a. The peritoneum is the serous membrane that lines the abdominal cavity and covers the visceral organs.

Peritonitis is inflammation of the peritoneum. Inflammation may be generalized throughout the peritoneum, affecting the visceral and parietal surfaces of the abdominal cavity, or may be localized in one area as an abscess.

b. Peritonitis occurs as a result of leakage of contents from an abdominal organ into the abdominal cavity. Generally, this disorder results from perforation of the GI tract, allowing bacterial contamination of the peritoneum. Peritonitis may also occur as a result of chemical irritation, and subsequent infection, caused by rupture of an organ. (For example, the ovaries, spleen, or urinary bladder.)

c. Signs and symptoms.

(1) Diffuse pain that eventually localizes in the area of the underlying process.

(2) Abdominal tenderness.

(3) Abdominal muscle rigidity.

(4) Rebound tenderness.

(5) Nausea and vomiting.

(6) Paralytic ileus.

(7) Fever.

(8) Rapid pulse rate.

(9) Elevated WBC.

d. Nursing implications. The objectives of medical treatment are to identify and eliminate the cause, treat the infection, and maintain fluid and electrolyte balance, while promoting patient comfort. To promote patient comfort, the nursing personnel should do the following:

(1) Observe for signs of hypovolemia and shock. These conditions may result from loss of fluids and electrolytes into the abdominal cavity.

(2) Strictly monitor I&O and vital signs.

(3) Observe safety precautions, since fever and pain may cause the patient to become disoriented.

(4) Administer prescribed medications and intravenous fluid replacement.