstruction occurs when - Answer-1. intestinal contents cannot pass through
the GI tract.
2. The obstruction may occur in the
-small (SBO) or
-large (LBO) intestine.
3. It can be partial or
-complete,
-simple or
-strangulated.
OBSTRUCTION EXAM QUESTIONS WITH
CORRECT ANSWERS
the most common symptom of peritonitis - Answer-1. Abdominal pain
2. A universal sign is tenderness over the involved area.
3. Rebound tenderness,
-muscular rigidity, and
-spasm are other signs of peritoneal irritation.
4. Patients may lie still and
-take only shallow breaths because movement worsens the pain.
5. Abdominal distention,
-fever,
-tachycardia,
-tachypnea,
-nausea,
-vomiting, and
-altered bowel habits may be present.
6. These manifestations vary, depending on the severity and acuteness of the underlying
condition.
7. Complications include
-hypovolemic shock,
-sepsis,
-intraabdominal abscess formation,
-paralytic ileus, and
-acute respiratory distress syndrome. 8. Peritonitis can be fatal if treatment is delayed.
Causes of Peritonitis - Answer-1. Primary
-Blood-borne organisms
-Cirrhosis with ascites
-Genital tract organisms
2. Secondary
-Appendicitis with rupture
-Blunt or penetrating trauma to abdominal organs
-Diverticulitis with rupture
-Ischemic bowel disorders
-Pancreatitis
-Perforated intestine
-Perforated peptic ulcer
-Peritoneal dialysis
-Postoperative (breakage of anastomosis)
Interprofessional Care: Peritonitis - Answer-1. Diagnostic Assessment
,-History and physical examination
-CBC, including WBC differential
-Serum electrolytes
-Abdominal x-ray
- Abdominal paracentesis and culture of fluid
- CT scan or ultrasound
-Peritoneoscopy
2. Management Preoperative or Nonoperative
-NPO status
-IV fluid replacement
-NG to low-intermittent suction
-O2 PRN
-Parenteral nutrition as needed
3. Drug Therapy
-Antibiotic therapy
-Analgesics (morphine)
-Antiemetics as needed
4. Postoperative
-NPO status
-NG to low-intermittent suction
-Semi-Fowler's position
-IV fluids with electrolyte replacement
-PN as needed
-Blood transfusions as needed
5. Drug Therapy
-Antibiotic therapy
-Sedatives and opioids
-Antiemetics as needed
Diagnostic Studies: Peritonitis - Answer-1. A CBC is done to determine elevations in
WBC count and
-hemoconcentration from fluid shifts. 2. Peritoneal aspiration may be done with the fluid
analyzed for
-blood,
-bile,
-pus,
-bacteria,
-fungus, and
-amylase content.
3. An abdominal x-ray may show dilated loops of bowel consistent with
-paralytic ileus,
-free air if perforation has occurred,or
-air and fluid levels if an obstruction is present.
4. Ultrasound and
-CT scans may be useful in identifying
-ascites and
, -abscesses.
5. Peritoneoscopy may be helpful in the patient without ascites.
-It allows for direct examination of the peritoneum and
-the ability to obtain biopsy specimens for diagnosis.
6. Patients with milder cases of peritonitis or those who are poor surgical risks receive
conservative care.
7. Treatment consists of
-antibiotics,
-NG suction,
-analgesics, and
-IV fluid administration.
8. Surgery is indicated to locate the cause of the inflammation,
-drain purulent fluid, and
-repair any damage ( perforated organs).
The patient with peritonitis is extremely ill and needs skilled supportive care: - Answer-1.
Establish IV access so that you can give replacement fluids lost to the peritoneal cavity
and
-have access for antibiotic therapy.
2. Monitor the patient for pain and
-response to analgesics.
3. You may position the patient with knees flexed to increase comfort.
4. Sedatives may relieve anxiety and promote rest.
5. Accurate monitoring of intake and output and electrolyte status is essential to
determine replacement therapy.
6. Frequently monitor vital signs.
7. Give antiemetics to decrease nausea and vomiting and
-prevent further fluid and electrolyte losses.
8. Place the patient on NPO status.
9. The patient may need an NG tube to decrease gastric distention and
-further leakage of bowel contents into the peritoneum.
10. Give low-flow oxygen therapy as needed.
11. If the patient had an open surgical procedure,
-drains are inserted to remove purulent drainage and
-excess fluid.
12. Postoperative care is similar to that for the patient who had a laparotomy
Intestinal obstruction occurs when - Answer-1. intestinal contents cannot pass through
the GI tract.
2. The obstruction may occur in the
-small (SBO) or
-large (LBO) intestine.
3. It can be partial or
-complete,
-simple or
-strangulated.
